bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keeping healthy at home and school: ‘it's my body, so it's my job‘
Authors: Mayall Berry 
Published: August 2010

AbstractThis paper focusses on children as a social group, in order to discuss the division of labour in health care between children, parents and teachers. It draws on data from a qualitative study of children's, parents’ and teachers’ perspectives on the health care of primary school children. The paper argues that the distinctive social and emotional context of the home and the school are critical for the structuring of children's health care activities and experience. In particular the paper considers children's own contributions to health care and the functions of their own social worlds in the division of labour.
Anaesthetists, the discourse on patient fitness and the organisation of surgery
Authors: Fox Nicholas J. 
Published: August 2010

AbstractThe organization of daily procedures within the operating theatre is considered in terms of rival perspectives on their patient held by surgeon and anaesthetist. The privileging of the surgeon's authority is challenged in anaesthetists' efforts to fabricate a distinctive position on the patient. While surgeons focus on patient as the carrier of disease, for the anaesthetist, the focus is upon the patient's complement of fitness.A postmodern analysis of the organization of surgery reflects the continual struggle between the two specialisms to privilege its particular definition of the surgical patient. In some circumstances, the struggle can have damaging consequences for patient care.
Passive smoking and ill‐health: practice and process in the production of medical knowledge
Authors: Jackson Peter W. 
Published: August 2010

AbstractThis paper examines the development of medical knowledge about passive smoking from a constructionist perspective. It draws upon the work of Ludwik Fleck, particularly his central idea that facts are produced in relation to the possibilities of stylised thought. Early epidemiological insights into changing disease patterns, with regard to active smoking, are initially discussed and shown to be related to a style of thought which encourages the production of a world of disconnected bodies. The paper then explores how connections between those bodies were constructed, and the medicalisation of passive smoking advanced, by a stylised perception of tobacco smoke. Problems of ‘subject’ visibility, however, remained; problems overcome by the production rather than the revelation of facts, notably the distinction between mainstream and sidestream smoke. This development opened up the space for the emergence of the previously invisible passive smoker. This processual reordering of reality is then mapped onto other processual patterns and the stylisation of social relationships, particularly apparent in the later ‘spouse as index’ studies, is discussed. The point is further explored in an analysis of the ideas associated with biochemical markers, particularly the notion that once invisible social connections can now be rendered visible through a reading of these markers in the body.
The rise and fall of a fact: the increase in anorexia nervosa
Authors: van't Hof Sonja , Nicolson Malcolm 
Published: August 2010

AbstractOver the last thirty years, it has regularly been asserted that the incidence of anorexia nervosa is increasing. The paper examines the background of this idea, traces its origins, and analyses the process whereby it became widely accepted within the medical and sociological literature. The study is based upon a citation list of all the epidemiological studies of anorexia nervosa with publication dates between 1960 and the end of 1990, which has been used to identify the most important publications on the prevalence and incidence of the disease. Scrutiny of the content of these key publications has allowed us to follow the emergence, and then the partial break‐up, of a broad consensus ‐ involving clinical psychiatrists and psychoanalysts, as well as medical sociologists and historians‐around the assertion that anorexia nervosa was increasing in incidence. In the course of this historical reconstruction, four distinctive patterns of citation behaviour were revealed. The paper also examines the changing nature of the explanation offered for the putative rise in the numbers of sufferers and suggests reasons why such a perspective upon the disease was widely supported by clinicians and by a variety of other commentators.
The social patterning of child mortality: the importance of social class, gender, family structure, immigrant status and population density
Authors: Östberg Viveca 
Published: August 2010

AbstractWhich structural dimensions are most important for life chances have been the subject of debate. In this study, which uses data from the Swedish Census‐linked Deaths registry for the period 1980–86, structural differences in child mortality are analysed. The structural dimensions focused on are social class, gender, family structure, immigrant status and population density. When all structural dimensions were controlled for simultaneously, only social class and gender influenced disease mortality. Of these two structural dimensions, social class seemed to be the most important in terms of producing the greatest differences. For mortality due to accidents, on the other hand, all dimensions proved to be important. The mortality risk was higher for children in single‐parent households, for children whose parents were born outside Sweden, and for children living in the least densely populated areas. The greatest differences in mortality from accidents, however, were attributable to gender, followed by social class. Furthermore, mortality differences by the father's, the mother's and the family's class position, determined by the dominance method of class assignment, were compared. The class position of both parents was independently associated with child mortality but the family's position seemed to be the better discriminator in terms of class variation. The implications of these findings are that death risks during the whole childhood period are socially structured in Sweden and that social class is still a structural dimension of great importance.
Notions of child health: mothers' accounts of health in their young babies
Authors: Lauritzen Sonja Olin 
Published: August 2010

AbstractThis paper is concerned with mothers’ understandings of child health in their young babies. To explore how child health is depicted, explained and contextualised by mothers, altogether 29 mothers in Stockholm and London were interviewed through the baby's first months about day‐to‐day experiences of the baby's health and well‐being. The analysis of the mothers’ accounts reveals how the mothers, in the process of assessing health, try to ‘read’ the bodily signs and reactions in their babies. Some major themes emerge on how the mothers identify and characterise threats to the health of the baby; here described as threats of abnormalities, threats to the survival of the baby, threats to the thriving of the baby and threats from illnesses. Notions of child health are discussed in relation to the ‘bodily’ and the ‘social’, and how the embodied images of child health are intertwined with the mothers’ presentations of themselves as responsible for the health of their children and as ‘worthy’ parents.
The baby and the bath water: disabled women and motherhood in social context
Authors: Thomas Carol 
Published: August 2010

AbstractThe aim of this paper is to explore key dimensions of the reproductive experiences of disabled women who are, or who are thinking about becoming, mothers. The paper reports a qualitative study which involved semi‐structured interviews with 17 disabled women who were contemplating childbearing, or were pregnant, and/or had young children. The interpretation of these women's experiences is situated with reference to current debates on the meaning and nature of disability, and draws attention to the ways in which these experiences can be understood as manifestations of disablism. More specifically, the paper considers three themes which emerged in the data analysis: the women's engagement with the medical ‘risk’ discourse; the pressure felt by disabled women to demonstrate that they are, or could be, ‘good enough mothers’; and their experiences of receiving unhelpful ‘help’ from health and social care workers.
The many meanings of care in clinical research
Authors: Easter Michele M. , Henderson Gail E. , Davis Arlene M. , Churchill Larry R. , King Nancy M. P. 
Published: August 2010

AbstractThe conduct of clinical research often involves two distinguishable sets of relationships: the researcher‐subject relationship, and the clinician‐patient relationship. Some scholars argue that being a patient in a clinical care setting and a subject in a research study are so different that anything that would promote in subjects the view that they are in clinician‐patient relationships is exploitative and deceptive. This paper presents findings intended to initiate a more empirically‐based discussion of this issue. Using data from 82 in‐depth interviews with physician‐investigators, nurse‐study coordinators and patient‐subjects in early phase clinical trials, we find that research personnel are likely to be seen, and to see themselves, as clinical caregivers. We also find evidence that while researchers and subjects often tend to view care and research as conflicting activities, both parties tend to see research as a way of caring for patients. We found no relationship, however, between subjects’ perception of care‐giving by researchers and the tendency to misunderstand that they are in a research study. Because research, by necessity and inclination, is unlikely ever to be ‘care‐free’, we recommend that the ethical debate surrounding the danger of confusing research with treatment take into account the kinds of care described by respondents.
The power of ethics: a case study from Sweden on the social life of moral concerns in policy processes
Authors: Hoeyer Klaus 
Published: August 2010

AbstractIn this paper I report on an ethnographic study of an ethics policy developed by a start‐up genomics company at the time it gained all commercial rights to a population‐based biobank in the town of Umeå in northern Sweden. Tracing the interdependencies between power and morality, my research compares moral reflections and stances among 1) policymakers, 2) health professionals and 3) donors, in relation to the issues identified in the policy. These people seem to agree that trust and fairness are important issues and that ‘something’ needs protection in the face of commercial genetic research. However, their perceptions of trust, fairness and what it is that needs protection differ significantly. I conclude by considering the implications of variances in moral perspectives for the social study of ethics.
From biopolitics to bioethics: church, state, medicine and assisted reproductive technology in Ireland
Authors: McDonnell Orla , Allison Jill 
Published: August 2010

AbstractThis paper examines the emerging bioethical debate on assisted reproductive technology (ART) in Ireland, which is shaped by the long‐standing contentious issue of abortion and the constitutional protection afforded to the ‘unborn’. The focus of the paper is on the way in which the terms of this debate are shaped and constrained by the historical relations of power between church, state and medicine. Since the representation of Ireland as a post‐Catholic, plural republic is becoming increasingly mainstream to cultural and political discourse, we pay particular attention to how the Catholic Church embraces bioethics as a meta frame or code for refocusing questions of values, beliefs and meanings to sustain the ideal of Ireland as a ‘pro‐life’ and essentially Catholic nation. The Catholic Church is not simply asserting its voice of dissent in the context of public debate as one voice amongst a plurality of other voices, but to shape the emerging debate as a powerful, institutional actor. The opportunity to do so is afforded by the lack of public debate on bioethical issues and the exceedingly slow pace at which bioethics is moving towards an institutionalised framework in Ireland. These events can be explained by the legacy of the social power of the Catholic Church in Ireland and the direct and indirect influence it has long exercised over public policy vis‐à‐vis the state and its institutions, including medicine. There are two interconnected threads to the contextual analysis presented in our case study: first, the legacy of the social power wielded by the Catholic Church, and its slow and incremental demise reflected in the pace of secularisation in Ireland and the privatisation of morality; second, the emergence of a bioethical regulatory debate on ART, which is mired in the abortion controversy. Our analysis focuses on a number of key contradictions and tensions in the way in which the key institutions of church, state and medicine navigate their own positions vis‐à‐vis a bioethics debate, and how this constrains public participation.
Unhealthy prisons: exploring structural determinants of prison health
Authors: De Viggiani Nick 
Published: August 2010

AbstractPrisoner health is influenced as much by structural determinants (institutional, environmental, political, economic and social) as it is by physical and mental constitutions of prisoners themselves. Prison health may therefore be better understood with greater insight into how people respond to imprisonment – the psychological pressures of incarceration, the social world of prison, being dislocated from society, and the impact of the institution itself with its regime and architecture. As agencies of disempowerment and deprivation, prisons epitomise the antithesis of a healthy setting. The World Health Organisation's notion of a ‘healthy prison’ is in this sense an oxymoron, yet the UK government has signalled that it is committed to WHO's core health promotion principles as a route to reducing health inequalities. This paper reports on the findings of an ethnographic study which was conducted in an adult male training prison in England, using participant observation, group interviewing, and one‐to‐one semi‐structured interviews with prisoners and prison officers. The paper explores how different layers of prison life impact on the health of prisoners, arguing that health inequalities are enmeshed within the workings of the prison system itself.
Gender, pregnancy and the uptake of antenatal care services in Pakistan
Authors: Mumtaz Zubia , Salway Sarah M. 
Published: August 2010

AbstractAn integrated analysis of detailed ethnography and large‐scale survey data is presented to explore the gendered influences on women's uptake of antenatal care (ANC) services in Punjab, Pakistan. Pregnancy and its associated decisions were shown to be normatively the older women's domain, with pregnant women and their husbands being distanced from the decision‐making process. Women who successfully claimed ANC did so not by overtly challenging the dominant construction of young femininity, but rather by using existing gendered structures and channels of communication to influence authority figures. The quality of a woman's inter‐personal ties, particularly with her mother‐in‐law and husband, were found to be important in accessing resources, including ANC. Gendered influences were moderated by social class. Family finances were an important determinant of ANC use, as was women's education. Wealthier, higher status women also found it easier to circumvent gendered proscriptions against their mobility while pregnant. As well as illuminating the ways in which the sociocultural construction of gender acts to constrain women's access to ANC, the empirical findings are used to highlight significant inadequacies in the ‘autonomy paradigm’ that has dominated much of the research into women's reproductive health in South Asia.
Illness action rediscovered: a case study of upper limb pain
Authors: Calnan M. , Wainwright D. , O’Neill C. , Winterbottom A. , Watkins C. 
Published: August 2010

AbstractTheoretical frameworks provide generalised accounts of illness action although empirical studies of the process are still in short supply. This study of upper limb pain provided a case study of illness action; as it is a common condition, there is uncertainty about its treatment and management, orthodox and non‐orthodox care are seen as legitimate sources of help and it is linked with a range of causes.Face‐to‐face informal interviews were carried out with 47 informants with upper limb pain and their practitioners (n= 19). The data were analysed in two different ways. The general stages of the illness action process were identified through a descriptive analysis of the upper limb pain sufferers’ accounts and the policies and practices reported by their practitioners. Then, case studies were constructed to depict individual pathways through healthcare and consequences for sufferers. The illness action process was characterised by the normalisation and accommodation of pain informed by a discourse that predominantly invoked ageing and the wear and tear of the body. Practitioners also preferred to adopt a biomechanical approach and were reluctant to attribute psychosocial labels. The case studies illustrated the divergent, negotiated and opportunistic nature of the process and showed that the use of both orthodox and non‐orthodox care formed only part of strategies used to manage upper limb pain. Sufferers evaluated the care they received in terms of pain alleviation, and were resigned to searching for the best way of living with their pain.
Watch out for the Aunties! Young British Asians’ accounts of identity and substance use
Authors: Bradby Hannah 
Published: August 2010

AbstractThis paper considers how young people able to trace their origins from Pakistan or India (henceforth ‘Asians’), discuss their use of, or abstention from, alcohol and tobacco in terms of religious and cultural tradition. The role of religion, ethnicity, gender and generation in the uptake or avoidance of alcohol and tobacco was explored in 19 qualitative group and individual interviews with 47 Asians aged 16–26 years and analysed in terms of pioneering and conservative forms of tradition. Religious proscriptions on alcohol and tobacco were reported to be formally gender blind, but concerns about reputation and future marriage chances, sanctioned by gossip, meant that women's behaviour was consistently more constrained than men's. Muslims’ abstinence from alcohol was tightly linked with an Islamic identity in that drinking jeopardised one's claim to being a Muslim, whereas cigarette smoking was tolerated among young men. Sikhs’ and Hindus’ avoidance of tobacco was strongly sanctioned, but smoking did not strongly jeopardise a religious identity. Sikh men's abstention indicated manly strength central to a devout identity. Some experimentation was possible out of view of the older generation, especially the aunties, but the risk of gossip damaging young women's reputations was keenly felt. While damage to women's reputations was hard to undo, men's reputations tarnished by substance use, could be compensated for by their parents’ honourable status. Discussion of tradition as innovation was rare and met with resistance. Tradition was largely experienced as a constraint to be circumvented.
Learning disability and the limits of liberal citizenship: interactional impediments to political empowerment
Authors: Redley Marcus , Weinberg Darin 
Published: August 2010

AbstractRecent policy initiatives have moved decisively toward empowering learning disabled citizens, recognising ability over disability, and promoting people's political empowerment and voice in the design of public services. While laudable and encouraging, these initiatives raise an important question: to what extent can a group of service users, whose very entitlement to state‐sponsored assistance is justified by putative intellectual impairment, be empowered according to an exclusively liberal model of citizenship that presumes and requires, as its very defining features, intellectual ability and independence? In this paper we consider this question by means of an ethnographic analysis of an innovative advocacy group: the Parliament for People with Learning Disabilities (PPLD). We first document both an institutional and an interactional preference for clients to speak actively for themselves. We then describe three types of interactional trouble that emerged in the PPLD as obstacles to realising this preference in practice and the strikingly similar remedies that were generated to overcome these troubles. We conclude by discussing the limits of an approach to empowering learning disabled individuals that is cast too exclusively in terms drawn from liberal models of citizenship that prioritise voice over care, security, and wellbeing.
Women drug users in North Cumbria: what influences initiation into heroin in this non‐urban setting?
Authors: Payne Jennifer 
Published: August 2010

AbstractThis paper reports on a qualitative study which has investigated female problem drug use in North Cumbria, a relatively isolated area of the UK. Cumbria is the second most sparsely populated county in England with some of the most beautiful countryside juxtaposed with areas of disadvantage, particularly in towns along the west coast. Previous research has focused on female city dwellers and less is known about the social and cultural context of drug use in non‐urban settings. The reasons for women's drug use remain controversial but gender differences appear to emerge. One frequent explanation is the influence of male oppression but some studies describe women as active players in their initiation. Findings from North Cumbria challenge the conventional view of women being coerced into illicit drug use and present greater complexity. The data derived from semi‐structured interviews account for the impact of curiosity and trust, motives often tempered by a range of complex personal circumstances. A known individual, usually male, was often present at initiation and this relationship appears pivotal. I discuss these factors and will call for prevention initiatives to recognise the gender‐specific determinants of initiation into problem drug use.
‘No one agrees except for those of us who have it’: endometriosis patients as an epistemological community
Authors: Whelan Emma 
Published: August 2010

AbstractThis paper contributes to the literature on patients’ claims‐making work by analysing the epistemological strategies and standards used by members of an endometriosis patient community. It draws upon focus group research with members of a support group for endometriosis sufferers, and an open‐ended survey of an e‐mail list for women with the disease. Lynn Hankinson Nelson's (1993) concept of epistemological community is used to examine standards and practices for developing and evaluating knowledge used by women with endometriosis. Particular attention is paid to the use and centrality of the notion of experience within this community.