Social science & medicine
-
Social science & medicine · Jan 1986
Historical ArticleAedes aegypti mosquitoes in the Americas: a review of their interactions with the human population.
This paper describes the significant changes in the relationship between Aedes aegypti mosquitoes and the human population in the Americas from the 1800s to present. First, the history of the arrival of the mosquito, the consequent epidemics of yellow fever and dengue, and the eventual implication of the mosquito as vector is described. ⋯ Third, the limited efforts of the United States to control its A. aegypti population, which has serious implications for the success of the control of the species in the rest of the Americas, are commented upon. It is shown, in conclusion, that politics and economics, in addition to the state of biomedical knowledge, have a significant impact on the relationship between the mosquito and human populations in the Western hemisphere.
-
This paper debates some of the issues involved in attempting to apply economic analysis to the health care sector when medical ethics plays such an important part in determining the allocation of resources in that sector. Two distinct ethical positions are highlighted as being fundamental to the understanding of resource allocation in this sector -- deontological and utilitarian theories of ethics. ⋯ It is further argued that the structure of the health care sector augments these "individualistic' ethics. It is also suggested that different actors in the health care sector address questions of resource allocation with respect to different time periods, and that this serves to further enhance the influence of "individualistic' ethical codes in this sector.
-
Social science & medicine · Jan 1985
Comparative Study Clinical TrialInformed consent in psychiatric research: preliminary findings from an ongoing investigation.
Preliminary findings from an investigation of informed consent processes in four psychiatric research projects (two being carried out at a university medical center and two at a public psychiatric hospital) are reported. Study methods include the systematic observation of investigator/subject information disclosure sessions using audio and videotape, as well as the use of standardized interaction rating forms and subject understanding interviews. In an attempt to determine if subjects' understanding of research can be improved through increased subject education, several modes of information disclosure are compared. ⋯ Subjects' problematic understanding of research purposes and methodology was compounded by investigator disclosures which often emphasized the therapeutic, personalistic and nonresearch-oriented aspects of the project. Nevertheless, even when information disclosures were significantly improved, subject understanding in many cases continued to be low--suggesting that additional factors aside from the quality of investigator disclosure are involved in psychiatric subjects' comprehension and understanding of research. The implication of these findings for informed consent, regulation of biomedical research and the protection of human subjects are discussed.
-
Social science & medicine · Jan 1985
Hospital care utilization in a 17,000 population sample: 5-year follow-up.
The growing utilization of hospital care, especially of the services of Emergency Departments (ED), has been of great concern for many Western countries. The purpose of this study was to relate the amount of hospital care utilization to the frequency of ED visits. The study, based on a computerized medical information system, was carried out at Huddinge hospital which serves a suburban area of Stockholm, Sweden. ⋯ The difference increased gradually with increasing number of ED visits and was also evident in each age group. The mortality was also significantly increased for those with several ED visits. Higher migration in the latter group may besides indicate social instability.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Social science & medicine · Jan 1985
Mobilizing indigenous resource for primary health care in Nigeria: a note on the place of traditional medicine.
Noting the challenges posed by the goal of health For All by the Year 2000, this paper re-echoes the need to mobilize traditional medicine for Primary Health Care in Nigeria. The paper points to the inadequacy of modern health facilities and the obstacles that stand in the way of providing enough modern health facilities to meet the demand of Nigeria's population by the year 2000. It is observed that traditional medicine offers an alternative model not only because it is relatively inexpensive both to the practitioners and patients who often settle their bills in kind or cash but also because of its acceptability among Nigerians. Finally, it is suggested that government and traditional medical practitioners should cooperate for it is in this way that the practice of traditional medicine can be improved and the practitioners encouraged to add Primary Health Care activities to the repertoire.