AZT kill or cure? The social essences of scientific authority

This paper examines differing institutional responses to and interpretation of the same scientific and medical data, and looks at the way in which policies, ostensibly based upon these interpretations, are presented to public audiences. The case study concerns the use of AZT as a prophylactic for injured health care workers. Data was collected from personal in depth interviews in two health authorities and telephone interviews with a further 35 health authorities. Observations include the fact that widely different interpretations of scientific data by scientific and medical experts is likely to be presented to the lay audience in terms of scientific certainty, based on an institutional need for certainty and consensus. Contrary to conventional perspectives which would suggest that scientific knowledge was completed in its expert arena, then applied in different settings, this analysis suggests that the scientific knowledge is socially ‘completed’ or ‘closed’ in each of the different situations in which it is interpreted into practice. Ideal models of both the science and of organisational working practice, appear to have been used as the basis of these different constructions.     

Framing Black women: The utility of knowledge

This article reviews the literature on the socially constructed knowledge or myths about Black women by placing it within a cultural context. I identify three domains of research within this field. The first is the cultural production of socially constructed mythologies of Black women throughout various historical epochs, which includes an analysis of books, journals, scientific/medical documents, images, and other cultural products. I focus on two primary categories of stereotypes found in the literature: 1.) the myth of pathology and primitiveness and 2.) the myth of antithetical womanhood. The second is the utility of cultural knowledge—which is to control and regulate culture and to justify and establish particular types of norms, preferences, laws, policies, and practices within society. Lastly, I will discuss the resistance culture of Black women, which developed in response to stereotypical perceptions created about them.     

Ethnicity and psychotherapy with HIV-infected patients: Three case studies

Nationwide, demographic changes have led to an increased awareness of the impact of cultural diversity on the delivery of medical and psychological care . Due to the over-representation of minority and socially stigmatized groups among those affected by HIV, understanding the effects of psychosocial, linguistic and cultural membership on treatment relationships is crucial. In the psychological treatment of HIV-infected patients, psychotherapists can enhance the lives of their patients and support their involvement and compliance with medical treatment planning. Case studies are presented in which psychotherapy helped resolve difficulties in the medical care of three HIV-positive women that were due to cultural misunderstanding between doctors and patients.     

Development of a Short-Form Scale of Public Attitudes Toward Homelessness

Nationwide, demographic changes have led to an increased awareness of the impact of cultural diversity on the delivery of medical and psychological care. Due to the over-representation of minority and socially stigmatized groups among those affected by HIV, understanding the effects of psychosocial, linguistic and cultural membership or treatment relationships is crucial. In the psychological treatment of HIV-infected patients, psychotherapists can enhance the lives of their patients and support their involvement and compliance with medical treatment planning Case studies are presented in which psychotherapy helped resolve difficulties in the medical care of three HIV-positive women that were due to cultural misunderstanding between doctors and patients.     

Assessment of a computerized medical record system: disclosing scripts of use

In the last two decades, empirical studies adopting a critical sociological approach to technology have shown how innovations are socially shaped, and how their introduction into human practices is often problematic. This paper describes how the Actor–Network Theory (ANT) can contribute to the evaluation of information technology. Results of the evaluation of a computerized medical record system implemented in four Quebec (Canada) hospitals are presented. The distribution of skills and tasks among nurses, physicians and managers (as implied by the design), and the use of the computerized medical record system proved highly problematic since they radically modified clinical practices. Theoretical and practical implications of using ANT as an evaluation framework are discussed.     

Birthdate and mortality: an evaluation of the death-dip/death-rise

The effect on mortality of socially significant events is examined using birth date as the criterion date for a large sample from official state mortality records for Ohio. The sample consisted of all deaths from natural causes for 1979-1981. "The findings show that there is a greater tendency for persons to die within thirty days after the date of birth than before. More specifically, there was a statistically significant pattern of increased mortality for those who were never married and for ill-defined causes of death. A theoretical foundation and a brief interpretation of these findings is offered."     

Adoption and Family Therapy

The aim of this article is to sensitise family therapists to adoption. A major assertion of the paper is that adoptive families are different from biological families. The family therapy context is a natural framework for examining these issues, as adoption affects and alters both birth and adoptive families, and adoption‐related problems occur within the context of the extended family system. The differences between intra‐racial (socially‐motivated) and inter‐racial adoptions are discussed, as well as the differences between closed and open adoptions. The study of families affected by adoption provides a model for other family forms, such as stepfamilies, foster families and families who form through new birth technologies.     

Fathers-The Secondary Partners: Professional Perceptions and Fathers' Reflections

SUMMARY. The following is an account of a research project exploring the recollections of seven fathers at the time of the birth of their children with Down's Syndrome. It discusses the disclosure of diagnosis and subsequent contacts the fathers made both professionally and socially during the period following both in the hospital and at home. This is combined with the personal recollections of one father, not part of the original study, whose child was born with special needs. The implications for both professional practice and fathers are highlighted. Whilst there is an acknowledgement that the project was small scale, the conclusions will raise challenging issues for further discussion both among professionals and individual members of families.     

Do Socially Anxious Children Show Deficits in Classifying Facial Expressions of Emotions?

Studies with socially anxious adults suggest that social anxiety is associated with problems in decoding other persons' facial expressions of emotions. Corresponding studies with socially anxious children are lacking. The aim of the present study was to test whether socially phobic children show deficits in classifying facial expressions of emotions or show a response bias for negative facial expressions. Fifty socially anxious and 25 socially non-anxious children (age 8 to 12) participated in the study. Pictures of faces with either neutral, positive (joyful) or negative (angry, disgusted, sad) facial expressions (24 per category) were presented for 60 ms on a monitor screen in random order. The children were asked to indicate by pressing a key whether the facial expression was neutral, positive, or negative, and to rate how confident they were about their classification. With regard to frequency of errors the socially anxious children reported significantly more often that they saw emotions when neutral faces were presented. Moreover, reaction times were longer. However, they did not feel less certain about their performance. There is neither an indication of an enhanced ability to decode negative facial expressions in socially anxious children, nor was there a specific tendency to interpret neutral or positive faces as negative.     

At Women's Expense:

Analyses of so-called maternal-fetal conflict typically take fetal rights as given. In contrast, this paper argues that rights are socially created and do not come free. It analyzes how courts participate in the social construction of fetal rights in the areas of pregnant women's medical treatment and drug and alcohol use. Women are forced to bear the costs of making fetal rights real, burdening them without demonstrating any clear patterns of benefit to fetuses. It concludes that social policy that cares about women and empowers them will serve fetuses as well.     

Developmental well-being among low and normal birth weight U.S. Puerto Rican children

Low birth weight is a more common occurrence among Puerto Rican children than among children from most other racial and ethnic groups in the United States, and they are more likely to experience the added risk of living in poverty. This study addresses what is protective for the development 602 normal birth weight and 554 low birth weight children from the Puerto Rican Maternal and Infant Health Study. The results presented in the current analysis identify several protective influences for development (particularly maternal social support, medical insurance, and paternal employment) among low birth weight children (who are at a high risk for developmental problems), and almost none for normal birth weight children. The results largely support the contention that protective factors emerge, or increase in strength, only in the presence of risk, indicating the use of targeted child health programs based on birth weight are an effective and efficient way to improve the developmental well-being of young Puerto Rican children in the United States.     

“Our Own Little Language”: Naming and the Social Construction Of Alzheimer's Disease

Social meanings and cultural definitions attached to illness, disability, and aging have a powerful influence on the development and operations of medical care as well as the social, behavioral, and therapeutic processes occurring within these settings. Specialized care environments designed to meet the needs of what some would argue is a dramatically increasing population worldwide, those with Alzheimer's disease, have been dominated by a medical model of care where treatment of disease has primacy over person. In contrast to the medical model, the Certified Nursing Assistants (CNAs) at Starrmount (pseudonym) Alzheimer's Unit have socially constructed an alternative to the medical model of care through what I argue is the use of language and a process of “naming and reframing.” In this “different world,” as the CNAs call the world of the Unit, the resident is depicted as a socially responsive actor with a surviving self that is to be treated with respect. Using a symbolic interactionist framework, this paper examines the CNAs' construction and use of a “language of openings”—that is, the language arising out of the lifeworld of the residents—as the counterpoint to the “language of limits” of the medical model. Spoken everywhere but nowhere inscribed as “official” knowledge, this “little language,” as the CNAs speak of it, is the fundamental medium for social interaction in the Alzheimer's Unit.     

Looking back at fascism: a phenomenological analysis of BUF membership*

The purpose of this paper is to show that when former members of the British Union of Fascists give an account of their membership today, they take into consideration the common-sense hostility evoked by fascism. This is hardly surprising. However, the significance of this should not be too easily dismissed. One of the main criticisms of using oral history to explore certain kinds of events, is that actors engage in ex post facto rationalization. This form of ‘bias’ is in fact shown to exist in the former members but is made the central theme of the paper. A framework drawn from Schutz's social phenomenology is used to show that in looking back, the former members constructed the reflective accounts on the basis of their unique personal biography, which was seen as leading them towards fascism, and the socially given and transmitted common-sense typifications which now give pejorative connotations to fascist support. The respondents accomplished the view of themselves as former fascists by presenting their personal biography in such a way as to confront and challenge these common-sense typifications, such that their membership became a rational act. This was achieved through the notion of crisis. This empirical demonstration of Schutz's ideas will be used in defence against his idealist critics who claim that this emphasis on socially given and transmitted common-sense typifications makes Schutz's phenomenology too socially over-deterministic. It will also be used against his sociological critics who claim that Schutz's social phenomenology is incapable of being operationalized in empirical research.     

U.A.R.: influential factors in the acceptance of birth control and the consequential approaches to family planning

A number of factors have retarded the acceptance of birth control methods among peasant communities in Egypt: 1) the religious world-view of the peasant discourages him from interfering with the natural process of procreation; 2) the large family is important socially and economically in peasant society for strength and security and for the distribution of labor; 3) the status of a married woman depends to a great extent on the number of children, particularly the number of sons, she bears; and 4) in the Egyptian village, the midwife discourages the use of contraception. Acceptance and utilization of birth control methods in Egypt are directly proportionate to the level of education of the individual. The better the economic status of the family, the smaller the family is likely to be. Demographically, the closer a family lives to Cairo, the more likely it is that birth control techniques are being used. Egyptian family planning programs which take into consideration the difficulties of spreading the acceptance and use of contraceptives in traditional societies are discussed.     

DEMAND INDUCEMENT AND THE PHYSICIAN/PATIENT RELATIONSHIP

The physician/patient relationship is a paradigm for any expert/client relationship. The physician both diagnoses the patient's illness and recommends a treatment. This dual role gives the physician incentive to recommend treatments whose costs outweigh their medical benefits. These socially inefficient treatments correspond to the notion of "physician-induced demand." The level of inducement chosen by the physician is shown to depend on the price and potential medical benefits of treatment and the relative diagnostic skills of physician and patient. This model offers several testable hypotheses, some of which are confirmed by related studies.     

Predictors of child protective service contact between birth and age five: An examination of California's 2002 birth cohort

This study utilizes population-level birth data to describe those children who may be at greatest risk of maltreatment during the first five years of life. Based on a unique dataset constructed by linking California's administrative child welfare data to statewide vital birth records, a cohort study design was employed to track reports of maltreatment involving children born in 2002. Twelve variables captured in the birth record were selected for analysis. Generalized Linear Models were used to estimate adjusted risk ratios (RR) for each independent variable. Predicted probabilities of CPS contact were computed based on the count of risk factors present at birth. Results suggest that many of the associations previously observed between birth variables and subsequent maltreatment have sustained value in foretelling which children will be reported to CPS beyond infancy. Of the 531,035 children born in California in 2002, 14% (74,182) were reported for possible maltreatment before the age of five. Eleven of the twelve birth variables examined presented as significant predictors of contact with child protective services.     

Predictors of child protective service contact between birth and age five: An examination of California's 2002 birth cohort

This study utilizes population-level birth data to describe those children who may be at greatest risk of maltreatment during the first five years of life. Based on a unique dataset constructed by linking California's administrative child welfare data to statewide vital birth records, a cohort study design was employed to track reports of maltreatment involving children born in 2002. Twelve variables captured in the birth record were selected for analysis. Generalized Linear Models were used to estimate adjusted risk ratios (RR) for each independent variable. Predicted probabilities of CPS contact were computed based on the count of risk factors present at birth. Results suggest that many of the associations previously observed between birth variables and subsequent maltreatment have sustained value in foretelling which children will be reported to CPS beyond infancy. Of the 531,035 children born in California in 2002, 14% (74,182) were reported for possible maltreatment before the age of five. Eleven of the twelve birth variables examined presented as significant predictors of contact with child protective services.     

Minding the (Information) Gap: What Do Emerging Adult Adoptees Want to Know About Their Birth Parents?

Abstract

The formation of an adoption information gap was examined for a group of 169 emerging adults (M?=?25.0?years) who were adopted as infants. Participants completed interviews and questionnaires at adolescence and emerging adulthood (late teens to 20s). The Adoption Curiosity Pathway model guided research questions about formation of an adoption information gap, which exists when there is a difference between what an adopted person knows and what he or she desires to know regarding his or her adoption. In addition, specific issues were identified about which emerging adults were curious. Differences in these specific issues were examined across gender and openness arrangement with birth parents at emerging adulthood. The most frequently sought information was medical and health history. Logistic regression analyses revealed that the formation of an adoption information gap, which contains the specific items of curiosity, was more likely for those who were less satisfied with the amount of openness with birth parents during both adolescence and emerging adulthood. Implications for practice are presented.     

The Social Construction of Infertility

Health and illness are not objective states but socially constructed categories. We focus here on infertility, a phenomenon that has shifted from being seen as a private problem of couples to being seen as a medical condition. Studying infertility provides an ideal vantage point from which to study such features of health care as inter‐societal and cross‐cultural disparities in health care, the relationship between identity and health, gender roles, and social and cultural variations in the process of medicalization. Infertility is stratified, both globally and within Western societies. Access to care is extremely limited for many women in developing societies and also for marginalized women in some highly industrialized societies. We also discuss the ways in which responses to infertility are influenced by the process of self‐definition. The experience of infertility is profoundly shaped by varying degrees of pronatalism and patriarchy. In advanced industrial societies, where voluntary childfree status is acknowledged, many women experience infertility as a ‘secret stigma’; in other cultures, where motherhood is normative for all women, infertility may be impossible to hide. In the West, acceptance of the medical model is virtually hegemonic, but in other societies medical interpretations of infertility coexist with traditional interpretations.