Social science & medicine
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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.
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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.
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Deinstitutionalization, originally hailed as a major advance in public policy towards mental illness, has recently become increasingly controversial. This paper reviews the implementation of this policy in the United States, providing a critical examination of some of the central issues and problems that are the focus of current debates. It concludes with a pessimistic assessment of the likelihood of substantial improvements occurring in the lot of the chronic mental patient in the contemporary United States.
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Social science & medicine · Jan 1985
Historical ArticleMissionary doctors vs Chinese patients: credibility of missionary health care in early twentieth century China.
This paper deals with the encounter between the Chinese and Western medical missionaries in early twentieth century China. Based on data of two Canadian Protestant missions in China before 1937, this study reveals that medical missionaries were generally ignorant of Chinese medicine, and they regarded Chinese medicine as part of an inferior, heathen culture. ⋯ The functional complementarity of Western medicine to the pluralistic Chinese medical structure enabled missionary medicine to gain increasing credibility from the Chinese, although few Chinese actually understood the basic principles of Western medicine. Implications of this missionary doctor-Chinese patient relationship in China are discussed.
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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)