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Professional socialization: implications for occupational therapy education.

This article examines the implications that adult socialization theory can have on occupational therapy education. Sociological literature about professional socialization is reviewed and related to the preparation of occupational therapists. The discussion includes a description of the goals, processes, and participants in professional socialization. Consistency of socializing influences is presented as a critical factor in the formation of strong professional role identities. Finally, the article considers which values and attitudes may be transmitted during the socialization process for occupational therapists and other health professionals.

Adult

Lifestyle, metabolic control and social implications of pump therapy in 54 routine type I diabetic patients.

Our aims were to evaluate the clinical and social implications of continuous subcutaneous insulin infusion (CSII) in ordinary type 1 diabetics, followed on a routine basis using a simple (Mill Hill) or a more complex (Microject MC20, Ames) pump. Fifty four type 1 diabetics were studied during 2 randomized periods of 4 months, one of conventional treatment (CT) (2 to 3 injections/day, self blood glucose (BG) monitoring) and the other of CSII. Each period was preceded by a 5 day training course. We studied clinical parameters, metabolic control (daily values of BG strips, urine analysis, insulin reactions, HbA1c), and acceptability of the treatment to the patient and their relatives. We also recorded all their unexpected phone-calls, consultations and admission to hospital. Thirty-four patients the initial cohort, completed the study, 7 dropped-out, 9 interrupted CSII, mainly because of skin problems and 4 refused to revert back to CT. During CSII, patients noted slight disturbance of sleep (30%), sexual activity (68%), and the wearing of clothes (26%). The main concern was with moderate skin problems (71%) whereas the main advantages were dietary liberalization, reduced numbers of insulin reactions and an improved feeling of well being. The type of pump used did not affect the results. Though acceptability was good in every patient trying the pump, it was better in those who asked to keep the pump after the trial (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Facial plastic surgery for persons with Down syndrome: research findings and their professional and social implications.

The literature on the effectiveness of facial surgery for persons with Down syndrome was reviewed. Research based on impressions of involved persons (e.g., parents and doctors) generally provided evidence for the surgery's effectiveness. However, studies that used before-after research designs, control groups, indirect measures, and ratings of less involved persons were less supportive of the operation's positive effects. Certain of these studies indicated that the operation failed to achieve its goals. Furthermore, in evaluations of the operation, investigators generally did not critically examine the assumptions upon which the operation is based and the professional and social implications of facial surgery for persons with Down syndrome.

Adolescent

Fetal surgery: the social implications of medical and surgical treatment of the unborn child.

Advances in microsurgery provide physicians with the opportunity to correct malformations of the fetus prior to birth. However, these techniques are being developed at a time when the legal status of the unborn is unclear and the rights of pregnant women to determine the nature of their care are not universally recognized. This paper examines some of the social implications of medical and surgical treatment of the fetus. In attempting to clarify the rights of pregnant women in relationship to the rights of the fetus, the authors examine the law related to abortion and the protection of the fetus after it has achieved viability. Ambiguities in the legal interpretations of viability, coupled with societal ambivalence over the rights of women have resulted in confusion. Several cases have been reported in which the courts overrode an otherwise competent woman's refusal of surgery in the interest of the unborn fetus. Thus, legal precedent exists for the judicial suspension of the rights of pregnant women to consent or refuse medical or surgical treatment. This trend in the law may reflect more conservative values regarding the rights of women. At the same time, the benefits to the fetus remains unexamined outside of a medical frame of reference.

Congenital Abnormalities

Social implications of multiple pathology.

The degree of multiple pathology in 184 consecutive patients admitted to a geriatric unit was recorded using the 13 commonest conditions present at the time of admission to provide a standard group of disorders for comparison. All of the conditions were chronic in nature, and 35% of the patients had a combination of four or more of these present. Multiple pathology was associated with poor prognosis in terms of mortality and the need for long-term institutional care. Families, including those who were elderly, continued to support most of the frail elderly people even in the presence of multiple pathology. This emphasizes the social implications of multiple pathology and the need for support and information in the management of long-term disability.

Aged

Social implications of the "dyscontrol syndrome" (neuropsychiatric correlates).

The recent literature contains numerous publications which have tried to stimulate a new and biologically oriented approach to the problem of violence. Experimental brain research indicates that biologically important predatory and aggression responses have multiple representations in the nervous system. However, knowledge gained so far concerning emotional brain function in violent persons with brain disease, or from experimental research, can only infrequently be applied to combat the violence-triggering mechanisms in the brains of the non-diseased. In the hope of determining the neurological basis of aggression, the present author studied the brains of forty-two patients whose clinical history indicated definite aggressive behaviour. Results are reported and discussed. It is also the aim of this paper to discuss the social implications of the surgical treatment of patients with a "dyscontrol syndrome" whose investigations do not reveal definite evidence of "hard" signs and symptoms of brain pathology.

Aggression

Stigmatization of carrier status: social implications of heterozygote genetic screening programs.

Possible latent psychological and social consequences ensuing from genetic screening programs need to be investigated during the planning phase of national genetic screening programs. The relatively few studies which have been performed to determine psychological, social, and economic consequences resulting from a genetic screening program are reviewed. Stigmatization of carrier-status, having major psychosocial implications in heterozygote genetic screening programs, is discussed and related to Erving Goffman's work in the area of stigmatization. Questions are raised regarding the relationship between such variables as religiosity and sex of the individual and acceptance of the status of newly identified carrier of a mutant gene. Severity of the deleterious gene and visibility of the carrier status are two important factors to consider in an estimation of potential stigma. Specific implications are discussed for four genetic diseases: Tay-Sachs, Sickle-Cell Anemia, Huntington's disease and Hemophilia.

Anemia, Sickle Cell