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PubMed1984

Organizational impact on medicine: the HMO concept.

This paper examines the role of physicians within the HMO (health maintenance organization) context. The development of HMOs in the United States is traced from their origins to the present time. The literature reveals the emergence of four factors within the practice of medicine; a shift of control away from physicians, the reduction of their prestige, the redefinition of medical quality and increased patient control over the treatment regimen. The paper concludes that (a) while physicians remain relatively powerful, some of their control and prestige are eroded by the organizational setting, (b) HMO physicians must pay greater attention to colleagues, personnel and patients than their fee-for-service counterparts and (c) definitions of medical quality are becoming increasingly rationalized.

Health Maintenance Organizations↗
PubMed1978

Some social consequences of partial prohibition in Auckland, New Zealand.

Information was gathered from two hospitals, Police, and Traffic Departments in Auckland, New Zealand, for a 4-week period during which beer supplies were erratic or stopped and compared with 4 weeks during normal beer production. Reductions occurred in the mean weekly numbers of accident and emergency admissions at one hospital, in the number of Friday road traffic accidents and injuries reported by the Traffic Department, and in the weekly number of arrests for drunkenness and other alcohol-related offences made by the Police. A larger effect might have been expected in this country, where beer drinking has become an important part of the male lifestyle.

Accidents↗
PubMed1988

Forensic science and the law.

Forensic Science today makes an important contribution to the operation of the Criminal Justice System providing evidence which could help decide the guilt of a suspect. Forensic Science is able to do so because it has developed to operate within the reality determined by the Criminal Justice System. Changes that are occurring today seem to upset the relationship between Forensic Sciences and the Criminal Justice System by the creation of communication problems. Examples of these problems exist in the changes occurring in the concept of death made necessary by organ transplants. These changes have shifted the focus from the quantity of life to the quality of life and make it impossible for the Forensic Scientist to answer honestly the questions that might be put him. The need for reforms in the law in view of social changes has been recognized and in many countries attempts at such changes are afoot. With these changes a new reality is being defined. Forensic Science, being a discipline that comes first in contact with a multitude of emergent problems, has a part to play in the definition of this reality.

Abortion, Legal↗
PubMed2006

An application of Stafford and Warr's reconceptualisation of deterrence to a group of recidivist drink drivers.

Recent revisions of deterrence theory have highlighted the powerful effects of personal and vicarious punishment avoidance on criminal activity. The present paper reports on an application of Stafford and Warr's [Stafford, M.C., Warr, M., 1993. A reconceptualization of general and specific deterrence. J. Res. Crime Delinq. 30 (2), 123-135] reconceptualisation of deterrence theory to a group of recidivist drink drivers to explain their self-reported offending behaviours. The analysis indicated that punishment avoidance exerted the greatest influence on self-reported offending behaviours, although perceptions of arrest certainty and severity also appear associated with drink driving offences. In contrast, vicarious exposure to others who have been punished or avoided punishment was not associated with further drink driving behaviours. The results suggest that recidivist drink drivers are not heavily influenced by vicarious experiences, and that past behaviour is an efficient predictor of future behaviour. The findings have direct implications for the reconceptualisation and application of deterrence models to elucidate offending behaviours.

Accidents, Traffic↗
PubMed2006

School regulations governing bicycle helmet use and head injuries among Japanese junior high school students.

We examined the effectiveness of school regulations concerning bicycle helmet use in reducing head injuries among student bicycle commuters to junior high schools in the Japanese prefecture of Saitama. This was done by comparing the rates of head injuries and the ratios of head injuries to non-head injuries between junior high schools with and without school regulations concerning helmet use. Bicycle injury data were derived from school insurance records. Information relating to numbers of bicycle commuters and demographics was collected for each school. We identified that the head injury rate was significantly higher in schools that had no regulations governing the use of bicycle helmets (rate ratio 2.97, 95% confidence interval (CI) 1.03-8.56; odds ratio 2.46, 95% CI 0.80-7.60). The observed trend was more prominent in male students than in female students. The actual rate of bicycle injuries did not significantly differ between the schools with and without regulations concerning helmet use. This suggests that students at schools with regulations were no more cautious in riding their bicycles than their counterparts in schools with no regulations, and that there was no significant difference in the traffic environments surrounding each school. Thus implicating that the observed difference in the head injury rate was most accounted for by the presence of school regulations governing helmet use.

Adolescent↗
PubMed2007

Protective resources and long-term recovery from alcohol use disorders.

AIMS: This study examined indices of personal and social resources drawn from social learning, behavioral economics, and social control theories as predictors of medium- and long-term alcohol use disorder outcomes. DESIGN AND MEASURES: Individuals (N = 461) who initiated help-seeking for alcohol-related problems were surveyed at baseline and 1, 3, 8, and 16 years later. At baseline and each follow-up, participants provided information about their personal and social resources and alcohol-related and psychosocial functioning. FINDINGS: In general, protective resources associated with social learning (self-efficacy and approach coping), behavioral economics (health and financial resources and resources associated with Alcoholics Anonymous), and social control theory (bonding with family members, friends, and coworkers) predicted better alcohol-related and psychosocial outcomes. A summary index of protective resources associated with all three theories significantly predicted remission. Protective resources strengthened the positive influence of treatment on short-term remission and partially mediated the association between treatment and remission. CONCLUSIONS: Application of social learning, behavior economic, and social control theories may help to identify predictors of remission and thus to allocate treatment more efficiently.

Adaptation, Psychological↗
PubMed2006

Life imprisonment: recent issues in national and international law.

This article notes that, because understandings of what life imprisonment means are often ambiguous, the life sentence is sometimes perceived to be relatively uncontroversial. Life imprisonment without the prospect of parole for children under the age of 18 years is the most extreme form of this sentence that can be imposed. However, in the United States of America even such sentences have only recently become the subject of public debate. In contrast, in a small but growing number of jurisdictions all life sentences are regarded as constitutionally suspect and contrary to human rights, whilst in the majority of jurisdictions the imposition of life imprisonment is strictly limited. The article traces recent developments in the imposition and implementation of life imprisonment that have evoked some controversy. It pays particular attention to attempts that have been made in practice to ensure that life imprisonment produces punishment that is proportionate to the crime. It points out, however, that a renewed focus on combating dangerous offenders through indeterminate preventive sentences has blunted even this modest safeguard. It warns that this tendency increases the risk of life imprisonment being an unfairly harsh penalty.

Adolescent↗
PubMed2005

Social regulation, medicalisation and the nurse's role: insights from an analysis of nursing documentation.

BACKGROUND: Medicine is recognised as a dominant source of governmentality and social regulation, and although nursing has been implicated in the same process, analytical work in this area has been sparse. OBJECTIVES: The article aims to present an analysis of nursing records in order to understand the structural and social processes that mediate the texts. METHODS: 45 sets of nursing records drawn from four clinical sites in Ireland were subjected to a discourse analysis. RESULTS: This article focuses on two main themes that were derived from data: (i) the manner in which nurses controlled, regulated and invigilated patients' activities of daily living and (ii) the way in which activities of daily living were mediated by a biomedical worldview in the clinical settings. Through the organising framework of Activities of Daily Living (ADLs), normative social practices relating to hygiene, eating and drinking, sleeping and so forth were surveyed and monitored within clinical settings. We construct qualitative categories around a range of ways that nurses assessed and judged patients' capacities at ADLs. Furthermore, it is argued that the framework of ADLs epitomises the medicalisation of normative social practices, whereupon the most mundane of normal functions become redefined as an actual or potential clinical pathology, legitimating nursing interventions. According to the nursing documentation, biochemical interventions in the form of various medications were the most dominant means through which nurses attempted to restore or improve the functional capacity of an ADL. CONCLUSION: We conclude by proposing that nurses' invigilation of patients' ADLs is not necessarily a repressive feature of nursing practice, but rather has the potential to be used to advocate on patients' behalf in certain circumstances.

Activities of Daily Living↗
PubMed2006

Review of what youth programs do to increase the connectedness of youth with adults.

Common sense and psychological research tell us that connections to adults--parents and others--are integral to the process of normal human development. A substantial research literature exists on the role of the parent-child relationship in development, and there is a smaller, but growing body of research that explores the effects of nonparental relationships. Adolescents, in particular, are open to nonparental adults as they strive to create for themselves lives more independent from their parents while still valuing advice from those more experienced than they. The most commonly examined nonparental relationship is that of a teacher and a student. One of the less explored areas of investigation is the importance of relationships youth have with adults they find in their weekend and after-school activities. This article examines field research that has been conducted over the past 15 years on youth programs, to address what has been learned about "connectedness" as it manifests itself in the field. By connectedness, we mean primarily the attachment youth have to the adults in the programs.

Adolescent↗
PubMed2004

"Social thinking" and cultural images: teenagers' notions of tobacco use.

The health hazards of tobacco use are well-known, and it is considered particularly important to prevent tobacco use among teenagers. New generations of teenagers still start using tobacco. To develop a more profound understanding of tobacco use among teenagers, the purpose of this study is to explore representations of tobacco use, smoking as well as snuffing, at the age when young people often start using tobacco. Focus-group interviews were carried out with 14-15 year olds in two schools in the Stockholm area. The analysis reveals that teenagers are well informed about the health-hazards of tobacco use. At the same time they hold complex and conflicting ideas concerning the relationship between tobacco use, risk, the body and "human nature". At the most general level of "social thinking" there is a dynamic relation between the three main representations of tobacco use related to: (1) notions of risk, (2) "human nature" and; (3) society's efforts to discipline its citizens, which together can be seen as the social representation of tobacco use. These representations of tobacco use are discussed as related to the teenagers' identity-work and gender identities.

Adolescent↗
PubMed2004

The medical text: between biomedicine and hegemony.

The unequal distribution of power in contemporary society is reflected and reproduced in medical ideology. The present article analyses some articles from Israeli medical journals in order to show the ways in which biomedicine--the dominant medical ideology--is reinforced through hegemonic discourse. The central ways by which this is achieved are medicalization--which includes the desocialization of disease and the explanation of social phenomena in medical terms--and the affirmation by the Israeli medical literature of national, ethnic, class and gender relationships of domination. Analysis of the Israeli example provides useful insights about biomedicine's desocializing role, as the disregard for the social dimension of disease is particularly telling in a society characterized by several cleavages which determine a clearly unequal distribution of power and resources.

Arabs↗
PubMed2005

Imposition of virginity testing: a life-saver or a license to kill?

Little is known about medical and juridical (medicolegal) responses to sexual abuse in Palestinian society. Conventional wisdom posits that the actions of the medicolegal community help victims of sexual abuse and deter offenders. This study focuses on the prevailing practice of imposing a virginity test (IVT) on women in Palestinian society when questions of sexual abuse or perceived misconduct arise. We found that the continuing practice of uncritically collecting forensic reports and the refusal to closely examine the specific dynamics of oppression (medical, cultural, legal, political) in which the victims of sexual abuse are necessarily implicated actually increases the power of medicine and law to adversely function as tools of oppression. However, as I elaborate below, despite the localized factors in play, it is critically important not to view the process of virginity testing merely through the rubrics of "culture"-an approach that more often than not impedes understanding and fails to contextualize what we observe.

Adolescent↗