bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embodied self‐identity, healthy lifestyles and school physical education
Authors: Kirk David , Tinning Richard 
Published: February 2004

AbstractThis paper draws on a study of female and male adolescents' social constructions of the body and self‐identity in and around physical education lessons. The concepts of the social construction of the body and embodied self‐identity are discussed and related to popular physical culture in Australia. Data from a two year study in Australian secondary schools is then used to illustrate the ways in which popular physical culture is appropriated, reconstructed and accommodated within adolescents' lifestyles. It is argued, on the basis of this data, that many girls and some boys experience degrees of disembodiment in physical education lessons as a strategy for the protection of self‐identity. As a result, many are hindered in appropriating the resources of popular physical culture to lead active or healthy lifestyles. The paper concludes by raising issues for the teaching of physical education and for health promotion more broadly.
Adolescent women, identity and smoking: leisure experience as resistance
Authors: Wearing Betsy , Wearing Stephen , Kelly Kathy 
Published: February 2004

AbstractRecent theorising concerning leisure has suggested that this sphere, along with the family, the educational system and the occupation system, contributes to identity formation and more especially to gender identity. However, feminist analyses suggest that leisure can be both an area for the subordination and domination of women and an area of resistance to dominant ideologies and discourses. Questions are raised within this framework as to the need in late adolescence for girls, because of a lack of opportunity within their leisure experiences, to seek identity in other ways—smoking may be a form of resistance but also adopted because of a lack of leisure opportunities suitable for them. While males have role models and a culture that provides them with individual competitive pursuits which at least give them a perception of identity, women lack such a culture and are thus deprived of the opportunity to participate in leisure activities to the same extent as males. This paper argues that adventurous leisure which provides physical, mental and emotional challenge and satisfaction can provide a sound basis to resist gender stereotypes and provide alternatives to tobacco consumption.
Dying of awareness: the theory of awareness contexts revisited
Authors: Timmermans Stefan 
Published: February 2004

AbstractIn this paper, I employ a grounded theory approach to extend an existing theory. My starting point is the theory of awareness contexts, first formulated in 1965 by Strauss and Glaser. Using introspective ethnography, I illustrate that the way patients and relatives emotionally cope with terminal information defines the kind of awareness context. I therefore suggest that the open awareness context should be split into three different contexts. In the suspended open awareness context, the patient or kin ignores or disbelieves the message communicated by the physician. In the uncertain open awareness context, the patient or family member dismisses the bad parts of the message and hopes for the best outcome. In the active open awareness context, the patient or relative accepts the impending death and prepares for it. This revision reclaims the emotional power of terminal illness from the viewpoint of patients and relatives and adapts the theory to changed structural conditions.
Social inequalities in ill‐health: the significance of occupational status, education and income‐results from a Norwegian survey
Authors: Dahl Espen 
Published: February 2004

AbstractThe aim of the paper is to examine the interrelationships between socioeconomic indicators such as occupational status, education and income, and self‐reported ill‐health in a nationwide, representative sample of employed Norwegians aged 20–64 years. Three measures of ill‐health were selected for scrutiny: long‐standing somatic illness, reduced work potential due to longstanding somatic illness, and symptoms of nervous conditions. The relationships between the health outcomes and the socioeconomic variables were modelled by means of logistic regression while controlling for age, sex, marital status, and area of residence. The analyses show that occupational status stands out as the most important and most consistent predictor of ill‐ health, as it was significantly related to all three health outcomes. The pattern which appeared was a familiar one; the experience of ill‐health was more common among people in low status occupations, e.g. unskilled workers, compared with people in high status occupations, e.g. higher salaried employees. Education, on the other hand, was not significantly related to any of the three measures of ill‐health when other variables were controlled for. Disposable household income had an independent effect on longstanding somatic illness and symptoms of nervous conditions, while personal gross income had an independent effect on reduced work potential due to longstanding somatic illness. Personal income and occupational status also interacted with respect to work potential: Among unskilled workers, lower salaried employees, and ‘other’ self‐employed the odds ratios of experiencing reduced work potential increased with increasing income, while for the other occupational groups the trend was the opposite. In a closing section, possible interpretations of these patterns are discussed.
The potential social impact of predictive genetic testing for susceptibility to common chronic diseases: a review and proposed research agenda
Authors: Davison Charlie , Macintyre Sally , Smith George Davey 
Published: February 2004

AbstractRecent advances in molecular genetics are making it increasingly feasible to construct individual genetic profiles predicting susceptibility to heart disease, cancer and respiratory disorders. This paper reviews current knowledge about the social and cultural impact of providing people with information relating to their risk for future disease, focusing not only on currently available predictive genetic testing but also on hypertension, hyperlipidaemia and cancer screening. We highlight the importance of issues of probability and uncertainty, and the tension between collective and individual goals in the assessment of medical risk. We conclude with a proposed research agenda for studies of the social and cultural impact of predictive genetic testing, and argue that there is a pressing need for rigorous, empirical, social research in this area.
An explication of treatment ideology among mental health care providers
Authors: Scheid Teresa Linnea 
Published: February 2004

AbstractThis paper presents an exploratory analysis of the treatment ideologies of mental health care providers who work with the chronically ‘mentally ill.’ Treatment ideology is understood as the complex set of beliefs providers hold about the aetiology of mental illness, the role of the client and the provider, and the efficacy of various treatments or interventions. A case study of a large, urban mental health care organisation providing care to the chronically‘mentally ill’was conducted in 1992. The author attended a series of staff retreats, administered a questionnaire, and completed in‐depth interviews with 22 providers. A typology reflecting two dimensions that juxtapose alternative treatment preferences was developed to represent the range of treatment ideologies uncovered. The first dimension reflects differing conceptions of the role of the provider (supportive or facilitative) and the second dimension reflects differing treatment goals (adjustment or autonomy). This typology was then theoretically extended to include a custodial role for the provider and a treatment goal oriented toward social control of clients. Further study of providers in differing organisation settings is needed to determine the salience of these typologies. Research must also investigate the development and consequences of treatment ideologies, with critical attention focused on the consistency (or inconsistency) of treatment ideologies within a given system, the professional and organisational sources of differing preferences for treatment, and the effect of various belief sets on health care services and outcomes.
‘An epidemic of good health’ at the workplace
Authors: Virtanen Pekka 
Published: February 2004

AbstractTowards the end of 1986 a total of 32 workers who were frequently absent from work due to illness were made redundant at an engineering works. In 1987 sickness absences in the remaining work force were reduced by one third in comparison with the figures for the previous three years. In 1988 sickness absence figures started to climb again.The events are described from the point of view of the local health centre physician. The clinical and epidemiological features of the ‘health epidemic’ are demonstrated. Two comments are presented. The first concerns the unspecificity of sickness absenteeism as a measure of illness. The second concerns the concept of ‘illness behaviour’ which should not be taken as a phenomenon determined by a set of causes, but as a human activity construed in interaction between the individual and significant others.
Attending to patients' stories: reframing the clinical task
Authors: Clark Jack A. , Mishler Elliot G. 
Published: February 2004

AbstractCommunication between patients and physicians is currently a significant topic in medical training programmes and in research on clinical practice. Physicians are encouraged, for example, to attend to patients' stories as ways of providing their concerns and understandings of their illnesses. However, there is little research on how storytelling is actually accomplished in the context of clinical encounters. Drawing on studies of medical discourse, conversational storytelling, and narrative, we present a comparative analysis of two encounters. Both revolve around the same clinical tasks, but in one the patient's story is prominent and in the other it is unheard. We follow the course of successful storytelling in one and its interruption in the other showing how the encounters unfold through patients' attempts to negotiate a story topic, set the scene, and clarify the action and its consequences. The physicians adopt distinctive alignments with respect to the emerging story. These differences appear to be related to the outcomes of the encounters, including the framing of clinical decisions and the maintenance of cooperative patient‐physician relationships. Focusing on the patients' attempts to tell a story illuminates the exercise of authority in clinical encounters, and the way in which clinical tasks are embedded in the social process of authoring the accounts of patients' illnesses.
Self, identity and radical surgery
Authors: Kelly Michael 
Published: February 2004

AbstractData are reported from interviews, analysed qualitatively, with persons who had had ulcerative colitis cured by radical surgery. The procedures performed on the subjects were total colectomy and ileostomy. The subjects were left permanently faecally incontinent by these procedures. Using concepts derived from the work of Mead, and developed in interactionist sociology, the consequences for self and identity of these operations are considered. The tension between the private self of the person with an ileostomy and their public social identity as an ileostomist is examined.
Sickness as a dominant symbol in life course transitions: an illustrated theoretical framework
Authors: Prout Alan 
Published: February 2004

AbstractThe paper examines how sickness as a cultural performance might be analysed as a dominant symbol within life course transitions. The concept of dominant symbol is taken from Victor Turner's framework for Symbolic Processual Analysis in ritual and pilgrimage and is used to interrogate data collected in an ethnographic study of sickness absence in an English primary school. It is suggested that sickness played a central part in the construction of meaning around the transition from primary to secondary school. The performance of sickness seemed to condense ideological features (especially those of gender and work discipline) and to express modulations in the meaning of the transition in its different phases. The concept of dominant symbol (and the related notion of liminality) illuminate these data but need modification to take account of the unritualised and fragmented character of many life course transitions in contemporary Western societies. It is suggested that with modification these concepts might be applied to the meaning of sickness in other life course transitions.
Knowledge of shadows: the introduction of X‐ray images in medicine
Authors: Pasveer Bernike 
Published: February 2004

Abstract Ever since the discovery of X‐rays in 1895, X‐ray imaging has played a large role in the cognitive and practical organization of medicine. This article analyses the way X‐ray images were introduced and made sense of in medical thinking and acting around the turn of the century. The implicit assumption in many histories of radiology is that the specific (diagnostic) message of the X‐ray images resided inside them from the beginning, and that it is obscured either by technological or epistemological problems. These being solved, it would then be no problem to see directly what information the image contains.In this article this assumption is contested. It is argued that the specific content of the images was shaped by the activities of X‐ray workers within the context of medical developments of the time. This shaping, as it is historically reconstructed here, consisted of four methods. X‐ray workers (be they physicians, technicians or scientists) experimented with the technology, the images, the photographic materials and the objects that were X‐rayed. They used X‐ray images of dead bodies to compare them with radiographs of living patients. Radiologists tried to‘translate’diagnostic information acquired with other methods into the shadows of the X‐ray images. And finally they compared images with images.The process of shaping the content and use of X‐ray images, of making them represent reality, took place within specific institutions, and it took a different form in different countries, but also for different parts of the body. Developments of institutionalisation and professionalisation of radiology in England and the Netherlands are presented to provide a small part of the background of this shaping of knowledge of shadows.
The social construction of help among Danish children: the intentional act and the actual content
Authors: Christensen Pia Haudrup 
Published: February 2004

AbstractThis paper is based on an ethnographic study of younger Danish school children's actions and social relations during episodes of sickness and minor accidents. The focus is on how children as social actors give help to others. The main points concern first, the need for a cultural approach to distinguish between the intention and the motive of an action in order to understand children's evaluation of and communication about help. A second point concerns the recognition of children's individual actions as they combine in a collective strategy. Finally I discuss the relationship between children's cultural practices and constitutive elements of their everyday life. I specifically focus on ‘the act of looking’ and time and tempo as it relates to understanding childhood sickness and its relevance in social negotiation between children and adults.
Psychotropics, sociology and women: are the ‘halcyon days’ of the ‘malestream’ over?
Authors: Ettorre Elizabeth , Riska Elianne 
Published: February 2004

AbstractThe purpose of this paper is to lay the foundation for the development of a gender‐sensitive perspective on psychotropic drug use. This paper reviews existing research on psychotropic drug use and highlights gender biases in three ways. First, a review of the early work on gender differences in tranquilliser use reveals how ‘one‐dimensional’ accounts are offered by proponents who are either ‘no‐objections’, ‘cautious‐no‐ answer’, ‘women's‐role’ or ‘political’ advocates. Second, with special reference to women, a critical review of the two predominant discourses, the medical and the sociological, are outlined. It is argued that they have a common approach that makes women's drug use invisible. The paper concludes that the approach prevailing in current research is individualistic and gender blind and needs to be complemented with an analysis that problematises gender.
Paper and people: the work of the casualty reception clerk
Authors: Hughes David 
Published: February 2004

AbstractThis paper examines the exercise of discretion by casualty reception staff, focussing on the problems of accountability that arise when their judgements help shape the process of patient categorization that culminates in clinical diagnosis. Rules and guidelines which ostensibly relate to bureaucratic objectives, are applied in ways which reflect situational exigencies of reception work, and values embedded in organisational culture. But reception staff are reluctant to acknowledge the importance of their decisions, and, particularly where judgements relate to patient condition, present rule‐use as a straightforward and certain activity in which interpretation plays little part.
James Mackenzie, General Practitioner: a modest contribution to the archaeology of clinical reason
Authors: Osborne Thomas 
Published: February 2004

AbstractThis paper focuses on the work of the influential general practitioner and heart specialist, James Mackenzie (1853–1925), and seeks to reconstruct ‐ using some of the perspectives broadly associated with actor‐network theory as well as Michel Foucault's work on clinical medicine ‐ the epistemological rationality of his medical programme as a particular kind of network of knowledge. The paper concludes with a brief discussion of some of the implications of this analysis both for the sociological study of medical knowledge, and for our contemporary ideals of medical practice.
Trends in socioeconomic mortality differentials in post‐war Norway: evidence and interpretations
Authors: Dahl Espen , Kjærsgaard Pål 
Published: February 2004

AbstractThe aim of the study was to describe changes in socioeconomic mortality differentials among adults in post‐war Norway and to examine some selected interpretations. Three separate data sets were obtained. In each set, census information on occupational class was linked to subsequent mortality during three five‐year periods, 1960–65, 1970–75 and 1980–85. The analysis showed a general decline in mortality but an increase in the socioeconomic mortality differentials among men, as measured by standardised mortality ratios (SMR). Women, however, displayed inconsistent SMR patterns and no clear trends. It is argued that this is due to an artefact, ie classification by women's own occupational class, and to health‐related exits from the labour market. Women were thus excluded from the analysis that followed. Over the years covered, socioeconomic age‐specific mortality differentials decreased among younger men and increased among older men. To mirror these changes, ‘potential years of life lost’ (PYLL) were calculated. Essentially, PYLL rendered the same picture as SMR did. The size of the increase in mortality differentials, as measured by SMR and PYLL, among men was somewhat underestimated due to health‐related exits from the work force, especially among unskilled workers, ie a ‘healthy worker effect’. A distinct change took place in the balance between the occupational groups at the extremes in the occupational structure over the years in question. This led to fewer deaths occurring among unskilled workers. Still, however, it seemed justified to state that social inequality in mortality remains a severe health problem. Little evidence was found of the hypothesised cohort effects.
Just the job? Is the relationship between health and domestic and paid work gender‐specific?
Authors: Hunt Kate , Annandale Ellen 
Published: February 2004

AbstractGendered assumptions about working lives are inherent in explanatory models and empirical analysis of the relationship between work and health. Although some of these assumptions reflect the reality of gender divisions of labour, they are rarely empirically tested and male and female samples are too often considered separately. Here we take a broader definition of work which includes aspects of paid work and domestic work, treating both domains as being relevant in principle to both men and women.Using multivariate analysis and two measures of current health (malaise and physical symptoms), it was found that the association between domestic work (at least as measured here) and health is relatively small, and restricted to women's health. Paid work, in contrast, has much stronger associations with malaise for both men and women, and some indicators of specific aspects of work suggest that effects are not gender‐ specific. Taking account of both paid and domestic work together has an enhanced effect for women though not men, especially when indicators of conflict between paid work and other areas of life are taken into account. However, reports of work conflict are associated with more malaise in both men and women. Although the model is successful in explaining the variance in malaise symptoms this was not true for physical symptoms.
Fringe work: peripheral work in health visiting
Authors: de la Cuesta Carmen 
Published: February 2004

AbstractFringe work is a category developed in a grounded theory study into health visiting, accounting for a series of activities that health visitors were not expected or supposed to engage in. It is mainly a response to the deficiencies or gaps that health visitors encountered in both the health care and social systems, and operates by mobilising, developing and substituting resources. Fringe work highlights for the client the relevance of the health visitor's service, and contributes to the development of relationships with clients in two ways: it produces reciprocity and it enhances solidarity. While it may be said that fringe work represents a progressive form of work it can also be viewed as a paternalistic approach to health visiting.
Violence and vulnerability: conditions of work for streetworking prostitutes
Authors: Barnard Marina A. 
Published: February 2004

AbstractThis paper looks at the issue of violence in the context of streetworking prostitutes and their clients in Glasgow, Scotland. Street prostitutes routinely face the threat and reality of violence in their work which suggests that the health risks associated with prostitution need to be considered not only as public health issues but also in terms of occupational health. Using data derived from semi‐structured interviews as well as observation the paper focuses on the dynamics of the client/prostitute encounter. A particular focus is on the ways in which prostitutes try to establish and maintain client compliance throughout the commercial sex encounter. Prostitutes in this study framed control over the encounter as being a critical issue, particularly in terms of limiting the potential for violence to occur. Instances where prostitutes were unable to secure client compliance through intimidation on the part of the client are discussed. The strategies used by women to reduce the likelihood of client violence are considered. The paper ends with a reflection of possible policy initiatives to reduce the likelihood of client violence against prostitutes. The potential for change to take place is clearly limited by the illegalities surrounding prostitution and the highly stigmatised nature of the work.