Social Science & Medicine (1967)最新文献

This paper presents the findings resulting from one portion of a broad study relating to the socialization of pharmacy students. Of specific interest in this component of the study was an analysis of the values demonstrated by the objects and agents of socialization in pharmacy on the Study of Values. The Study of Values was administered to preceptors and faculty persons in pharmacy and students representing four academic class levels. It was found that the socialization process in pharmacy does not alter the value structuring of student groups in terms of movement away from or toward those values held by preceptors and faculty. Independent differences between preceptors and students on the AESTHETIC, SOCIAL and RELIGIOUS value scales were detected. Furthermore, preceptors differed from faculty on their response to the SOCIAL value scale. However, these differences did not seem to contribute to a differential socialization pattern among students.

9% of mothers aged 35–39 and 20% of mothers aged 40 and over who had a livebirth or stillbirth in Sheffield in 1974/75 were screened prenatally for a chromosomal anomaly. 33 and 41% of mothers aged 35–39 and 40+ respectively arrived for their first hospital antenatal check too late for an amniocentesis to be carried out for chromosomal analysis. Late hospital antenatal attendance was significantly related to high parity and a mother's country of origin being outside the British Isles. There was no significant association between early attendance and a history of a stillbirth or previous malformed child. It is concluded that if an efficient extension to the screening programme for Down's Syndrome (mongolism) in elderly mothers is to be achieved, attention to earlier hospital antenatal care in these high risk groups should be a priority.

This study examines the nature and outcome of professional communication with parents of mentally retarded children. The research was conducted at a multidisciplinary, diagnostic clinic for children with developmental disabilities. Data collection included interviewing parents before and after they received a report of the diagnostic findings, observing professional-parent interaction during the so-called Informing Interview, and reviewing medical record and questionnaire data. The results indicated that the professionals discussed the diagnosis of mental retardation with varying degrees of frankness, explained the concept of mental retardation in less than one-third of the cases, and discussed certain test results in about one-half of the cases. There was a significant relationship between the nature of professional communication and the parents' willingness to accept the diagnosis of mental retardation; parents who received specific, clear, and frank communication were more apt to accept the diagnosis. Parental acceptance was not significantly related to the characteristics of the child, the parents, or the professional who informed them.

Historically, scientism has been a prominent rationale both for the extensive Westernization of other indigenous medical systems, and for a vigorous pursuit of orthodoxy within Western medicine. But the 19th century colonial spread of Western medicine preceded the 20th century achievement of relative scientific orthodoxy within Western medicine, epitomized in the United States by the Flexner reforms in medical education. At the same time, increased technical standards in medical education led to unsolved problems of production and availability of physicians. Also the ideological success of science within academic Western medicine preceded the improvements in medical efficacy which resulted from the application of new science and technology to therapy. Considerations of medical efficacy include amelioration of suffering, as well as effects upon mortality (which are more conclusively demonstrable) and the curing of an individual's disease (which is a more popular expectation). In contemporary Western medicine there remain contradictions between therapeutics and the scientific study of disease. And in the West and elsewhere there remain a variety of medical sub-cultures. Continued or increased emphasis in medicine upon the pursuit of science may be neither universal nor eufunctional.

International health planners have been slow to recognize that barriers slowing down the acceptance of modern medicine in traditional societies are just as much inherent in bureaucratic premises and operations as in the sociocultural forms of the recipient peoples. Beginning a generation ago anthropologists suggested an “adversary model” that posited a contest between modern and traditional medicine based largely on cultural dissonance, to explain resistances to change. Today it appears that quality, cost, and convenience of modern medicine rather than cultural incompatibility are the primary determinants of its acceptance. Medical role perceptions and the social costs of changes and reorganizations in health organizations are noted as problems in designing the most appropriate health services for developing countries. Possible roles for traditional healers in helping provide primary health care are discussed. Except for the use of indegenous midwives and perhaps mental illness specialists, it is argued, this approach will enjoy little success. In addition to doubts stemming from differing ideas of traditional and modern curers about etiologies and treatment, the proposal is based on an erroneous premise: that traditional healers will continue to be produced at the same rate as in the past. Contemporary evidence suggests their numbers will drop to a point where they will not constitute an adequate manpower reservoir, even should they be deemed accaptable on other grounds.