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PubMed1995

[Treatment of leg ulcers with fibrin glue].

The work is based on two years studied cases. It consists of 80 patients between 35 and 80 years old with leg ulcers (73.8% women and 26.2% men). In 80% of patients this affection is due to a venous disease. In 10% of cases the cause was an arterial insufficiency of the lower extremity. Lymphatic and extravascular diseases are rarely involved. A group of 54 patients was treated with a traditional method. In the remaining 26 patients we used fibrin glue. Leg ulcers are an evolutive chronic pathology characterized by slow recovery. This means expensive social and therapeutic costs. From this point of view the treatment with fibrin glue, weekly applied, besides reducing pain, has a favourable impact on the outcome, times of re-epithelialization are shortened.

Adult↗

PubMed1994

School nursing.

School nursing has been in a process of transition since its inception. This role evolution parallels the growing complexity of the health, education, and social needs of America's youth. The workplace within which school nurses practice is equally complicated because health and education administrators often hold differing philosophies of management, and school health programs are ill-defined. Fortunately, there is growing support for an integrated services approach and the development of school health systems with nurses joining an interdisciplinary team rather than continuing to function as "boundary dwellers." The roles of the school nurse as primary care provider, school health coordinator, case manager, and epidemiologist are emerging and replacing outdated nursing functions. As the role of the school nurse shifts and expands, it produces a cascade effect. The role of the school health assistant to aid the nurse surfaces as the next logical step in planning. Numerous model school health programs exist today. The emphasis, and rightfully so, is preventive in nature and should be targeted at the preparation of a new generation of health consumers who are more self-reliant than their predecessors. Unfortunately, all these programs are plagued with financing problems that could be alleviated with the right plan for health care reform, such as an expansion of maternal and child health funds (Title V) to health departments and the introduction of school nursing leadership into the DASH office at the Centers for Disease Control and Prevention, a health education unit largely run by health educators, to reallocate some of these resources to the clinical preventive services needed in schools to reduce health risk behaviors. Finally, total quality management is the next issue on the horizon for this nursing specialty; benchmarking would be the place to start. In summary, systems development in the school health field is now underway, and it will not be easy, but this sort of work never has been simply. It must be remembered that there is nothing more difficult to plan, more doubtful of success, nor more dangerous to manage than the creation of a new system. For the initiator has the enmity of all who would profit by the preservation of the old institution and merely lukewarm defenders of those who would gain by the new ones.

Delivery of Health Care↗

PubMed1996

An evaluation of the feasibility of using first-year veterinary students in animal health education programmes.

Awareness of the importance and relevance of community-oriented medical education is increasing. Although a number of medical faculties have already adopted this approach for their undergraduate training, this idea does not appear to have received the same degree of acceptance within veterinary schools. This study attempts to provide evidence in support of the feasibility of a community-oriented curriculum. First-year veterinary science students at the Medical University of Southern Africa received a very short orientation course on the social determinants of disease; the Primary Health Care (PHC) philosophy and how PHC differs from the basic health service approach; how to shift the locus of control for health away from the health professional and back into the community; dependency theory; basic pet care; sociology (including systems and conflict theory); problems with the application of a technological imperative within a systems perspective; social research; basic statistical concepts; health care systems and their evolution; marketing principles in relation to health education; the importance of positioning and how to effectively use communication skills within a classroom setting. After this course the students successfully participated in an animal health education programme within the community.

Animal Husbandry↗

PubMed1999

Cantabria first-episode schizophrenia study: three-year follow-up.

BACKGROUND: We present the findings from the three-year follow-up of all first episodes of schizophrenia occurring during a two-year period in Cantabria (in Spain). AIMS: (a) To describe the clinical characteristics of the illness from the early stages of the disease, and (b) to study the long-term psychosocial adjustment and psychopathological evolution of these patients, identifying predictors for the course of the illness. METHOD: Of the original cohort of 86 patients, 76 (88.3%) were fully evaluated at three-year follow-up. Psychiatric assessment was performed (PSE-9 and SANS/SAPS). Social adjustment was evaluated using the Disability Assessment Schedule (DAS). Information regarding the clinical evolution and use of health resources was also gathered. RESULTS: The majority of patients with a first-contact diagnosis of schizophrenia failed to meet the criteria for a CATEGO diagnosis at follow-up. The SANS/SAPS assessments revealed a doubling in the proportion of patients with 'negative schizophrenia'. The pattern of clinical course was also evaluated, with 24 (31.5%) of the patients having a good outcome. Being male and having low social class tended to be associated with poor clinical outcome CONCLUSIONS: The outcome of schizophrenia is less pessimistic than was originally thought.

Adaptation, Psychological↗

PubMed2000

From ex-patient alternatives to consumer options: consequences of consumerism for psychiatric consumers and the ex-patient movement.

The psychiatric consumer movement in the United States evolved out of the political activism of a small group of antipsychiatry "ex-patients" (former patients) early in the 1970s. The shift in the movement from radical opposition to the medical model to viewing the latter as a possible choice in treatment occurred gradually under a series of social and political changes (e.g., deinstitutionalization), responses to those changes (e.g., the Community Support Program of the National Institute of Mental Health), and the involvement of new actors on the scene (e.g., the National Alliance for the Mentally Ill, a family consumer movement). This article traces the evolution of the psychiatric consumer movement up to the early 1990s in the light of these larger social, political, and economic developments. The author then considers the consequences of that evolution for both consumers and the ex-patient movement in the context of the unique nature of consumerism in the United States and the more recent restructuring of mental health services under managed care.

Commitment of Persons with Psychiatric Disorders↗

PubMed1987

Drunks, livers, and values. Should social value judgments enter into liver transplant decisions?

The idea that social value judgments should enter into the distribution of scarce resources has been debated for many years. The question of transplanting livers into alcoholic patients, even if they do not constitute a technically worse group than do nonalcoholics, is used to examine this issue. The paper concludes that (a) "social worth," as a criterion for distribution of scarce resources, is morally precluded in allocations directly involving the patient-physician relationship; (b) social worth criteria may be useful in macroallocation decisions prior to resorting to a lottery approach or to a market approach; (c) social worth criteria may be more legitimately applied when it comes to transplanting organs than in the distribution of other resources. Social worth criteria constitute an expression of communal value and are prone to the evolution of communal sensitivities and to growth.

Alcoholism↗

PubMed1977

The mid-life transition: a period in adult psychosocial development.

For the past nine years my colleagues and I have been working on a theory of adult psychosocial development in men (Levinson et al., 1974, 1977; Levinson, 1977). We have started some research on women (Stewart, 1977), but it is too early yet to report definitive theory or findings. Our aim is to encompass the many components of a man's life-all of his relationships with individuals, groups, and institutions that have significance for him. The components of life include his occupation and its evolution over the years, his love relationships, marriage, and family life, his various other roles and careers in numerous social contexts. This psychosocial approach includes the man's personality and the ways in which it influences and is influenced by the evolution of his careers in occupation, family, and other systems. The resulting theory is not a theory of personality development, nor of occupational development, nor of development in any single aspect of living. It deals, rather, with the development of the individual life in the broadest sense, encompassing all of these segments. This theory provides a context within which we can study in more detail the development of personality and of particular careers. I shall briefly describe the developmental periods we discovered in early and middle adulthood, giving major emphasis to one period, the Mid-life Transition. Like childhood and adolescence, these periods are found in the lives of all men. Of ourse, men traverse them in myriad ways, as a result of differences in class, ethnicity, personality, and other factors. My primary aim is to present some of our major concepts, hypotheses, findings, and ways of thinking about adult development. None of them have been fully validated. Together, they comprise a framework for the analysis of adult development. No doubt the theory will be modified an extended as a result of further investigation.

Adult↗

PubMed2004

Science and technology integration for increased human potential and societal outcomes.

Unifying science based on the material unity of nature at the nanoscale provides a new foundation for knowledge, innovation, and integration of technology. Revolutionary and synergistic advances at the interfaces between previously separated fields of science, engineering and areas of relevance are ready to create nano-bio-info-cogno (NBIC) transforming tools. Developments in systems approach, mathematics, and computation in conjunction with NBIC allow us to understand the natural world and scientific research as closely coupled, complex, hierarchical entities. At this unique moment of scientific and technical achievement, improvement of human performance at individual and group levels, as well as development of suitable revolutionary products, becomes possible and these are primary goals for converging new technologies. NBIC addresses long-term advances in key areas of human activity, including working, learning, aging, group interaction, organizations, and human evolution ((Roco and Bainbridge, 2003)). Fundamentally new tools, technologies, and products will be integrated into individual and social human architecture. This introductory chapter of the Annals outlines research and education trends, funding activities, and the potential of development of revolutionary products and services.

Biological Evolution↗

PubMed1999

Queen-Worker Conflict over Sexual Production and Colony Maintenance in Perennial Social Insects.

An important idea from kin selection theory as applied to life-history evolution in perennial insect societies suggests that potential conflict exists between the queen and workers over the relative allocation of resources to colony reproduction and colony growth. This prediction assumed a colony with one singly mated queen, sterile workers, and independent colony foundation by dispersing queens. We argue that this prediction is mistaken because queen and workers under these circumstances can only invest in sexuals (new queens and males) derived from the colony queen. Assuming population sex ratio equilibrium, potential conflict is absent because both parties maximize fitness by maximizing the colony's total output of these sexuals. However, a similar queen-worker conflict is predicted in facultatively polygynous species in which existing queens are superseded. We hypothesize that queens favor the production of relatively more new workers to prolong their lives as reproductives, whereas workers favor raising relatively more new queens as possible replacements. We tested this hypothesis using productivity data from the ant Leptothorax acervorum. As predicted, queen number and worker number were, respectively, positively and negatively associated with the investment ratio of new workers to new queens. These findings imply a queen-worker conflict over caste determination in ants.

Formicidae↗

PubMed2000

Evolutionary biology. In search of biological weirdness.

The late William D. Hamilton (1936-2000) was drawn to the unusual and paradoxical. His observations led to a new understanding of social interactions and shaped a generation of evolutionary biologists. At a symposium here in October honoring this giant of evolutionary biology, who died of malaria in March at age 63, about 70 researchers discussed where Hamilton's ideas have taken them.

Animals↗

PubMedDate not supplied

The social implications of questionable cancer therapies.

Questionable or "unorthodox" treatments are not selected in a vacuum; their degree of popularity and the particular types used are functions of their social and cultural context. The liquid preparations that were popular earlier in this century reflected fascination with bottled medicinals, consistent with the growing era of pharmaceutical medicine. Today's questionable remedies are similarly consistent with their social and cultural context. "Metabolic" therapies emphasizing diet, self care, vitamins, and internal cleansing, along with "immune-enhancing" regimens, represent today's reigning "alternatives." Such approaches reflect underlying social trends and values, such as belief in assuming personal responsibility for one's health, the importance of self care and physical fitness, patients' rights movements, dietary emphases encouraged by conventional and alternative medicine alike, the holistic medicine movement, and general disaffection with organized medicine. Just as questionable therapies are born of the values and beliefs of their culture, so these treatments and their use affect the social environment in which they exist. The relationship is reciprocal and cyclic, with social trends encouraging particular forms of questionable regimens and these regimens, in turn, reinforcing prevailing social beliefs. Public beliefs about cancer were reflected in responses to our studies of unorthodox cancer therapies and of psychosocial correlates of survival. Responses revealed widely held values and beliefs about cancer, cancer treatment, and medicine generally. These themes are described.

Cultural Evolution↗

PubMed2006

Evolutionary dynamics of social dilemmas in structured heterogeneous populations.

Real populations have been shown to be heterogeneous, in which some individuals have many more contacts than others. This fact contrasts with the traditional homogeneous setting used in studies of evolutionary game dynamics. We incorporate heterogeneity in the population by studying games on graphs, in which the variability in connectivity ranges from single-scale graphs, for which heterogeneity is small and associated degree distributions exhibit a Gaussian tale, to scale-free graphs, for which heterogeneity is large with degree distributions exhibiting a power-law behavior. We study the evolution of cooperation, modeled in terms of the most popular dilemmas of cooperation. We show that, for all dilemmas, increasing heterogeneity favors the emergence of cooperation, such that long-term cooperative behavior easily resists short-term noncooperative behavior. Moreover, we show how cooperation depends on the intricate ties between individuals in scale-free populations.

Biological Evolution↗

PubMed1999

Honest signalling during prey-predator interactions in the lizard Anolis cristatellus.

Current theory on the evolution of pursuit-deterrent signals predicts that it may be advantageous for the prey to communicate to the predator its alertness and its ability to escape an attack. I tested these predictions by staging predator-prey encounters between A. cristatellus lizards and a model of one of its predators under natural conditions. Results supported the use of pushup displays as pursuit-deterrent signals. The intensity of signals, measured as the number of pushups given during predation episodes, was significantly positively correlated with individual physiological condition measured as endurance capacity. Because endurance capacity can be a critical aspect limiting the ability of A. cristatellus to escape a predatory attack, pushup displays can potentially communicate an individual's ability to escape an attack and, therefore, can be categorized as honest signals. Furthermore, because pushup displays are widely used during anoline social interactions, predation pressure and sexual selection may simultaneously favour the evolution of honest communication to allow both the predator and the potential mate or male rival to assess individual quality using the same signal. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗

PubMed1987

[From social epidemiology to the sociology of prevention: 15 years' research on the social etiology of disease].

Social epidemiology is this field of inquiry that regards the role of social and psychological factors in the aetiology of chronic diseases. In his examination of the evolution of the field, the author stresses the reconceptualization efforts that have been done in the 70's and that gave meaning to research on stress, traits or types of personalities and social support. In conclusion, this research tradition is viewed as perhaps overemphasizing the identification of risk factors while underemphasizing the explanation of the conditions under which good health is maintained.

Disease↗

PubMed1998

[Evolution of breast cancer. A 5-year clinical experience at a city hospital].

In order to clarify the role that some epidemiologic factor might have on the clinical evolution of breast cancer, a retrospective study was conducted. Seventy six women diagnosed with breast cancer were selected from the population of the Hospital de Ginecobstetricia 3 del Centro Medico Nacional "La Raza" del Instituto Mexicano del Seguro Social, from 1985 to 1990. Age, medical and family history, clinical onset, diagnosis, treatment, evolution and clinical status at present were analyzed. Survival analysis and Pearson's correlation were carried out. Thirty one percent of the women were 41 to 50 years old, and thirty percent had family history of breast cancer. Other systemic condition was present in 42% of the patients and multiparity in 12%. The mean age of menopause onset was 47 +/- years. Eighty-three percent of the patients looked for medical attention due to a mammary tumor mainly in the left breast (75% of the cases). Fifty-one percent of the cases were diagnosed in advanced stages. The commonest histologic variety found was the invasive ductal carcinoma (94%). Sixty six patients underwent surgical therapy. Sixteen percent of the sample had already metastases when diagnosed; mainly at lung, bone liver or brain, in that order. Systemic therapy was administered in 63% of the cases and radiotherapy in 22 patients. About 48% of the whole sample presented recurrency and 24% progression. The overall survival at five years was 82%. Sixteen percent of these patients had tumor activity clinically apparent. In general, mortality was present in advanced stages. Survival analysis demonstrated that age and tumor persistency directly influenced survival rate in this population. Other variables' role could not be evaluated. Nevertheless variables analyzed are very helpful in actions implementation to the breast cancer management.

Adult↗

PubMed2006

Evolution of sensory complexity recorded in a myxobacterial genome.

Myxobacteria are single-celled, but social, eubacterial predators. Upon starvation they build multicellular fruiting bodies using a developmental program that progressively changes the pattern of cell movement and the repertoire of genes expressed. Development terminates with spore differentiation and is coordinated by both diffusible and cell-bound signals. The growth and development of Myxococcus xanthus is regulated by the integration of multiple signals from outside the cells with physiological signals from within. A collection of M. xanthus cells behaves, in many respects, like a multicellular organism. For these reasons M. xanthus offers unparalleled access to a regulatory network that controls development and that organizes cell movement on surfaces. The genome of M. xanthus is large (9.14 Mb), considerably larger than the other sequenced delta-proteobacteria. We suggest that gene duplication and divergence were major contributors to genomic expansion from its progenitor. More than 1,500 duplications specific to the myxobacterial lineage were identified, representing >15% of the total genes. Genes were not duplicated at random; rather, genes for cell-cell signaling, small molecule sensing, and integrative transcription control were amplified selectively. Families of genes encoding the production of secondary metabolites are overrepresented in the genome but may have been received by horizontal gene transfer and are likely to be important for predation.

Deltaproteobacteria↗

PubMedDate not supplied

Social cognition and psychopathology in an evolutionary perspective. Current status and proposals for research.

The phylogenetic and ontogenetic developments of social cognition have been a major research focus of evolutionary and developmental psychology. Theory of mind or so-called Machiavellian intelligence, that is the capacity to infer mental states of other individuals and to manipulate them in order to maximise social success, probably emerged due to the need to cope with an increasingly complex social environment. Studies on social reasoning suggest disturbances of mental state attribution in psychiatric disorders. However, apart from autism spectrum disorders, the systematic evaluation of social cognition is still in its infancy, and the present data are ambiguous due to methodological difficulties. Based on the concept of the modular organisation of the mind, a stepwise investigation of social cognition in psychiatric disorders is proposed, including clinical description and available standardised methods. The specific characteristics of psychiatric disorders in respect of social cognition, therefore, may vary according to the hierarchical organisation of the social module. Systematic studies on social reasoning processes in psychiatric disorders may provide new insights also useful for the development of coping strategies in cognitive-behavioural therapy.

Biological Evolution↗

PubMed2002

Human eating behaviour in an evolutionary ecological context.

Present-day human eating behaviour in industrialised society is characterised by the consumption of high-energy-density diets and often unstructured feeding patterns, largely uncoupled from seasonal cycles of food availability. Broadly similar patterns of feeding are found among advantaged groups in economically-emerging and developing nations. Such patterns of feeding are consistent with the evolutionary ecological understanding of feeding behaviour of hominids ancestral to humans, in that human feeding adaptations are likely to have arisen in the context of resource seasonality in which diet choice for energy-dense and palatable foods would have been selected by way of foraging strategies for the maximisation of energy intake. One hallmark trait of human feeding behaviour, complex control of food availability, emerged with Homo erectus (1.9 x 10(6)-200000 years ago), who carried out this process by either increased meat eating or by cooking, or both. Another key trait of human eating behaviour is the symbolic use of food, which emerged with modern Homo sapiens (100000 years ago to the present) between 25000 and 12000 years ago. From this and subsequent social and economic transformations, including the origins of agriculture, humans have come to use food in increasingly elaborate symbolic ways, such that human eating has become increasingly structured socially and culturally in many different ways.

Animals↗