Sociology of health and medicine

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Architecture and health care: a place for sociology

Architecture and health care: a place for sociology

examine ways in which buildings give concrete expression to ideologies of health and recursively help to configure medical knowledge. Cultural geographers have generated insights into the landscapes of health care, but we suggest medical sociologists should complement these in order to extend our understanding of how the built environment implicates and embeds ideas, ideologies and knowledge of health and medicine, and in turn may be consequential for those who use them. To date there is an extant literature on the use of buildings but little on the social processes of their production; our focus then is on the role that buildings, at all stages of their production, play in the configuration of the embodied experience of health and illness. A key finding is that there is a lack of, and need for, sociological work on buildings and architecture in the making. Through gathering together these literatures we identify substantive and methodological affordances that could be developed within the sociology of health and illness i .
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Feminism and the sociology of gender, health and illness

Feminism and the sociology of gender, health and illness

In an article on doctor-nurse relations Karen Davies observed that one of the difficulties in theorising gender is that in western society it is a primary social category which we automatically and unconsciously categorise any specific other with whom we must relate (Davies 2003: 729). A social relationship with a person of indeterminate gender is less tolerable than ambiguity around age, sexuality, class or disability. The potential for women to conceive and bear new life has played an important role in maintaining the binary division of gender, since it homogenizes all women as mothers, and locks women into reproduction as central to everyone’s lives, echoing medicine’s determinacy (Annandale and Clark 1996: 29). Thinking premised on a binary division between men and women, between male and female has the unfortunate effect of ‘universalising and valorising’ gender differences. A focus on the abnormalities of women’s reproductive health means that, at the same time as sociology criticises biomedicine’s pathologisation of women, it also replicates its problematic (Annandale and Clark 1996: 32), allowing women’s health problems to stand for the broader issue of gender and health.
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Medical understandings of lifestyle : an interpretive study of 'lifestyle' as a medical explanatory framework

Medical understandings of lifestyle : an interpretive study of 'lifestyle' as a medical explanatory framework

While there is little consensus within sociology about consumerism and medicine two issues which have relevance for contemporary medical and lay understandings of lifestyle and health ar[r]

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Ethics in the infertility clinic: a qualitative study

Ethics in the infertility clinic: a qualitative study

In a special issue of the journal Medicine, Health Care and Philosophy devoted to the use of empirical research in bioethics, Molewijk et al 2004 outlined a form of sociology in bioethic[r]

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Ontology to symbolic reality of medicine: view from  critical medical sociology

Ontology to symbolic reality of medicine: view from critical medical sociology

medicine has been criticized by Hucklenbroich (1998), who argues that the methodology of medicine consists of two separate methodologies: a research methodology and a clinical methodology. Although there has been a lot of work on the former, there is no generally agreed-upon model for such things as clinical decision making and problem solving. Furthermore, there is no general agreement on what constitutes the proper goals for medicine. Curing disease, promoting individual health, and promoting public health may come to be at odds with one another. Perhaps even more significant is that social problems are increasingly “medicalized.”Medicine should not define its goals so narrowly as to exclude important matters of health, but neither should it define its goals so broadly that all social and political means to increase health become included in the practice of medicine (Nordin 1999). Nonetheless, social and political conditions have significant bearing on health, and so drawing a line between the medical and the sociopolitical will always be a challenge. Certainly medicine is about healing, but the question of which healing methods count as medicine remains controversial. Furthermore, much medical research does not directly pursue healing, but rather seeks to understand biological function. Whether that is part of medicine or a separate “medical science,” or even just a biological science, is not a settled issue. It is hard to say whether such uncertainties have led some to deny the existence of the philosophy of medicine, relegating philosophical reflection on medicine either to bioethics or to philosophy of science. Still, given the numbers of publications overtly professing to be about philosophy of medicine, the field has not achieved the status of philosophy of science or philosophy
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Guest Editorial: Sociology, environment and public health

Guest Editorial: Sociology, environment and public health

Today there is burgeoning interest among sociologists in these interactions between society and environment, and the British Sociological Association has a vibrant study group on Climate Change, and a newer and smaller ‘Environment and Health’ study group. In 2016 these groups together ran a successful day conference on sociological aspects of environment and health at the London School of Hygiene and Tropical Medicine; the idea for the Special Section in this issue of Public Health was born from this event.

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Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors

Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors

For example, NHS Digital’s Digital Assessment Ques- tionnaire comprises 12 domains and several hundred questions which, in addition to covering more technical issues such as data protection, security and interoper- ability, explore issues that imply a degree of evaluation, such as effectiveness, clinical safety, usability and acces- sibility. NICE presides over the indicators of effective- ness questions and, in its own appraisals of e.g. Improving Access to Psychological Therapies apps, tends to expect Randomised Control Trial level evidence. Thus, in the most recent evidence standards framework for digital health technologies [39], high quality observa- tional or quasi-experimental studies demonstrating rele- vant outcomes are described as the minimum practice standard for demonstrating effectiveness. High quality intervention studies (quasi-experimental or experimental design) which incorporate a comparison group are con- sidered the best practice standard.
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From waste product to blood, brains and narratives:developing a pluralist sociology of contributions to health research

From waste product to blood, brains and narratives:developing a pluralist sociology of contributions to health research

Also neglected from the traditional hierarchy of donation, the value held by narrative interviews donated to qualitative health research studies is distinct. Biosamples and supplementary information require each other to extract maximum value, whereas the value of a narrative is more self-contained and intrinsic, and both need interpretation and analysis to achieve their full value. Mazanderani et al. (2013) extend Mitchell and Waldby’s (2010) notion of biovalue in relation to tissue samples to the value which may be derived from narrative interviews. This ‘biographical value’ may include value to social scientists, clinical researchers and doctors, in understanding better the embodied experience of illness, but also value to the self and to other patients. Narratives (particularly celebrities’) could also raise the profile of a disease and generate pressure for research funding and better treatment.
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<p>Medical Students at the School of Medicine and Health Sciences, University of Papua New Guinea: Predictors of Performance and Student Backgrounds</p>

<p>Medical Students at the School of Medicine and Health Sciences, University of Papua New Guinea: Predictors of Performance and Student Backgrounds</p>

Background: Papua New Guinea, a lower middle income country with a population of around 8.5 million, the majority of whom live in rural areas, produces far fewer than the number of medical graduates required to meet the WHO-recommended doctor/population ratio. The School of Medicine and Health Sciences is under pressure to increase its output and ensure the graduates are able to function in rural settings. Through two studies, we aimed to determine the predictors of student performance and their socioeconomic and educational background to assist in determining admission policies and improve completion rates. Methods: A retrospective study analysed data relating to student performance from six annual cohorts. A cross-sectional study among currently enrolled students sought informa- tion about their socioeconomic and educational background.
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<p>Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: a randomized controlled trial</p>

<p>Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: a randomized controlled trial</p>

The present study demonstrates that BMPI can be a sui- table evidence-based intervention for community-dwelling older people living with chronic musculoskeletal pain. The results showed that even very old and frail persons are able to participate in such a complex intervention and achieve behavioral changes that endure over time. The BMPI showed there was a decrease in pain-related disability and pain severity, improvement in the level of physical activity, HRQL, management of everyday life, and self- ef fi cacy. All these factors can in the long term support and promote active aging and age in place among this vulner- able and frail group of older individuals. This is also the main goal of all interventions by health care professionals, as well as research conducted and developed for the target population.
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The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist

The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist

A second concern relates to methodological differences among studies. For example, studies reviewing the mental health impact of genocides have investigated a variety of out- comes, including depression, anxiety, schizophrenia [4, 5], suicide [6, 7], post-traumatic stress as well post-traumatic growth. Some studies documented a negative impact, while others found resilience or no association notwithstanding immense cruelties to which survivors had been exposed. [8] Some of this variability may be due to the methodological challenges inherent in conducting studies on populations af- fected by genocide. Some are common to any epidemio- logical research and include recruitment bias, measurement error, and the need to adjustment for potential confounding. Attempts to attribute symptoms to the experience of geno- cide may be complicated by confounding factors unrelated to the genocide, such as discrimination in another country due to migration or poverty. [9] Other factors, however, are specific to genocide research. One is memoralization, whereby groups valorize, marginalize, or disable acts of re- membrance, or forgetting. [10, 11] Anthropological research has reported how some genocide survivors or children of survivors challenge the pathologizing construct of long term impact of genocides. It can be politically expedient to pa- thologize the long term consequences of genocide, or, con- versely, to deny the long term impacts of genocides as part of an attempt to relieve the perpetrator from responsibility for having committed genocide. Disorders associated with genocide are therefore subject to the influence of various in- terests, institutions, and political interests.
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Further, some of the assumptions of community participation in health activities in most developing countries may not be realistic. For instance, it is not known the extent to which the ordinary people can have some control over health workers who are supposed to serve their needs. It is also quite uncertain the real extent of improvement in the quality of decision-making through the participation of the ordinary people in health action. In Nigeria in particular, such factors as corruption, ignorance, leadership and bureaucracy have negative impact on the success of health participatory efforts. Besides, as this study revealed, some cultural factors and belief systems such as religion, taboos and magico-religious value systems have tended to obliterate the participation of the local populace in most traditional societies in health projects. Also there has always been the reported risk of not communicating the right message to the people in the process of organizing them in a strategy to solve an identified problem. Summary and Conclusion
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In the difficult process that has led to the establish- ment of ESS in the upper secondary curriculum and the incorporation of a sociological dimension into the subject, teachers’ action has had a significant influ- ence. Teachers have been helped by their professional association, by trade unions and by some academic so- ciologists and economists. It may be considered rather surprising that they were motivated to take such ac- tion, since they are trained more in economics than in sociology. They supported sociology not so much for its own sake but because in doing so they were helping to give social science teaching a certain politi- cal and pedagogic slant. Teachers enjoy teaching ESS because its political orientation matches their own; it is a progressive ideology, critical of neo-liberalism and in favour of state intervention and public policies. They were also strongly motivated by the support they obtained from their students; this achievement gave them the energy and the reason to defend a mode of teaching and a type of content. Now pupil interest has a bearing on current problems; they want to under- stand and they are encouraged to put some effort into their school work. This is why teachers promote this way of teaching, which begins with concrete exam- ples of social problems. As a consequence they agree with introducing new themes into their teaching pro- grammes. However, in doing so, they are pursuing a particular pedagogical purpose and, at the same time, adopting an academic and political stance. A way of successfully teaching students about social issues with political implications has been found.
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Recruiting Community Faculty

Recruiting Community Faculty

Health behavior and health education programs in schools of public health and departments of psychol- ogy or perhaps sociology may have desirable ada- demic faculty for a program to incr[r]

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Against and beyond   for sociology : a study on the self understanding of sociologists in England

Against and beyond for sociology : a study on the self understanding of sociologists in England

criticism. Another famous example is the work of Matthew Arnold, who was a headmaster in a school in Rugby in the 1830s and connected sociology with literary criticism. However, the demarcation between literature and science as reference points for sociology is not always that clear cut, as the life and work of Beatrice Webb in the late nineteenth and the beginning of the 20 th century show. Having had Herbert Spencer as her mentor, Beatrice Webb first embraced a strong belief in sociology as the science of society before pursuing more literary ambitions and taking socialist thinkers such as Lenin as a point of reference. She finally connected literary ways of writing with her major themes of sociological research, the emancipation of women and the advance of state welfare services although her novel ‘Sixty Years On’ in which these two themes were supposed to be connected, remained unfinished (Halsey, 2004: 19). 25 According to Martin Bulmer, ‘The nineteenth-century sources of British sociology in social investigation are surely the most important – the blue books, the investigations of public health, Henry Mayhew, the National Association for the Promotion of Social Science, Charles Booth, Seebohm Rowntree, and as we turn into the twentieth century, A. L. Bowley. Many of these figures, however, are also seen as part of the tradition of British social policy, while some British sociologists would not recognise them as their ancestors (Bulmer, 2005: 38). The fact that Hobhouse became Head of Department at the London School of Economics is also indicative of sociology’s commitment to social policy in the early days. Bulmer further points out that the social-policy roots of British sociology and the centrality of Labourism as a reference point can be seen up
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Probabilistic thinking and health risks: An editorial

Probabilistic thinking and health risks: An editorial

Such claims to superiority would be justified if key assumptions underpinning the mathematics of probability, particularly randomness and independence of events, hold true unproblematically. However, as sketched out below, these presuppositions themselves provide no more than heuristics, simplifications which usefully offer partial glimpses of the future, but only at the price of deliberately accepting distortions which generate systematic errors. As also briefly illustrated below, patients sometimes appreciate the limitations inherent in probabilistic reasoning itself, and their responses to its inherent shortcomings matter clinically. Furthermore, well-documented rules of thumb used by ‘people’, the de-cultured representatives of human nature constructed in much main-stream psychology (Valsiner, 2012), for example viewing a more mentally available risk as also more probable, stand at one remove from the official probability heuristic. Such rules of thumb can therefore be viewed as heuristics about heuristics. This analytical move adds a further layer of complexity to social scientific consideration of health risk decision-making, but also slightly rescues ‘humans’ from the charge of incompetence vis a vis science, since the crudity in lay thought processes merely add another layer to the low forms of science which are forced to rely on probability assessment, faute de mieux. A deconstruction of probabilistic thinking is sketched out below.
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Post-war sociology in Yugoslavia.

Post-war sociology in Yugoslavia.

from historical materialism, and after obtaining a place for sociology among the other academic disciplines, the Yugoslavs are now calling for a total de-ideologization of all social sciences in their country. Most sociologists in Yugoslavia feel that a true sociology must strive to be free and object­ ive in spite of the fact that no country, East or West, can claim to have such an ideal, ideoligically neutral, sociology. The Yugoslav sociologists feel proud of having their discip­ line re-established in the family of the social sciences. The question of independence from the external influences is only a matter of time. Indications, so far, are quite e n ­ couraging in this regard as well. It is not surprising to see many American scholars observing the on-going process of change in sociology in Yugoslavia. Milorad Draskovic,
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The role of traditional medicine practice in primary health care within Aboriginal Australia: a review of the literature

The role of traditional medicine practice in primary health care within Aboriginal Australia: a review of the literature

More ethnographic research was completed within the Warlpiri community in the Northern Territory, specific- ally on two recorded illness episodes to examine health behaviour of people using ngangkari’ [22]. In his obser- vations the author discovered that the use of bush medi- cine was used to treat specific symptoms of illnesses and included coughs, colds, wounds and sores, and that every adult and many children had some knowledge of bush medicine. If the disease however was caused by sorcery then an Ngangkari was consulted. Two illness- related cases were followed to examine health behaviour. The first case was a 44yr old male who consulted several Ngangkari over a period of weeks before finally visiting the clinic (biomedical) after his condition was not improv- ing and becoming worse. The second case was a 33yr old girl who after years of biomedical healthcare ceased visit- ing the clinic (except to collect her long-term medicines) to engage with an Ngangkari. These two cases give an ex- ample of different age and gender who both utilised THs in different sequences, and whilst the same subjectivity may apply as for the above ethnographic study and lack of understanding of the level of the community who engage with Ngangkari, it does give us an indication of the role of the TH based on health beliefs of illness causes.
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Medicine registration and medicine quality: a preliminary analysis of key cities in emerging markets

Medicine registration and medicine quality: a preliminary analysis of key cities in emerging markets

degraded, or counterfeit medicines. This includes visual inspection of packaging and pills for correctness, disinte- gration for basic solubility, and semiquantitative thin-layer chromatography (TLC) to determine the presence and rela- tive concentration of active ingredients. Each test was run in duplicate, with the generous assumption that the result that was more consistent with the reference was recorded. Quality control of the Minilab was performed daily prior to testing and consisted of performing TLC on Minilab refer- ence samples for the medicine classes being analyzed. In addition, Minilab reagents were quality control tested using reference samples when a new lot was introduced. The Mini- lab protocols award medicines a “pass” if they have 80% or more of the labeled active ingredient(s). For fixed-dose combinations and sulphadoxine–pyrimethamine, a “pass” was awarded only if both active ingredients met this standard.
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‘It's like taking a bit of masculinity away from you’ : towards a theoretical understanding of men's experiences of infertility

‘It's like taking a bit of masculinity away from you’ : towards a theoretical understanding of men's experiences of infertility

A proliferation of social science research has explored the connections between expressions of masculinity and how men experience of a range of health problems (e.g. Chapple and Ziebland 2002, Emslie et al. 2006). One signi fi cant contribution to this has been Connell ’ s (1995) con- cept of ‘ hegemonic masculinity ’ . This relational approach to theorising gender can account both for men ’ s dominance over women and over less powerful groups of men because it intro- duces the notion of hierarchy and competition between different kinds of masculinity. Accord- ing to Connell (1995), gender relations are not fi xed but shift in historical context and are infused with other modes of social differentiation, such as social class and ethnicity, with cer- tain con fi gurations of masculine practice gaining dominance at the expense of other less pow- erful forms that become subordinated to and/or marginalised from hegemonic patterns. De fi ning gender as relational and intertwined with other modes of social differentiation pro- vides access to the social dynamics of gender relations, their construction and the possibilities for change that emanate from the tensions and contradictions in men ’ s experiences over time (Connell 2012). However, most work regarding men ’ s health has been devoted to how cultural properties are transmitted to men and work as conditional in fl uences on them rather than the other side of the structure-agency equation, namely how they are received by men and how new practices may be incorporated into the dominant culture causing aspects of hegemonic masculinity to change over time (Lohan 2007).
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