Social science & medicine
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Social science & medicine · Mar 1999
Drug policy in China: pharmaceutical distribution in rural areas.
In 1978, China decided to reform its economy and since then has gradually opened up to the world. The economy has grown rapidly at an average of 9.8% per year from 1978 to 1994. Medical expenditure, especially for drugs, has grown even more rapidly. ⋯ Marketing factors have influenced drug distribution so strongly that there is a risk of fake or low quality drugs being distributed. The government has taken some measures to fight these negative effects. This paper describes the drug policy reform in China, particularly the distribution of drugs to health care facilities.
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Social science & medicine · Feb 1999
Multicenter StudyCosts of formal care for frail older people in England: the resource implications study of the MRC cognitive function and ageing study (RIS MRC CFAS).
The aim of this paper is to quantify service use and costs of supporting frail older people at home in the community, using data collected in a longitudinal multicentre stratified randomised study for 1055 mentally frail, physically frail, and mentally and physically frail subjects. Average costs per person per week were found to total 64.45 Pounds Sterling, with a small number of services accounting for a large proportion of the total costs. The level of services offered by the nonstatutory voluntary and private sectors was found to be small. ⋯ Multiple regression analysis demonstrated that 26% of the variation in log average weekly costs could be explained by a number of socio-demographic and health status variables. A particularly close relationship was observed between costs and whether admission to continuing care accommodation occurred, highlighting a need for policy-makers to examine the nature and scale of provision of alternative community based care packages. The results demonstrate that descriptive cost data such as those presented can provide information useful to the planning process, enabling more informed choices to be made over the provision of services for particular groups of people.
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Social science & medicine · Dec 1998
The meaning of playing-related musculoskeletal disorders to classical musicians.
In creating and performing music, musicians can experience health problems from the high physical and psychological demands of their profession. Musculoskeletal disorders related to playing are painful, chronic and disabling conditions which are prevalent among classical musicians. The widespread study of the prevalence, etiology, and management of playing-related musculoskeletal disorders (PRMDs) is a recent development known as performing arts medicine. ⋯ Although a PRMD is not a medically serious or life-threatening illness, it is devastating to musicians physically, emotionally, socially, and financially. The overall theme of suffering captures the meaning of these problems which threaten the identity of the musician. The findings of this study are consistent with other studies of the experience of work-related musculoskeletal disorders, and other illnesses.
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Social science & medicine · Nov 1998
Comparative Study Historical ArticleFrom reviving the living to raising the dead; the making of cardiac resuscitation.
Cardiac arrest (the process of the heart ceasing to beat) and cardiac resuscitation (the attempt to restart the heart) were created in the surgical theatres of the early to middle twentieth century, in response to the cardiac arrests which were being caused by the "theatre" doctors themselves. These patients were young and healthy (a consequence of the preselection surgery involves), cardiac resuscitation was trying to revive the living. The paper explores the intimate relationship between cardiac arrest and cardiac resuscitation. ⋯ The outcome of this is the changed nature of cardiac resuscitation, no longer attempting to revive the living, cardiac resuscitation now attempts to raise the dead and dying, and at this it fails. Despite the remarkable success of cardiac resuscitation as a fact, the paper argues that it is a failure as a technique, paradoxically the more successful a fact it became, the more it failed as a procedure. The paper explains this apparent contradiction and the resistance to anomalies, by showing how cardiac resuscitation was created simultaneously inside and outside medical science, from its very start being a social and scientific fact with a vast network of stabilising allies.
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Social science & medicine · Sep 1998
ReviewPlace of death and access to home care services: are certain patient groups at a disadvantage?
Research indicates that fewer people are able to die at home than would wish to do so. Furthermore the ability to die at home is unequally distributed depending on patient characteristics. Unless factors associated with home deaths are identified and interventions are targeted accordingly, further general improvements in care support may only help those already at an advantage. ⋯ While home care may help redress the gender imbalance, men may also need to be encouraged and enabled to take on the carer role. Cancer patients in higher socioeconomic groups were both more likely to die at home and to access home care. Hence home deaths may increase by improving access for lower socioeconomic groups to the services available.