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Biomedical subjects

P L Rosenfield

Publications and source records attributed to P L Rosenfield.

7 recordsLinked to original sources

The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences.

The last decade of the twentieth century is witnessing a profusion of projects drawing together social and health scientists to study and recommend solutions for a wide range of health problems. The process--practiced in both developed and developing countries--is usually called multidisciplinary or interdisciplinary research. Its historical precedents are briefly reviewed in this paper along with the types of problems addressed. From a review and discussion of a sample of projects selected from two major proponents of this approach to research, the Social and Economic Research Component of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases and the Applied Diarrheal Disease Research Project, conclusions are drawn about the nature of contributions from such efforts--very useful for short-term problem solving, less so for longer-term programmatic changes, especially beyond the health sector, and even more limited in impact on theory building for coping with the changing human condition. The recognition of such limitations is now widespread in the social and natural sciences beyond the health sector, in population, ecology, and the humanities. Following these observations, I argue for a new approach to transcend the disciplinary bounds inherent in multi- and interdisciplinary research. A transdisciplinary approach can provide a systematic, comprehensive theoretical framework for the definition and analysis of the social, economic, political, environmental, and institutional factors influencing human health and well-being. The academic and career challenges for such researchers, while considerable, may be overcome since there is now a new flexibility in research-supporting organizations to encourage new ideas in international health, such as that of essential national health research.

Cooperative Behavior↗

The economics of parasitic diseases: research priorities.

Parasitic diseases are primarily diseases of poverty. At serious risk are individuals, communities and countries least able to afford the costs of treatment or prevention. In turn, economic development projects which aim to increase income levels may lead to negative results because of increased transmission of parasitic diseases often results. In attempting to analyse the economic consequences of parasitic diseases and the economics of their control, economists have usually relied on the tools of cost-benefit analysis, cost-effectiveness analysis and financial analysis. These efforts are briefly reviewed in the paper. The results have been subject to considerable criticism because of conceptual and methodological problems. For example, most studies have not taken into account the epidemiology and natural history of the disease in estimating the associated economic losses, thereby leading to inappropriate conclusions. The UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases through its Social and Economic Research Scientific Working Group (SER-SWG) is promoting research on the economics of parasitic diseases. In an attempt to improve the usefulness and reliability of such studies, conceptual and methodological approaches have been suggested which are reported on here. To improve the research design of these projects, a conceptual framework is proposed which consists of four components: (1) baseline social, cultural and economic conditions influencing disease transmission; (2) resources already invested in the health system and investments in other related sectors such as agriculture, housing, water supply and sanitation; (3) health consequences resulting from (1) and (2); and (4) social and economic consequences resulting from (3). A key concern in relation to the framework is to determine the most useful basis for linking results from studies of one component to another so as to analyse more systematically the impacts of disease on individuals and society. Such studies are inherently interdisciplinary and close collaboration of economists with medical scientists and disease control programme staff is needed to ensure completeness and reliability of input data and results. Results from these studies could be used to inform national decision-makers about the social and economic consequences of the parasitic diseases and their control and, thus, should strengthen support for increased investment to reduce the parasitic disease burden in developing countries.

Communicable Disease Control↗

Development and verification of a schistosomiasis transmission model.

Development of a model to predict the impact of water resource projects on transmission of schistosomiasis is described and verified with data from 54 villages in Khuzestan Province, Iran. Changes in disease prevalence following construction of an irrigation project are related to the linear extent of snail habitats and size of the infected human population. The model is used to compare the costs and effectiveness of alternative disease control measures. Results indicate that a combined controls program is most cost-effective but further work is needed to determine the optimal combination of controls.

Animals↗