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At least 19 recordsLinked to original sources
PubMed1990

The logic of failure.

Unlike other living creatures, humans can adapt to uncertainty. They can form hypotheses about situations marked by uncertainty and can anticipate their actions by planning. They can expect the unexpected and take precautions against it. In numerous experiments, we have investigated the manner in which humans deal with these demands. In these experiments, we used computer simulated scenarios representing, for example, a small town, ecological or economic systems or political systems such as a Third World country. Within these computer-simulated scenarios, the subjects had to look for information, plan actions, form hypotheses, etc.

Africa, Western↗
PubMed1992

Ethical issues in case management from a political and systems perspective.

This article has been excerpted from a talk which provided a description of the systemic context in which case management operates in relation to other services and provides an overview of the political context in which the system of services for older people operates. The ethical issues of case management, which are discussed elsewhere in this issue, are imposed in part by the role of case managers in the system as a whole, which in turn reflects our society's political consensus on how older persons will be served and at what cost.

Ethics, Medical↗
PubMed1987

Political attitudes and voting among unemployed and employed youth.

This study investigated the political involvement of a sample of 1294 young people aged 17-18 years old. Seventeen per cent were employed and 83 per cent were unemployed, and the sample included males and females, blacks and white. When compared with the employed, the unemployed were more disaffected with the political system, more likely to support the Labour Party, less likely to support the Conservative Party, more likely to have voted Labour in the 1983 General Election, and less likely to have voted Conservative. Ethnic comparisons indicated that blacks were more politically disaffected than whites, were more likely than whites to express support for the Labour Party, and were more likely to vote Labour in the 1983 General Election. The only major sex difference was amongst whites, such that males were more likely to support the National Front, and females more likely to support Labour. Results are interpreted as indicating increased detachment from the main political system for some unemployed young people, and with increased attachment to Labour politics among others.

Adolescent↗
PubMed1992

Nursing in Nazi Germany.

German nursing did indeed change during the Nazi period. There were external changes, in terms of the improved social status of nursing, the tightening and unification of professional nursing organizations, the laws affecting nursing, and the politicization of the profession. Articles written by nurses at the time and more recent interviews suggest that there were internal changes as well. It appears that at least a portion of German nurses accepted the National Socialism reinterpretation of professional nursing ethics and humanitarian principles in the assumption that through their obedience they were doing good. This historical research points to clear lessons for contemporary nurses. Nurses in Nazi Germany were under the illusion that they were remaining true to their professional ethics, unaffected by the social change around them. This apolitical professional consciousness made it possible for the profession to be subsumed as a part of the larger political system. I believe that we must be clear that nursing never takes place in a value-free, neutral context; it is always a socially significant force. This means that we cannot simply observe what is taking place around us but must take a stand and get involved, helping to shape sociopolitical developments. I also believe that we must deal with the history of our profession, especially its darkest hours, so that we may remain sensitive to any signs of inhumanity. We must call into question traditional principles, such as obedience, and replace them with professional competence, professionalism, and creative self-consciousness. And not least, we have a moral obligation to the millions of victims of National Socialism, even if it only means that, through historical research, we assure that they are not forgotten. By taking responsibility for this part of our history, we can become more sensitive for the future, with eyes and ears open for all social injustices.

Complicity↗
PubMed1975

Medical education in China in the postcultural Revolution era.

The Cultural Revolution has had an important impact on Chinese medical education. The Chinese system is engaged in a vigorous program to solve health-manpower needs in the rural areas by emphasizing de-professionalization, mass orientation and accountability to the community. Among the notable changes within the medical schools are the following: an admission process favoring the recruitment of peasants, factory workers, and the military; a three-year program with heavy emphasis on practicing in rural communities; widespread integration of the traditional Chinese and Western systems of medical practice; and manual labor and political seminars, which compose more than 25 per cent of the required curriculum. These innovations have been greatly facilitated by a strong national commitment and supportive political system. The fact that less than 10 per cent of doctors in China today are graduates of college-level medical education indicates the importance of other entry possibilities.

Allied Health Personnel↗
PubMed1978

Organizational complexity in family practice: a sociological model of a family practice group.

The growth of a family practice goup is presented as a case study. Enlarging size and increasing functions require organizational change--from solo to collegial to bureaucratic to political systems. Organizational theory distinguishes between the characteristics and functions of individual, collegial, bureaucratic, and political organizations. Different styles and strategies are appropriate at different stages.

Decision Making↗
PubMed1989

Developing wellness programs: a nurse-managed Stay Well Center for senior citizens.

This article describes the process from conception to implementation of developing a nurse-managed wellness center for senior citizens. The center was established in a federally subsidized high rise residential complex in midtown Manhattan. The unique senior population living in this New York City community includes a large proportion of performing artists. These individuals are struggling to maintain ties to their community at a time when their most productive performing years have passed. A health needs assessment was designed to evaluate whether or not these seniors were interested and would participate in a nurse-managed wellness center. The strategies needed to propose and move the project forward through all systems are explored. Two clinical nurse specialists assessed the need, proposed the center, and guided it through several political systems while maintaining leadership to establish a viable and innovative hospital-based health center based on prevention.

Aged↗
PubMed1992

Teaching health policy and politics in U.S. schools of public health.

Because most public health endeavors in the United States are funded by the public sector, public health practitioners need to be adept at working within the political system. However, the 1988 Institute of Medicine report, The Future of Public Health, found that many public health professionals are ignorant or disdainful of political processes and will not participate in activities that they perceive to be political. Our study examined the health policy and politics curricula of the 24 accredited schools of public health in the U.S., finding that most public health students are not exposed to these areas during their graduate coursework. Moreover, those students who do take health policy and politics courses study these areas within the context of health care delivery; the politics of public health and prevention are ignored by most schools of public health. Recommendations for improving public health curricula in health policy and politics are presented, including linkages with prevention activities.

Curriculum↗
PubMed1990

Orphans as a window on the AIDS epidemic in Sub-Saharan Africa: initial results and implications of a study in Uganda.

Provisional estimates from a Save the Children Fund enumeration study in four Ugandan districts indicate that the total number of orphans (one or both parents missing) ranges between 620,000 and 1,200,000. Needs assessments with guardians and local administrators show that although extended family networks are absorbing these children according to traditional rules, they may be vulnerable to increased mortality due to economic and health stresses on their caretakers, many of whom are elderly persons. The orphan burden will increase in Uganda and other Sub-Saharan African countries over the next few years. Allocation of additional national and international resources must be considered to avert breakdowns in community and familial support systems and consequent increases in under 5 mortality. The orphan burden is a window on the potential for massive social breakdown and dislocation in Sub-Saharan Africa resulting from high AIDS-related mortality. Methodologies for data collection and planning that use indigenous political systems must be built quickly to avert disaster.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Accommodating rapid growth in physician supply: lessons from Israel, warnings for Canada.

Most developing countries find themselves grappling with the implications of rapid growth in physician supply. The purpose of this article is to search for lessons or warnings for Canada (and, ultimately, elsewhere) in the manner in which Israel has chosen to accommodate its huge supply of physicians. Under extremely conservative assumptions about immigration, and assuming rates of domestic training of physicians at levels somewhat lower than at present, Canada's physician supply will continue to grow at rates in excess of general population growth for at least the next 45 years. In this article we describe the Israeli health care system from a perspective of identifying the consequences of accommodating a physician supply about 50 percent higher than that in Canada. A number of key "accommodation attributes" (low physician incomes, restricted access to hospitals for general practitioners, intramedical-professional conflicts over income and authority, a flourishing black market) are argued to be more than simply products of a unique cultural and political system, but also symptoms of a system vastly oversupplied with physicians. Early signs in Canada of similar "products" of a growing physician supply are noted. While a two-country comparison makes drawing lessons somewhat speculative, the coincidence of events suggests that these trends in Canada warrant, if not immediate action, at least careful monitoring.

Adult↗
PubMed1992

Debates, divisions, and decisions: recombinant DNA advisory committee (RAC) authorization of the first human gene transfer experiments.

Possibly the most far-reaching, controversial research currently being conducted in the international biological science community involves human gene therapy experimentation. In this paper, I report the dynamics of the political process which ultimately found the Recombinant DNA Advisory Committee (RAC) of the National Institutes of Health approving for the first time protocols of this genre. A full appreciation of the policy-making dialogue shows that significant participants perceived the process from very different vantage points regarding the way in which the American political system works and the way in which it ought to work. I argue that, if we are to understand how the RAC should proceed in orchestrating a human gene therapy policy agenda, then we must flesh out and critically analyze these competing vantage points. To that end, I postulate seven possible "action models" for characterizing how protocol assessments of the type at issue might be developed given the nature of our politics, reaching the conclusion that one of these models holds out the most promise for synthesizing efficaciously the key factors involved. In conclusion, I discuss how the RAC might profitably employ this preferred strategy in these and other cases.

Advisory Committees↗