Understanding social factors and inequalities in health: 20th century progress and 21st century prospects

The development of social epidemiology and medical sociology over the last half of the 20th century, in which Leo Reeder played a central role, transformed scientific and popular understanding of the nature and causes of physical health and illness. Viewed in the early 1950s as shaped almost entirely by biological processes and medical care, physical health and illness are now understood to be as much or more a function of social, psychological, and behavioral factors. Utilizing a stress and adaptation conceptual framework, social epidemiology has identified a broad range of psychosocial risk factors for health, most notably: (1) social relationships and support; (2) acute or event-based stress; (3) chronic stress in work and life; and (4) psychological dispositions such as anger/hostility, lack of self-efficacy/control, and negative affect/hopelessness/pessimism, with new risk factors continuing to be identified. However, proliferation of risk factors must be balanced by conceptual integration and causal understanding of the relationships among them, their causes, and consequences. One source of such integration and understanding has been the rediscovery of large and persistent socioeconomic and racial-ethnic disparities in health. Socioeconomic position and race/ethnicity shape individuals' exposure to and experience of virtually all known psychosocial, and well as many environmental and biomedical, risk factors, and these risk factors help to explain the size and persistence of social disparities in health. Improving the socioeconomic position of a broad range of disadvantaged socioeconomic and racial-ethnic strata constitutes a major avenue for reducing exposure to and experience of deleterious risk factors for health, and hence for improving the health of these groups and the overall population. This in turn requires better understanding of the macrosocial forces that influence the socioeconomic position of individuals.     

The aging male in the 21st century

Background.?Prostate cancer incidence varies significantly among different ethnic groups. However, the report concerning the clinical outcome after radical prostatectomy (RP) in the low incidence Asian population is still limited. We aimed to compare the clinical outcome in patient treated with RP among different ethnic groups and to identify significant prognostic factors in Taiwanese patients.

Methods.?A total of 341 patients with clinical localized prostate cancer undergoing curative RP in three medical centers in Taiwan were included in this study. Ethnic group comparison was performed using the CaPSURE, SEARCH databases from United States (US) and one large European series. The Kaplan–Meier analysis and Cox proportional hazard model were used to identify significant predictors for prostate-specific antigen (PSA) recurrence.

Results.?Compared to the Caucasian white population in the US and Europe studies, the Taiwanese population have higher age at surgery and higher pre-operative PSA level. With mean and median follow-up of 39.1 months and 31.0 months (range 5–120 months), 127 men (37.2%) had PSA recurrence which was significant higher than the Western series. Significant predictors for PSA recurrence identified in the post-operative overall model were PSA level, pathological Gleason Score, pathological tumor stage and lymph node metastasis.

Conclusions.?The clinical outcome of Taiwanese male with prostate cancer post-RP appears inferior to the Western country, which is largely due to delay surgery at higher PSA level. Earlier diagnosis and treatment may improve the cancer control of RP.     

面向21世纪的中埃关系

冷战结束后,中国和埃及的友好关系得到全面发展,两国间的友谊愈益巩固.政治关系的发展有力地促进了双边经贸合作的发展,使埃及成为我国在中东和北非地区的贸易重点国家.我国在埃及的承包工程和劳务合作重新取得突破,对埃及的经济技术援助发展顺利.在这世纪之交,在深厚的传统友谊的基础上,在两国政府和人民的推动下,中埃关系必将得到进一步的全面发展.     

Mental health and aging in the 21st century

This article reviews pressing issues in mental health care for older adults in the 21st century. After examining current forces for change in older adults' mental health care and coverage, the authors discuss barriers to accessing mental health care resulting from the fragmentation of the United States health care system as well as the history behind the multiple and competing systems of care for older adults. The article continues with a discussion of goals for the provision of good mental health service delivery for older adults and concludes by addressing potential responses and future target areas regarding mental health care for older adults as well as a potential realistic collaboration to address mental health and aging.     

21世纪天津的城市交通

一、新世纪、新目标、新蓝图跨入新世纪前夕，中央对天津城市定位为：“天津是环渤海地区的经济中心，要努力建设成为现代化港口城市和我国北方重要的经济中心。”为适应经济社会的新发展，新的规划布局为双心一轴大格局。一个心是以外环线（含绿化带）围合３７１平方公里中心城区，包括一是以陈塘庄铁路支线、昆仑路、红旗路、真理道、普济河道围合的９３平方公里，以商贸、金融、办公、教育、科研、体育、居住为主的城市功能区（中心区）；二是中心区与外环线间的２４１平方公里区域，包括９个工业区、２０余个居住区和居住小区；三是外环…     

The problem of the 21st century: Economics faculty and the color line

With historical data on black economist hirings in Ph.D. granting economics programs and the supply of new black economics doctorates in the United States, this paper examines the conventional pipeline explanation for the dearth of blacks on economics faculties. Parameter estimates from count data specifications of a demand–supply relationship reveal that increases in the supply of new black economics doctorates do not increase, but instead decrease the likelihood of a Ph.D. granting economics department hiring black economists. Our results suggest that black economists are underrepresented on the faculties of Ph.D. granting economics departments by at least a factor of two. Instead of there simply being too few blacks earning economics doctorates to fill faculty jobs—the so-called pipeline problem—there appears to be a “color line” problem in that race explains the underrepresentation of blacks on the economics faculties of Ph.D. granting departments in the U.S.     

Psychiatric nursing for the 21st century. The PACED model.

Health care reform has had a profound effect on the way psychiatric treatment occurs in this country. Decreasing length of stay, increasing acuity, and reducing staff levels are making traditional approaches to mental health care infeasible. Resources already in place may still be focusing on long-term treatment issues and do not facilitate rapid stabilization and discharge planning that includes continued care within an integrated system. Research supports the feasibility of quality mental health care, which can be accomplished in shortened lengths of stay, as long as clinical managers plan inpatient programs focused on short-term goals followed by appropriate aftercare. In addition to recommendations for clinical managers, this article provides a proposal for executives redesigning a mental health care delivery system, which includes the goals of rapid assessment and stabilization, as well as discharge planning and appropriate follow up within an integrated system.     

The prospects for sociology into the twenty-first century

In contrast to the malaise that Collins (1986), characterized for sociology of the 1980s, I argue that the future for sociology and sociologists is bright. There are three structural changes that lead to my optimism. First, the professoriate is changing from one that has been overwhelmingly white, male, and tenured, to one that will become younger and more diverse by gender and race. Second, the fiscal crisis of the state will limit monies for funded research, which will lead to more critical and more qualitative research. Third, societal and global changes will present sociologists with unprecedented opportunities. Globally, three momentous historical turning points present sociologists with incredible opportunities: (a) the shift to a post cold war era; (b) the ecological crises threatening the worlds’s ecosystem; and (c) the transformation of the economy. Within the United States, there are many contemporary trends with considerable sociological relevance: the aging of the baby boom; the increasing proportion of the elderly; the growing racial/ethnic diversity; the regional shifts as the frost belt loses population, resources, and power, while the sun belt gains; and the growing urban underclass that is being left further and further behind. In short, the next two decades or so will present sociologists with exciting opportunities and challenges.     

The dynamics of dining out in the 21st century: Insights from organizational theory

The world of restaurants—as organizations as well as indicators of social status and cultural tastes—has, thus far in the 21st century, become especially dynamic in the United States and elsewhere. Social scientists have begun to engage seriously with issues concerning germane shifts in the culinary profession and the emergence of new forms of cooking and dining out. For sociologists interested in consumption, organizations, and creative work, this offers a number of timely topics, such as restaurants' financing strategies and ownership models, the institutionalization of new culinary trends, the expanding roles of chefs, and the labor practices of upmarket restaurants. This article synthesizes recent scholarship on the modern culinary field in the United States, specifically examining three interrelated themes: tensions between concurrent demands for creativity and financial returns, new ways of catering to consumer desires for authenticity, and issues of inequality in professional kitchens. It concludes by discussing several issues facing the future of dining out, as forecast by field leaders themselves, which offer further opportunities for burgeoning sociological and organizational inquiry.