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The article examines abstracts of papers submitted but not included in the program of the annual meeting of the American Public Health Association, Medical Care Section, 1962. Some of these are "Experiences and Activities at a Medical Computing Center," by L.D. Cady, M.A. Woodbury, and L.J. Tich and "An Internist's Experiences With Medical Care of Welfare Patients in Proprietary Nursing Homes," by Sidney M. Greenberg. The first abstract focuses on the center that is cooperating with investigators in the area of mathematical and theoretical analysis and statistical data handling and analysis, information coding, keypunching and storage of medical data for further study and retrieval. The second abstract contains observations of the medical, nursing, and administrative practices in four nursing homes as made by an internist responsible for the medical Scare of welfare patients in these homes. In evaluating these activities the recognition and meeting of the patient's total needs was utilized as the criterion of quality of performance.

The paper deals with the organizational context of medical practice, help-seeking, and illness behavior in a manner which attempts to show their relevance to more extensive sociological issues. In the first part of the paper, both the advantages and costs of bureaucratization of medical practice are discussed in relation to changes in society itself. The second part of the paper deals with the strategy for developing a social psychological help-seeking model. Although the entire paper attempts to identify strategic areas for research in medical sociology, the third part of the paper is more specifically directed to needed areas in research. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to test the hypothesis that oldest daughters are more likely to become pediatric nurse than girls: in other sibling positions. A test of this hypothesis was made on a sample of 109 student nurses at the Children's Hospital School of Nursing. The hypothesis was accepted for students who come from large sibling.. groups (four or more siblings), and rejected for students who come from sibling groups of three or fewer members. The theory advanced to account for this phenomenon was that oldest daughters were more likely to be strongly identified with their mothers and to choose an occupation with a feminine orientation. It is felt that more evidence is needed to substantiate the theory, although there are indications that it may be valid. These data suggest extensions of this study. It might be of special interest to study the mothers of these girls to discover the characteristics of women who might develop in their daughters a strong feminine identification. Very little information is available on this point except as daughters mentioned it more or less incidentally in their answers to the questionnaire. Also, it would be of interest to know what happens to the other. members of these sibling groups. Do other daughters in these groups become housewives, enter other kinds of nursing schools, or choose careers entirely in contrast with those of their pediatric nursing sisters. A special contribution of this paper is the method used to test a hypothesis relating to sibling position. This variable has perhaps been neglected due to its complexity. Many clinical studies, however, give the impression that sibling position is an important variable in the formation of personality. Results of this study suggest that sibling position is indeed important in the selection of a career in pediatric nursing, if one simultaneously takes into account number and sex of siblings. [ABSTRACT FROM AUTHOR]

The article presents abstracts of various research papers published in the June 1961 issue of "Journal of Health and Human Behavior." One of the abstract discusses the relationship between and intrapsychic processes. Another abstract presents a study which attempts to ascertain, and account for, the presence of significant differences in knowledge of attitudes toward mental disease between a sample of high school boys and one from a boys' reformatory. The purpose of one of the papers on hospital-patient relationships is to clarify the precise nature of the relationship between mental hospitals and patients and to compare and contrast it with the relationship between medical hospitals and patients. Another paper on mental hospitals presents information about four types of "pathway" organizations which seek to assist in the transitional period between the discharge of a mental patient from a hospital and his re-entry into community life. The four general types considered are day hospitals, halfway houses, sheltered workshops, and ex-patient organizations.

The main purpose of this article is to draw special attention to ideas developed, questions raised, and opinions expressed by some working scholars invited to present research papers on teaching the social sciences in medical schools at the 1959 meetings of the Society for Applied Anthropology held in Madison, Wisconsin. These research papers advance ideas about research and teaching that can add new dimensions to the management of conditions having obvious psychosocial components: alcoholism, hypertension, mental illness, chronic complaints of unclear etiology and so on. By training, and because of his recent advent to the medical area, the social scientist is uniquely qualified to seek to apply the "stress" theory of illness to these complaints. Another area of concern relates to social science in patient management. Nurses, social welfare workers and psychologists, as well as some medical sociologists, already participate in some aspects of patient management. There are many obstacles to the successful integration of social or behavioral science in the medical curriculum.

There is a significant lack of patient-centered studies in current socio-medical research, and also very little use made of experimental designs. As a departure from this trend, this paper presents the design and result s of a clinical experiment indica-. ting greater effectiveness of a patient-centered nursing approach used to administer a standard nursing procedure. [ABSTRACT FROM AUTHOR]

Previous theory and research in role conflict provided empirical tools and hypotheses regarding conflict resolution. A pencil-and-paper conflict situation was administered to workers in a mental hospital, a setting previously described as conflict- ridden. A positive association was found between mode of conflict resolution, ideology and worker's effectiveness as a hospital employee. [ABSTRACT FROM AUTHOR]

This paper presents a descriptive process' for understanding disclosure of terminal illness. This process combines both (1) the stages typically present in the response stimulated by such disclosure and (2) the characteristic forms of interaction between the patient and hospital staff at each stage of the process. [ABSTRACT FROM AUTHOR]

The increasing concern with social structural factors affecting the treatment process of the hospitalized mental patient has led to a reconsideration of the organization of services provided for patients in these settings. A new format-the unit system-has been designed to enhance the therapeutic potentiality of the large mental hospital by decentralizing the treatment activities of both patients and staff members. This paper examines the unit system in terms of organizational theory, indicating some of the more problematic issues and concerns activated by a decentralization move. [ABSTRACT FROM AUTHOR]

It is the major contention of this paper that one avenue of approach to the problem of a shortage of physicians in the U.S.A. is the proper utilization of paramedical personnel. Physicians tend to resist the transfer of traditional medical functions to others for a variety of reasons which are discussed. These factors are: conservatism, economic self-interest and specialization; the issue of "final medical responsibility"; delegation versus surrender of function; and comprehensiveness of function. Decreasing resistance in the future is posited and reasons discussed. [ABSTRACT FROM AUTHOR]

This paper examines the internal and external stresses which accompany the gradual shift of responsibility from local boards of health to a possible eventual domination by the state health department. Fifty seven members of boards of health in 14 communities in one county in Eastern Pennsylvania were interviewed on the present functions of the local boards of health. Our finding suggests that the local board of health is not simply an organization. It is symbolic of a way of life in a community and it represents many things-a part of town, individualism, self-rule. [ABSTRACT FROM AUTHOR]

This paper reports a study of 49 families of ambulatory schizophrenics and 52 families of hospitalized schizophrenics. The obtained data were related to Wolman's power and acceptance theory, and divided into instrumental, mutual and vectorial relations. In all 101 families each parent expected the other parent to be his parent. A reversal in social roles was the general rule in all the investigated families. Parents disappointed in one another fought against each other and the child was expected to satisfy their emotional needs. The conclusion was made that in schizogenic families, the parents turned children and the child was forced into a premature pseudo-parental hypervectorial role that leads to schizophrenia. [ABSTRACT FROM AUTHOR]

Different classes of behavior may be degraded by traumatic physical disability. Description of the disabled adult patient in terms of emotional and symptomatic responses, such as anxiety, depression, denial of disability, etc., does not have systematic therapeutic implications. This paper proposes a classification scheme in terms of basic personal-social functions. Intra-personally, the disability may result in reduced executive control over behavior, difficulties in interpreting and integrating bodily cues, inability to channel and focus energy in the direction of remaining performance capabilities, and self-devaluation. Inter-personally, the disability may result in impaired social communication, inadequate social goal-setting, and difficulties in development of appropriate role-behaviors. [ABSTRACT FROM AUTHOR]

This paper coin pares the conceptions of mental illness held by a group of psychiatrists and a random sample of the general public in the same locality. The hypothesis was that the public, but not the psychiatrists, would tend to consider troublesome behavior as being more indicative of mental illness than non-troublesome behavior. Statements representing five pairs of troublesome non-troublesome types of behavior were rated by both groups as indicators of mental illness. Analysis of the data, using the statements at face value and with a weighting system, did not support the hypothesis. Both public and psychiatrists appear to have similar views but not in the expected order. Most notably, manic behavior ranked very low among the conceptions of mental illness. This finding accords with recent reports of a decline in the incidence of manic- depressive psychoses. Is this decline due to changes in modern society that alter public and psychiatric conceptions of mental illness? [ABSTRACT FROM AUTHOR]

The purpose of this paper is to demonstrate that "total institutions," specifically state operated mental hospitals, contain two cultures: (1) that brought by the inmates and (2) that found in the "institution." Attempts to develop a therapeutic milieu in mental hospitals have been largely directed to `modification of the social structure and have largely ignored cultural norms. There appears to be an implicit assumption that a therapeutic community may be achieved through a social structure with certain universal characteristics. A study of selected background norms of patients in one such "therapeutic milieu" revealed significant differences from the norms of behavior maintained on the ward. [ABSTRACT FROM AUTHOR]

Labor unions are slowly becoming related to the special needs of the chronically ill. This paper reports one labor-health program's study of the impact of chronic illness on union member households and the potential demand for rehabilitation. The findings of this study led to recommendations for closer union involvement in the vocational aspects of rehabilitation, modification of the disabled worker's expectations regarding help, and new patterns of relations between labor and the public vocational rehabilitation agencies. An action program is currently underway to implement these recommendations. [ABSTRACT FROM AUTHOR]

As part of a study of the ways in which boards of trustees influence hospital decisions, this paper reports on the historical changes in the participation patterns of economic influentials (EI's) on the board and degree of control they manifested over present day decisions. Historically, there was only a slight decline in El representation on the board with an increasing trend toward EI representation in strategic organizational positions. A "pecking order" of control was observed: The EI's exerted the most control over management, next over their non-EI fellow board members. Several advantages and disadvantages of such control are explored. [ABSTRACT FROM AUTHOR]

One of the most universal complaints of hospitalized patients in Western society is that they do not have enough communication with hospitalized functionaries. This paper briefly reviews the meaning and function of communication to hospitalized patients and some barriers to that communication. Possible reasons for lack of communication between patients and hospital functionaries are examined from the standpoint of their relation to the ends of the hospital as a social organization and the possible anticipated and unanticipated consequences of such a policy for the therapeutic process. Finally, a series of propositions are developed in regard to communication between nurses and hospitalized patients, and physicians and hospitalized patients. [ABSTRACT FROM AUTHOR]

The Spanish-speaking villagers of the mountain valleys of northern New Mexico and southern Colorado, isolated for centuries from outside influence, have retained a folk medical system which, at times, is at odds with that of the "scientific" medical community. The concept of good or normal health is basically equated to that of "adequately functioning" in one's age-sex role. The common criteria for identification as healthy are: (1) a high level of physical activity, (2) a well-fleshed body, and (3) the absence of pain. A basic purpose of this paper has been to define in detail the culturally specific elements of these criteria. [ABSTRACT FROM AUTHOR]

A fresh humanistic spirit has swept through medicine in the last 25 years, partly in reaction to the enormous technological strides and emphases of the previous period, partly in response to democratic forces in the larger society. One expression of this spirit is seen in the new conceptions of medical education, and even in the design of medical school buildings and teaching hospitals; the implementation of this approach at a new medical center in Kentucky is explained in the following paper. [ABSTRACT FROM AUTHOR]

In the health insurance movement, the provision of drugs has been one of the medical needs least well met. One prepaid medical care plan has pioneered in an effort to meet this need, and its precise experience is reported in this paper. [ABSTRACT FROM AUTHOR]

The article considers social factors conditioning recruitment of nurses in Israel. Occupational recruitment of women to sex-linked occupations is a problem involving at least two major complexes of social factors: those associated with occupational recruitment in general, that is, for members of both sexes; those associated with female social roles in the society and the structural relationship between such roles and the occupational system. The major theoretical complexes are viewed as crucial to choosing nursing as an occupation in Israel. These are, first, an essentially affective-nurturant component in the young recruit's personality, and second, a seeking after social status which, when viewed against the background of the Israeli occupational system, will be seen to place nursing in a relatively favorable position in the occupational status hierarchy, particularly for girls from lower class families of orientation. This paper has demonstrated the importance of two variables in conditioning an interest in nursing among high school girls in Israel.

The article presents the abstracts of various research papers published in the December 1960 issue of the journal " Journal of Health and Human Behavior". One of the abstracts talks about pat terns of role dominance and conflict in parents of schizophrenic patients. The main purpose of this study was to test the hypothesis that there is an association between the sex of the dominant parent and the premorbid adjustment of the schizophrenic son. Another abstracts talks about innovation, integration, and marginality. It is suggested that innovations of different kinds find readiest adoption among individuals in different positions of the social structure. Another abstracts talks about research needs in the vocational rehabilitation of the deaf. The research needs are analyzed in terms of psychological assessment of the deaf; the language, problems of the deaf; the sub-culture of the deaf, with particular emphasis on the barriers to social participation by deaf persons in the hearing community.

This article presents various abstracts related to the field of human health and behavior. The first one is "Sociological Aspects of Aging," by Howard E. Jensen. The author stresses the disparate, though complimentary, biological and sociological problems of aging. The aging of an individual, as a sociocultural phenomenon, is defined not by physical deterioration or by time but by the value system of his society. The author points out that the simplest part of the sociological problem of aging is to ascertain the objectively determinable physical needs of the aged and to provide for them. The next abstract is "The Sentence Completion Test As a Predictor of Continuation in Psychotherapy," by E. Wesley Hiler. The purpose of this study was to evaluate the Michigan Sentence Completion Test as a predictor of a patient's prematurely terminating therapy. Another abstract is "Decision-Making in a Mental Hospital: Real, Perceived, and Ideal," by Mark Lefton, Simon Dinitz and Benjamin Pasamanick. This paper attempts to examine the decision-making process in a small, institute type of psychiatric hospital in terms of differences in real, perceived and ideal influence patterns of 53 mental health specialists.

The article discusses social knowledge in medicine. An appreciation of the importance of social knowledge is growing among physicians. Papers by physicians in the first issue of the "Journal of Health and Human Behavior," emphasize this fact. Awareness of the social factors in health and disease in the minds of doctors, however, is not universal. Social knowledge in the medical setting is important not only for doctor, nurse, and interne. It is important in the patient. The patient's understandings, misunderstandings, loves, hates, fears, and reassurances, which grow out of his appreciation, or lack of appreciation, of his life situation, obviously affect his food and drink habits, his attitude toward medical care and convalescence, and his motivation to stay well. Research in medical care, in the minds of the respondents, should be directed toward the social structure and its influence on the practice of medicine, doctor-nurse-patient relations, medical settings and institutions, the personalities of doctor, patient, nurse, and the ecology and economics of medical care.

The article presents information about this special "Medical Care Issue," which presents reports of several specific programs that illustrate contributory streams in this larger movement of medical care organization. The variety in the movement derives from locality as well as content. One report in this issue comes from the Appalachian coalfields, where new forms of consumer-sponsored prepaid group medical practice are evolving. Another comes from the nation's capital, where a long established health insurance plan has added drugs to its benefits. Another comes from New York City, where organized "home care" has been explored, for the first time as a feature of hospitalization insurance. Another comes from Southern California, where efforts are being made to up-grade the quality of nursing homes. Another comes from a college town in Kentucky, where a great new medical center is being established. Two papers of generic orientation are then presented: one is on the economic characteristics of health services and how they differ from other services or commodities. The final paper offers a review of sociological research conducted on the organization of medical care over the years.