Subjects -> HEALTH AND SAFETY (Total: 1562 journals)
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    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (740 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH FACILITIES AND ADMINISTRATION (390 journals)                  1 2 | Last

Showing 1 - 200 of 397 Journals sorted alphabetically
ACI Open     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 22)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access   (Followers: 1)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 17)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 48)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Medical Education and Practice     Open Access   (Followers: 34)
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 89)
Advances in Nursing Science     Hybrid Journal   (Followers: 43)
Advances in Simulation     Open Access   (Followers: 7)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
AIDS and Behavior     Hybrid Journal   (Followers: 18)
American Journal of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 48)
American Journal of Managed Care     Full-text available via subscription   (Followers: 13)
Analytical Methods     Full-text available via subscription   (Followers: 14)
Anthropologie et santé     Open Access   (Followers: 5)
Applied Clinical Informatics     Hybrid Journal   (Followers: 5)
Applied Health Economics and Health Policy     Full-text available via subscription   (Followers: 24)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 13)
Archives of Public Health     Open Access   (Followers: 13)
Asian Journal of Health     Open Access   (Followers: 4)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian and New Zealand Journal of Public Health     Hybrid Journal   (Followers: 17)
Australian Health Review     Hybrid Journal   (Followers: 7)
Australian Journal of Primary Health     Hybrid Journal  
Australian Journal of Rural Health     Hybrid Journal   (Followers: 18)
Autism     Hybrid Journal   (Followers: 350)
Avicenna     Open Access   (Followers: 3)
Balint Journal     Hybrid Journal   (Followers: 2)
Bereavement Care     Hybrid Journal   (Followers: 13)
BJR     Hybrid Journal   (Followers: 21)
BMC Medical Informatics and Decision Making     Open Access   (Followers: 25)
BMC Oral Health     Open Access   (Followers: 7)
BMJ Leader     Hybrid Journal  
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 50)
British Journal of Healthcare Assistants     Full-text available via subscription   (Followers: 33)
British Journal of Healthcare Management     Full-text available via subscription   (Followers: 19)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 18)
British Journal of Nursing     Full-text available via subscription   (Followers: 297)
British Journal of School Nursing     Full-text available via subscription   (Followers: 14)
Bruce R Hopkins' Nonprofit Counsel     Hybrid Journal   (Followers: 2)
Building Better Healthcare     Full-text available via subscription   (Followers: 1)
Canadian Nurse     Full-text available via subscription   (Followers: 8)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Children and Schools     Hybrid Journal   (Followers: 8)
Chinese Medical Record English Edition     Hybrid Journal  
CIN : Computers Informatics Nursing     Hybrid Journal   (Followers: 11)
Clinical Audit     Open Access   (Followers: 4)
Clinics and Practice     Open Access  
Cognition, Technology & Work     Hybrid Journal   (Followers: 14)
Communication & Medicine     Hybrid Journal   (Followers: 5)
Community Based Medical Journal     Open Access  
Conflict and Health     Open Access   (Followers: 8)
Contemporary Nurse : A Journal for the Australian Nursing Profession     Hybrid Journal   (Followers: 7)
Critical Public Health     Hybrid Journal   (Followers: 26)
Culture, Health & Sexuality: An International Journal for Research, Intervention and Care     Hybrid Journal   (Followers: 17)
Current Opinion in Supportive and Palliative Care     Hybrid Journal   (Followers: 28)
Das Gesundheitswesen     Hybrid Journal   (Followers: 10)
Death Studies     Hybrid Journal   (Followers: 22)
Dental Nursing     Full-text available via subscription   (Followers: 3)
Disaster Health     Hybrid Journal   (Followers: 1)
DoctorConsult - The Journal. Wissen für Klinik und Praxis     Full-text available via subscription  
Droit, Déontologie & Soin     Full-text available via subscription   (Followers: 3)
E-Health Telecommunication Systems and Networks     Open Access   (Followers: 2)
East and Central African Journal of Surgery     Open Access  
Éducation thérapeutique du patient     Full-text available via subscription   (Followers: 1)
eGEMs     Open Access  
Emergency Radiology     Hybrid Journal   (Followers: 10)
Enfermería Clínica     Full-text available via subscription   (Followers: 3)
Epidemiologic Methods     Hybrid Journal   (Followers: 4)
Ergonomics     Hybrid Journal   (Followers: 24)
Escola Anna Nery     Open Access   (Followers: 1)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
European Journal of Public Health     Hybrid Journal   (Followers: 27)
European Journal of Work and Organizational Psychology     Hybrid Journal   (Followers: 35)
European Research in Telemedicine / La Recherche Européenne en Télémédecine     Full-text available via subscription   (Followers: 2)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidence-Based Nursing     Hybrid Journal   (Followers: 74)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Expert Opinion on Therapeutic Patents     Hybrid Journal   (Followers: 12)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family Practice Management     Full-text available via subscription   (Followers: 5)
Focus on Health Professional Education : A Multi-disciplinary Journal     Full-text available via subscription   (Followers: 7)
Frontiers in Public Health Services and Systems Research     Open Access   (Followers: 5)
Future Hospital Journal     Full-text available via subscription   (Followers: 2)
Gastrointestinal Nursing     Full-text available via subscription   (Followers: 5)
Geron     Full-text available via subscription  
Global & Regional Health Technology Assessment     Open Access   (Followers: 1)
Global Health Action     Open Access   (Followers: 12)
Global Health Management Journal (GHMJ)     Open Access   (Followers: 1)
Global Health Research and Policy     Open Access   (Followers: 4)
Global Journal of Hospital Administration     Open Access   (Followers: 1)
Global Public Health: An International Journal for Research, Policy and Practice     Hybrid Journal   (Followers: 21)
Globalization and Health     Open Access   (Followers: 9)
Handbook of Practice Management     Hybrid Journal   (Followers: 2)
Health     Open Access   (Followers: 5)
Health & Social Care In the Community     Hybrid Journal   (Followers: 54)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 16)
Health and Interprofessional Practice     Open Access   (Followers: 6)
Health and Technology     Hybrid Journal   (Followers: 4)
Health Care Analysis     Hybrid Journal   (Followers: 17)
Health Care Management Review     Hybrid Journal   (Followers: 16)
Health Economics     Hybrid Journal   (Followers: 59)
Health Expectations     Open Access   (Followers: 16)
Health Facilities Management     Free   (Followers: 10)
Health Informatics Journal     Hybrid Journal   (Followers: 28)
Health Information : Jurnal Penelitian     Open Access   (Followers: 5)
Health Information Science and Systems     Open Access   (Followers: 4)
Health Policy and Management     Open Access   (Followers: 7)
Health Policy and Planning     Hybrid Journal   (Followers: 27)
Health Professions Education     Open Access   (Followers: 3)
Health Promotion International     Hybrid Journal   (Followers: 28)
Health Promotion Practice     Hybrid Journal   (Followers: 18)
Health Psychology     Full-text available via subscription   (Followers: 62)
Health Psychology Review     Hybrid Journal   (Followers: 46)
Health Reform Observer : Observatoire des Réformes de Santé     Open Access   (Followers: 2)
Health Research Policy and Systems     Open Access   (Followers: 16)
Health Science Journal of Indonesia     Open Access   (Followers: 2)
Health Services Research and Managerial Epidemiology     Open Access   (Followers: 3)
Health, Risk & Society     Hybrid Journal   (Followers: 14)
Healthcare : The Journal of Delivery Science and Innovation     Full-text available via subscription   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Management Forum     Hybrid Journal   (Followers: 8)
Healthcare Policy / Politiques de Santé     Full-text available via subscription   (Followers: 5)
Healthcare Quarterly     Full-text available via subscription   (Followers: 10)
Healthcare Risk Management     Full-text available via subscription   (Followers: 5)
HealthcarePapers     Full-text available via subscription   (Followers: 2)
Hispanic Health Care International     Full-text available via subscription  
História, Ciências, Saúde - Manguinhos     Open Access   (Followers: 2)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 3)
Hospital     Open Access   (Followers: 3)
Hospital a Domicilio     Open Access  
Hospital Medicine Clinics     Full-text available via subscription   (Followers: 2)
Hospital Peer Review     Full-text available via subscription   (Followers: 1)
Hospital Pharmacy     Partially Free   (Followers: 18)
Hospital Practice     Hybrid Journal   (Followers: 2)
Hospital Practices and Research     Open Access  
Housing, Care and Support     Hybrid Journal   (Followers: 9)
Human Factors : The Journal of the Human Factors and Ergonomics Society     Full-text available via subscription   (Followers: 39)
Human Resources for Health     Open Access   (Followers: 12)
ICU Director     Hybrid Journal  
Ids Practice Papers     Hybrid Journal  
IEEE Pulse     Hybrid Journal   (Followers: 5)
IISE Transactions on Healthcare Systems Engineering     Hybrid Journal   (Followers: 2)
Independent Nurse     Full-text available via subscription   (Followers: 3)
Index de Enfermeria     Open Access   (Followers: 7)
Indian Journal of Public Health     Open Access   (Followers: 1)
Informatics for Health and Social Care     Hybrid Journal   (Followers: 10)
Innovation and Entrepreneurship in Health     Open Access   (Followers: 1)
INQUIRY : The Journal of Health Care Organization, Provision, and Financing     Open Access   (Followers: 1)
Interface - Comunicação, Saúde, Educação     Open Access   (Followers: 1)
International Archives of Health Sciences     Open Access  
International Journal for Equity in Health     Open Access   (Followers: 9)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 41)
International Journal of Care Coordination     Hybrid Journal   (Followers: 7)
International Journal of Computers in Healthcare     Hybrid Journal   (Followers: 3)
International Journal of Electronic Healthcare     Hybrid Journal   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 27)
International Journal of Health Administration and Education Congress (Sanitas Magisterium)     Open Access  
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 15)
International Journal of Health Economics and Management     Hybrid Journal   (Followers: 12)
International Journal of Health Governance     Hybrid Journal   (Followers: 27)
International Journal of Health Planning and Management     Hybrid Journal   (Followers: 6)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services Research and Policy     Open Access   (Followers: 1)
International Journal of Health System and Disaster Management     Open Access   (Followers: 3)
International Journal of Healthcare     Open Access   (Followers: 1)
International Journal of Healthcare Technology and Management     Hybrid Journal   (Followers: 7)
International Journal of Hospital Research     Open Access  
International Journal of Human Factors and Ergonomics     Hybrid Journal   (Followers: 20)
International Journal of Human Rights in Healthcare     Hybrid Journal   (Followers: 5)
International Journal of Medicine and Public Health     Open Access   (Followers: 6)
International Journal of Migration, Health and Social Care     Hybrid Journal   (Followers: 12)
International Journal of Occupational and Environmental Medicine, The     Open Access   (Followers: 16)
International Journal of Palliative Nursing     Full-text available via subscription   (Followers: 32)
International Journal of Positive Behavioural Support     Full-text available via subscription   (Followers: 38)
International Journal of Prisoner Health     Hybrid Journal   (Followers: 14)
International Journal of Privacy and Health Information Management     Full-text available via subscription   (Followers: 3)
International Journal of Public and Private Healthcare Management and Economics     Full-text available via subscription   (Followers: 4)
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 22)
International Journal of Reliable and Quality E-Healthcare     Full-text available via subscription   (Followers: 1)
International Journal of Research in Nursing     Open Access   (Followers: 12)
International Journal of Technology Assessment in Health Care     Hybrid Journal   (Followers: 16)
International Journal of Telemedicine and Clinical Practices     Hybrid Journal   (Followers: 5)
International Journal of Telework and Telecommuting Technologies     Full-text available via subscription  
International Journal of Therapy and Rehabilitation     Full-text available via subscription   (Followers: 42)
International Journal of User-Driven Healthcare     Full-text available via subscription   (Followers: 1)
International Journal on Disability and Human Development     Hybrid Journal   (Followers: 23)
Irish Journal of Paramedicine     Open Access   (Followers: 3)
JAAPA     Hybrid Journal   (Followers: 3)
Jaffna Medical Journal     Open Access  
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
Journal for Healthcare Quality     Hybrid Journal   (Followers: 28)
Journal of Advanced Nursing     Hybrid Journal   (Followers: 252)
Journal of Advances in Medical Education & Professionalism     Open Access   (Followers: 10)
Journal of Aging and Health     Hybrid Journal   (Followers: 27)
Journal of Ambulatory Care Management, The     Hybrid Journal   (Followers: 4)
Journal of Applied Arts and Health     Hybrid Journal   (Followers: 1)

        1 2 | Last

Similar Journals
Journal Cover
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
Journal Prestige (SJR): 0.524
Citation Impact (citeScore): 2
Number of Followers: 16  
Hybrid Journal Hybrid journal   * Containing 1 Open Access Open Access article(s) in this issue *
ISSN (Print) 1363-4593 - ISSN (Online) 1461-7196
Published by Sage Publications Homepage  [1149 journals]
  • Articulating the canon: The sociology of medical education from 1980 to
    • 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)
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
  • ‘Bad choices’: Unintended pregnancy and abortion in nurses’ and
           counsellors’ accounts of providing pre-abortion counselling
    • Authors: Jabulile Mary-Jane Jace Mavuso, Catriona Ida Macleod
      Abstract: Health, Ahead of Print.
      Little research tackles healthcare providers’ experiences in conducting pre-abortion counselling sessions in circumstances where pregnant persons may request an abortion. We report on a study conducted in South Africa, in which two nurses and two counsellors were asked about how they conduct these counselling sessions. Using a synthetic narrative approach, we present these health workers’ micro-narratives about their motivations for providing abortion services, the purpose of the counselling, their information-giving practices, and whether and how third parties are included in the counselling. We highlight how these micro-narratives are premised on discursive resources that problematise unintended pregnancy and abortion. These resources enable and justify directive counselling that undermines pregnant peoples’ reproductive autonomy. We locate such directiveness within dominant anti-abortion discourse and call for training to reframe normative understandings of abortion.
      Citation: Health
      PubDate: 2021-01-21T09:09:36Z
      DOI: 10.1177/1363459320988873
  • Vulnerability as a palimpsest: Practices and public policy in a Mexican
           hospital setting
    • 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
    • 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
  • Book review: Dahlia Schweitzer, Going Viral: Zombies, Viruses, and the End
           of the World and Mark Honigsbaum, The Pandemic Century: 100 Years of
           Panic, Hysteria, and Hubris
    • Authors: Jeremiah Morelock
      Pages: 395 - 396
      Abstract: Health, Volume 25, Issue 3, Page 395-396, May 2021.

      Citation: Health
      PubDate: 2020-07-27T11:19:17Z
      DOI: 10.1177/1363459320944732
      Issue No: Vol. 25, No. 3 (2020)
  • A new kind of gatekeeper: The increasing prevalence of Advanced Practice
           Nurses as case managers in US hospitals
    • Authors: Scott Feyereisen, Neeraj Puro, Clayton Thomas, William McConnell
      Abstract: Health, Ahead of Print.
      Case management is a representation of managed care, cost-containment organizational practices in healthcare, where managed care and its constitutive parts are situated against physician autonomy and decision-making. As a professional field, case management has evolved considerably, with the role recently taken up increasingly by Advanced Practice Nurses in various health care settings. We look at this evolution of a relatively new work task for Advanced Practice Nurses using a countervailing powers perspective, which allows us to move beyond discussions of case management effectiveness and best practices, and draw connections to trends in the social organization of healthcare, especially hospitals. We evaluated organizational (hospital-level) and environmental (county and state-level) characteristics associated with hospitals’ use of Advanced Practice Nurses as case managers, using data from U.S. community acute care hospitals for 2016–2018, collected from three data sources: American Hospital Association annual survey (AHA), Centers for Medicare and Medicaid Services (CMS), and Area Resource File. Among organizational characteristics, we found that hospitals that are a part of established Accountable Care Organizations (OR = 2.55, p = 0.009; 95% CI = 1.26–5.14) and those that serve higher acuity patients, as indicated by possessing a higher Case Mix Index (OR = 1.32, p = 0.001; 95% CI = 1.13–1.55), were more likely to use Advanced Practice Nurses as case managers. Among environmental characteristics, having higher local Advanced Practice Nurses concentrations (OR = 1.24, p 
      Citation: Health
      PubDate: 2020-12-16T07:35:12Z
      DOI: 10.1177/1363459320976758
  • ‘To more than I can be’: A phenomenological meta-ethnography of
           singing groups for people with chronic obstructive pulmonary disease
    • Authors: Heather Yoeli, Jane Macnaughton
      Abstract: Health, Ahead of Print.
      Anecdotal experience and qualitative accounts suggest that singing groups, classes or choirs specifically for people with COPD (henceforth referred to as COPD-SGs) are effective in improving health. However, this is not reflected in the quantitative evidence. This meta-ethnography deployed phenomenological methods to explore this discrepancy. Analysis identified the phenomena of being together, being uplifted and being involved as central benefits of COPD-SGs. When viewed through the phenomenological lens of body-social as distinct from body-subject and body-object, findings demonstrated that the qualitative effectiveness of COPD-SGs is greatest on a collective basis. Qualitative research into the effectiveness of COPD-SGs offers more favourable results because phenomenological approaches can identify collective benefits that quantitative methods cannot. COPD-SGs should seek to maximise these collective benefits by rediscovering their cultural and artistic heritage within the national and global Arts in Health (AiH) movement, which has long emphasised the radical creative and healing power of group activity.
      Citation: Health
      PubDate: 2020-12-15T08:56:06Z
      DOI: 10.1177/1363459320978520
  • Medicalisation, suffering and control at the end of life: The interplay of
           deep continuous palliative sedation and assisted dying
    • Authors: Gitte Hanssen Koksvik, Naomi Richards, Sheri Mila Gerson, Lars Johan Materstvedt, David Clark
      Abstract: Health, Ahead of Print.
      Medicalisation is a pervasive feature of contemporary end of life and dying in Western Europe and North America. In this article, we focus on the relationship between two specific aspects of the medicalisation of dying: deep continuous palliative sedation until death and assisted dying. We draw upon a qualitative interview study with 29 health professionals from three jurisdictions where assisted dying is lawful: Flanders, Belgium; Oregon, USA; and Quebec, Canada. Our findings demonstrate that the relationship between palliative sedation and assisted dying is often perceived as fluid and complex. This is inconsistent with current laws as well as with ethical and clinical guidelines according to which the two are categorically distinct. The article contributes to the literature examining health professionals’ opinions and experiences. Moreover, our findings inform a discussion about emergent themes: suffering, timing, autonomy and control – which appear central in the wider discourse in which both palliative sedation and assisted dying are situated, and which in turn relate to the wider ideas about what constitutes a ‘good death’.
      Citation: Health
      PubDate: 2020-12-12T07:06:09Z
      DOI: 10.1177/1363459320976746
  • The patient as a policy problem: Ambiguous perceptions of a critical
           interface in healthcare
    • Authors: Peter Garpenby, Ann-Charlotte Nedlund
      Abstract: Health, Ahead of Print.
      The interface between the patient and the health service has changed, which constitutes a potential problem for various policy-makers. Using a critical policy perspective and drawing on the theory of problem framing, this paper explores how actor groups with different responsibilities perceive the patient as a constructed policy problem. This is a qualitative study where data consists of single episode interviews with healthcare politicians, senior administrators, service strategists, and unit mangers from one regional health authority in Sweden. A thematic content analysis of the interviews was carried out in accordance with “the framework approach”. The study illustrates how the actors interpret their reality using diverse problem frames. This becomes more visible when the framing is disentangled with regard to what perspective they employ in relation to different accounts: society or the individual, or the (healthcare) system or the (healthcare) professional. The actor groups are part of the same institutional context, which explains certain tendencies of similarities in terms of the accounts being used, but still they approach the constructed problem differently which is visible as shifts—scaling up and down—between different accounts. By analyzing and structuring the various problem frames (including its policy styles) we can enhance our knowledge about how those responsible for the governance of healthcare approach the patient as a policy problem, as something that concerns only the patient and/or the provider, or as something that needs to be addressed in broader strategic terms.
      Citation: Health
      PubDate: 2020-12-09T06:07:36Z
      DOI: 10.1177/1363459320976757
  • Psychosocial challenges and concerns of COVID-19: A qualitative study in
    • Authors: Fardin Alipour, Maliheh Arshi, Shokoufeh Ahmadi, Richard LeBeau, Asiyeh Shaabani, Leila Ostadhashemi
      Abstract: Health, Ahead of Print.
      As the world struggles to cope with the COVID-19 pandemic, it is critical that the psychosocial aspects related to health are attended to in addition to biological aspects. To this end, the present study aimed to explore the challenges and concerns facing people affected by COVID-19. This qualitative study was conducted using the content analysis method. A total of 25 people affected by COVID-19 were selected purposefully and administered semi-structured interviews. The sampling continued until data saturation. Coding and analysis of data were performed simultaneously using the Granheim method. After reviewing codes, checking the consistency and comparing categories, 5 categories, and 15 subcategories were explored. The most important psychosocial challenges of COVID-19 included the lack of accurate and timely dissemination of information, the intensification of economic problems, psychological instability, weakness in social prevention, and the suspension of social rituals. Identifying the psychosocial challenges and problems of people who faced by pandemic diseases such as COVID-19, and developing appropriate and timely planning for managing them can lead to designing effective strategies for prevention, treatment, and recovery of affected communities.
      Citation: Health
      PubDate: 2020-12-08T06:44:32Z
      DOI: 10.1177/1363459320976752
  • Enacting objects and subjects in a children’s rehabilitation clinic:
           Default and shifting ontological politics of muscular dystrophy care
    • Authors: Patricia Thille, Thomas Abrams, Barbara E Gibson
      Abstract: Health, Ahead of Print.
      In health care clinics, problems are constructed through interactions, a choreography of human and non-human actors together enacting matters of concern. Studying the ways in which a body, person, family, or environment is objectified for clinical purposes opens discussion about advantages and disadvantages of different objectification practices, and exploration of creative ways to handle the diversity and tensions that exist. In this analysis, we explored objectifications in a Canadian neuromuscular clinic with young people with muscular dystrophy. This involved a close examination of clinical objectification practices across a series of 27 observed appointments. We identified the routinised clinical assessments, and argue these embed a default orientation to how to intervene in people’s lives. In this setting, the routine focused on meeting demands of daily activities while protecting the at-risk-body, and working toward an abstract sense of an independent future for the person/body with muscular dystrophy. But the default could be disrupted; through our analysis of the routine and disruptions, we highlight how contesting visions for the present and future were consequential in ways that might be more than what is anticipated within rehabilitation practice.
      Citation: Health
      PubDate: 2020-11-02T11:19:48Z
      DOI: 10.1177/1363459320969783
  • “This is what the truth is”: Provider-patient interactions serving as
           barriers to contraception
    • Authors: Virginia Kuulei Berndt, Ann V Bell
      Abstract: Health, Ahead of Print.
      Contraception is a vital component of women’s reproductive health, but not all women use it consistently and effectively. Many studies explore individual-level barriers to contraceptive use, yet interactional barriers are important to understand since contraception is primarily obtained through provider-patient interactions. Thus, through interviews with 86 women and 51 providers in the United States, we employ a framework of biomedicalization to study how such interactions, including the knowledge bases that inform them, shape women’s contraceptive decision-making. We find that when women’s embodied knowledge and providers’ biomedical knowledge differ, providers’ preferences supersede women’s. Providers, however, overlook this hierarchy, instead viewing their relationships with patients as empowering equal partnerships. This pattern precludes women from achieving their desired contraceptive method and highlights the process through which women’s concerns become barriers to contraceptive use. Moreover, these findings reflect how provider-patient hierarchies continue to thrive despite purported patient-centered care models.
      Citation: Health
      PubDate: 2020-10-30T12:00:40Z
      DOI: 10.1177/1363459320969775
  • Disciplining empathy: Differences in empathy with U.S. medical students by
           college major
    • Authors: Lauren D. Olsen, Hana Gebremariam
      Abstract: Health, Ahead of Print.
      Citing their students’ low levels of empathy, medical educators have scrambled to implement curricula with the hopes of buffering against the corrosive effects of biomedical and clinical experiences in medical school. The assumption undergirding these studies by social scientists and medical educators alike is that immersion in biomedical education and clinical experience erodes students’ empathic capacities, and that exposure to humanities and social sciences content will amend these losses. But we do not know if this assumption is correct. In this project, we empirically assess this assumption by utilizing a unique data set constructed from student applicant and survey data from the American Medical College Application Service (AMCAS) and the Association of American Medical Colleges (AAMC). We test whether medical school students (N = 8255) from the United States (U.S.) with different academic backgrounds represented by their college major have different levels of empathy, net of demographic control variables. We report two findings. First, we find that students who majored in humanities or interpretive social sciences disciplines have higher empathy scores than their peers who majored in the positivistic social sciences and STEM (science, technology, engineering, and mathematics) disciplines. Second, we find that the relationship between empathy and time in medical school is more nuanced than we would expect from the existing literature.
      Citation: Health
      PubDate: 2020-10-20T06:43:18Z
      DOI: 10.1177/1363459320967055
  • Examining the language demands of informed consent documents in patient
           recruitment to cancer trials using tools from corpus and computational
    • Authors: Talia Isaacs, Jamie Murdoch, Zsófia Demjén, Fiona Stevenson
      Abstract: Health, Ahead of Print.
      Obtaining informed consent (IC) is an ethical imperative, signifying participants’ understanding of the conditions and implications of research participation. One setting where the stakes for understanding are high is randomized controlled trials (RCTs), which test the effectiveness and safety of medical interventions. However, the use of legalese and medicalese in ethical forms coupled with the need to explain RCT-related concepts (e.g. randomization) can increase patients’ cognitive load when reading text. There is a need to systematically examine the language demands of IC documents, including whether the processes intended to safeguard patients by providing clear information might do the opposite through complex, inaccessible language. Therefore, the goal of this study is to build an open-access corpus of patient information sheets (PIS) and consent forms (CF) and analyze each genre using an interdisciplinary approach to capture multidimensional measures of language quality beyond traditional readability measures. A search of publicly-available online IC documents for UK-based cancer RCTs (2000-17) yielded corpora of 27 PIS and 23 CF. Textual analysis using the computational tool, Coh-Metrix, revealed different linguistic dimensions relating to the complexity of IC documents, particularly low word concreteness for PIS and low referential and deep cohesion for CF, although both had high narrativity. Key part-of-speech analyses using Wmatrix corpus software revealed a contrast between the overrepresentation of the pronoun ‘you’ plus modal verbs in PIS and ‘I’ in CF, exposing the contradiction inherent in conveying uncertainty to patients using tentative language in PIS while making them affirm certainty in their understanding in CF.
      Citation: Health
      PubDate: 2020-10-13T08:59:30Z
      DOI: 10.1177/1363459320963431
  • The transdisciplinary health research apparatus: A Baradian account of
           knowledge boundaries and beyond
    • Authors: Holly Thorpe, Marianne Clark, Julie Brice, Stacy Sims
      Abstract: Health, Ahead of Print.
      This paper engages with new materialist theory to reimagine transdisciplinary health research. In particular, we draw upon Karen Barad’s theory of agential realism and concept of apparatus to rethink the processes of doing transdisciplinary research. A Baradian inspired approach to transdisciplinarity encourages us to not only explore ways of knowing health phenomena differently by working across disciplines, but also to pay close attention to the politics and practices in such research. We offer a case study based on a two-year transdisciplinary research project focused on the health condition known as Low Energy Availability (LEA) in sportswomen. Through this case we highlight three key ways that Barad’s concept of apparatus helped us know transdisciplinarity differently: (1) Reading disciplines through each other, (2) Intra-actions and the everyday performativity of disciplinary boundaries, and (3) Troubling the boundaries of the apparatus. Ultimately this paper illustrates the value in feminist new materialist conceptual tools for encouraging different questions of transdisciplinary research as ethico-onto-epistemological practices, processes, and politics of knowledge production.
      Citation: Health
      PubDate: 2020-10-03T07:20:10Z
      DOI: 10.1177/1363459320961429
  • Exiting Alcoholics Anonymous disappointed: A qualitative analyses of the
           experiences of ex-members of AA
    • Authors: Hannah Sally Glassman, Paul Rhodes, Niels Buus
      Abstract: Health, Ahead of Print.
      Alcoholics Anonymous (AA) is an NGO designed to support anyone who identifies as alcoholic to stop drinking alcohol. Existing qualitative research in this field has primarily reflected the experiences of those who have conformed to AA ideology and had positive experiences in AA. To address this, the current study aimed to explore the perspectives and experiences of individuals who have left AA with some degree of disappointment. The study involved semi-structured interviews with 11 ex-members of AA from America, Australia, and England, who were recruited from several private social media platforms. The study used an interactionist conception of social career involving conversion and deconversion, and data were analyzed thematically. Findings included that while participants experienced some genuinely positive aspects of AA, they retrospectively believed that they remained in AA because they had been indoctrinated into a particular way of understanding themselves. Moreover, findings highlighted participants’ concerns with the people, ideology and practices within AA that ultimately led to their dissociation from the community. Our findings demonstrate a disparity between the idealistic principles in AA and the actual experiences of participants, and this is discussed in relation to the breadth of possible experiences across varying groups and AA’s unregulated peer-to-peer framework.
      Citation: Health
      PubDate: 2020-09-30T07:38:48Z
      DOI: 10.1177/1363459320961438
  • Mass media and communication interventions to increase HIV testing among
           gay and other men who have sex with men: Social marketing and visual
           design component analysis
    • Authors: Julie Riddell, Gemma Teal, Paul Flowers, Nicola Boydell, Nicky Coia, Lisa McDaid
      Abstract: Health, Ahead of Print.
      Mass media and communication interventions can play a role in increasing HIV testing among gay, bisexual and other men who have sex with men (GBMSM). Despite the key role of social marketing principles and visual design within intervention development of this type, evidence is limited regarding interventions’ social marketing mix or visual design. As part of a systematic review, intervention content was assessed using social marketing theory and social semiotics. Data were extracted on the nature of the intervention, mode of delivery, use of imagery, content and tone and the eight key characteristics of social marketing. Data were synthesised narratively. Across the 19 included studies, reference to social marketing principles was often superficial. Common design features were identified across the interventions, regardless of effectiveness, including: the use of actors inferred to be GBMSM; use of ‘naked’ and sexually explicit imagery; and the use of text framed as statements or instructions. Our results suggest that effective interventions tended to use multiple modes of delivery, indicating high social marketing complexity. However, this is only part of intervention development, and social marketing principles are key to driving the development process. We identified consistent aspects of intervention design, but were unable to determine whether this is based on evidence of effectiveness or a lack of originality in intervention design. An openness to novel ideas in design and delivery is key to ensuring that evidence-informed interventions are effective for target populations.
      Citation: Health
      PubDate: 2020-09-19T10:58:12Z
      DOI: 10.1177/1363459320954237
  • Becoming a complementary health practitioner: The construction of
           alternative medical knowledge
    • Authors: Maayan Roichman
      Abstract: Health, Ahead of Print.
      Complementary and alternative medicine (CAM) has become widely popular in many countries, yet little is known about the actual training of CAM practitioners. This article employs ethnographic research methods to closely examine the meaning-making processes used in such training at a complementary and alternative medical college. It delineates how CAM practitioners in training, specialising in naturopathy, make sense of alternative medical knowledge and transform it into medical truth. The study indicates that the core of CAM training rests on overturning the biomedical epistemological hierarchy between the objectification of disease and the experience of illness through extended intersubjective sharing by instructors and students. This study therefore adds to the extensive CAM literature by carefully examining the way naturopathic knowledge is inculcated during practitioner training. The emerging insight is that introspection and the search for authenticity, a central narrative of modernity, have become powerful resources in CAM’s construction of alternative medical truth.
      Citation: Health
      PubDate: 2020-08-13T09:49:16Z
      DOI: 10.1177/1363459320946463
  • HIV stigma in UK press reporting of a case of intentional HIV transmission
    • Authors: Rusi Jaspal, Brigitte Nerlich
      Abstract: Health, Ahead of Print.
      The UK has set itself the ambitious target of zero new HIV transmissions by 2030. HIV stigma is a significant barrier to achieving this target. Media reporting plays an important role in shaping social representations of HIV and of stigma. Between 2016 and 2018, the media in the UK reported on the Daryll Rowe case – the first criminal prosecution for intentional transmission of HIV in the UK. This article examines the way that UK newspapers reported this case, which may have exacerbated HIV stigma. Using Nexis, 178 UK newspaper articles were extracted and subjected to qualitative thematic analysis through a social constructionist lens. Informed by social representations theory, the analysis yielded three discursive themes: (1) Representing the perpetrator through HIV-focussed metaphors; (2) Constructing volitional ambiguity; and (3) Anchoring the lived experience of HIV to misery and death. UK newspapers constructed an ‘evil vs victimhood’ dichotomy in relation to Rowe and the men infected with HIV, respectively. This article argues that news coverage of the Rowe story constructs HIV in ways that are inconsistent with public health messaging. Reporting failed to note innovations in HIV treatment and prevention but instead disseminated stigmatising social representations of HIV. This is important because stigma impedes effective HIV prevention, engagement with HIV care and ultimately our ability to achieve the zero-infections target.
      Citation: Health
      PubDate: 2020-08-08T10:29:59Z
      DOI: 10.1177/1363459320949901
  • Beyond the hour of death: Family experiences of grief and bereavement
           following an end-of-life hospitalization in the intensive care unit
    • Authors: Julia I Bandini
      Abstract: Health, Ahead of Print.
      End-of-life decision-making is an important area of research, and few sociological studies have considered family grief in light of end-of-life decision-making in the hospital. Drawing on in-depth interviews with family members in the intensive care unit (ICU) during an end-of-life hospitalization and into their bereavement period up to six months after the death of the patient, this article examines bereaved family members’ experiences of grief by examining three aspects from the end-of-life hospitalization and decision-making in the ICU that informed their subsequent bereavement experiences. First, this article explores how the process of advance care planning (ACP) shaped family experiences of grief, by demonstrating that even prior informal conversations around end-of-life care outside of having an advance directive in the hospital was beneficial for family members both during the hospitalization and afterwards in bereavement. Second, clinicians’ compassionate caring for both patients and families through the “little things” or small gestures were important to families during the end-of-life hospitalization and afterwards in bereavement. Third, the transition time in the hospital before the patient’s death facilitated family experiences of grief by providing a sense of support and meaning in bereavement. The findings have implications for clinicians who provide end-of-life care by highlighting salient aspects from the hospitalization that may shape family grief following the patient’s death. Most importantly, the notion that ACP as a social process may be a “gift” to families during end-of-life decision-making and carry through into bereavement can serve as a motivator to engage patients in ACP.
      Citation: Health
      PubDate: 2020-08-04T10:10:14Z
      DOI: 10.1177/1363459320946474
  • Understanding ‘risk’ in families living with mixed blood-borne viral
           infection status: The doing and undoing of ‘difference’
    • Authors: Asha Persson, Anthony KJ Smith, Jack Wallace, kylie valentine, Joanne Bryant, Myra Hamilton, Christy E Newman
      Abstract: Health, Ahead of Print.
      ‘Risk’ has long been at the centre of expert and popular perceptions of transmissible and stigmatised blood-borne viral infections, such as HIV and viral hepatitis. There is a substantial body of research on transmission risk among couples with mixed viral infection status (serodiscordance). But we know very little about how families affected by HIV and viral hepatitis engage with understandings of infectiousness and how these shape family relationships in different ways. Guided by cultural theories of risk that build on Mary Douglas’ work, we draw on qualitative interviews to explore the ‘performativity’ of risk in serodiscordant families in Australia. We show how the ‘doing’ of risk could be constitutive of difference, which unsettled the family connection or deepened existing fault lines. Conversely, the ‘undoing’ of risk enabled the preservation of the family bond by rejecting difference and reframing risk as an external threat to the family in the form of stigma. We conclude that risk in the context of serodiscordant families had relational implications far beyond viral transmission and consider what our findings might mean for service provision and health promotion campaigns related to blood-borne viruses.
      Citation: Health
      PubDate: 2020-08-01T09:01:57Z
      DOI: 10.1177/1363459320946469
  • Book review: Johan P. Mackenbach, Health Inequalities. Persistence and
           Change in European Welfare States
    • Authors: Eero Lahelma
      Abstract: Health, Ahead of Print.

      Citation: Health
      PubDate: 2020-07-29T09:54:51Z
      DOI: 10.1177/1363459320944733
  • A qualitative exploration of the prescribing and use of statins in
           asymptomatic people in Ireland: A case of medicalisation,
           biomedicalisation and pharmaceuticalisation
    • Authors: Paula Byrne, Órla O’Donovan, Susan M Smith, John Cullinan
      Abstract: Health, Ahead of Print.
      There has been a notable increase in the use of statins in people without cardiovascular disease but who may be at risk in the future. The majority of statin users now fall into this category but little research has focused exclusively on this group. Debate has ensued regarding medicating asymptomatic people, and processes described variously as medicalisation, biomedicalisation and pharmaceuticalisation are used to explain how this happens. These overlapping and interrelated processes require issues to be ‘problemised’ as medical problems requiring medical solutions given the prevailing understandings of health, risk and disease. However, current understandings of risk and disease are not simply the result of technological and scientific advances, they are also socially constructed. We interviewed members of the public, GPs and others, and found that rather than high cholesterol being seen as one of several risk factors that contributes to heart disease, it tended to be promoted simplistically to the status of a disease needing treatment of itself. Statins were justified by those taking them as different to ‘unnecessary medicines’. However, some participants demonstrated resistance to statins, worried about over-medicalisation and deviated from accepted practices, indicating a complex ‘muddling through’ in the face of uncertainty.
      Citation: Health
      PubDate: 2020-07-27T11:19:28Z
      DOI: 10.1177/1363459320946067
  • Book review: Margaret McAllister and Donna Lee Brien, Paradoxes in
           Nurses’ Identity, Culture and Image: the shadow side of nursing
    • Authors: Michael Traynor
      Abstract: Health, Ahead of Print.

      Citation: Health
      PubDate: 2020-07-27T11:19:19Z
      DOI: 10.1177/1363459320944735
  • Addiction stigma and the production of impediments to take-home naloxone
    • Authors: Renae Fomiatti, Adrian Farrugia, Suzanne Fraser, Robyn Dwyer, Joanne Neale, John Strang
      Abstract: Health, Ahead of Print.
      Opioid overdose deaths are a major health issue in Australia and around the world. Programmes to provide opioid consumers with ‘take-home’ naloxone to reverse overdose exist internationally, but uptake by mainstream health services and consumers remains inconsistent. Researchers have identified a range of important educational, training and logistical impediments to take-home naloxone uptake and distribution, yet they have focused less on the social dynamics that can enhance or limit access, such as stigma. In this article, we also explore impediments to uptake, drawing on qualitative interview data gathered for an Australian research project on take-home naloxone. Mobilising a performative approach to stigma, we argue that overdose and prevention are shaped by the social dynamics of stigma and, as such, responsibility for dealing with overdose, as with take-home naloxone, should also be considered social (i.e. shared among peers, the public, communities and governments). Our interview data illuminate the various ways in which addiction stigma limits the possibilities and capacities of take-home naloxone and overdose prevention. First, we focus on how stigma may impede professional information provision about take-home naloxone by limiting the extent to which it is presented as a matter of interest for all opioid consumers, not just those who consume opioids illicitly. Second, we explore how stigma may limit the scale-up and expansion of programmes and access points. From here, we focus on how stigma co-constitutes the politics of overdose and prevention, rendering take-home naloxone ill-suited to many social settings of overdose. In closing, we point out that stigma is not just a post hoc impediment to access to and use of take-home naloxone but is central to opioid overdose production itself, and to effective prevention. While take-home naloxone is an excellent life-saving initiative, uncritically valorising it may divert attention from broader goals, such as the de-stigmatisation of drug consumption through decriminalisation, and other ambitious attempts to reduce overdose.
      Citation: Health
      PubDate: 2020-06-12T10:41:06Z
      DOI: 10.1177/1363459320925863
  • Patient-centered care in Russian maternity hospitals: Introducing a new
           approach through professionals’ agency
    • Authors: Ekaterina Borozdina, Anastasiia Novkunskaya
      Abstract: Health, Ahead of Print.
      The article relies on qualitative research methods to investigate how by the means of institutional work healthcare professionals introduce patient-centered care in Russian maternity hospitals. Post-socialist healthcare is commonly viewed in academic literature as a highly centralized and state-controlled domain, where autonomy and agency of both patients and practitioners are significantly restricted. Our research contributes empirically to scholarly debate by questioning this assumption and by providing shreds of evidence of healthcare professionals’ ground-level initiatives. On the conceptual level, we add to the discussion about the dynamic interrelation between institutional change, clients’ demands, and the transformation of professionals’ position. We argue that neoliberal reforms in Russian healthcare have created institutional uncertainty which is strategically used by professionals to expand the scope of their workplace autonomy and to develop patient-centeredness as an institutional innovation. However, our research shows that the resulting model of patient-centeredness contributes to empowering healthcare practitioners, rather than to increasing patients’ participation in decision-making.
      Citation: Health
      PubDate: 2020-06-09T01:34:35Z
      DOI: 10.1177/1363459320925871
  • Legitimating complementary therapies in the NHS: Campaigning, care and
           epistemic labour
    • Authors: Kathy Dodworth, Ellen Stewart
      Abstract: Health, Ahead of Print.
      Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM’s growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM’s ‘publics’, however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public’s effort to legitimate CAM within the UK’s National Health Service: the campaign to ‘save’ Glasgow’s Centre for Integrative Care (CIC). Campaigners skilfully intertwined ‘experiential’ knowledge of the value of CIC care with ‘credentialed’ knowledge regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance.
      Citation: Health
      PubDate: 2020-06-08T06:19:29Z
      DOI: 10.1177/1363459320931916
  • Recovering the body in grief: Physical absence and embodied presence
    • Authors: Caroline Pearce, Carol Komaromy
      Abstract: Health, Ahead of Print.
      This paper addresses the complex issue of the embodiment of grief. It explores how a theoretical shift to the body has influenced scholarly literature about grief and bereavement. Despite this shift, we argue that bodily interpretations and experiences are undertheorised in western psychological literature on bereavement. Specifically, we argue that linear stage models of grief have encouraged the view that grief needs ‘working through’ in the mind, and not necessarily the body. We draw on empirical data from interviews with bereaved people undertaken in England to illustrate aspects of the embodied experience of grief that differ from how psychological grief theories conceive of the bereaved person’s body. Findings highlight the role of the bereaved person’s body in managing grief and how the absence and continuing presence of the deceased person is managed through embodied practices. We conclude that understanding grief as an embodied experience can enable the development of grief theories that better capture the complex negotiation between the psychological processes of grief and the materiality of bodies.
      Citation: Health
      PubDate: 2020-06-07T12:15:30Z
      DOI: 10.1177/1363459320931914
  • The 2009 H1N1 pandemic, vaccine-associated narcolepsy, and the politics of
           risk and harm
    • Authors: Venla Oikkonen
      Abstract: Health, Ahead of Print.
      The article traces the emergence of a new type of vaccine injury—vaccine-associated narcolepsy—following immunization with Pandemrix vaccine during the 2009 H1N1 pandemic in Europe. The article highlights the processual nature of vaccine injury: it shows how vaccine-associated narcolepsy emerges gradually as a recognized object through epidemiological and immunological studies as well as patient organizations’ public discourses. The article argues that despite public recognition of injury, vaccine-associated narcolepsy remains an incongruous object characterized by underlying tensions. These tensions take shape in relation to the history of vaccine injury debates, on the one hand, and the connection between vaccine-associated narcolepsy and non-vaccine-related narcolepsy, on the other. The article shows how these underlying tensions enable a range of mutually incompatible framings and mobilizations through which risk, harm, responsibility, and justice are claimed and negotiated.
      Citation: Health
      PubDate: 2020-06-03T04:05:30Z
      DOI: 10.1177/1363459320925880
  • The storying of birth
    • Authors: Jennifer MacLellan
      Abstract: Health, Ahead of Print.
      Birth narratives have been found to provide women with the most accessible and often utilised means for giving voice to their exploration of meaning in their births. The stories women tell of their birth come out of their pre- and post-experience bodies, reproducing society through the sharing of cultural meanings. I recruited a selection of 20 birth stories from a popular ‘mums’ Internet forum in the United Kingdom. Using structural and thematic analyses, I set out to explore how women tell the story of their body in childbirth. This project has contributed evidence to the discussion of women’s experiences of subjectivity in the discursive landscape of birth, while uncovering previously unacknowledged sites of resistance. The linguistic restrictions, sustained by the neoliberal control mechanisms on society and the self, act to shape the reality, feelings, and expressions of birthing women. Naming these silencing strategies, as I have done through the findings of this project, and celebrating women’s discourse on birth, as the explosion of birth stories across the Internet are doing, offer bold moves to challenge the muting status quo of women in birth. Reclaiming women’s language for birth and working to create a new vocabulary encapsulating the experiences of birthing women will also present opportunities for the issue of birth and women’s experiences of it to occupy greater political space with a confident and decisive voice.
      Citation: Health
      PubDate: 2020-06-03T04:05:29Z
      DOI: 10.1177/1363459320925866
  • Resistance or appropriation': Uptake of exercise after a nurse-led
           intervention to promote self-management for osteoarthritis
    • Authors: Andrew Morden, Bie Nio Ong, Clare Jinks, Emma Healey, Andrew Finney, Krysia S Dziedzic
      Abstract: Health, Ahead of Print.
      The philosophical underpinning of trials of complex interventions is critiqued for not taking into account causal mechanisms that influence potential outcomes. In this article, we draw from in-depth interviews (with practice nurses and patients) and observations of practice meetings and consultations to investigate the outcomes of a complex intervention to promote self-management (in particular exercise) for osteoarthritis in primary care settings. We argue that nurses interpreted the intervention as underpinned by the need to educate rather than work with patients, and, drawing from Habermasian theory, we argue that expert medicalised knowledge (system) clashed with lay ‘lifeworld’ prerogatives in an uneven communicative arena (the consultation). In turn, the advice and instructions given to patients were not always commensurate with their ‘lifeworld’. Consequently, patients struggled to embed exercise routines into their daily lives for reasons of unsuitable locality, sense-making that ‘home’ was an inappropriate place to exercise and using embodied knowledge to test the efficacy of exercise on pain. We conclude by arguing that using Habermasian theory helped to understand reasons why the trial failed to increase exercise levels. Our findings suggest that communication styles influence the outcomes of self-management interventions, reinforce the utility of theoretically informed qualitative research embedded within trials to improve conduct and outcomes and indicate incorporating perspectives from human geography can enhance Habermas-informed research and theorising.
      Citation: Health
      PubDate: 2020-06-03T04:05:28Z
      DOI: 10.1177/1363459320925879
  • What was lost, missing, sought and hoped for: Qualitatively exploring
           medical crowdfunding campaign narratives for Lyme disease
    • Authors: Anika Vassell, Valorie A Crooks, Jeremy Snyder
      Abstract: Health, Ahead of Print.
      Lyme disease remains a contested illness in Canada, thereby making the diagnostic and treatment journeys difficult for some people. One outcome of this is that increasing numbers of people are turning to medical crowdfunding to support access to alternative therapies, non-local health care providers and assist with managing the costs of everyday life. In this analysis, we qualitatively explore the narratives shared in Canadians’ crowdfunding campaigns to support Lyme disease treatment or diagnosis to identify whether or not any common elements shared in these narratives exist, and if so, what they are. We identified 238 campaigns for inclusion from three prominent crowdfunding platforms. Thematic analysis of the campaign narratives shows four consistent themes shared in these campaigns: what is lost (e.g. bodily ability), what is missing (e.g. local care options), what is sought (e.g. funds to cover treatment abroad) and what is hoped for (e.g. return to wellbeing). These themes demonstrate the highly personal and emotional nature of medical crowdfunding, particularly in the context of a contested illness that may lead some to question the legitimacy of one’s financial need. This analysis contributes valuable new insights to the nascent scholarship on medical crowdfunding, and particularly to our understanding of how people communicate about their health and bodily needs on this public platform. It also identifies important directions for future research, including the potential for crowdfunding narratives to be used for advocacy.
      Citation: Health
      PubDate: 2020-03-23T11:04:35Z
      DOI: 10.1177/1363459320912808
  • Surrender to win: Constructions of 12-step recovery from alcoholism and
           drug addiction
    • Authors: Cosmo Duff Gordon, Carla Willig
      Abstract: Health, Ahead of Print.
      This article focuses on the ways in which members of Alcoholics Anonymous and Narcotics Anonymous construct themselves as being in recovery from addiction. In this original study, data were taken from 19 participants. They were analysed using Willig’s six-stage Foucauldian discourse analytic method. This method is suited to enabling the analyst to locate discourse resources used by participants within broader, dominant, discourses, and for exploration of the implications of these constructions for subjectivity and practice. This article presents a discussion of analytic findings. Mainstream academia has often constructed 12-Step recovery as a largely totalising discourse. This is likely to have negatively prejudiced health professionals and may help explain relatively low referral rates into 12-Step resources for addicted clients. However, our analysis suggested that participants constructed themselves not as subjected by Alcoholics Anonymous and Narcotics Anonymous discourse, but as drawing on it in ways aligned with agency, in order to practice care of the self in pursuit of various ethical goals. This implies 12-Step recovery to be less antithetical to, and indeed more aligned with, humanistic practitioner values than is perhaps often assumed to be the case. This finding suggests that practitioners may need to consider reappraising their view of 12-Step recovery. The discussion will therefore focus on the agency-structure dialectic that seemed to be at the heart of participant constructions of addiction and recovery. It is also a finding which points to an urgent need for more qualitative studies in the currently under-researched, and hence perhaps poorly understood, area of 12-Step recovery from addiction.
      Citation: Health
      PubDate: 2020-03-19T01:47:23Z
      DOI: 10.1177/1363459320912837
  • Federative patient organizations in a decentralized health-care system: A
           challenge for representation'
    • Authors: Anna Mankell, Mio Fredriksson
      Abstract: Health, Ahead of Print.
      Over the last two decades, the inclusion of patient voices and public values in the field of health care through deliberation has become increasingly emphasized, by patients as well as policy-makers. This is achieved not only through individual patient participation but also through patient interest organizations. Geographical representation within national interest organizations is especially important in a decentralized, multilevel policy field such as Swedish health care, allowing representation from all regions to be present in national advocacy. Using Pitkin’s conceptualization of political representation, this study aims to characterize the shaping of representation among Swedish federative patient organizations, in a time of professionalization and centralization of civil society. The results show that patient organization representation has functioning mechanisms for all studied aspects of representation; however, the nature of the substantive representation seems to contain a challenge from a democratic perspective. This leads us to a discussion about management, rooted in democratic ideals but simultaneously strongly characterized by more managerial ideals, and the contradiction of democracy and actionable management.
      Citation: Health
      PubDate: 2020-03-19T01:46:59Z
      DOI: 10.1177/1363459320912807
  • Managing risks or generating uncertainties' Ambiguous ontologies of
           testing in Australian healthcare
    • Authors: Kiran Pienaar, Alan Petersen, Diana M Bowman
      Abstract: Health, Ahead of Print.
      Medical testing promises to establish certainty by providing a definitive assessment of risk or diagnosis. But can those who rely on tests to offer advice or make clinical decisions be assured of this certainty' This article examines how Australian health professionals, namely clinicians, microbiologists, specialist physicians and health policymakers, delineate the boundary between certainty and uncertainty in their accounts of medical testing. Applying concepts from science and technology studies, and drawing on qualitative data from a sociological study of testing in Australian healthcare, we consider how professionals ascribe meaning to testing and test results. As we argue, for these health professionals, the ‘evidence’ that testing generates has ambiguous ontological significance: while it promises to provide diagnostic certainty and clear direction for advice or treatment, it also generates uncertainties that may lead to yet further tests. Our analysis leads us to question a key premise of testing, namely that it is possible to establish certainty in medical practice via the measurement of individual health risks and disease markers. Against this dominant view, the responses of the health professionals in our study suggest that uncertainty is intrinsic to testing due to the constantly changing, unstable character of ‘evidence’. We conclude by considering the implications of our analysis in light of healthcare’s increasing reliance on sophisticated technologies of ‘personalised’ testing using genetic information and data analytics.
      Citation: Health
      PubDate: 2020-03-18T12:23:30Z
      DOI: 10.1177/1363459320912830
  • News media stories about cancer on Facebook: How does story framing
           influence response framing, tone and attributions of responsibility'
    • Authors: Tegan S Starr, Melissa Oxlad
      Abstract: Health, Ahead of Print.
      This content analysis explored associations between the framing of cancer-related health news stories on Facebook and their corresponding comments. It was found that regardless of story framing the majority of responses involved users engaging in debate and discussion rather than sharing personal experiences. Furthermore, stories framed episodically had a greater proportion of both supportive and unsupportive comments than stories framed thematically. As predicted, episodic stories were associated with more attributions of responsibility directed towards the individual whereas thematic stories lead to more societal-level attributions of blame. Contrary to predictions, responses did not contribute towards the stigmatisation of lung cancer, instead more responses were aimed at reducing stigma for this illness. Within the findings strong beliefs about cancer treatment and management were also identified, which raises concern over the spread of misinformation. Overall, this research provided insight into the framing of cancer news and highlighted potential implications of Facebook comments.
      Citation: Health
      PubDate: 2020-03-18T12:22:30Z
      DOI: 10.1177/1363459320912817
  • Taking responsibility for the tooth: A semiotic and thematic analysis of
           oral health and disease in the TV show ‘Embarrassing Bodies’
    • Authors: Alexander CL Holden, Patricia Neville, Barry Gibson, Heiko Spallek
      Abstract: Health, Ahead of Print.
      Oral health and dentistry are seldom the subject of medical reality TV. This study investigates whether the dental segments within the British medical reality show, ‘Embarrassing Bodies’, may contribute to the anthropological understanding of oral health and social status, through semiotic and thematic analysis. This methodology involves close examination of both the visual and narrative themes within the programme. The show presents mouths afflicted by oral disease as traumascapes, the framing of which provides voyeuristic appeal. The portrayal of dental disease as negatively affecting human flourishing through shame and the inhibition of intimacy was common across the analysed cases. The key themes of intimacy and social distance; discipline, blame and personal responsibility; carnography; disciplining gaze and authority; and redemption and rebirth were identified through analysis. The cases also present a strong correlation between a lack of personal responsibility and the development of dental disease within the wider context of social class, with the dentist as a disciplining authority, enforcing professional and societal norms.
      Citation: Health
      PubDate: 2020-02-05T02:12:03Z
      DOI: 10.1177/1363459320904419
  • Uncovering, creating or constructing problems' Enacting a new role to
           support staff who raise concerns about quality and safety in the English
           National Health Service

         This is an Open Access Article Open Access Article

    • Authors: Graham P Martin, Sarah Chew, Mary Dixon-Woods
      Abstract: Health, Ahead of Print.
      Employee voice is an important source of organizational intelligence about possible problems in quality and patient safety, but effective systems for encouraging and supporting those who seek to speak up have remained elusive. In the English National Health Service, a novel role known as the ‘Freedom to Speak Up Guardian’ has been introduced to address this problem. We critically examine the role and its realization in practice, drawing on semi-structured interviews with 51 key individuals, including Guardians, clinicians, managers, policymakers, regulators and others. Operationalizing the new role in organizations was not straightforward, since it had to sit in a complex set of existing systems and processes. One response was to seek to bound the scope of Guardians, casting them in a signposting or coordinating role in relation to quality and safety concerns. However, the role proved hard to delimit, not least because the concerns most frequently voiced in practice differed in character from those anticipated in the role’s development. Guardians were tasked with making sense of and dealing with issues that could not always straightforwardly be classified, deflected to the right system or escalated to the appropriate authority. Our analysis suggests that the role’s potential contribution might be understood less as supporting whistleblowers who bear witness to clear-cut wrongdoing, and more as helping those with lower-level worries to construct their concerns and what to do with them. These findings have implications for how voice is understood, imagined and addressed in healthcare organizations.
      Citation: Health
      PubDate: 2020-01-27T01:02:04Z
      DOI: 10.1177/1363459319901296
  • Lifestylisation of the social: The government of diabetes care in Denmark
    • Authors: Sine Grønborg Knudsen, Peter Triantafillou
      Abstract: Health, Ahead of Print.
      Since the 1970s, the public authorities of many OECD countries have emphasised the need for preventing lifestyle diseases and promoting the vigour of their populations. Based on the Foucauldian analytics of dispositive, we critically address some of the normative implications of the preventive interventions in the area of type 2 diabetes care. Through an analysis of public health documents from 1981 to 2016, it is shown that the government of lifestyle was extended and institutionalised by a reform of the Danish public sector in 2007. Following the reform, rationalities of public health policies sought to prevent unhealthy lifestyles not only through individual behaviour but also through the social surroundings of citizens. In contrast to the claim that we are seeing a retraction of state responsibility and interventions in the area of public health, it is suggested that we are witnessing an expansion in state ambitions expressed through a lifestyle dispositive. These ambitions are less about transferring the responsibility to the individual and more about governing and mobilising the social relations and environments of type 2 diabetes patients and citizens in general to make the everyday choice of a healthy lifestyle easier.
      Citation: Health
      PubDate: 2020-01-22T11:16:51Z
      DOI: 10.1177/1363459319899454
  • Patient safety in medical residency training: Balancing bravery and
    • Authors: Guusje Bressers, Iris Wallenburg, Renée Stalmeijer, Mirjam oude Egbrink, Kiki Lombarts
      Abstract: Health, Ahead of Print.
      Distributing responsibility for patient safety between individual professionals and organisational systems is a pressing issue in contemporary healthcare. This article draws on Habermas’ distinction between ‘lifeworld’ and ‘system’ to explore patient-safety culture in medical residency training. Sociological accounts of medical training have indicated that applying systemic solutions in patient-safety training and practice may conflict with residents’ needs. Residents would navigate safety systems to get their work done and safeguard learning opportunities, acting ‘in between’ the system and traditional processes of socialisation and learning on the job. Our ethnographic study reveals how residents seek to connect system and professional-based learning, and do them together in situated manners that evolve in the course of medical training. We reveal three themes that closely align with the residents’ developmental process of maturing during training and on the job to become ‘real’ physicians: (1) coming to grips with the job; (2) working around safety procedures; and (3) moving on to independence. A more explicit focus on learning to deal with uncertainty may enable residents to become more skilled in balancing safety systems.
      Citation: Health
      PubDate: 2020-01-21T11:03:02Z
      DOI: 10.1177/1363459319899444
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