bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do cancer patients express their points of view?
Authors: Pinell P. 
Published: February 2004

Abstract This paper analyses the representations of cancer on the basis of a corpus of letters addressed by cancer patients to the ‘Concertation Nationale sur le Cancer’.Whenever social agents tackle the question of the aetiology of their cancer, their act consists of retaining data borrowed from medical models and organising it into a narrative reconstruction that gives a meaning to the appearance of their disease. In our case, this reconstruction is based upon a homology between social disorder and biological disorder, which constitutes their frame of reference for defining their personal responsibility. Being able to classify oneself as ‘innocent’ seems to be a necessary condition entitling one to convey one's point of view in public and, in particular, a condition for expressing a critical discourse with regard to the representations of cancer made by non‐afflicted persons. The very act of writing to the Concertation Nationale Cancer is a political act ‐ an ‘official’ intervention in regard to representations is sought through the invalidation of the opinions of the healthyHowever, these critical discourses are not free from the very representations which constitute the targets of their criticisms. Cancer patients are still prisoners of ‘archaic representations of the disease’.
Deciphering chronic pain
Authors: Baszanger Isabelle 
Published: February 2004

AbstractChronic pain is a problematic reality at least for two reasons. First, pain is a person's private experience, to which no one else has direct access. Second, chronic pain is lasting proof of a failure that questions the validity of actions and explanations, both past and future, of all involved. Because pain is a private sensation that cannot be reduced by objectification, it cannot, ultimately, be stablised as an unquestionable fact that can serve as the basis of medical practice and thus organise relations between professional and lay persons. This fragile factuality increases the work a physician has to do to decipher a patient's pain. The aim of this paper is to examine how physicians specialising in pain medicine work at this deciphering. Because of these characteristics of pain, physicians are forced to work on the elusive information provided by patients so as to bring into being something called chronic pain. When doing this they tap various, nearly incompatible, resources. I shall study the way these multiple resources are put to use by physicians as they form judgements about cases. By using as a field experiment two pain centres with opposite conceptions and practices, it can be shown how physicians in each centre determine patients' pain situations and formulate advice to them, how the characteristics of this work involve physicians in specific systems of relations with patients, and how these systems are related to dimensions of this work: either to a justification of physicians' actions or else to a confirmation, or realignment, of the initial doctor‐patient agreement.
Images of scientific medicine
Authors: Calnan Michael , Williams Simon 
Published: February 2004

AbstractThis paper draws on empirical evidence from recent survey and qualitative research to develop an analysis of lay perceptions of modern medicine and medical practice. It builds on previous exploratory work and examines lay evaluation of a range of medical procedures which include medicines and drugs; elective surgery; reproductive technology and life saving technology. Overall, there was an ambivalence to modern medicine and the criteria used to evaluate modern medicine included whether it was: life saving or life threatening, quality of life enhancing or diminishing, natural or unnatural, restored independence or created dependence, and whether it was good value for money or not. The theoretical implications of these findings for understanding the structure and nature of lay perceptions are discussed.
Taboos and excesses: lay health moralities in middle class families
Authors: Backett Kathryn 
Published: February 2004

AbstractThe paper is based on a multi‐interview qualitative study of whole family groups. The sample comprised a randomly selected group of home‐owning, middle‐class couples, each with two children. It was hypothesised that, by virtue of their socio‐economic circumstances, such a group would be likely to have a positive view of health; to be receptive to health education messages; to be less likely to engage in health‐damaging behaviour; and to have sufficient material resources to provide an environment conducive to health promoting practices. The study aimed to understand health‐related beliefs and behaviours within the social contexts of everyday domestic and work life.It was evident that knowledge about health was not necessarily translated into behavioural practices, even in a health promoting environment. Differences also existed between respondents' initial accounts of their ‘usual’ behaviours and the detailed descriptions of their daily lives obtained in later interviews. A concern for good health was simply one amongst many competing sets of priorities which affect daily behaviours. Choices amongst such priorities often included wider social and moral evaluations. This paper focuses on the role of such evaluations in respondents' accounts of health; in their everyday health‐relevant decisions; and in interactions between family members.
Discourse, organisation and the surgical ward round
Authors: Fox Nicholas J. 
Published: February 2004

AbstractThe surgical ward round is examined as an organisational strategy entered into by surgeons to enable particular claims about the success of surgery to be validated.The paper reports ethnographic data from UK surgical wards which suggest that surgeons organise the discourse of their interactions with patients around three themes: physiology, wound condition and recovery/discharge. These themes are surgeon‐centred, and are organised to deny patients access to the agenda of these encounters.Within a post‐structuralist and postmodern framework, these strategies of discourse organisation are understood as techniques of power. Surgeons privilege discourses which support their claims to be healers, denying those which focus on the necessary injury which surgical resection causes. The paper argues that the ‘ward round’ is a mythical structure constituted as an organisational strategy to counter challenges from patients to their hegemonic discourse.
The role of social support in mediating the psychological consequences of economic stress
Authors: Whelan Christopher T. 
Published: February 2004

AbstractThe idea that social support can act as a buffer against the negative consequences of stress has been a particularly influential one. Most of the relevant research has focused on the impact of life events as measured through the standard life‐event inventory methodology. Such research has lacked a sociological character in that the structural contexts of people's lives are treated as if they were extraneous to the stress process. In this paper I have drawn on the sociological literature relating to the conceptualisation and measurement of poverty in order to situate the stress process in the context of people's location within an unequal distribution of resources. The measure of chronic stress which is employed is based on enforced absence of socially defined necessities. Exposure to such stress is the primary determinant of psychological distress. Both instrumental and emotional support, however, serve to buffer the effects of extreme life‐style deprivation.
Coalitions and conflict in the national health service: some implications for general management
Authors: Thompson David 
Published: February 2004

Abstract This paper suggests that conflict is an inescapable feature of National Health Service organisational life, and that it is legitimate area of study. It describes a number of powerful coalitions whose interactions can produce conflict as they attempt to influence the distribution of scarce resources. In particular, it focusses on the beliefs and power of a ‘practitioner interests’ coalition and an ‘administrative ethic’ coalition.To survive in this world of coalitions, NHS general managers need to assert their own positions. Are they to be agents of the existing coalitions or can they construct their own and achieve its dominance? The paper concludes by discussing how a distinctive general management coalition might emerge.
The process of problem (re)formulation in psychotherapy1
Authors: Davis Kathy 
Published: February 2004

AbstractOne frequently heard critique of psychotherapy, particularly in feminist circles, is that it individualizes client's problems, i.e. they are shorn of their social significance and reduced to personal (psychological) shortcomings of the client herself. The present paper attempts to demonstrate what this phenomenon might look like at the level of the actual conversational interaction between the client and her therapist. It will become clear that the (re)formulation of the client's initial version of her troubles is by no means a spontaneous artefact of the therapeutic interview, but the result of considerable interactional ‘work’ on the part of the therapist. The process of problem (re)formulation consists of three analytically distinct stages, which are accomplished primarily by means of the everyday conversational device of ‘formulations.’ By using formulations in a special way, the therapist is able to transform the client's difficulties in her situation as full‐time housewife and mother into a typical ‘therapy problem’.
Health care rationing: its effects on cardiologists in the United States and Britain
Authors: Gross Edith B. 
Published: February 2004

AbstractCardiologists practicing under contrasting types of health care rationing in the United States and Britain were found to differ significantly in the occupational stresses they experience, according to this exploratory study. In‐depth interviews revealed that the 24 American physicians complained most about increasing limits to their autonomy resulting from the intrusion of government, insurance companies and managed care agencies. Twenty‐one British cardiologists indicated greater concern about workloads and the lack of resources in the National Health Service. The stresses are associated with the different types of health care rationing in the two countries. In the United States, where explicit rationing exists, external controls are placed on length of hospital stays, tests and procedures, physicians' fees and the use of drugs. In Britain, implicit rationing is imposed by limiting overall funding of health care, leaving physicians free to make clinical decisions. However, the ethic of care for all and the limited funding create waiting lists and a lack of facilities.
Protesting patients: a study of complaints submitted to a Family Health Service Authority
Authors: Nettleton Sarah , Harding Geoff 
Published: February 2004

AbstractThe issue of complaints is a topical one. It is of interest to the Government who espouses a consumerist philosophy and to health care consumer groups who are keen to ensure that effective mechanisms for the redress of grievances are in place. The complaints machinery is currently being reviewed and debated by interested parties and the main suggestions for change are set out in this paper. It is suggested that the factors which impede reform are professional self regulation, which limits lay involvement in the assessment of matters complained about, and the new managerialism which, through its emphasis on consumerism, has the paradoxical effect of reinforcing the control of managers. If complaints procedures are to be reformed it is paramount that we have an insight into what people complain about. To this end this paper presents an analysis of the letters of complaint submitted to one Family Health Service Authority in the early 1990s.
Sex education and the AIDS epidemic in the Former Soviet Union
Authors: Williams Christopher 
Published: February 2004

AbstractThis paper describes the Russian response to sexuality, sex education and AIDS. Using primarily Russian language sources, it analyses the background to the current Russian debate on sex education since the 1960s. The nature of the government response – the introduction of a health education programme designed largely to combat specific sexual diseases such as syphilis and gonorrhoea – is also explored. It is suggested that the demise of the Communist edifice has not significantly altered official attitudes towards sex and sexuality. Particular attention is devoted to the impact of the AIDS epidemic on government and popular reaction to this sex education programme. Given the adverse effects which the breakup of the FSU, economic crisis and the disintegration of the USSR Ministry of Public Health in November 1991, have had on the possibility of launching a unified, co‐ordinated and systematically concerted sex education programme it is concluded that backward attitudes towards sexuality are likely to exist for many years to come and the same is true with regard to the widespread prejudices towards the victims of AIDS in the FSU.
The methodology of Focus Groups: the importance of interaction between research participants
Authors: Kitzinger Jenny 
Published: February 2004

AbstractWhat are focus groups? How are they distinct from ordinary group discussions and what use are they anyway? This article introduces focus group methodology, explores ways of conducting such groups and examines what this technique of data collection can offer researchers in general and medical sociologists in particular. It concentrates on the one feature which inevitably distinguishes focus groups from one‐to‐one interviews or questionnaires – namely the interaction between research participants ‐ and argues for the overt exploration and exploitation of such interaction in the research process.
Epidemic psychology: a model
Authors: Strong Philip 
Published: February 2004

AbstractWhen the conditions are right, epidemics can potentially create a medical version of the Hobbesian nightmare ‐ the war of all against all. A major outbreak of novel, fatal epidemic disease can quickly be followed both by plagues of fear, panic, suspicion and stigma; and by mass outbreaks of moral controversy, of potential solutions and of personal conversion to the many different causes which spring up. This distinctive collective social psychology has its own epidemic form, can be activated by other crises besides those of disease and is rooted in the fundamental properties of language and human interaction. It is thus a permanent part of the human condition ‐ and widely known to be such.
Women prostitutes in the AIDS era
Authors: Scambler Graham , Peswani Rita , Renton Adrian , Scambler Annette 
Published: February 2004

AbstractThe prevalence and nature of female prostitution in the west is considered, as are the main types of motivation for engaging in sex work. The variable tendency to define western prostitutes as causal agents in the transmission and spread of HIV/AIDS is noted, and the medical/epidemiological evidence against doing so briefly summarised. The impact of the AIDS pandemic on prostitutes and their work is discussed, as are a number of legal, ideological and representational issues relating to prostitution which have been given new salience by the AIDS debate. It is contended that the legal process continues to discriminate unjustly against women prostitutes; that a ‘double standard’ of sexual morality persists; and that prostitute groups have articulated a clear response to law and ideology, hinging on the de‐criminalisation of uncoerced adult prostitution. It is suggested that one likely consequence of decriminalisation would be improved access to health education and care facilities, as relevant for the general health status of women workers as for STDs, including AIDS.
A comparison of HIV‐related risk behaviour and risk reduction between female street working prostitutes and male rent boys in Glasgow
Authors: McKeganey Neil , Barnard Marina , Bloor Michael 
Published: February 2004

AbstractIn this paper we provide an early report of two continuing ethnographic studies of prostitution. We compare female streetworking prostitutes and male rent boys in Glasgow in terms of risks of HIV infection and practice of safer sex. It is shown that a considerable proportion of streetworking female prostitutes in Glasgow were injecting drug users but that drug use was much less common among rent boys. Although condom use appeared to be widespread amongst the women it was less common among the rent boys. We then examine the nature of the relationship established with clients. It is shown that the rent boys were much less directive in relation to clients ‐ much less likely to insist on safer sexual practices than were the female prostitutes. It is suggested that this lack of directiveness is associated with retrospective payment ‐ payment after the commercial sex act takes place. In a final section we look at the policy implications of our work.
AIDS counselling: the interactional organisation of talk about ‘delicate’ issues
Authors: Silverman David , Peräkylä Anssi 
Published: February 2004

AbstractAlthough the AIDS pandemic has generated considerable social science research, the focus has almost entirely been on epidemiology and on survey research studies of health knowledge and behaviour. In contrast, this paper offers an early report on ongoing work into HIV and AIDS counselling as it occurs in practice in a number of English clinics. An analysis of transcripts of such naturally occurring encounters reveals how professionals and clients organise their talk in relation to the ‘delicate’ issues to be discussed. Particular attention is paid to the phenomenon of delay in the production of ‘delicate’ items and to the social organisation of the description of such items. Drawing, in part, on methods from conversation analysis, it is shown how a detailed analysis of how talk is produced in naturally occurring settings can generate findings relevant to professional practice.
Audience understandings of AIDS media messages: a discussion of methods
Authors: Kitzinger Jenny 
Published: February 2004

AbstractWhat do people think of the media coverage of AIDS; how do they interpret what they hear and see? This article explores the methods used on the AIDS Media Research Project to examine audience ‘readings’ of AIDS media messages. It highlights the advantages of employing a combination of questionnaires, group discussion and different group exercises and presents some preliminary findings to show how these data collection techniques can throw light on audience understandings of AIDS and the media. In particular the focus is on how such methods help to explain two areas of apparent ‘misunderstanding’: the distinction between HIV and AIDS and the risks of blood donation and lesbian sex.
Women's socio‐economic status and self assessed health: identifying some disadvantaged groups
Authors: Macran Susan , Clarke Lynda , Sloggett Andrew , Bethune Ann 
Published: February 2004

AbstractThis paper uses data from the British Health and Lifestyle Survey to explore the relationship between women's overall assessment of their health and their occupation, employment status, household composition and household income. Logistic regression was used to predict the odds of assessing health as either ‘good’ or ‘less‐than‐good’. These findings suggest that after controlling for age and the presence of a long‐standing illness or disability, women's occupational group has the strongest influence on self‐assessed health. The re‐classification of certain occupational groups, in particular retail occupations, from their conventional socio‐economic categories is also vindicated in terms of their assessed health adding in line with the suggestion that, with respect to their income and terms of employment, retail workers are ‘misclassified’ as non‐manual. This analysis shows also that women who were economically inactive were more likely to evaluate their health as ‘less‐than good’ than women in paid work, after controlling for the presence of a long‐standing illness or disability. This is interpreted as evidence that not all of the poor health usually attached to the role of ‘housewife’ can be explained in terms of health selection out of the labour market.
Expert and lay participation in the construction of medical knowledge
Authors: Arksey Hilary 
Published: February 2004

AbstractThis paper examines the explanatory value of Fleck's conceptual analysis with regard to the development of medical knowledge. The discussion is illustrated by empirical data gathered as part of an on‐going study into Repetitive Strain Injury (RSI), a condition currently disputed within medical circles. Whilst there is empirical substantiation for some of Fleck's beliefs, the findings suggest his notion that general practitioners are educated and patients uneducated is too simplistic; in particular circumstances these attributes may be reversed. Furthermore, there is little evidence to show that ideas are circulated and exchanged between specialists, GPs and a lay audience; according to this revised view, medical knowledge is determined by experts alone. By invoking an extended version of Collins' notion of the ‘core‐set’, the paper considers how seemingly marginal actors can exploit their technical competence and thus play an influential role in medical debate.
A transformed pregnancy: the psychosocial consequences of gestational diabetes
Authors: Lawson Erma Jean , Rajaram Shireen 
Published: February 2004

AbstractGestational diabetes (i.e. diabetes diagnosed during pregnancy) has important implications for maternal and foetal well‐being. This paper presents an ethnographic study of gestational diabetes, an unexpected, potentially life‐threatening illness diagnosed during the second half of pregnancy. While previous research has conceptualised gestational diabetes as producing few consequences since it commonly disappears after delivery, this study explores the meaning women attach to the disorder. It found that gestational diabetes had a profound effect on the respondents, resulting in fear, depression and anxiety. The respondents' imagery of diabetes as a debilitating disease concomitant with blindness, amputations, and premature death generated increased anxiety throughout pregnancy and six‐weeks postpartum. The personal disruption in complying with the diabetic regimen as well as health care provider transactions exaggerated the unique stress of a ‘normal’ pregnancy. We suggest that a strictly medical view of gestational diabetes minimises its broader psychosocial significance and recommend effective provider‐patient interactions with ‘high‐risk’ pregnant women.
Beyond medicalisation‐demedicalisation: the case of holistic health
Authors: Lowenberg June S. , Davis Fred 
Published: February 2004

AbstractDiscourse relating to the dual processes of medicalisation and demedicalisation has become deeply embedded in the sociological literature and increasingly in the cultural fabric itself. This paper highlights several contradictory dimensions and discrepancies inherent in those notions of medicalisation and demedicalisation. Three key components of the conceptualisations of medicalisation are separated out for examination: the locus of causality, the purview of the pathogenic sphere, and status inequality or professionalisation. Data from the holistic health movement are utilised to illustrate more precisely those problematic and at times contradictory dimensions.