Subjects -> HEALTH AND SAFETY (Total: 1527 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (88 journals)
    - HEALTH AND SAFETY (721 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (381 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (113 journals)
    - PHYSICAL FITNESS AND HYGIENE (120 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (721 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
ACM Transactions on Computing for Healthcare     Hybrid Journal  
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 29)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 2)
African Health Sciences     Open Access   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 5)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 38)
Aging and Health Research     Open Access   (Followers: 7)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 8)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 2)
Akademika     Open Access  
American Journal of Family Therapy     Hybrid Journal   (Followers: 6)
American Journal of Health Economics     Full-text available via subscription   (Followers: 18)
American Journal of Health Education     Hybrid Journal   (Followers: 35)
American Journal of Health Sciences     Open Access   (Followers: 11)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 32)
American Journal of Public Health     Full-text available via subscription   (Followers: 188)
American Journal of Public Health Research     Open Access   (Followers: 30)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 8)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Clinical Medicine and Public Health     Open Access   (Followers: 11)
Annals of Global Health     Open Access   (Followers: 11)
Annals of Health Law     Open Access   (Followers: 6)
Applied Ergonomics     Hybrid Journal   (Followers: 17)
Apuntes Universitarios     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 9)
Archivos de Prevención de Riesgos Laborales     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 7)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Asian Journal of Social Health and Behavior     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access  
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 5)
Bijzijn XL     Hybrid Journal  
Biograph-I : Journal of Biostatistics and Demographic Dynamic     Open Access   (Followers: 5)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 7)
Biosafety and Health     Open Access  
Biosalud     Open Access  
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 20)
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 48)
Buletin Penelitian Kesehatan     Open Access  
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access  
Cadernos de Saúde     Open Access  
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 14)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 13)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 25)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
CASUS : Revista de Investigación y Casos en Salud     Open Access  
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access  
Child and Adolescent Obesity     Open Access   (Followers: 4)
Child's Nervous System     Hybrid Journal  
Chinese Journal of Physiology     Open Access   (Followers: 1)
CHRISMED Journal of Health and Research     Open Access   (Followers: 1)
Christian Journal for Global Health     Open Access   (Followers: 1)
Ciencia & Salud     Open Access  
Ciencia & Trabajo     Open Access  
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 1)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access  
Cities & Health     Hybrid Journal   (Followers: 4)
Cleaner and Responsible Consumption     Open Access   (Followers: 5)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 1)
Cuaderno de investigaciones: semilleros andina     Open Access  
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal  
D Y Patil Journal of Health Sciences     Open Access   (Followers: 1)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal  
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 12)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access  
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 22)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 23)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 8)
ElectronicHealthcare     Full-text available via subscription   (Followers: 2)
Emerging Trends in Drugs, Addictions, and Health     Open Access   (Followers: 4)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 3)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 6)
EsSEX : Revista Científica     Open Access  
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access  
Ethics & Human Research     Hybrid Journal   (Followers: 4)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 6)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access  
European Journal of Health Communication     Open Access   (Followers: 5)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Exploratory Research in Clinical and Social Pharmacy     Open Access   (Followers: 5)
Expressa Extensão     Open Access  
F&S Reports     Open Access  
Face à face     Open Access  
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Hybrid Journal   (Followers: 13)
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Relations     Partially Free   (Followers: 11)
FASEB BioAdvances     Open Access  
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 11)
Food Hydrocolloids for Health     Open Access   (Followers: 6)
Food Quality and Safety     Open Access   (Followers: 2)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Neuroergonomics     Open Access  
Frontiers in Public Health     Open Access   (Followers: 7)
Frontiers of Health Services Management     Partially Free   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 2)
Galen Medical Journal     Open Access  
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 8)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Annual Review     Open Access   (Followers: 2)
Global Health Innovation     Open Access  
Global Health Journal     Open Access   (Followers: 2)
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Public Health     Open Access   (Followers: 15)
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access  
Global Transitions     Open Access  
Global Transitions Proceedings     Open Access   (Followers: 5)
Globalization and Health     Open Access   (Followers: 7)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 5)
Health and Human Rights     Open Access   (Followers: 9)
Health and Research Journal     Open Access  
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 62)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 2)
Health Care Analysis     Hybrid Journal   (Followers: 13)
Health Equity     Open Access   (Followers: 2)
Health Information : Jurnal Penelitian     Open Access  
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 44)
Health Policy and Technology     Hybrid Journal   (Followers: 5)
Health Policy OPEN     Open Access  
Health Promotion International     Hybrid Journal   (Followers: 23)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 7)
Health Prospect     Open Access  
Health Psychology     Full-text available via subscription   (Followers: 56)
Health Psychology Bulletin     Open Access   (Followers: 1)
Health Psychology Research     Open Access   (Followers: 21)

        1 2 3 4 | Last

Similar Journals
Journal Cover
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
Number of Followers: 11  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1363-4593 - ISSN (Online) 1461-7196
This journal is no longer being updated because:
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  • A solidarity paradox – welfare state data in global health data
           economy

    • Free pre-print version: Loading...

      Authors: Karoliina Snell, Heta Tarkkala, Aaro Tupasela
      Abstract: Health, Ahead of Print.
      Nordic welfare states have well institutionalised practises of gathering health and social wellbeing data from their citizens. The establishment of population registers coincided with the building of welfare state institutions and a social contract relying on solidarity. During the last decade, the significance of Nordic registers and health data has increased and they have become sources of economic value. Recent policies expect registers, health data and biobanks to attract international investments, making Nordic countries world-leaders in the global health data economy. In this article we question the conditions and boundaries of solidarity in the emerging data-driven health economy. We argue that the logics of welfare state and data-driven health economy create a paradox – the data economy is not possible without the welfare state data regime, but the logic of data-driven health economy contradicts the value bases of the welfare state data regime and therefore the justifications for data gathering and use become questionable. We develop the concept of solidarization to describe the process by which individuals are expected to behave in a solidaristic way to support data gathering and related policy processes. We demonstrate the solidarity paradox through a recent legislative and data infrastructure reform in Finland and discuss it in relation to academic literature on solidarity.
      Citation: Health
      PubDate: 2021-12-30T06:38:08Z
      DOI: 10.1177/13634593211069320
       
  • Corona hotels in Israel: Care and abandonment under the auspices of
           digital medicine

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      Authors: Shirly Bar-Lev
      Abstract: Health, Ahead of Print.
      Following the onset of the COVID-19 pandemic, Israel established a number of ‘corona hotels’ – hybrid spaces that were neither fully treatment-oriented nor fully incarcerational, in which people known or suspected to be infected with the coronavirus were confined, sometimes for prolonged and indefinite periods. This paper describes the experience of 25 people who were confined in corona recovery and isolation hotels between March and July 2020. The corona hotels exemplify how remote medical technology and digital medicine together enable a new ‘technogeography of care’, where care and abandonment are inextricably linked. The paper adds to the growing number of critical studies on digital health by showing how the employed technologies impact the concepts of human embodiment, subjectivity and social relations, as well as how the occupants negotiated the meaning of these technologies and resisted their effects.
      Citation: Health
      PubDate: 2021-12-24T06:09:05Z
      DOI: 10.1177/13634593211067904
       
  • From domestication to imperial patronage: Deconstructing the
           biomedicalisation of occupational therapy

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      Authors: Pier-Luc Turcotte, Dave Holmes
      Abstract: Health, Ahead of Print.
      Occupational therapy knowledge emerged in the 19th century as reformist movements responded to the industrialisation of society and capitalist expansion. In the Global North, it was institutionalised by State apparatuses during the First and Second World Wars. Although biomedicine contributed to the rapid expansion and establishment of occupational therapy as a health discipline, its domestication by the biomedical model led to an overly regulated profession that betrays its reformist ideals. Drawing on the work of Deleuze and Guattari, our aim in this article is to deconstruct the biomedicalisation of occupational therapy and demonstrate how resistance to this process is critical for the future of this discipline. The use of arts and crafts in occupational therapy may be conceptualised as a ‘nomad science’ aesthetically resisting the domination of industrialism and medical reductionism. Through the war efforts, a coalition of progressive nurses, social workers, teachers, artisans and activists metamorphosed into occupational therapists. As it did with nursing, biomedicine proceeded to domesticate occupational therapy through a form of ‘imperial’ patronage subsequently embodied in the evidence-based movement. ‘Occupational’ jargon is widely used today and may be viewed as the product of a profession trying to establish itself as an autonomous discipline that imposes its own regime of truth. Given the symbolic violence underlying this patronage, the future of occupational therapy should not mean behaving according to biomedicine’s terms. As a discipline, occupational therapy must resist the appropriation of its ‘war machine’ and craft its own terms through the release of new creative energy.
      Citation: Health
      PubDate: 2021-12-24T06:03:06Z
      DOI: 10.1177/13634593211067891
       
  • Book Review: Critical Realism for Health and Illness Research: A Practical
           Introduction

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      Authors: Juma Kasadha
      Abstract: Health, Ahead of Print.

      Citation: Health
      PubDate: 2021-12-11T11:25:58Z
      DOI: 10.1177/13634593211065295
       
  • An auto-ethnographic reflection on the nature of nursing in the UK during
           the Covid-19 pandemic

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      Authors: Helen T Allan
      Abstract: Health, Ahead of Print.
      In this article I discuss the effects on the patient experience of isolation nursing during the CoronaVirus Disease (COVID)-19 pandemic. An unintended consequence of isolation nursing has been to distance patients from nurses and emphasise the technical side of nursing while at the same time reducing the relational or affective potential of nursing. Such distanced forms of nursing normalise the distal patient in hospital. I consider ways in which this new form of distanced nursing has unwittingly contributed to the continued commodification of nursing care in the British NHS. Autoethnography is used to describe and reflect on the illness experience, the experiences of caregivers and the sociocultural organisation of health care. The findings discuss three areas of the illness experience: intimate nursing care; communication; the ‘distanced’ patient experience.
      Citation: Health
      PubDate: 2021-12-11T11:24:43Z
      DOI: 10.1177/13634593211064122
       
  • Disciplinary differences in the study of the relationship between social
           variables and mental health: A systematic mapping review

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      Authors: Tegan Cruwys, Baptiste Brossard, Haochen Zhou, Gabriel Helleren-Simpson, Kathleen A Klik, Dirk Van Rooy, Philip J Batterham, Alison L Calear
      Abstract: Health, Ahead of Print.
      There has been sustained interest in the intersection between social constructs and mental health from diverse disciplines including psychiatry, sociology and public health. However, no systematic attempt has been made to catalogue what is meant by ‘social’ by different researchers, how variables deemed ‘social’ constructs are linked to mental health, nor whether these patterns differ by academic discipline. Understanding interdisciplinary differences and commonalities may reveal opportunities for interdisciplinary collaboration to enhance our understanding of how social factors relate to mental health. This article presents a prospectively registered systematic map of social approaches to mental health using an innovative synthesis methodology (coding all sentences from a random selection of N = 287 articles). Results indicated that although approaches are diverse, disciplinary overlap is substantial. Psychology and psychiatry led articles tend to focus on social skills or emotions as features of mental (ill-)health, while public health and social sciences led articles tend to focus on social relationships, status or context as determinants of mental (ill-)health. Medicine led articles were most likely to focus on social outcomes of mental (ill-)health. Potential growth areas are noted, particularly the relative dearth of intervention research drawing upon social approaches. The findings are discussed with a view towards enabling more effective interdisciplinary collaboration.
      Citation: Health
      PubDate: 2021-12-08T11:08:57Z
      DOI: 10.1177/13634593211063049
       
  • Constituting good health citizenship through British Columbia’s
           COVID-19 public updates

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      Authors: Philippa Spoel, Naomi Lacelle, Alexandra Millar
      Abstract: Health, Ahead of Print.
      The COVID-19 pandemic has augmented discourses of individual citizen responsibility for collective health. This article explores how British Columbia, Canada’s widely praised COVID-19 communication participates in the development of neo-communitarian “active citizenship” governmentalities focused on the civic duty of voluntarily taking responsibility for the health of one’s community. We do so by investigating how public health updates from BC’s acclaimed Provincial Health Officer Dr. Bonnie Henry articulate this civic imperative through the rhetorical constitution of the “good covid citizen.” Our rhetorical analysis shows how this pro-social communication interpellates citizens within a discourse of behavioral, epistemic, and ethical responsibilisation. The communal ethos constituted through this public health communication significantly increases the burden of personal responsibility for health beyond norms of self-care. Making the protection of community health primarily the responsibility of individual citizens also presumes a privileged identity of empowered, active agency and implicitly excludes citizens who lack the means to successfully fulfill the expectations of good covid citizenship.
      Citation: Health
      PubDate: 2021-12-08T05:05:32Z
      DOI: 10.1177/13634593211064115
       
  • Racial biases in healthcare: Examining the contributions of Point of Care
           

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      Authors: Sachil Singh
      Abstract: Health, Ahead of Print.
      Sophisticated algorithms are used daily to search through hundreds of medical journals in order to package updated medical insights into commercial databases. Healthcare practitioners can access these searchable databases—called Point of Care (PoC) tools—as downloadable apps on their smartphones or tablets to comprehensively and efficiently inform patient diagnosis and treatment. Because racist biases are unintentionally incorporated into the search reports that the companies generate and that practitioners regularly access, the aim of this article is to examine how healthcare practitioners’ “pre-existing” racial stereotypes interact with pithy conclusions about race and ethnicity in PoC tools. I use qualitative research methods (content analysis, discourse analysis, open-ended semi-structured interviews, and role play) to frame the analysis within the Public Health Critical Race Praxis (PHCRP). This approach facilitates an understanding of how biological racism—the use of scientific evidence to support inherent differences between races—that is embedded in PoC algorithms informs a practitioner’s assessment of a patient, and converges with persistent racial bias in medical training, medical research and healthcare. I contextualize the study with one semi-structured interview with an Editor of a leading PoC tool, MedScope (pseudonomized), and 10 semi-structured interviews with healthcare practitioners in S.E. Ontario, Canada. The article concludes that PoC tools and practitioners’ personal biases contribute to racial prejudices in healthcare provision. This warrants further research on racial bias in medical literature and curriculum design in medical school.
      Citation: Health
      PubDate: 2021-12-08T05:04:16Z
      DOI: 10.1177/13634593211061215
       
  • Individualizing the burnout problem: Health professionals’ discourses of
           burnout and recovery in the context of rehabilitation

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      Authors: Maija Korhonen, Katri Komulainen
      Abstract: Health, Ahead of Print.
      This discourse analytical study explores how health professionals (HPs) construct burnout as a form of mental distress in the context of Finnish burnout rehabilitation framed with a particular rehabilitation ethos. Burnout is a fuzzy concept and lacks a disease status. Therefore, it calls for context-specific definition and justification. By highlighting the socially and interactionally produced character of categories of mental distress, the study investigates the kinds of discourses HPs use to formulate “the problem” and its solutions, and how people dealing with burnout are categorized in these discourses. The data consists of field notes from the observation of group discussion sessions in two 1-year burnout rehabilitation courses. As a result of the analysis, five partly overlapping discourses were identified: psychological, evolutionary, healthy lifestyle, biomedical, and welfare. Within these discourses, people who experience burnout were categorized as over-conscientious employees, “good girls,” “primitive people,” self-responsible rehabilitees, patients, and (aging) employees with social and legal rights. Burnout rehabilitation and HPs’ views reproduce a cultural and clinical discourse around burnout in which work-related problems are treated as individual-level problems and individuals are responsibilized for the management of mental distress. Based on the results, it is concluded that the hybrid type of interventions that attempt to influence both individual- and work-related problems behind burnout would help to prevent people dealing with burnout from being over-responsibilized for solving problems at the workplace.
      Citation: Health
      PubDate: 2021-12-03T06:00:52Z
      DOI: 10.1177/13634593211063053
       
  • Bodies of concern' A qualitative exploration of eating, moving and
           embodiment in young mothers

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      Authors: Grace Lucas, Ellinor K Olander, Debra Salmon
      Abstract: Health, Ahead of Print.
      In some countries, including the United Kingdom, young mothers’ pregnant and postnatal bodies remain an area of concern for policy and practice, with interventions developed to support improved health behaviours including diet and physical activity. This article explores what young women themselves think and feel about eating and moving during and after pregnancy. Semi-structured interviews with 11 young mothers were conducted within two voluntary organisations. Data were analysed using thematic analysis with the theoretical lens of embodiment, which provided an understanding of how young women’s eating and moving habits related to how they felt about their bodies in the world. Four themes situated in different experiences of being and having a body were identified: pregnant body, emotional body, social body and surveilled body. Stress and low mood impacted eating habits as young women responded to complex circumstances and perceived judgement about their lives. Food choices were influenced by financial constraints and shaped by the spaces and places in which young women lived. Whilst young women were busy moving in their day-to-day lives, they rarely had the resources to take part in other physical activity. Holistic approaches that focus on how women feel about their lives and bodies and ask them where they need support are required from professionals. Interventions that address the structural influences on poor diet and inequalities in physical activity participation are necessary to underpin this. Approaches that over-focus on the achievement of individual health behaviours may fail to improve long-term health and risk reinforcing young women’s disadvantage.
      Citation: Health
      PubDate: 2021-11-29T10:16:04Z
      DOI: 10.1177/13634593211060760
       
  • And they slept happily ever after: Online interpretive repertoires on the
           use of benzodiazepines and z-drugs

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      Authors: Melissa Ceuterick, Thierry Christiaens, Hanne Creupelandt, Piet Bracke
      Abstract: Health, Ahead of Print.
      Drawing on a critical social-psychological framework for discourse analysis, data from a popular forum for people over 50 were analysed to study how the habitual use of benzodiazepines and Z-drugs (BZD/Z) is discursively negotiated by Flemish older adults. We present five different repertoires (risk and addiction; alternative pathways; suffering; rationalisation; cessation) that illustrate how a pharmaceutical imaginary of these medications is constructed online and how posters act as reflexive users taking on a health role. Most repertoires emerge from a tacit norm on the undesirability of medication use for sleeping problems. In the alternative pathways and cessation repertoires this norm is implicitly accepted by focussing on how to either prevent or overcome chronic use with various alternative solutions or through tapering off, while the risk and addiction repertoire is used to more openly defend and discursively magnify the idea that medication has to be avoided at all cost. We discuss how this reflects a prevailing imperative of health and ethos of healthicisation of sleep. The rationalisation and suffering repertoires on the other hand challenge this norm by defending medication use. We further explore how these repertoires are used to self-position as either ‘noble non-user’, ‘deserving and/or compliant patient’ or ‘rational user’, reflecting previously found moral positions in offline settings. Our data add another position that has thus far not been discussed extensively with regard to prescription medication use, namely that of a ‘recovered user’. As such, this study shows how this particular online community is a site for contestation of health promotion and medical/pharmaceuticalised discourses on sleep by users and non-users alike and offers a unique insight into how people in the age group that is known to use most BZD/Z discursively negotiate the use of these medications in pseudonymised online interactions.
      Citation: Health
      PubDate: 2021-11-25T08:48:03Z
      DOI: 10.1177/13634593211060770
       
  • Hype, evidence gaps and digital divides: Telehealth blind spots in rural
           Australia

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      Authors: Deborah Warr, Georgina Luscombe, Danielle Couch
      Abstract: Health, Ahead of Print.
      Despite high unmet demand for health services across rural Australia, uptake of telehealth has been slow, piecemeal and ad hoc. We argue that widespread failure to understand telehealth as a socio-technical practice is key to understanding this slow progress. To develop this argument, we explore how technocentric approaches to telehealth have contributed to critical blind spots. First, the ‘hype’ associated with the technological possibilities of telehealth discourages thoughtful consideration of the unanticipated consequences when technologies are rolled out into complex social fields. Second, it contributes to critical gaps in the telehealth evidence base, and particularly a paucity of analyses focussing on the experiences of service users and patients. A third blind spot concerns the limited attention paid to the social determinants of health and digital divides in rural areas. The final blind spot we consider is an apparent reluctance to engage community stakeholders in co-designing and coproducing telehealth services. We used an iterative approach to identify studies and commentary from a range of academic fields to explain the significance of the telehealth blind spots and how they might be addressed. Insights suggest how expanding understanding of the social dimensions of telehealth could enhance its accessibility, effectiveness and responsiveness to community needs and contexts.
      Citation: Health
      PubDate: 2021-11-25T08:46:22Z
      DOI: 10.1177/13634593211060763
       
  • Past, present and imaginary: Pathography in all its forms

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      Authors: Annemarie Jutel, Ginny Russell
      Abstract: Health, Ahead of Print.
      Diagnosis is a profoundly social phenomenon which, while putatively identifying disease entities, also provides insights into how societies understand and explain health, illness and deviance. In this paper, we explore how diagnosis becomes part of popular culture through its use in many non-clinical settings. From historical diagnosis of long-deceased public personalities to media diagnoses of prominent politicians and even diagnostic analysis of fictitious characters, the diagnosis does meaningful social work, explaining diversity and legitimising deviance in the popular imagination. We discuss a range of diagnostic approaches from paleopathography to fictopathography, which all take place outside of the clinic. Through pathography, diagnosis creeps into widespread and everyday domains it has not occupied previously, performing medicalisation through popularisation. We describe how these pathographies capture, not the disorders of historical or fictitious figures, rather, the anxieties of a contemporary society, eager to explain deviance in ways that helps to make sense of the world, past, present and imaginary.
      Citation: Health
      PubDate: 2021-11-25T08:44:59Z
      DOI: 10.1177/13634593211060759
       
  • The UK COVID-19 contact tracing app as both an emerging technology and
           public health intervention: The need to consider promissory discourses

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      Authors: Gabrielle Samuel, Rosie Sims
      Abstract: Health, Ahead of Print.
      The UK’s National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and ‘save lives’. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors – in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities.
      Citation: Health
      PubDate: 2021-11-23T11:23:56Z
      DOI: 10.1177/13634593211060768
       
  • Exempting the state and responsibilizing individuals during pandemic
           governance: Analyzing the health minister’s responses to the Covid-19
           pandemic in Turkey

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      Authors: G Ezgi Akguloglu, Gulcin Con Wright
      Abstract: Health, Ahead of Print.
      The COVID-19 pandemic pushed the governments of the world to implement different regulative and protective measures. Although these measures required serious re-considerations of public health strategies, they were still grounded on pre-existing contexts of countries’ health systems, namely the “new public health” paradigm. Turkey’s neoliberal health reforms since 2003 coincide with the principles of this paradigm’s trends toward marketizing services and responsibilizing individuals; yet the Turkish context of the pandemic also stands out due to its mixed and unique form of governance. Utilizing the tweets of the Turkish Health Minister between March 13th and October 1st, 2020, we conducted a thematic qualitative analysis investigating the Turkish state’s response to the COVID-19 pandemic. Our analysis revealed that state responsibility was framed around building new pandemic hospitals, informing the public, and building trust. Conversely, his tweets assigned Turkish individuals an active role in shaping pandemic outcomes through their “informed” and “empowered” agency. Finally, he coined “togetherness,” referring to the sum of individual actions, as an indispensable goal in assuring public compliance with precautions. The Minister’s tweets reflect the unique nature of pandemic governance in Turkey with a relatively imposing and swift response of centralized power but a primary focus on “responsibilized” individuals’ collective actions.
      Citation: Health
      PubDate: 2021-11-15T12:24:45Z
      DOI: 10.1177/13634593211060766
       
  • The power struggle: exploring the reality of clinical reasoning

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      Authors: Thiani Pillay, Mershen Pillay
      Abstract: Health, Ahead of Print.
      Purpose:Historically, clinical reasoning has largely been considered from an empirical, biomedical standpoint. This epistemology, rooted in imperial rule, is influential in how healthcare practitioners practice. An empirical approach to healthcare often oversimplifies the complex nature of clinical reasoning by obscuring the influence of imperial ideologies on decision-making. This can perpetuate inequitable approaches to healthcare delivery which deepen social, political and economic divides globally. This paper aims to explore and challenge this standpoint by exploring how power, imperialism and performativity influences healthcare provision and decision-making amongst healthcare practitioners in dysphagia rehabilitation.Methods:Qualitative exploratory interviews were undertaken with seven South African trained SLPs with experience working in dysphagia. To allow for participation and collaboration from participants, three data collection tools were employed within the interviews: oral histories, cognitive mapping and arts-based tasks. An initial modified thematic analysis followed by a further ideological analysis were undertaken to analyse the data collected.Results:The results suggest that the participants felt influenced by several manifestations of power within healthcare. We argue that this demonstrates that imperial practices can influence knowledge, interaction and context and therefore affect how healthcare practitioners make decisions.Conclusion:By acknowledging the impact of imperialism and power dynamics on healthcare provision and clinical reasoning we can potentially begin to transform the epistemology from which we approach healthcare provision in favour of one which is better suited to the current realities of healthcare to allow for equitable service provision.
      Citation: Health
      PubDate: 2021-11-12T05:44:05Z
      DOI: 10.1177/13634593211054008
       
  • The mouth and oral health in the field of dementia

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      Authors: Sasha Scambler, Sarah Curtis, Jill Manthorpe, Kritika Samsi, Yvonne M Rooney, Jennifer E Gallagher
      Abstract: Health, Ahead of Print.
      An ageing population, an estimated 47 million people currently living with dementia, and predictions of a threefold increase in people living with a diagnosis by 2050 have led the WHO to declare dementia a public health priority. Emerging research also suggests that dementia is linked to poor oral health and that oral health declines alongside cognitive decline. Drawing on Bourdieu’s concepts of field and capital, this paper presents an analysis of interview data from participants with dementia, carers and carer/diagnosed dyads participating in a qualitative study of the mouth and oral health. We argue that Bourdieu’s conceptual toolkit provides a way of contextualising experiences of oral health within dementia and un-picking the multi-layered impact of structure, institutions, biology, resource mobilisation and self in the context of a progressive disease which ultimately challenges knowledge of the self and the ability to interact with the world around us.
      Citation: Health
      PubDate: 2021-11-03T04:53:26Z
      DOI: 10.1177/13634593211049891
       
  • The making and unmaking of Hashimoto’s thyroiditis: On the mismatch
           between illness and disease. Results from an Italian study

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      Authors: Mario Cardano, Eleonora Rossero
      Abstract: Health, Ahead of Print.
      The diagnostic process in contemporary medical practice is increasingly technical, specialised and relying on population-based ranges of biological normalcy. Disease is defined according to a hierarchy of evidence that privileges specialist knowledge and marginalises subjective experiences of illness. Medical and individual definitions of the situation can conflict in two ways: (i) a diagnosis is made in the absence of symptoms, (ii) individual suffering does not constitute ‘real’ disease if it is not validated by scientific evidence. This article investigates how the discrepancy between specialist and embodied knowledge is experienced and tentatively solved by patients’ self-narratives. Starting from the analysis of 22 in-depth interviews with people affected by autoimmune diseases, we focus on the subgroup affected by Hashimoto’s thyroiditis. Applying the most-different-systems design, we confront two flesh-and-blood ideal-types of illness narratives characterised by a mismatch between illness and disease. Their diagnostic trajectories are outlined and discussed as poles of a continuum of experiences resulting from different configurations of medical evidence of disease and subjective evidence of illness.
      Citation: Health
      PubDate: 2021-10-30T05:26:07Z
      DOI: 10.1177/13634593211048370
       
  • “Lifestyle, finitude, or inequality'”: Illness explanation in
           Kathlyn Conway’s and Arthur Frank’s cancer memoirs

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      Authors: Hwa-Yen Huang
      Abstract: Health, Ahead of Print.
      The lifestyle model, which attributes etiological power and moral responsibility to the individual, is dominant in health promotion discourse. While sociologists rightly critique this model’s individualistic outlook, there has been insufficient distinction between the two anti-individualistic models that commonly inform their work: the well-known “sociological model” and the culturally influential but under-conceptualized model tentatively called the “finitude model.” Not only is there insufficient awareness of the different etiological causes (inequality and human fragility) and political orientations (redistribution and recognition) underlying the sociological and finitude models, but there is also insufficient recognition of how the finitude model may inform illness explanation. To raise awareness about the existence and analytical utility of the finitude model, I elucidate its core assumptions through a brief review of some influential texts in late-modern health politics. Further, I illustrate the empirical utility of the notion of the finitude model by analyzing how it is used to explain illness in Arthur Frank’s and Kathlyn Conway’s influential cancer memoirs. Thematic analysis of the memoirs produces two major findings. First, Frank and Conway rely on the finitude model to claim victimhood and blame the blamers. Second, they seem unaware of the double-edged character of such a model, which tends to downplay how social inequality shapes health. My analysis reveals the one-sidedness of both the finitude and sociological models, and that any illness explanation therefore needs to integrate both anti-individualistic models to challenge the lifestyle model successfully.
      Citation: Health
      PubDate: 2021-10-22T08:38:55Z
      DOI: 10.1177/13634593211054009
       
  • Transgender debates and healthcare: A critical realist account

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      Authors: David Pilgrim
      Abstract: Health, Ahead of Print.
      The meta-theoretical resource of critical realism (CR) is deployed in order to examine transgender and healthcare. CR treads a middle way between positivism and postmodernism, within post-Popperian discussions of the philosophy of natural and social science. It focuses on the conditions of possibility for the emergence of a phenomenon under investigation. In this case, the focus is on the emergence of debates about transgenderism in healthcare. These have been technological (about the prospect of biomedical solutions to personal problems) and ideological, with the enlarged salience of identity politics and our currently unresolved “culture wars.” Identity politics have brought a focus on epistemological privilege or “lived experience” and on rights to healthcare being driven by consumer choice. The current contestation and its history are discussed in relation to our four planar social being (nature, relationality, socio-economic structures, and our particular personalities) and future scenarios are rehearsed.
      Citation: Health
      PubDate: 2021-10-05T11:11:30Z
      DOI: 10.1177/13634593211046840
       
  • Becoming frail: A more than human exploration

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      Authors: Victoria Cluley, Nick Fox, Zoe Radnor
      Abstract: Health, Ahead of Print.
      ‘Frailty’ is increasingly used as a clinical term to refer and respond to a particular bodily presentation, with numerous scores and measures to support its clinical determination. While these tools are typically quantitative in nature and based primarily on physical capacity, qualitative research has revealed that frailty is also associated with a range of social, economic and environmental factors. Here, we progress the understanding of frailty in older people via a new materialist synthesis of recent qualitative studies of frailty and ageing. We replace a conception of frailty as a bodily attribute with a relational understanding of a ‘frailty assemblage’. Within this more-than-human assemblage, materialities establish the on-going ‘becoming’ of the frail body. What clinicians refer to as ‘frailty’ is one becoming among many, produced during the daily activities and interactions of older people. Acknowledging the complexity of these more-than-human becomings is essential to make sense of frailty, and how to support and enhance the lives of frail older people.
      Citation: Health
      PubDate: 2021-09-22T12:16:43Z
      DOI: 10.1177/13634593211038460
       
  • ‘Think before you drink’: Challenging narratives on foetal alcohol
           spectrum disorder and indigeneity in Canada

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      Authors: Nora Yousefi, Claudia Chaufan
      Abstract: Health, Ahead of Print.
      Foetal Alcohol Spectrum Disorder (FASD) has emerged as a significant public health issue, in Canada and elsewhere. Health experts increasingly acknowledge that the disproportionate impact of FASD on indigenous people is driven by social and historical contexts, especially in settler colonial states like Canada. However, they generally frame FASD as preventable through abstinence and the effects of FASD as manageable through provision of appropriate medical and legal protection to affected offspring. Drawing from Marxist, anticolonial and anti-imperial theories and applying a Critical Discourse Analysis approach, we identify the (re) production of colonial and capitalist dominance in the expert literature. We show that dominant narratives depoliticize FASD by conceptualizing settler colonialism as a past event, ignoring ongoing, contemporary forms of settler colonial dispossession and resituating FASD within an expert language that locates solutions to FASD within affected individuals and communities. In so doing, these narratives legitimize, and contribute to perpetuating, existing disease inequities, prevent the formulation of policies that address the very real and as yet unmet needs of FASD affected individuals, families and communities and erase from the public discourse discussions about changes that could truly address FASD inequities at their root. We conclude by elaborating on the implication of these narratives for policy, practice and equity, in Canada and other settler colonial states.
      Citation: Health
      PubDate: 2021-09-22T12:14:50Z
      DOI: 10.1177/13634593211038527
       
  • “Writing nutritionistically”: A critical discourse analysis of lay
           people’s digital correspondence with the Swedish Food Agency

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      Authors: Karolin Bergman, Paulina Nowicka, Karin Eli, Elin Lövestam
      Abstract: Health, Ahead of Print.
      This article analyzes lay people’s use of nutritionistic discourse in written correspondence with the Swedish Food Agency, an authority responsible for dietary advice. Examining 60 food related written digital messages, we apply a critical discourse analysis to parse the lexical items and grammar people use when constructing “food” in scientific terms. The findings show how message writers place nutrients at the discursive center. Message writers’ grammatical constructions instrumentalize food and eating. This is reinforced by the message writers’ frequent use of terms that indicate preciseness, such as numbers and amounts. Messages therefore emphasize the what, but not the how, of eating, implying a focus on food as subject to regulation and control. As such, eating is discursively reduced to an act of ingesting nutrients that can be decontextualized and managed in isolation—as entities to increase or avoid separately. These discursive features preclude the conceptualization of food choice and eating as subjective experiences of feelings, taste, and tradition.
      Citation: Health
      PubDate: 2021-09-20T12:41:27Z
      DOI: 10.1177/13634593211038533
       
  • Parental experiences of the liminal period of a child’s fatal
           illness

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      Authors: Bernadetta Janusz, Maciej Walkiewicz
      Abstract: Health, Ahead of Print.
      The article offers a description of parents’ experiences of their child’s ultimately fatal illness as it unfolds over the successive stages of medical treatment, in the context of the liminality theory. The parents (N = 23) were interviewed 1–4 years after their child’s death. The research method involved conducting narrative interviews with parents in order to obtain a spontaneous narration of the child’s illness as it unfolded. The grounded theory approach, including the narrative and performative aspects of such parental utterances, was applied as the main research strategy. The results provide insight into the main areas and processes of common parental experiences, such as the pervasive sense of becoming trapped in timelessness and ambiguity. Further states reported by parents included oscillating between a distancing stance and involvement, and a dualistic relationship with medical staff and the medical system: between alignment and disharmony. The study indicates the importance of treating delivery of such a diagnosis as a process rather than as a one-time event. The sense of ambiguity is treated as a kind of necessary parental coping mechanism, whilst the sense of timelessness gives parents a unique sense of time in which they do not have to think about the child’s potentially imminent death.
      Citation: Health
      PubDate: 2021-09-20T11:36:55Z
      DOI: 10.1177/13634593211046850
       
  • The immune self, hygiene and performative virtue in general public
           narratives on antibiotics and antimicrobial resistance

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      Authors: Mark DM Davis, Davina Lohm, Paul Flowers, Andrea Whittaker
      Abstract: Health, Ahead of Print.
      This paper employs an assemblage lens to generate analyses of general public narratives on antimicrobial resistance (AMR). Global efforts to reduce AMR include communications aiming to promote general public awareness, provide knowledge, encourage careful antibiotics use, and discourage demands for them. These efforts are somewhat compromised by the assumptions they make of individual lack of knowledge and motivation and the manner in which the AMR problem is framed in isolation from the biological, social and economic structures that produce it. Conceptualising AMR as an effect of antimicrobial assemblages of which publics are but one part, we analysed interviews with the general public on the lived experience of infections, antibiotic treatments and AMR. Far from science and policy discourse on AMR, these narratives showed antibiotics to be partly solutions to the social and biomedical challenges of infection, framed by self-defensive immunity and hygiene, the affective benefits of ‘immune boosting’, and the imperative to sustain the moral standing of the healthy citizen. Failing public awareness and action on AMR can be attributed to public health messages that overlook the social, affective and moral dimensions of infection care and separate AMR from its socio-economic drivers.
      Citation: Health
      PubDate: 2021-09-18T09:41:27Z
      DOI: 10.1177/13634593211046832
       
  • “That chart ain’t for us”: How Black women understand “obesity,”
           health, and physical activity

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      Authors: Tori Alexis Justin, Shannon Jette
      Abstract: Health, Ahead of Print.
      In this article, we use qualitative methodology to explore how eight physically active Black women, who self-identify as “obese,” understand and experience health and physical activity, as well as how they position themselves in relation to discourses pertaining to “obesity” and Black femininity. Drawing on Foucauldian-informed critical obesity scholarship and Black feminist thought, we explore the ways in which physically active Black women concurrently resist, reproduce, and navigate racialized and gendered obesity discourse. Our findings advance critical obesity scholarship as we indicate that participants simultaneously adapt to, negotiate, and resist obesity discourse by re-defining health, questioning the BMI, and centering their desire for corporeal “thickness” as critical to their identity as Black women.
      Citation: Health
      PubDate: 2021-09-15T10:41:25Z
      DOI: 10.1177/13634593211046844
       
  • Kidney failure, status passage, and the transitional nature of living with
           the disease: A qualitative study in Argentina

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      Authors: Javier Roberti, Juan Pedro Alonso, Leandro Blas, Carl May
      Abstract: Health, Ahead of Print.
      The span of kidney failure (KF) has been extended by advances in treatment. To elucidate the lived experiences of people with KF, we draw on Glaser and Strauss’s theory of status passage. Semi-structured interviews were conducted with 50 patients with KF and 14 health professionals, from two healthcare facilities in Buenos Aires, Argentina. The theory informed on the temporal dimensions of people’s passages and dimensions related to what actors know of this passage. We described the status passage as a sequence of transitions (starting dialysis, receiving a transplant, returning to dialysis) that have devastating effects on patient’s roles, and are accompanied with fear and experience of wasting time. Temporal aspects were crucial and planning was useless; indeed, timing of statuses was uncertain. With a transplant, certain roles and capacities could be regained. Some patients were not aware of the chronic nature of the disease and the ultimate reversibility of the transplant. Control over the passage was minimal because of the unpredictable prognosis of the disease but patients employed strategies to regain it. Control was even more limited for people who migrated to receive a treatment; whose lives were completely altered. Status passage theory signaled the overwhelming impact of the passage on all aspects of people’s lives, the uncertainty of the transitions, lack of control and awareness of essential aspects, and unexpected aspects of desirability, adding to our understanding of how people experience this disease and its treatments.
      Citation: Health
      PubDate: 2021-09-15T10:40:26Z
      DOI: 10.1177/13634593211046842
       
  • Unintended harm: A qualitative study of “harm” upon people who inject
           drugs in Bangkok, Thailand

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      Authors: Niphattra Haritavorn
      Abstract: Health, Ahead of Print.
      Given the highly pervasive health threats faced by people who inject drugs, harm reduction has been implemented in Thailand. Although harm reduction is a particularly effective public health strategy for reducing risky behavior, it is currently practiced with minimal understanding of unintended harm—drug policy, social exclusion, stigma, and discrimination—for people who inject drugs (PWID) in Thailand. This study aims to understanding the “unintended harm” encountered by people who inject drugs in Bangkok in their everyday lives through social interaction at all levels of society from macro, micro, and individual levels. In-depth interviews were conducted with 28 people who inject drugs in Bangkok (21 men and 7 women) and 4 people who are a nurse, a community leader, a policeman, and a family member (2 men and 2 women). The result shows that individuals, society, and politics are not separable phenomena and all produce harm upon people who inject drugs. These unintended harms on the macro, micro, and individual level are closely linked; each in their own way poses a threat to the health and well-being of people who inject drugs and embody negative social responses as the people who inject drugs become typecast as “deviants.” In conclusion, there is an urgent need to develop a “harm reduction” model that addresses unintended harm and could be integrated within the existing socio-cultural context of Thai society.
      Citation: Health
      PubDate: 2021-09-15T10:38:45Z
      DOI: 10.1177/13634593211046841
       
  • Patient narratives of hope in stem cell technologies: Trust in biomedicine
           and the body’s natural ability to heal itself

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      Authors: Lindsay J DePalma, Lauren D Olsen, John H Evans
      Abstract: Health, Ahead of Print.
      The scholarship on patient hope in biomedical technologies describes two narratives of hope: the biomedical and the individual. The biomedical narrative represents patients’ beliefs that the institution of science will eventually produce treatment for their disease, whereas the individual narrative represents patients’ beliefs that they can alter their prognosis through affective and behavioral modifications. The distinct analytical categories of “biomedical” and “individual,” however, fail to account for the fact that patient hope has been found to be much more complex. Building upon extant literature, we contribute to the understanding of the complexity of patient hope in biomedical technologies by examining a case that highlights interdependencies between the biomedical and individual narratives: hope in stem cell technologies (SCTs). We draw upon interviews with patients with Parkinson’s Disease, and find two narratives of hope: a biomedical narrative, as captured above, and an additional hybrid narrative, which we call a nature narrative. The nature narrative reflects patients’ beliefs that scientists will eventually create SCTs that will allow their individual body to naturally heal itself, which combines a biomedical and an individual narrative.
      Citation: Health
      PubDate: 2021-09-15T10:37:07Z
      DOI: 10.1177/13634593211046834
       
  • ‘It reminds me that I should stop for the little moments’: Exploring
           emotions in experiences of UK Covid-19 lockdown

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      Authors: Stella Bullo, Jasmine Hearn, Lexi Webster
      Abstract: Health, Ahead of Print.
      In this study, we explore how participants articulate experiences of emotions during Covid-19 lockdown in the UK. We posit that emotions fulfil experiential and interpersonal functions, which are construed and conveyed through language choices. An online narrative survey was carried out. About 88 responses were analysed. Participants were from England and Wales. The mean age was 48.9 years old (SD = 62). A mixed-method approach was used. This combined quantitative Corpus Linguistics analysis and qualitative Interpretative Phenomenological Analysis with linguistic analysis. The findings show similarities to the public health and medical literature that highlight negative emotions, such as fear, distrust and anger in participants. However, we also found positive emotions not considered elsewhere, including happiness, relaxation, safety, optimism for the future and connectedness arising from the thematic IPA analysis. Emotions were construed using language explicitly labelling emotions and language implicitly signalling emotions. Our study highlights implications for managing risk behaviours associated with transmission in public health practices such as social distancing, as indicated by negative emotions. We also bring to light implications with perceived benefits of engaging in protective behaviours and social support central to public health measures, as suggested by the communication of positive emotions.
      Citation: Health
      PubDate: 2021-09-13T09:21:11Z
      DOI: 10.1177/13634593211046833
       
  • The discursive construction of HIV stigma in Irish print media

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      Authors: Elena Vaughan, Martin Power
      Abstract: Health, Ahead of Print.
      As interlocutors in national level discourse with the power to influence public opinion and inform policy, the news media are an important data source in understanding the constitutive roles played by culture and discourse in shaping health experiences and outcomes. This paper reports on a critical discourse analysis of news media coverage of HIV in the Republic of Ireland between 2006 and 2016. This period is significant because of the considerable increase in new HIV diagnoses that occurred in Ireland after the 2008 recession. Analysis of articles (n = 103) demonstrated a pattern of dividing practices whereby people living with or affected by HIV were frequently positioned as somatically and morally deficient via discourses of risk and responsibility. Little focus was given over to examination of the structural drivers of HIV, occluding the social context of the epidemic. The findings suggest that media discourses on HIV have the potential to other people living with HIV and generate stigma by invoking a dynamic of blame and shame frequently implicated in the stigma process.
      Citation: Health
      PubDate: 2021-08-23T08:55:42Z
      DOI: 10.1177/13634593211038525
       
  • Talking about chronic pain: Misalignment in discussions of the body, mind
           and social aspects in pain clinic consultations

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      Authors: Jana Declercq
      Abstract: Health, Ahead of Print.
      In Western societies, human existence and illness are mostly constructed from the perspective of mind-body dualism: body and mind are considered to function independently, and the body/the physical as primary and more real. Research shows, however, that mind-body dualism is no longer tenable, especially in healthcare contexts. This led to the rise the biopsychosocial model, in which bodily experiences, including illness, are seen an interplay of the physical and the psychological, and the social. This model is the current gold standard for treating chronic pain. As these perspectives on the body and illness are potentially conflicting, and discursively constructed, this paper examines whether they are a source of misalignment in interactions between chronic pain patients and their doctors in a pain clinic. The analysis shows these perspectives indeed lead to misalignment, for instance when discussing the relevance of psychotherapy, and lead to intricate uses of argumentative resources to account for the differing perspectives on (the treatment of) pain.
      Citation: Health
      PubDate: 2021-07-22T09:50:20Z
      DOI: 10.1177/13634593211032875
       
  • Access to intervene. An ethnographic study of public health practices
           targeting health inequalities

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      Authors: Mette Terp Høybye, Ditte Herring Holt, Morten Hulvej Rod
      Abstract: Health, Ahead of Print.
      Much public health research has devoted attention to the question of how interventions aimed at reducing health inequalities can access so-called “hard-to-reach” populations. This work has generally reflected an instrumentalist approach, which implies the preexistence of particular target groups characterized by specific public health problems. The key research interests are to find ways to effectively alleviate health inequalities and to identify the best ways to intervene to address disparate health problems among certain groups of people. Based on ethnographic research with public health officers in four Danish municipalities, this article turns the issue on its head by examining how public health officers gain access to intervene in practice and, as part of this process, define and delineate target groups and public health problems. Through detailed descriptions of two ethnographic cases, we develop the argument that public health interventions carry with them moral differentiations that may contradict the overall intention of reducing health inequalities. We adopt a theoretical perspective developed by Lakoff and Collier, suggesting that public health interventions can be understood as “regimes of living.” This leads us to the conclusion that the practices of gaining access result in the production of unforeseen target groups and new moral configurations where the value of health becomes linked to other types of value, most importantly economic value. For public health officers, the complicated issue of gaining access to intervene is not simply a matter of finding practical solutions; it also defines and delineates the scope of public health itself.
      Citation: Health
      PubDate: 2021-07-20T05:59:09Z
      DOI: 10.1177/13634593211032869
       
  • A syndemics approach to exercise is medicine

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      Authors: Caitlin Vitosky Clarke, Brynn C Adamson
      Abstract: Health, Ahead of Print.
      This paper offers new insights into the promotion of the Exercise is Medicine (EIM) framework for mental illness and chronic disease. Utilising the Syndemics Framework, which posits mental health conditions as corollaries of social conditions, we argue that medicalized exercise promotion paradigms both ignore the social conditions that can contribute to mental illness and can contribute to mental illness via discrimination and worsening self-concept based on disability. We first address the ways in which the current EIM framework may be too narrow in scope in considering the impact of social factors as determinants of health. We then consider how this narrow scope in combination with the emphasis on independence and individual prescriptions may serve to reinforce stigma and shame associated with both chronic disease and mental illness. We draw on examples from two distinct research projects, one on exercise interventions for depression and one on exercise interventions for multiple sclerosis (MS), in order to consider ways to improve the approach to exercise promotion for these and other, related populations.
      Citation: Health
      PubDate: 2021-06-04T05:36:08Z
      DOI: 10.1177/13634593211021481
       
  • The unexpected other: Challenges and strategies after acquired impairment

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      Authors: Per Koren Solvang, Ida Heiaas, Grace Romsland, Helene Lundgaard Søberg
      Abstract: Health, Ahead of Print.
      People experiencing traumatic brain injury or multitrauma will often live with problems in functioning for a profound period in life. A situation of great complexity emerges involving both the experience of an impaired body and the experience of a changed social position. This article addresses the intricate relations between the altered body, personal ambitions, and social surroundings in the first 2–3 years after an injury. The conceptual framework centers around the process of change, applying concepts such as the unexpected other and biographical reconstruction. Twenty-one people of working age were interviewed two times. All interviewees had experienced traumatic brain injury or multitrauma. A thematic narrative analysis was applied. Consequences of the injury took place at a carnal level where fatigue is something completely different from becoming exhausted and where elimination of body waste takes place through practices novel to the injured person. Living with impairment also took place at the level of social interaction. Here, family relations, shame, and establishing a new identity seemed profoundly important. This article makes two novel contributions. First, it emphasizes more than previous studies do that the daily management of altered body functions is more important for independence and wellbeing. Second, the article identifies the narrative about the accident as an important issue for injured people to settle.
      Citation: Health
      PubDate: 2021-06-02T10:07:45Z
      DOI: 10.1177/13634593211021482
       
  • Caring for affective subjects produced in intimate healthcare examinations

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      Authors: Jenny Gleisner, Ericka Johnson
      Abstract: Health, Ahead of Print.
      This article is about the feelings – affect – induced by the digital rectal exam of the prostate and the gynaecological bimanual pelvic exam, and the care doctors are or are not instructed to give. The exams are both invasive, intimate exams located at a part of the body often charged with norms and emotions related to gender and sexuality. By using the concept affective subject, we analyse how these examinations are taught to medical students, bringing attention to how bodies and affect are cared for as patients are observed and touched. Our findings show both the role care practices play in generating and handling affect in the students’ learning and the importance of the affect that the exam is (or is not) imagined to produce in the patient. Ours is a material-discursive analysis that includes the material affordances of the patient and doctor bodies in the affective work spaces observed.
      Citation: Health
      PubDate: 2021-05-27T09:43:43Z
      DOI: 10.1177/13634593211020072
       
  • Using Photovoice to understand physical and social living environment
           influence on adherence to diabetes

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      Authors: Alice Scavarda, Giuseppe Costa, Franca Beccaria
      Abstract: Health, Ahead of Print.
      Within the past several years, a considerable body of research on adherence to diabetes regimen has emerged in public health. However, the focus of the vast majority of these studies has been on the individual traits and attitudes affecting adherence. Still little is known on the role of the social and physical context in supporting or hindering diabetes self-management, particularly from a qualitative standpoint. To address these limitations, this paper presents the findings of a Photovoice study on a sample of 10 type 2 diabetic older adults living in a deprived neighbourhood of an Italian city. The findings reveal that the possibility to engage in diet, exercise and blood sugar monitoring seems to be more affected by physical and social elements of the respondents’ environment than by the interviewees’ beliefs and attitudes. Both environmental barriers and social isolation emerge as barriers to lifestyle changes and self-care activities related to blood sugar monitoring. The predominance of bonding social capital, the scant level of trust and the negative perception of local health services result in a low level of social cohesion, a limited circulation of health information on diabetes management and, consequently, in poor health outcomes.
      Citation: Health
      PubDate: 2021-05-27T09:43:13Z
      DOI: 10.1177/13634593211020066
       
  • Being and doing anorexia nervosa: An autoethnography of diagnostic
           identity and performance of illness

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      Authors: Lauren O’Connell
      Abstract: Health, Ahead of Print.
      This autoethnography examines my experience of the diagnosis and treatment of anorexia nervosa. Drawing on memory and personal and medical documents relating to inpatient admissions in an adult specialist eating disorder unit, I narrate and analyse my experience in terms of my relationship to the diagnosis of anorexia and the constructions of it I encountered. I show how I came to value an identity based on anorexia and how I learned ways of ‘doing’ the diagnosis in treatment. This involved me valuing medical markers of illness, including signs of poor health, which became crucial to how I performed my diagnosis and retained the diagnostically-informed sense of self that I valued. I suggest that, ultimately, these diagnostic-dynamics, alongside other effects of long-term inpatient treatment such as detachment from ‘normal life’, prolonged my struggles with self-starvation. The insights from this autoethnography shed light on potential iatrogenic impacts of diagnosis and treatment for anorexia.
      Citation: Health
      PubDate: 2021-05-27T09:42:58Z
      DOI: 10.1177/13634593211017190
       
  • “It’s not all nice and fun”: Narrating contested illness
           on YouTube and Instagram

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      Authors: Irene Groenevelt
      Abstract: Health, Ahead of Print.
      This empirical study draws on insights from narrative theory to tease out how women with a contested illness narrate their experiences on social media. Based on 13 months of online observations between 2017 and 2019, I analyse how a sample of eight highly active Dutch female social media users share their illness on YouTube and Instagram. In addition, I interviewed five of them. Through their online performances, the women in this study illustrate their investment in self-care practices, whilst simultaneously laying bare the limits of these practices in ensuring permanent well-being. Central to transmitting their experiences is the performance of balanced positivity; meaning that illness is dealt with in a predominantly ‘positive’ way, as well as through the occasional display of (moments of) hardship. I identify three main aspects of this performance of balanced positivity, namely: (1) appearances, (2) mindset, and (3) presence. The practice of balanced positivity is congruent with the concept of legitimacy narratives, because it allows women with a contested illness to show their efforts to cope with their condition as well as the myriad challenges that remain despite these efforts.
      Citation: Health
      PubDate: 2021-05-26T06:49:43Z
      DOI: 10.1177/13634593211017187
       
  • Non-Vaccination Stage Model (NVST): The decision-making process among
           Israeli ultra-orthodox Jewish parents

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      Authors: Ariela Popper-Giveon, Yael Keshet
      Abstract: Health, Ahead of Print.
      Although vaccination uptake is high in most countries, pockets of suboptimal coverage remain, such as those observed among ultra-orthodox Jews in Israel and elsewhere, posing a threat to both individual and public immunity. Drawing on the Precaution Adoption Process Model (PAPM), this study proposes a Non-Vaccination Stage Model (NVSM) to analyze the decision-making process among Non-Vaccinating Parents (NVPs), focusing on the ultra-orthodox Jewish population of Israel. In-depth interviews were conducted with 10 Israeli ultra-orthodox Jewish NVPs (mothers). The interviews revealed five stages in the participants’ decision-making process: Being good mothers who vaccinate their children; Emergence of doubts regarding the risks of vaccination; Personal vaccination policy—hesitancy concerning vaccination; Decision not to vaccinate; Confirmation signs of what participants perceive as a wise decision. NVSM can help understand parents who consider non-vaccination to be healthier behavior and explore the various stages of their decision-making process. Differentiating among the various stages of NVPs’ decision-making processes enables application of different intervention approaches by policymakers and healthcare practitioners.
      Citation: Health
      PubDate: 2021-05-18T11:53:31Z
      DOI: 10.1177/1363459320988884
       
  • Critical discourse analysis on the influence of media commentary on fatal
           fetal anomaly in Ireland

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      Authors: Stacey Power, Keelin O’Donoghue, Sarah Meaney
      Abstract: Health, Ahead of Print.
      Fatal Fetal Anomaly (FFA) has generated international media attention as termination of pregnancy (TOP) for FFA was legislated for, for the first time in Ireland. Media offers an insight into what health-related information is available to the public and how it is presented to them. The aim of this study was to examine how information related to FFA, TOP for FFA and perinatal palliative care (PPC) were framed in Irish published media. A critical discourse analysis, which examines the relations between discourse and social and cultural phenomena was implemented. Habermasian’s framework facilitated an objective analysis of the text, to facilitate interpretation and understanding of socially produced meanings. A broadsheet and journal were chosen. Dated from 2012 to 2017, 129 articles were identified. Themes of personification of the unborn, human rights and power and politics were embedded in the discourse, creating political influence to sway perceptions and views. Terminology were chosen by different ideological perspectives to create varying contexts and support arguments. PPC was suppressed within the published media. This study highlights misrepresentations in the information delivered to the public and suggests the need for healthcare professionals to expand their media literacy and develop these skills with their patients.
      Citation: Health
      PubDate: 2021-05-13T12:46:53Z
      DOI: 10.1177/13634593211015279
       
  • Place, health and dis/advantage: A sociomaterial analysis

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      Authors: Nick J. Fox, Katie Powell
      Abstract: Health, Ahead of Print.
      The substantial literature on interactions between places/spaces and well-being/health often differentiate between physical and social aspects of geographical location. This paper sidesteps this dualism, instead considering places as sociomaterial assemblages of human and non-human materialities. It uses this posthuman and ‘new materialist’ perspective to explore how place-assemblages affect human capacities, in terms of both health and social dis/advantage. Based on secondary analysis of interview data on human/place interactions, it analyses the physical, sociocultural, psychological and emotional effects of place-assemblages, assessing how these produce opportunities for, and constraints upon human bodies. It than assesses how these emergent capacities affect both social dis/advantage and well-being. This analysis of how place-assemblages contribute positively or negatively to health and dis/advantage offers possibilities for further research and for social and public health policy.
      Citation: Health
      PubDate: 2021-05-12T10:35:36Z
      DOI: 10.1177/13634593211014925
       
  • Book Review: HIV in the UK: Voices from the Epidemic

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      Authors: Jaime García-Iglesias
      Abstract: Health, Ahead of Print.

      Citation: Health
      PubDate: 2021-05-10T05:27:23Z
      DOI: 10.1177/13634593211015099
       
  • Personal recovery and socio-structural disadvantage: A critical conceptual
           review

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      Authors: Dimitar Karadzhov
      Abstract: Health, Ahead of Print.
      Despite its seeming breadth and diversity, the bulk of the personal (mental health) recovery literature has remained strangely ‘silent’ about the impact of various socio-structural inequalities on the recovery process. Such an inadequacy of the empirical literature is not without consequences since the systematic omission or downplaying, at best, of the socio-structural conditions of living for persons with lived experience of mental health difficulties may inadvertently reinforce a reductionist view of recovery as an atomised, individualised phenomenon. Motivated by those limitations in extant scholarship, a critical literature review was conducted to identify and critique relevant research to problematise the notion of personal recovery in the context of socio-structural disadvantage such as poverty, homelessness, discrimination and inequalities. The review illuminates the scarcity of empirical research and the paucity of sociologically-informed theorisation regarding how recovery is shaped by the socio-structural conditions of living. Those inadequacies are especially pertinent to homelessness research, whereby empirical investigations of personal recovery have remained few and undertheorised. The gaps in the research and theorising about the relational, contextual and socio-structural embeddedness of recovery are distilled. The critical review concludes that personal recovery has remained underresearched, underproblematised and undertheorised, especially in the context of homelessness and other forms of socio-structural disadvantage. Understanding how exclusionary social arrangements affect individuals’ recovery, and the coping strategies that they deploy to negotiate those, is likely to inform anti-oppressive interventions that could eventually remove the structural constraints to human emancipation and flourishing.
      Citation: Health
      PubDate: 2021-05-08T05:36:32Z
      DOI: 10.1177/13634593211014250
       
  • Barriers to physical activity for father’s living in marginalising
           conditions

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      Authors: Francine E Darroch, John L Oliffe, Gabriela Gonzalez Montaner, Jessica M Webb
      Abstract: Health, Ahead of Print.
      Physical activity can be a conduit for improving men’s social connectedness as well as physical gains for well-being. However, marginalised men, and fathers in particular, can be challenged to engage in leisure time physical activity. This qualitative study reports how fathers, who experience complex and significant social and health inequities, conceptualise and experience barriers to physical activity. Drawing from focus groups with 17 fathers, and semi-structured interviews with seven service providers about their perspectives on men’s physical activity in Vancouver’s Downtown Eastside (DTES), a highly marginalised neighbourhood. A masculinities framework was used to describe and contextualise physical activity in fathers’ lives. Three themes were inductively derived through the analyses: (1) ‘they’re busy surviving’ a finding referencing the work and limits invoked by poverty wherein survival was triaged ahead of leisure time physical activity; (2) ‘there is no activity centre’ chronicling the lack of physical activity spaces, programmes and resources available to fathers; and (3) ‘lifestyle affects our capability to exercise’ a theme detailing how social isolation amplified by factors including housing and opioid crises, and being a father in a resource poor setting imposed significant barriers to physical activity. The findings support reconceptualising physical activity programmes with men who are living in marginalising conditions to address behavioural and structural health inequities in tailoring father-centred programmes and resources.
      Citation: Health
      PubDate: 2021-05-05T06:09:39Z
      DOI: 10.1177/13634593211014275
       
  • Articulating the canon: The sociology of medical education from 1980 to
           2000

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      Authors: Alexandra H. Vinson
      Abstract: Health, Ahead of Print.
      An exciting development in the sociology of medical education has been its recent return as a distinct scholarly conversation in medical sociology. During the 1980s and 1990s, the sociology of medical education, an historically prominent subfield in sociology, seemed to disappear from the scholarly conversation despite ongoing development in this area. In this narrative review I describe this “missing period” of sociology of medical education, discussing complementary explanations for why it receded and describing what research activity did take place during those decades. In reviewing this work, I argue that articulating theoretical advances made within sociology of medical education research during these decades allows us to link foundational research from the 1950s and 1960s with the renaissance of this subfield in the early 2000s. Fundamentally, understanding the intellectual history and development of this subfield supports a broader movement to understand the import of studies of medical training for exploring questions of interest in general sociology.
      Citation: Health
      PubDate: 2021-05-03T06:49:12Z
      DOI: 10.1177/13634593211013886
       
  • Coding for quality' Accountability work in standardised cancer patient
           pathways (CPPs)

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      Authors: Erna Håland, Line Melby
      Abstract: Health, Ahead of Print.
      A vital part of standardised care pathways is the possibility to measure performance through different indicators – for example, codes. In this article, based on interviews with health personnel in a project evaluating the introduction of standardised cancer patient pathways (CPPs) in Norway, we explore the specific types of work involved when health personnel produce codes as (intended) signifiers of quality. All the types of work are dimensions of what we define as accountability work – work health personnel do to make the codes signifiers of quality of care in the CPP.Codes and coding practices raise questions of what quality of care represents and how it could and should be measured. Informants in our study advocate for coding as important work for the patient more than for ‘the system’. This shows how organising for quality becomes a crucial part of professional work, expanding what it means to perform high quality care.
      Citation: Health
      PubDate: 2021-04-30T08:05:12Z
      DOI: 10.1177/13634593211013882
       
  • From training wheels to chemical condoms: Exploring narratives of PrEP
           discontinuation

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      Authors: Jaime Garcia Iglesias
      Abstract: Health, Ahead of Print.
      This paper explores experiences of PrEP, a HIV-prevention intervention, among bugchasers, gay men who eroticize HIV. While PrEP has been hailed as a “game changer” in HIV-prevention, little attention has been paid to why and how some people may discontinue it in the face of HIV risk, such as bugchasers do. This paper relies on interview data with bugchasers themselves to discuss the process of discontinuation and its effects. The paper argues that, for these men, discontinuation is a fluid, complex, and sometimes contradictory process. It also describes how participants perceived themselves as being at different stages of discontinuation. The paper also analyzes how these men see PrEP as a barrier to intimacy, risk, and a tool to negotiate their desires and identity: through discontinuing PrEP, these men are able to reflect on and build their identities as bugchasers.
      Citation: Health
      PubDate: 2021-03-24T07:10:35Z
      DOI: 10.1177/13634593211005177
       
  • Becoming a cancer survivor: An experiment in dialogical health research

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      Authors: Arthur W Frank, Kari Nyheim Solbraekke
      Abstract: Health, Ahead of Print.
      The article makes cancer survivorship the topic of an experiment in a form of writing we call dialogical response. First, in the style of autoethnography, each author presents an account of her or his long-term survivorship of cancer and the issues that involves. Less conventionally, we then respond each to the other’s story. The article seeks to contribute to an in-depth understanding of long-term cancer survivorship. More important, we offer it as an example of a form of writing rarely practiced in health research: speaking to those who participate in research, rather than speaking about those people. Among the multiple theoretical implications that could be explored, we consider Foucault’s concept of subjectification. Our argument is that recognising the discursive formulation of the subject can and should be complemented by recognition of the local, immediate dialogical formulation of subjects. Rather than presenting research findings about cancer survivors, we offer a performative enactment of survivorship as an ongoing process of dialogical exchange. We show ourselves, responding to each other, in the process of becoming the cancer survivors we are as a result of those responses.
      Citation: Health
      PubDate: 2021-03-23T05:55:42Z
      DOI: 10.1177/13634593211005178
       
  • Social representations of the coronavirus and causal perception of its
           origin: The role of reasons for fear

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      Authors: Patrick Rateau, Jean Louis Tavani, Sylvain Delouvée
      Abstract: Health, Ahead of Print.
      In the midst of the COVID-19 pandemic (between 26 March and 2 April 2020), we analysed (n = 1144) the social representations of the coronavirus and the differentiated perceptions according to the origins attributed to the appearance of the virus (Human vs Non-Human and Intentional vs Unintentional) in a French population. The results show that the social representation is organized around five potentially central descriptive, anxiety-provoking and globally negative elements. But death and contagion are the only stable and structuring elements. The other elements vary according to the reason attributed to the object of fear. Depending on how individuals attribute the origin of the virus, social representations of it vary not only in terms of their content but also in terms of their structure. These results indicate how important it is to consider the perceptions that individuals share about the human (vs non-human) and intentional (vs unintentional) origin of an object of fear in the analysis of their representation of that object.
      Citation: Health
      PubDate: 2021-03-23T05:54:02Z
      DOI: 10.1177/13634593211005172
       
  • Medical assistance in dying and the meaning of care: Perspectives of
           nurses, pharmacists, and social workers

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      Authors: Anneliese Mills, Kristin Bright, Rachel Wortzman, Sally Bean, Debbie Selby
      Abstract: Health, Ahead of Print.
      Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. While it has generated significant academic interest, the experiences of healthcare workers other than physicians remain understudied. This paper reports on a qualitative study of interprofessional Healthcare Providers (HCPs) involved in the provision of MAiD in order to: (1) characterize providers’ views about the care they offer in general; (2) examine whether or not they consider MAiD a form of care; and (3) explore their reasons for viewing or not viewing MAiD as care. Semi-structured qualitative interviews were conducted with ten nurses, eight social workers, and three pharmacists with firsthand experience delivering MAiD at an academic hospital in Toronto, Canada. The study was approved by the hospital’s REB. Written informed consent was obtained prior to participation. Codebook thematic analysis and template analysis generated four themes: (1) care as advocacy, (2) care as easing suffering, (3) care as psychosocial, and (4) care as relational. Every participant viewed MAiD as a form of care and drew on these four themes to authenticate MAiD as care. Participants consider MAiD a form of care for patients, families, other healthcare workers, and even themselves. In alternating and composite fashion, they describe MAiD in terms of autonomy, easing suffering, and a kind death for the dying (and those entrusted with their care)—a complex choreography of social discourses and moral logics that refuse to settle into a simple dichotomy of “choice versus care.” Participants depict MAiD in many of the same terms and imagery they use to describe the care they offer in general. In light of ongoing social controversies surrounding MAiD, HCPs utilize a range of logics strategically to repel negative attention and enable their participation in what they see as a caring end for their patients.
      Citation: Health
      PubDate: 2021-03-09T04:55:08Z
      DOI: 10.1177/1363459321996774
       
  • Between a logic of disruption and a logic of continuation: Negotiating the
           legitimacy of algorithms used in automated clinical decision-making

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      Authors: Rikke Torenholt, Henriette Langstrup
      Abstract: Health, Ahead of Print.
      In both popular and academic discussions of the use of algorithms in clinical practice, narratives often draw on the decisive potentialities of algorithms and come with the belief that algorithms will substantially transform healthcare. We suggest that this approach is associated with a logic of disruption. However, we argue that in clinical practice alongside this logic, another and less recognised logic exists, namely that of continuation: here the use of algorithms constitutes part of an established practice. Applying these logics as our analytical framing, we set out to explore how algorithms for clinical decision-making are enacted by political stakeholders, healthcare professionals, and patients, and in doing so, study how the legitimacy of delegating to an algorithm is negotiated and obtained. Empirically we draw on ethnographic fieldwork carried out in relation to attempts in Denmark to develop and implement Patient Reported Outcomes (PRO) tools – involving algorithmic sorting – in clinical practice. We follow the work within two disease areas: heart rehabilitation and breast cancer follow-up care. We show how at the political level, algorithms constitute tools for disrupting inefficient work and unsystematic patient involvement, whereas closer to the clinical practice, algorithms constitute a continuation of standardised and evidence-based diagnostic procedures and a continuation of the physicians’ expertise and authority. We argue that the co-existence of the two logics have implications as both provide a push towards the use of algorithms and how a logic of continuation may divert attention away from new issues introduced with automated digital decision-support systems.
      Citation: Health
      PubDate: 2021-03-09T04:53:30Z
      DOI: 10.1177/1363459321996741
       
  • ‘I was just doing what a normal gay man would do, right'’: The
           

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      Authors: Mark Gaspar, Zack Marshall, Barry D. Adam, David J. Brennan, Joseph Cox, Nathan Lachowsky, Gilles Lambert, David Moore, Trevor A. Hart, Daniel Grace
      Abstract: Health, Ahead of Print.
      Drawing on 24 interviews conducted with gay, bisexual, queer and other men who have sex with men (GBM) living in Toronto, Canada, we examined how they are making sense of the relationship between their mental health and substance use. We draw from the literature on the biopolitics of substance use to document how GBM self-regulate and use alcohol and other drugs (AODC) as technologies of the self. Despite cultural understandings of substance use as integral to GBM communities and subjectivity, GBM can be ambivalent about their AODC. Participants discussed taking substances positively as a therapeutic mental health aid and negatively as being corrosive to their mental wellbeing. A fine line was communicated between substance use being self-productive or self-destructive. Some discussed having made ‘problematic’ or ‘unhealthy’ drug-taking decisions, while others presented themselves as self-controlled, responsible neoliberal actors doing ‘what a normal gay man would do’. This ambivalence is related to the polarizing binary community and scientific discourses on substances (i.e. addiction/healthy use, irrational/rational, uncontrolled/controlled). Our findings add to the critical drug literature by demonstrating how reifying and/or dismantling the coherency of such substance use binaries can serve as a biopolitical site for some GBM to construct their identities and demonstrate healthy, ‘responsible’ subjectivity.
      Citation: Health
      PubDate: 2021-02-26T06:50:24Z
      DOI: 10.1177/1363459321996753
       
  • The ‘disenchantment’ of traditional acupuncturists in higher
           education

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      Authors: Assaf Givati, Shelley Berlinsky
      Abstract: Health, Ahead of Print.
      Efforts of traditional acupuncturists in the UK to regulate their practice and standardise their training, led, from the mid-1990s, to the launch of acupuncture undergraduate programmes within, or validated by, universities. It appeared as if by so doing acupuncturists were on course to align themselves with ‘scientifically plausible’, state-regulated, allied health professionals, a remarkable development considering the marginality of acupuncture practice outside East Asia, and its paradigmatic tensions with biomedicine. But was it really to be' Based on in-depth interviews with higher education acupuncture educators and an analysis of educational documents published by the leading professional body, we explore the way in which this paradigmatic tension is negotiated within a framework that is dominated by biomedicine. By critically revisiting sociology of professions and anti-colonial analysis, we examine an over two decades long journey of acupuncture educators in academic institutions in the UK. Based on this analysis, we point at some of the challenges that acupuncturists faced in higher education that may have restricted the academic legitimisation of acupuncture and that left them in a position of academic marginality and greater exposure to scrutiny, leading to their academic and mainstreaming ‘disillusionment’. At the same time, by positioning themselves as ‘professional academics’ within higher education institutions and demonstrating professionalism, acupuncture educators were able to demonstrate academic and professional ‘credibility’ and therefore distance themselves from the continuous scrutiny over their ‘biomedical fragility’.
      Citation: Health
      PubDate: 2021-02-22T04:55:23Z
      DOI: 10.1177/1363459321990725
       
  • Gaining access to the field in medical ethnography: Reflections on
           ethical, methodological, and structural challenges in the study of
           long-term care facilities

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      Authors: Neta Roitenberg
      Abstract: Health, Ahead of Print.
      The article extends the discussion on the challenges in gaining access to the field in medical ethnographic research, focusing on long-term care (LTC) facilities. Medical institutions have been documented to be difficult sites to access. The reference, however, is to the recruitment of patients as informants. The challenges of recruiting practitioners as informants have not been investigated at all. The article presents the key issues that emerged in the process of gaining social access at the sites of two LTC facilities as part of a study on care workers’ identities. The main obstacles encountered during the fieldwork were organizational constraints and negotiating control over the process of recruiting the lower occupational tier of care workers with gatekeepers. The article presents the coping strategies implemented to overcome the ethical and methodological obstacles: continually reassessing the consent and cooperation of participants and developing a rapport with nurse’s aides during interviews.
      Citation: Health
      PubDate: 2021-02-06T05:36:20Z
      DOI: 10.1177/1363459320988872
       
  • The piety of optimization: The rhetoric of health awareness in
           ParticipACTION and Fitbit

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      Authors: Loren Gaudet
      Abstract: Health, Ahead of Print.
      This article uses the tools of rhetorical study to investigate how health awareness, as both a concept and a set of beliefs that reinforce ideals of health, permeates everyday life and affects ways of being. I explore how health awareness is communicated through both public health and commercial marketing campaigns, and argue that as the sources of information change, so too do the ideas of health that we are asked to be aware of. Through an analysis of the websites of ParticipACTION, a publicly funded health and fitness campaign, and Fitbit, a corporation that produces wearable technologies, I show that these organizations provide their audiences with instructions for self-conduct in the pursuit of health through the piety that time is a resource to be managed. Through this piety, ParticipACTION and Fitbit’s websites each reify an altar of health where health is represented as a socially and physically fitter (optimized) self, always just out of reach and attainable in the future. I conclude with a call for critical descriptions of health awareness to move beyond the explanatory power of neoliberalization of health, and turn to the work of Rachel Sanders, Annmarie Mol, and Donna Haraway as possible avenues for resisting optimization.
      Citation: Health
      PubDate: 2021-02-05T05:09:05Z
      DOI: 10.1177/1363459320988886
       
  • Pharmaceutical citizenship in an era of universal access to hepatitis C
           treatment: Situated potentials and limits

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      Authors: Jake Rance, Tim Rhodes, Kari Lancaster
      Abstract: Health, Ahead of Print.
      Until recently, the only medical treatment available for the hepatitis C virus (HCV) was interferon-based therapy, a notoriously long and arduous treatment with limited success. However, in December 2015, the Australian Government announced a scheme of ‘universal access’ to new, highly effective direct-acting antiviral therapies (DAAs). This article draws on in-depth interviews with community actors engaged in national and state-based drug user and viral hepatitis advocacy to trace how universal access to curative medicines affords revised notions of citizenship and social inclusion among people who inject drugs and others affected by HCV. To inform our analysis, we draw on and combine critical perspectives from the biological citizenship literature, particularly pharmaceutical citizenship, along with work on the concepts of ‘publics and counterpublics’. We ask: what kinds of emergent HCV communities or publics are being enacted through our participant accounts in response to the new DAA-era of universal access, and what forms of citizenship and inclusion (or non-citizenship and exclusion) do they postulate' Some accounts indeed enacted treatment as an individual, sometimes collective, ‘good’: a citizenship potential. However, a number of accounts enacted situated limits to a straightforward actualisation of this potential, performing a model of public health governance that prioritised viral cure whilst rendering injecting drug use and its attendant social disadvantages an absent presence. Reconceptualising HCV treatment within a counterpublic health sensibility would, by engaging with the everyday health needs and aspirations of people living with HCV in conditions of social disadvantage, create space for new social inclusions and citizenships.
      Citation: Health
      PubDate: 2021-01-28T10:03:12Z
      DOI: 10.1177/1363459320988887
       
  • Vulnerability as a palimpsest: Practices and public policy in a Mexican
           hospital setting

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      Authors: Tirsa Colmenares-Roa, Juan Guillermo Figueroa-Perea, Blanca Pelcastre-Villafuerte, Lugarda Cervantes-Molina, Clara Juárez-Ramirez, Jessica Guadarrama, Nashielli Ramirez-Hernández, Mario Ulises Pérez Zepeda, Ingris Peláez-Ballestas
      Abstract: Health, Ahead of Print.
      Vulnerability is a concept associated with the effects of social inequities to access health care services. On a hospital level, vulnerable populations must be identified and favored over others. The aims of this study were the analysis of the conceptions and practices of social workers regarding vulnerable patients, and the identification of theoretical elements of vulnerability given by academics. Hospital ethnography and a focus group were implemented. Social workers related vulnerability to the social needs of each patient; however, they state that they have dilemmas to identify a person in a vulnerable condition; these dilemmas are related to social differences and deservingness. Academics indicated that the vulnerability should refer to the lack of access to health services offered by the institution. Academics agree with social workers regarding the importance of considering the overlapped social and individual circumstances in each patient to recognize their vulnerable condition, regardless of belonging to any of the pre-established vulnerable groups. Finally, taking into account the way of conceptualizing vulnerability and how public policy on the identification of vulnerable patients in the hospital has been implemented, these two elements are explained using the palimpsest model, which is a figure of thought that can be applied to analyze the sociocultural significance of this complex issue, as well as other social dynamics.
      Citation: Health
      PubDate: 2021-01-20T07:03:37Z
      DOI: 10.1177/1363459320988879
       
  • Doing nothing' An ethnography of patients’ (In)activity on an
           acute stroke unit

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      Authors: Alessia Costa, Fiona Jones, Stefan T Kulnik, David Clarke, Stephanie Honey, Glenn Robert
      Abstract: Health, Ahead of Print.
      Health research has begun to pay increasing attention to inactivity in its broadest sense as lack of meaningful activity and boredom. Few studies however have taken a critical look at this phenomenon. We explore (in)activity drawing on ethnographic data from observations in an acute stroke unit and post-discharge interviews with stroke survivors and their families. Four themes emerged that explain patients’ (in)activity: (i) planned activities; (ii) ‘doing nothing’, (iii) the material environment of the unit; (iv) interactions with staff. Considering these themes, we seek to problematise received conceptual and methodological approaches to understanding (in)activity. We argue that (in)activity is best conceived not as lack of action or meaning, but as a situated practice encompassing both bodily and mental activities that reflect and reproduce the way in which life is collectively organised within a specific healthcare setting.
      Citation: Health
      PubDate: 2021-01-09T10:49:06Z
      DOI: 10.1177/1363459320969784
       
  • Critical suicide studies, between methodology and ethics: Introduction

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      Authors: Amy Chandler, Rob Cover, Scott J Fitzpatrick
      First page: 3
      Abstract: Health, Ahead of Print.

      Citation: Health
      PubDate: 2021-12-01T06:36:02Z
      DOI: 10.1177/13634593211061638
       
  • Representing suicide: Giving voice to a desire to die'

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      Authors: Ian Marsh, Rachel Winter, Lisa Marzano
      First page: 10
      Abstract: Health, Ahead of Print.
      Drawing on interview and online ethnographic data from a study of suicide on the railways, this paper describes the ways in which many of the concepts, assumptions and practices of mainstream suicide prevention are challenged in the accounts of those who are planning, or have enacted, a suicide attempt. We reflect on the ethical dilemmas which can arise for researchers (and practitioners) when lived experience accounts diverge – theoretically, morally and in terms of practical implications – from present-day expert ones. In online, ‘pro-choice’ suicide discussions, people describe beliefs, attitudes, ways of thinking and acting which stand in contrast to existing professional and clinical descriptions of suicide and suicidal behaviour. Most obviously, there is often a rejection of ‘pro-life’ positions, which are framed as ideological, oppressive and naïve. For researchers engaging in online ethnography of ‘pro-choice’ spaces, dilemmas can arise in relation to the representation of perspectives which fundamentally challenge not only prevailing norms within suicide research and prevention practice but socio-cultural norms more widely. Similar issues can arise when considering how best to represent research participants when their accounts diverge from accepted ‘expert’ knowledge and beliefs. In-depth qualitative interviews with those who have thought about or attempted to take their own life indicate that existing theories and models of suicide which start from assumptions of deficit and pathology underestimate the extent to which suicide, as the end result of an often-complex series of actions, requires a person to engage in logistical processes of planning, decision-making, imagination and adaptation. The accounts described here, gathered using two different methodological approaches, highlight the ethical issues which can surface when there are competing claims to (expert) knowledge, as well as differences in beliefs, attitudes and moral stance towards life and death. We argue that researchers need to reflect on their own ethical-moral position in relation to suicide, and on the practical consequences of their privileging of some voices at the expense of other, less well represented, ones.
      Citation: Health
      PubDate: 2021-09-20T09:47:34Z
      DOI: 10.1177/13634593211046843
       
  • Contesting constructs and interrogating research methods: Re-analysis of
           qualitative data from a hospital-based case study of self-harm management
           and prevention practices

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      Authors: Rhiannon Evans, Catherine Sampson, Sarah MacDonald, Lucy Biddle, Jonathan Scourfield
      First page: 27
      Abstract: Health, Ahead of Print.
      Discourses of self-harm, and also suicide, are often underpinned by a central tenet: prevention is the priority. This belief is seemingly so inscribed in research that it is rarely interrogated. The present paper re-analyses qualitative data from a hospital-based study of self-harm management and prevention practice. It aims to reflect upon, and disrupt, the authors’ latent assumptions about the construct of ‘prevention’, while reflecting on the research method used. Twenty-five individuals participated in semi-structured interviews: healthcare and affiliated professionals (n = 14); parents and carers (n = 8); and children and young people (aged 9–16 years) who had presented to an emergency department for self-harm, with or without suicidal intent (n = 3). We offer two central discursive considerations: (1) Self-harm prevention is largely an unintelligible concept, having to be reflexively constructed in situ. As such, it is questionable whether it makes sense to discuss the prevention of this amorphous and dynamic phenomenon, which cannot always be disentangled from everyday life; (2) Interviews entail significant biographical work for participants, notably the performance of personal and professional competence for the audience. These interactional dynamics offer a glimpse into the priorities, meanings and needs for participants in relation to self-harm. Together these considerations provide useful insights into how the interview method can serve as both a limiting and illuminating site of knowledge creation.
      Citation: Health
      PubDate: 2021-08-19T06:53:33Z
      DOI: 10.1177/13634593211038522
       
  • The ethics of facing the Other in suicide

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      Authors: Katrina Jaworski
      First page: 47
      Abstract: Health, Ahead of Print.
      Despite a plethora of existing literature on the topic of suicide, very little attention has been given to research ethics in practice in research on suicide. When suicide research does pay attention to the ethical issues researchers are likely to face, the focus is on the roles institutional human ethics review committees fulfil to ensure ethical conduct in all stages of research. In response to this problem, this article focuses on the philosophical relationship between qualitative methodology and research ethics in the context of researching queer youth suicide. In so doing, I draw on my experiences of interviewing gender-and sexually diverse young people about their familiarity with suicide. These experiences are based on a qualitative pilot study I conducted on queer youth suicide, which used the unstructured interview technique to collect data. Drawing on the works of Emmanuel Levinas and Judith Butler, I examine what it means to face the alterity of the suicidal ‘Other’, and what this facing entails in terms of research ethics as relational. I argue that facing reveals not only myself as more vulnerable than I anticipated, but also the suicidal ‘Other’ as agentic instead of only vulnerable and at-risk of suicide.
      Citation: Health
      PubDate: 2021-12-01T06:36:26Z
      DOI: 10.1177/13634593211061637
       
  • Suicide justice: Adopting Indigenous feminist methods in settler
           suicidology

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      Authors: Kristen Cardon
      First page: 66
      Abstract: Health, Ahead of Print.
      White settler colonies around the world have long reported disproportionately high rates of Indigenous suicides, a consequence of the continuing violence of imperialism. This article posits a need for interdisciplinary approaches to address this crisis and therefore turns to humanist methods developed in Indigenous and feminist scholarship. I analyze texts from U.S. psychologist Edwin Shneidman to rearticulate their relationship to what I call settler suicidology. I then evoke literary critic Eve K. Sedgwick’s reparative reading method to reimagine suicide prevention as suicide justice, reading the novel There There by Tommy Orange (Cheyenne and Arapaho) to advocate for distributive justice as a new approach to Indigenous suicide crises. My term suicide justice names increasing accountability between settler suicide workers and the communities they seek to serve.
      Citation: Health
      PubDate: 2021-09-21T06:45:14Z
      DOI: 10.1177/13634593211046837
       
  • The bounds of suicide talk: Implications for qualitative suicide research

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      Authors: Patti Ranahan, Veronica Keefe
      First page: 81
      Abstract: Health, Ahead of Print.
      Following the implementation of a provincial suicide prevention gatekeeper training initiative in western Canada between 2015 and 2018, we conducted a focused ethnography designed to capture the post-initiative context within one small community. Analyses of our field observations and interviews with community members suggest suicide prevention work is represented in multiple informal or coordinated actions to generate innovative pathways to provoke open conversations about suicide. Simultaneously, suicide talk is constrained and managed to limit vulnerability and exposure and adhere to community privacy norms. Further, parameters around suicide talk may be employed in efforts to construct the community and mental health care in livable ways. As the research process paralleled existing representations of suicide prevention work in the community, this paper explores our entanglement in the bounds of suicide talk during phases of recruitment, data collection and knowledge translation activities.
      Citation: Health
      PubDate: 2021-11-27T08:28:10Z
      DOI: 10.1177/13634593211060767
       
  • A question of justice: Critically researching suicide with Indigenous
           studies of affect, biosociality, and land-based relations

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      Authors: Jeffrey Ansloos, Shanna Peltier
      First page: 100
      Abstract: Health, Ahead of Print.
      This paper considers how Indigenous studies can inform the evolution of critical research on suicide. Aligned with critiques of mainstream suicidology, these methodological approaches provide a roadmap for structural analysis of complex systems and logics in which the phenomenon of suicide emerges. Moving beyond mere naming of social determinants of suicide and consistent with calls for a theory of justice within suicide research, Indigenous studies helps to advance conceptual knowledge of suicide in descriptive means and enhance ethical responses to suicide beyond psychocentric domains. Through centering Indigenous theories of affect, biosociality, and land-based relations, this article examines what new knowledge of suicide can emerge, as well as what ethical responses are possible to suicide and to a world where suicide exists. This new knowledge can inform practices for critical suicide studies which are invested in resisting structural violence, nourish agency, dignity and freedom for those living and dying in often-unlivable presents, and enhancing livability for individuals, communities, and the environment living under shadows of empire. Implications for theory, ethics, and suicide research and prevention practice are considered.
      Citation: Health
      PubDate: 2021-09-13T09:22:24Z
      DOI: 10.1177/13634593211046845
       
  • An autopsy of the coloniality of suicide: Modernity’s completed
           genocide

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      Authors: Tisha X, marcela polanco
      First page: 120
      Abstract: Health, Ahead of Print.
      From the Latin American modernity/coloniality project, we address the inhospitality of the modern/colonial and globally designed world-system in relation to suicidality. In our vernacular Spanglish, guided by epistemological disobedience, and responding to epistemicide, we interpellate ourselves to unmask the hidden colonial structures of power of modernity’s global design on suicide knowledge. Our intent is to argue, specifically from the perspective of coloniality and our racialized, gendered, and monetized bodies, that suicide is rather an extension of modernity’s colonial genocide. From the decolonial geo and body-politics of knowledge, our discussion on modernity’s Eurocentric rhetoric on suicide departs from the materialization of suicidality in our flesh. We story experiences of our bodies with life and pleas of death, within the context of our immigrant backgrounds, and as family therapists in the United States (U.S.). We adopt autopsy as an analogy from where to advance such analysis to contest Eurocentric configurations of suicide from within, but against modernity. We emphasize the hidden racism and capitalism of suicide embedded within the persuasive Eurocentric promises of the Anglo scientific method and the U.S. American Dream. We address the concepts of epistemicide, coloniality of knowledge and of being. It is our hope to contribute to further advance decolonizing possibilities to reinscribe options that would border with the current Western knowledge on suicide. This may require other configurations of the body, knowledge, hence ways of being, doing, thinking, sensing, feeling, imagining, and dreaming to coexist among pluriversal hospitable worlds of life and death.
      Citation: Health
      PubDate: 2021-08-18T09:19:10Z
      DOI: 10.1177/13634593211038517
       
 
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