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Interview data from a two and a half year study of 20 District General Managers (DGMs) from a wide variety of backgrounds confirmed the view that there has been widespread…
Interview data from a two and a half year study of 20 District General Managers (DGMs) from a wide variety of backgrounds confirmed the view that there has been widespread dissatisfaction about the work of the District Medical Officer (DMO). This dissatisfaction was often mirrored by the DMOs themselves. We therefore supplemented the interviews with a questionnaire listing 16 principal functions of community medicine and asked the DGMs and their DMOs independently to rate the amount of attention devoted by the DMO to each function both currently and ideally. We found a contrast between the overall uncertainty and concern expressed about community medicine during discussions, and the enthusiasm for the itemized community medical functions. There was close correlation between the DGMs' and DMOs' mean rates, which were always higher in the ideal than the current rating, and particularly so for the DMO's work in information and assessment of need, in service evaluation, and — only among the DMOs' responses — in the independent advocacy of public health. We present the detailed results for all the functions, and discuss the implications of these and our interview data for the implementation of the Acheson Report and for the managerial education of public health physicians.
The purpose of this paper is to draw attention to the work of sociologists who laid the foundation for queer and crip approaches to disability and to address how queer and…
The purpose of this paper is to draw attention to the work of sociologists who laid the foundation for queer and crip approaches to disability and to address how queer and crip theory has and can help to re-conceptualize our understandings of health, illness, disability, and sexuality.
This paper is an examination of historical moments and prominent literature within medical sociology and sociology of disability. Sociological and popular understandings of disability and sexuality have often mirrored each other historically. Although this literature review focuses primarily on medical sociology and disability studies literature, some works of scholars specializing in gender studies, sexuality, literature, history, and queer studies are also included
In this paper, I argue that the medicalization and pathologization of human differences specifically as it pertains to sexuality and disability within the medical sociological literature have led to constructionist, social model, and feminist critiques. It is these critiques that then laid the foundation for the development of queer and crip theoretical approaches to both disability and sexuality.
Crip and queer approaches to disability provide a clear call for future sociological research. Few social science scholars have applied queer and crip approaches in empirical studies on disability. The majority of work in this area is located in the humanities and concerned with literary criticism. A broader array of empirical work on the intersection of sexuality and disability from queer/crip perspectives is needed both to refine these postmodern theoretical models and to examine their implications for the complex lived experience that lies at the intersection of sexuality and disability. In queering disability and cripping sexuality and gender, we may be able not only to more fully conceptualize disability, sexuality, and gender as individual social categories, but also to more fully understand the complex intersection of these social locations.
A technological community framework can be used to explain and manage new medical technologies. It describes emergence, commercialization, and standardization of an…
A technological community framework can be used to explain and manage new medical technologies. It describes emergence, commercialization, and standardization of an innovation or technology within the context of its whole network (or community) of stakeholders. This framework is used to illustrate the emergence, commercialization, and standardization of a relatively new medical technology – umbilical cord blood (UCB) banking. Umbilical cord blood may prove to be a source of stem cells for bone marrow transplant that is safer, more accessible, and less expensive than current sources of stem cells. The technological community framework can signal potential problems as the technology emerges, and help healthcare delivery systems and providers to effectively assess and manage the technology. The framework can also be applied to other medical technologies and innovations.
This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized…
This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative information technology open architecture design and integrating Radio Frequency Identification Device data technologies and real-time optimization and control mechanisms as the critical technology components of the solution. The innovative information technology, which pursues the focused logistics, will be deployed in 36 months at the estimated cost of $568 million in constant dollars. We estimate that the Systems, Applications, Products (SAP)-based enterprise integration solution that the Army currently pursues will cost another $1.5 billion through the year 2014; however, it is unlikely to deliver the intended technical capabilities.
One of the most serious problems facing the country today is maintaining dietary standards, especially in the vulnerable groups, in the face of rising food prices. If it were food prices alone, household budgetry could cope, but much as rising food prices take from the housewife's purse, rates, fuel, travel and the like seem to take more; for food, it is normally pence, but for the others, it is pounds! The Price Commission is often accused of being a watch‐dog which barks but rarely if ever bites and when it attempts to do this, like as not, Union power prevents any help to the housewife. There would be far less grumbling and complaining by consumers if they could see value for their money; they only see themselves constantly overcharged and, in fact, cheated all along the line. In past issues, BFJ has commented on the price vagaries in the greengrocery trade, especially the prices of fresh fruit and vegetables. Living in a part of the country given over to fruit farming and field vegetable crops, it is impossible to remain unaware of what goes on in this sector of the food trade. Unprecedented prosperity among the growers; and where fruit‐farming is combined with field crops, potatoes, cabbage, cauliflower and leafy brassicas, many of the more simple growers find the sums involved frightening. The wholesalers and middle‐men are something of unknown entities, but the prices in the shops are there for all to see. The findings of an investigation by the Commission into the trade, the profit margins between wholesale prices and greengrocers' selling prices, published in February last, were therefore not altogether surprising. The survey into prices and profits covered five basic vegetables and was ordered by the present Prices Secretary the previous November. Prices for September to November were monitored for the vegetables—cabbages, brussels sprouts, cauliflowers, carrots, turnips and swedes, the last priced together. Potatoes were already being monitored.
The general population relies on the healthcare system for needed care during disasters. Unfortunately, the system is already operating at capacity. Healthcare facilities…
The general population relies on the healthcare system for needed care during disasters. Unfortunately, the system is already operating at capacity. Healthcare facilities must develop plans to accommodate the surge of patients generated during disasters. The purpose of this paper is to examine a concept for providing independent, technologically advanced medical surge capacity via a Convertible Use Rapidly Expandable (CURE) Center.
To develop this concept, a site was chosen to work through a scenario involving a large earthquake. Although the study‐affiliated hospital was built with then state‐of‐the‐art technologies, there is still concern for its continued functioning should a large earthquake occur. Working within these parameters, the planning team applied the concepts to a specific educational complex. Because this complex was in the initial building stages, required attributes could be incorporated, making the concept a potential reality. Challenges with operations, communications, and technologies were identified and addressed in the context of planning for delivery of quality healthcare.
The process highlighted several requirements. Planning must include community leaders, enhanced by agencies or individuals experienced in disaster response. Analyzing regional threats in the context of available resources comes first, and reaching a consensus on the scope of operation is required. This leads to an operational plan, and in turn to understanding the needs for a specific site. Use of computer modeling and virtual deployment of the center indicates where additional planning is needed.
Previous strategies for increasing surge capacity rely on continued availability of hospital resources, alternative care sites with minimal medical capability, or, costly hospital expansions. Development of a site‐specific CURE Center can allow communities to provide fiscally responsible solutions for sustained medical care during disasters.
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.
This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.
We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.
Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.
Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.
There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.
The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides:
Purpose – This study examines the consequences of sudden influx of medicalized discourse of gender in Japan by introduction of gender identity disorder (GID) in the late…
Purpose – This study examines the consequences of sudden influx of medicalized discourse of gender in Japan by introduction of gender identity disorder (GID) in the late 1990s where transgender identities and the LGBT activism have had a different history and meanings from Western societies.
Methodology – I use discourse analysis of autobiographies of people with GID in Japan and the limited studies concerning the history of GID and transgender in Japan.
Findings – The introduction of GID to Japanese society contributed to increased social awareness of transsexual individuals. However, it also resulted in transsexual fundamentalism, which has excluded individuals who do not meet certain rigid medical and social identity criteria. This development reinforces the conventional binary gender norms instead of problematizing them. Furthermore, a legislation strictly based on the diagnosis has produced two groups: transsexual individuals with GID diagnosis who will be legally and socially recognized as legitimate, and those who are not GID and thus undeserving of such recognitions.
Social implications – Diagnosis cannot exist without criteria, therefore it is impossible for GID to function as an inclusive identity category. Therefore, we must seek a system to provide medical services that do not necessitate diagnosis. It is also crucial to nurture the social environment where people can freely choose gender identities and expressions that go beyond conventional binary gender system and to keep insisting on plurality and fluidity of gender so that people do not have to rush for a narrow window of recognition.
An analysis of community health, its history, successes and failures, depends on an understanding of its scope, but there is little consensus as to precisely what the discipline entails. Some view it as a strict scientific discipline, others see it as a social movement, and still others conceive of it as a conglomerate of various disciplines. It is useful initially to identify the medical components of community health, and then to approach its interdisciplinary aspects. Community health, strictly defined, includes such fields as disease control, environmental sanitation, maternal and child care, dental health, nutrition, school health, geriatrics, occupational health, and the treatment of drug and alcohol abuse. This limited definition, though accurate, does not differentiate the field from the much older area of public health. Within community health, the disease focus of traditional public health epidemiology, the total health focus of community medicine, and the outcome focus of health services research are interconnected. Community health combines the public health concern for health issues of defined populations with the preventive therapeutic approach of clinical medicine. An emphasis on personal health care is the result of this combination. Robert Kane describes the field accurately and succinctly: “We envision community medicine as a general organizational framework which draws upon a number of disciplines for its tools. In this sense, it is an applied discipline which adopts the knowledge and skills of other areas in its effort to solve community health problems. The tools described here include community diagnosis (which draws upon such diverse fields as sociology, political science, economics, biostatistics, and epidemiology), epidemiology itself, and health services research (the application of epidemiologic techniques on analyzing the effects of medical care on health).”