Social science & medicine
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Social science & medicine · Jan 1996
Prostitutes, prostitution and STD/HIV transmission in mainland China.
China's opening to the world has enabled massive social and economic transformations and the liberalization of many policies, but also the rise of coincident social problems and diseases. A revival of wide-scale female prostitution since the 1980s has now accelerated to a nationwide dilemma. Prostitutes have long been considered to be reservoirs, if not 'vectors' for the transmission of sexual diseases. ⋯ However, given the type of clients serviced by prostitutes in China, a prostitute's own risk of HIV infection is discussed. Control measures by the Chinese government to curb prostitution are examined at both national and provincial levels. Questions are raised as to the effectiveness of present tactics as adjunctive strategies in reducing STD infection and HIV risk in the prostitution population.
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Social science & medicine · Dec 1995
ReviewCulture in treatment, culture as treatment. A critical appraisal of developments in addictions programs for indigenous North Americans and Australians.
Indigenous people in Australia and in North America have been creating innovative interventions in the addictions field for several years now--incorporating traditional healing practices and cultural values into otherwise western programs--although this process is more developed in Canada and the U. S. than it is in Australia. Through a process of cultural diffusion, Australian Aborigines have incorporated many ideas from Native Canadian treatment models. ⋯ Additionally, North American Indians have at their disposal a rich heritage of communal healing techniques; some (such as the sweat lodge) have been adapted and incorporated into the treatment both of solvent abuse by adolescents, and alcohol abuse by adults. In Australia on the other hand, traditional healing techniques have been less amenable to adaptation. On neither continent are indigenous people attempting to adapt recent mainstream models of intervention to suit their needs (such as Brief Intervention) which is currently receiving international attention in addictions research and treatment.
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Social science & medicine · Dec 1995
Public opinion regarding end-of-life decisions: influence of prognosis, practice and process.
The purpose of this study was to examine the effect of changing key factors in survey questions on public opinion regarding end-of-life decisions. These factors were: (a) patient prognosis (likely vs unlikely to recover from the illness); (b) end-of-life practice (foregoing treatment vs assisted suicide vs euthanasia); and (c) and decision making process (competent patient vs incompetent patient based on living will vs incompetent patient based on family wishes). A representative quota sample of 2019 Canadians 18 years of age or older were surveyed using a 13-item questionnaire with 12 items eliciting attitudes towards end-of-life decisions. ⋯ The influence of these key factors was similar in other cases examined. Ten percent of Canadians said they had completed a living will. It was concluded that patient prognosis has a major effect, end-of-life practice a moderate effect, and decision making process a minor effect on public opinion regarding end-of-life decisions.
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Social science & medicine · Nov 1995
German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International Quality of Life Assessment.
International translation and psychometric testing of generic health outcome measures is increasingly in demand. Following the methodology developed by the International Quality of Life Assessment group (IQOLA) we report the German work with the SF-36 Health Survey. The form was translated using a forward-backward method with accompanying translation quality ratings and pilot tested in terms of translation clarity and applicability. ⋯ Furthermore convergent validity, responsiveness to treatment and discriminative power in distinguishing between healthy and ill respondents was present. The preliminary results suggest that the SF-36 Health Survey in its German form may be a valuable tool in epidemiological and clinical studies. However further work as concerns responsiveness and population based norms is necessary.
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Social science & medicine · Nov 1995
Case ReportsThe ethics of discharge planning for older adults: an ethnographic analysis.
This paper uses ethnographic data to examine ethical dilemmas in discharging elderly persons from the hospital. The focus is on two elements significantly influencing that process, the patient's decisional capacity and the involvement of family members in decision-making. Within the field of bioethics these issues have been discussed in terms of factors compromising the autonomy of the patient and the interdependency of family members. ⋯ The structure of the discharge planner's role and processes of collective decision-making shape how medical staff perceive and define patients' decisional capacity and the involvement of families. This points to unintentional and unrecognized ways in which the patient's choices and control over decisions can be restricted. The analysis supports attempts to develop bioethical models based on socially grounded principles recognizing the importance of both autonomy and interdependence in long term care decisions.