bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lay constructions of genetic risk
Authors: Parsons Evelyn , Atkinson Paul 
Published: August 2010

AbstractThe paper reports one aspect of research on women (mothers and daughters) in families with Duchenne Muscular Dystrophy (Duchenne), a genetically transmitted disorder. The data were collected by means of extended unstructured interviews with the women, all of whom had had either a brother or a son who had inherited the disease. All the women have been defined by medical professionals as having a specific ‘risk’ of carrying and transmitting the defective gene. Their lay understanding of carrier risk rates is explored. There are fundamental differences between medical and lay understandings of the statistical issues involved. The discrepancies may have important consequences for the women's reproductive behaviour. The implications of genetic risk for spoiled identity on the part of some women are also described.
Social selection: what does it contribute to social class differences in health?
Authors: Blane David , Smith George Davey , Bartley Mel 
Published: August 2010

AbstractSocial selection, or the idea that an individual's health can influence their social mobility and, hence, their position in the social hierarchy, has been suggested as an important element in the process which produces social class differences in health. The present paper examines this idea by drawing together evidence from a range of published research. Direct selection according to health is judged to have little effect on class gradients. The logically distinct idea of indirect selection can be seen most usefully as referring to the accumulation of advantage or disadvantage during life.
Transcending the dualisms: towards a sociology of pain
Authors: Bendelow Gillian A. , Williams Simon J. 
Published: August 2010

AbstractTheories of pain have traditionally been dominated by biomedicine and concentrate upon its neurophysiological aspects, both in diagnosis and treatment. Hence, scientific medicine reduces the experience of pain to an elaborate broadcasting system of signals, rather than seeing it as moulded and shaped both by the individual and their particular socio‐cultural context. Although pain lies at the intersection between biology and culture, making it an obvious topic for sociological investigation, scant attention has been paid to understanding beliefs about pain within the study of health and illness. A major impediment to a more adequate conceptualisation of pain is due to the manner in which it has been ‘medicalised’, resulting in the inevitable Cartesian split between body and mind. Consequently, the dominant conceptualisation of pain has focused uponsensation, with the subsequent inference that it is able to be rationally and objectively measured. Yet as well as being a medical ‘problem’, pain is an everyday experience. Moreover,sociologicalandphenomenologicalapproaches to pain would add to, and enhance, existing bodies of knowledge and help to reclaim pain from the dominant scientific paradigm. In this paper, it is argued, firstly, that the elevation of sensation over emotion within medico‐psychological approaches to pain, can be shown to be limiting and reductionist. Secondly, we attempt to show how insights from the newly‐emerging sociological arenas of emotions and embodiment provide a framework which is able to both transcend the divide between mind and body and to develop a phenomenological approach to pain. Finally, in order to bring themeaningof pain into fuller focus, we draw attention to the importance of studying theodices and narratives, as well as the cultural shaping and patterning of beliefs and responses to pain.
The biographical challenge of caring
Authors: Chamberlayne Prue , King Annette 
Published: August 2010

AbstractThe article discusses the contribution of narrative methods to the contextualised study of subjectivity. More specifically, it introduces the key features of biographical interpretive methods, which derive from phenomenology, and presents four case studies of carers in East and West Germany. Through the cases, the article explores inner and outer dimensions of carers’ coming to terms with disability, together with patterns of biographical continuity and change. This is followed by a comparative discussion of the interplay between personal and structural factors in the two societies. The article thereby demonstrates the strength of the method in exploring interrelationships between the personal and the social, as well as its particular relevance for professional practice in the social field.
Anomalous patients: the experiences of doctors with an illness
Authors: McKevitt Christopher , Morgan Myfanwy 
Published: August 2010

AbstractVariations in the distribution of power have been used to account for and to advocate different types of doctor‐patient relationship. It might be expected that doctors who become patients would have a ‘mutual’ relationship with their treating doctor. Data from interviews with doctors with a recent illness show that this is not necessarily the case and may not even be doctors’ preferred model of doctor‐patient relationship for themselves when they become ill. Doctors constitute anomalous patients since they confound two categories generally held to be separate, ‘doctor’ and ‘patient’. This affects the type of medical encounter they have, raising issues of identity and role performance for both patient and treating doctor. Doctor/patients may be in control of the encounter (through choice or default); they may consciously choose or have explicitly ascribed to them the status of ‘ordinary patient’; some believe that doctors should be treated as extraordinary patients with particular needs dependent on their insider status as much as their pathology. The negotiation of power in the encounter between doctors and medically qualified patients is problematic but the existence of the power differential in the medical encounter emerges as ‘natural’ and largely as desirable, since it is linked to the ability and authority to take charge of the disorder which illness represents.
Co‐ordinating ‘ethical’ clinical trials: the role of research coordinators in the contract research industry
Authors: Fisher Jill A. 
Published: August 2010

AbstractChange in the way new drugs are developed, including the privatisation of clinical trials, has altered the arrangement and roles of healthcare professions. In this paper I examine one aspect of this change: the role of research coordinators in the conduct of contract research in the United States. My focus on coordinators highlights the ethical conflicts embedded in clinical trials. I describe the ways in which coordinators experience and contend with the conflict between research and care and show how their construction of ethics is distinct from institutional conceptions formally associated with human subjects research. My analysis demonstrates how the coordinators’ focus on ethics is a response to their role conflict and an attempt to reinsert individualised care into the context of research.
Diets and discipline: the narratives of practice of university students with type 1 diabetes
Authors: Balfe Myles 
Published: August 2010

AbstractType 1 diabetes is one of the most common chronic conditions of adolescence and young adulthood. It is characterised by a demanding and complex management regime. Individuals with diabetes must engage in continual self‐care actions such as eating healthily and exercising if they are to minimise their risks of developing long‐term diabetes’ complications. Research has demonstrated, however, that many young adults experience difficulties with exercising and eating healthily. Narrative approaches could provide important insights into the reasons why young people do or do not experience difficulties here. In this article I examine the food consumption and exercise narratives of a particular group of young adults with type 1 diabetes, university students, to see what personal, social and cultural factors influence their practices.
Health lifestyles and the absence of the Russian middle class
Authors: Cockerham William C. 
Published: August 2010

AbstractThis paper examines the pivotal role of social stratification in Russia's health crisis. The primary level causal factor is increased mortality from heart disease and alcohol‐related poisonings and accidents. In order to understand the origin of the primary causes, it is necessary to look further for secondary level factors. Whereas policy and stress are important, the leading secondary determinant is negative health lifestyles. The question then arises: What is the source of this lifestyle? This question necessitates a search for tertiary level causes and the absence of a strong middle class in Russia is identified. In Western society, the middle class, especially the upper middle class, is the social carrier of positive health lifestyles across class boundaries. The Russian middle class has not initiated positive health lifestyles countering the predominately negative health lifestyle practices because a middle class similar to that in the West does not exist. Russia needs a civil society in which a similarly stable and empowered middle class can promote positive health lifestyles within its own stratum and elsewhere in the class structure; until this happens, the health situation in that country may not stabilise for the better.
Perceptions of evidence‐based medicine: traditional acupuncturists in the UK and resistance to biomedical modes of evaluation
Authors: Jackson Sue , Scambler Graham 
Published: August 2010

AbstractAcupuncture and other types of ‘complementary and alternative medicine’ (CAM) are proving increasingly popular in the UK. As attempts to incorporate acupuncture into allopathic medicine have grown in number, the issue of assessing its effectiveness in ways consistent with the concept of evidence‐based medicine has become more urgent. The nature, relevance and applicability of such assessments remain controversial however. This paper reports a qualitative study of acupuncturists’ own perceptions of evidence and evidence‐based medicine in relation to their therapeutic interventions. The material is presented in two main sections: explaining how acupuncture works, and resisting evidence‐based medicine. The interviews reveal a great deal of scepticism and ambivalence and a deep questioning of the salience of conventional (biomedical) modes of evaluation of interventions.
Chronic illness, expert patients and care transition
Authors: Taylor David , Bury Michael 
Published: August 2010

AbstractDuring the last century demographic and epidemiological transitions have had a radical impact upon health and health service provision. A considerable body of research on the sociological aspects of living with chronic illness has accumulated. Debate has focused on how social environments shape disability‐related experiences, and the extent to which individual responses define health outcomes. Through the establishment of the Expert Patients Programme (EPP) in 2001, the Department of Health has sought to enhance NHS patients’ self‐management capacities. This paper discusses three areas relevant to this: the policy formation process leading up to the EPP's present stage of development; the evidence base supporting claims made for its effectiveness; and the significance of psychological concepts such as self‐efficacy in approaches to improving public health. The conclusion discusses NHS developments in primary care and public involvement in health and healthcare, and the implications that initiatives such as the EPP carry for the future. It is argued that to facilitate a constructive process of ‘care transition’ in response to epidemiological and allied change, awareness of cognitive/psychological factors involved in illness behaviours should not draw attention away from the social determinants and contexts of health.
Avian flu: the creation of expectations in the interplay between science and the media
Authors: Nerlich Brigitte , Halliday Christopher 
Published: August 2010

AbstractThis paper examines the emerging cultural patterns and interpretative repertoires in reports of an impending pandemic of avian flu in the UK mass media and scientific journals at the beginning of 2005, paying particular attention to metaphors, pragmatic markers (‘risk signals’), symbolic dates and scare statistics used by scientists and the media to create expectations and elicit actions. This study complements other work on the metaphorical framing of infectious disease, such as foot and mouth disease and SARS, tries to link it to developments in the sociology of expectations and applies insights from pragmatics both to the sociology of metaphor and the sociology of expectations.
Globalisation and medicine in Trinidad
Authors: Reznik David L. , Murphy John W. , Belgrave Linda Liska 
Published: August 2010

AbstractIn a qualitative study of urban Trinidadians who work in the medical industry, the concept of medical globalisation was provisionally analysed. Two research questions were addressed: what is globalisation, in the context of mainstream medicine, and how is this process manifested in everyday practices? Four fundamental principles of medical globalisation emerged from in‐depth interviews and analysis of observational materials: (1) the notion of history as an autonomous force with globalisation as the latest stage, (2) the expansion of ‘Total Market’ philosophy as a driving social force, (3) the fragmentation of society into atomistic, self‐interested, and competitive individuals, and (4) the adoption of a ‘centralised’ set of ideals as the normative core necessary for social order. In this paper, findings from this investigation and their implications are discussed. In particular, medical globalisation is linked with major themes in medical sociological theory including dualism and medicalisation.
‘It puts things out of your control’: fear of consequences as a barrier to patient disclosure of mental health issues to general practitioners
Authors: Dew Kevin , Morgan Sonya , Dowell Anthony , McLeod Deborah , Bushnell John , Collings Sunny 
Published: August 2010

AbstractResearch indicates that there is a high level of trust in health professionals but also a high level of non‐disclosure of mental health issues to general practitioners (GPs). This paper explores the issue of patients’ willingness to disclose mental health problems to GPs through interviews with 33 patients from the lower half of the North Island of New Zealand. Patients’ willingness to disclose related to a range of factors but this paper focuses on fear and sense of control as these issues have received little attention in the extant literature and provide important discussion points for the conduct of consultations. Fear of the consequences of consultation warrants attention if general practice is to be promoted as the preferred point of contact for mental health consultations. The research reported here suggests that trust in a range of institutions and agencies, not just in the individual practitioner, would need to be achieved for the GP to be the preferred point of contact.
Internet social support groups as moral agents: the ethical dynamics of HIV+ status disclosure
Authors: Rier David A. 
Published: August 2010

AbstractThis paper examines how, on Internet HIV/AIDS support groups, participants discuss the ethics of disclosing HIV seropositivity to partners. The data consist of all mentions of disclosure culled from over 16,000 pages overall of posts from 16 different groups, hosted on seven separate sites. The paper focuses on two main questions. First, apart from providing support and information, did the groups also debate moral dilemmas (and, despite groups’ common perception as ‘safe spaces’ for non‐judgmental exchanges, did these discussions include moral judgments and conflicts)? Secondly, did use of this new medium generate a new, alternative ethical discourse, or merely replicate existing discourses? The data demonstrate that online support groups did engage in debating, and trying verbally to enforce, certain views of the ethics of seropositivity disclosure. The most common view advocated full disclosure, though a range of positions existed. Unlike with most online support groups described elsewhere, these discussions often included harshly‐expressed moral judgments. The groups did not generate a truly new, alternative discourse, but served as clearinghouses for and transmitters of existing ‘off‐line’ discourses, both mainstream and alternative. Implications and limitations of the present study, and areas for further research, are discussed.
‘Making the best you can of it’: living with early‐stage Alzheimer's disease
Authors: MacRae Hazel 
Published: August 2010

AbstractDrawing upon data from a qualitative study of persons who are in the early stage of the condition, this paper examines the meaning of Alzheimer's disease. It contrasts the meaning of the disease as portrayed in popular culture with its meaning as interpreted by persons living with it. Findings show that persons with the illness do not necessarily accept the negative cultural meaning of the disease, nor the helpless ‘victim’ role in which they are generally cast. With a determination to ‘make the best of it’, strategies such as humour, normalisation, present‐time orientation, and life review are employed to create a meaningful life.
Regulating medical bodies? The consequences of the ‘modernisation’ of the NHS and the disembodiment of clinical knowledge
Authors: Nettleton Sarah , Burrows Roger , Watt Ian 
Published: August 2010

AbstractThe aim of this paper is to explore the consequences of modernisation and regulatory processes for the everyday lives of doctors working the UK National Health Service. We do this by reporting on interview data generated as part of a qualitative investigation into the working lives of 47 doctors. The analysis of the empirical findings is informed by two literatures: that which has sought to theorise the contemporary thrust of regulation and audit and that which has developed a sociology of embodiment. Doctors’ views are presented in relation to four areas of work which have – in the loosest sense of the word – been subject to regulation. Drawing on work from the sociology of embodiment we argue that changes in the institutional and cultural context of medical work could be altering both the ‘field’ and the ‘habitus’– to use Bourdieu's terms – of medicine, with a consequence that medical knowledge is becoming less embodied.
Distributed decision making: the anatomy of decisions‐in‐action
Authors: Rapley Tim 
Published: August 2010

AbstractConceptualising the doctor‐patient relationship has been a central project for both medicine and medical sociology. This paper seeks to show how an understanding of thedistributednature of medical practice can help us research the decision‐making process in doctor‐patient encounters. I draw on a range of empirical studies of medical interaction, knowledge, technology and work in primary and secondary care. I describe the ‘ethno‐methods’ (Garfinkel 1967) of patient‐orientated medical decision making in order to highlight some of the fundamental facets of distributed decision making. Initially, I outline how decision making is an ongoing event that often evolves over multiple encounters. I then show how decision making is never just a solo, cognitive activity but rather distributed over a range of people. Finally, I outline how decision making is initiated, sustained and transformed over a range of encounters with both people and technologies. I argue that recognising the distributed nature of decision making shifts the focus from overly prescriptive visions of decision making to more plausible, albeit, more mundane sets of ideals. Centrally, a focus on distribution offers new opportunities actively to engage with, support and research decision‐making‐in‐action.
‘It's something for you both to think about’: choice and decision making in nuchal translucency screening for Down's syndrome
Authors: Pilnick Alison 
Published: August 2010

AbstractPolicies and practices around antenatal screening services have long been the subject of debate in a sociological context. However, existing research has largely overlooked the way in which the policies and practices that underpin antenatal screening services are enacted through talk between pregnant women and their health professionals. This paper focuses on one such policy, that of informed choice. It uses data from 14 tape‐recorded pre‐screening consultations with community midwives, forming part of a newly introduced nuchal translucency screening programme, to examine how the issue of choice is topicalised and discussed. It concludes that, whilst there is clear evidence that midwives are at pains to explicitly invoke the issue of decision making, there are other more subtle factors in the interactional presentation of screening tests that serve to undermine whether and how a recognition of choice is received by pregnant women.
CITY NETWORKING WITH THE ‘GLOBAL SOUTH’: DUTCH POLICY AND PRACTICE
Authors: BONTENBAL MARIKE 
Published: August 2010

ABSTRACTWhereas the global networking of cities is commonly understood from a fiscal‐economical and technological perspective explaining world economy and globalisation structures, this paper discusses another viewpoint of city networking in which the exchange of knowledge on urban management and policy‐making is examined. It reviews the policy context and practice of Dutch cities in North‐South city networking and their role in international development co‐operation through the sharing of municipal knowledge and expertise with partner cities in developing countries. Against the background of shifts in development thinking leading to increased acknowledgement of the role of cities in development co‐operation, past and current policies at the national as well as the municipal level are considered that shape the framework for Dutch city networking with the ‘global South’.
EUROPEAN PLACE‐BASED DEVELOPMENT POLICY AND SUSTAINABLE ECONOMIC AGGLOMERATION
Authors: THISSEN MARK , VAN OORT FRANK 
Published: August 2010

ABSTRACTThe inherent tension between regional equality and economic growth (efficiency) is recently much debated in the context of place based development policy and agglomeration in the European Union. A general conclusion reached in the literature is that a policy targeted at regional equality may be harmful for economic growth. Such policy therefore should be transformed in such a way that it also promotes the mobility of both people and firms and hence facilitates the possibilities of increased agglomeration. Recent insights from economic theories suggest that agglomeration externalities are not taken into account in the migration decision of firms and people, causing the dynamic urbanisation processes to not necessarily result in a (social) welfare optimum. This is even more so if other welfare effects than GDP and product variety are taken into account. Regional economic development is not sustainable if the dynamic urbanisation processes stemming from agglomeration economies do not lead to a welfare optimum. In this paper we assess the possibility of a non‐sustainable regional development path. We conclude that strong additional negative externalities of growing large agglomerations are harder to prove than negative externalities of small agglomerations becoming smaller. Moreover, the size of short run negative effects that will stimulate the migration of people has not been adequately assessed. The European Union should therefore be careful in interpreting place‐based costs and benefits of growing, large agglomerations at the detriment of small regions.