Medical Sociology Research Papers - Academia.edu (original) (raw)

After beginning his historical work in Switzerland in the 1950s and then continuing it in the United States at the Menninger Foundation, Henri Ellenberger (1905–1993) became the leading historian of " dynamic psychiatry ". This expression... more

After beginning his historical work in Switzerland in the 1950s and then continuing it in the United States at the Menninger Foundation, Henri Ellenberger (1905–1993) became the leading historian of " dynamic psychiatry ". This expression commonly denotes mental medicine that draws from psychotherapeutic practices and psychological theories to improve our understanding of mental diseases and to cure them. Although still used today, usually in juxtaposition to 19th century alienism or to biological psychiatry, the origin and meaning of this expression are unclear. An unpublished lecture (1956) by Ellenberger on this subject, accompanied by an explanatory introduction, is reproduced here to shed light on Ellenberger's interpretation of that term. This article additionally aims to draw certain parallels and distinctions between Ellenberger, Michel Foucault and George Devereux's teaching in the 1950s. Considering that the history of psychiatry is now a well-established speciality in the academic world, Ellenberger's lecture is also an original document which enables us to trace the professionalization of psychiatric historiography as an academic discipline back to its beginnings after World War II.

Theorizing a sociology of emotion that links micro-level resources to macro-level forces, this article extends previous work on emotional capital in relation to emotional experiences and management. Emerging from Bourdieu's theory of... more

Theorizing a sociology of emotion that links micro-level resources to macro-level forces, this article extends previous work on emotional capital in relation to emotional experiences and management. Emerging from Bourdieu's theory of social practice, emotional capital is a form of cultural capital that includes the emotion-specific, trans-situational resources that individuals activate and embody in distinct fields. Contrary to prior conceptualizations, I argue that emotional capital is neither wholly gender-neutral nor exclusively feminine. Men may lay claim to emotional capital as a valued resource within particular fields. The concept of emotional capital should be seen as distinct from emotion management and felt emotional experience and distinctions between primary and secondary sources of capital clarify the simultaneously durable and evolving nature of capital and the habitus. To illustrate these conceptual refinements, I use interview and diary data from male nurses. Men bring primary emotional capital, developed during primary socialization, to the nursing profession while also developing secondary capital through occupational socialization centered on empathy and compassion. The construct of emotional capital is refined as a structured yet dynamic resource developed through primary and secondary socialization and activated and embodied in everyday emotion practice.

Disability studies and critical trauma studies are both deeply concerned with the social construction of meaning and identity. However, these disciplines often remain mutually disengaged, inadvertently overlooking shared mechanisms of... more

Disability studies and critical trauma studies are both deeply concerned with the social construction of meaning and identity. However, these disciplines often remain mutually disengaged, inadvertently overlooking shared mechanisms of oppression that foster stigma. This article explores the novel depiction of disability and trauma in the play Amy and the Orphans by Lindsey Ferrentino. Amy, a character with Down syndrome, challenges disability stereotypes by exercising autonomy; she is not solely defined by her disability or her experiences of abuse. The theatrical narrative is one of both disability and trauma, encouraging a nuanced reflection on the origins of stigma and revealing how theatre can be used as a tool of resistance to reclaim agency through performances that challenge conventional 'disability' stereotypes.

The enclosed publication is a compilation of articles and submissions made by a number of Australian professionals concerning the transgendering of children and adolescents. They come from a variety of professional backgrounds, including... more

The enclosed publication is a compilation of articles and submissions made by a number of Australian professionals concerning the transgendering of children and adolescents. They come from a variety of professional backgrounds, including paediatrics, psychiatry, psychology, the law, history, parenting, women’s sports and sociology. They raise questions about the lack of a scientific evidence base, the lack of data on the long-term consequences of medical gender affirmation protocols, and the surreptitious avoidance of the key medical ethic, ‘First, do no harm’. They also consider legal issues and the consequences of embodying ‘trans rights’ in law and policy – for example, the impact on girls’ and women’s sports of allowing trans identified males to compete with, and against, female people.
A wide-ranging government sponsored inquiry is needed urgently. The initial proposal to undertake this compilation elicited 500 pages of Australian articles and submissions from a range of individuals and groups. This compilation includes a representative selection of those articles and submissions.

Malta Medical Journal Volume 28 Issue 03 2016 Abstract: This research analyzes social interaction of cancer patients in Malta. In particular it applies a qualitative sociological approach to verify how cancer patients interact with family... more

Malta Medical Journal Volume 28 Issue 03 2016 Abstract: This research analyzes social interaction of cancer patients in Malta. In particular it applies a qualitative sociological approach to verify how cancer patients interact with family members and society. The research concludes that social interaction of cancer survivors in Malta is characterized by mixed experiences, but at the same time, all cancer patients emphasize the importance of family support. A major finding is that cancer patients do not simply receive support from family members, but also provide it themselves to their relatives. This is not an intended effect of cancer survivorship, but nevertheless it helps strengthen social bonds within families of cancer patients.

Аннотация. В профилактике инсультов и борьбе с их последствиями важна не только работа системы здравоохранения, но и самосохранительное поведение населения, которое в значимой мере обусловлено компетентностью в данном вопросе. Изучение... more

Аннотация. В профилактике инсультов и борьбе с их последствиями важна не только работа системы здравоохранения, но и самосохранительное поведение населения, которое в значимой мере обусловлено компетентностью в данном вопросе. Изучение информированности населения об инсульте и выработка рекомендаций по информационной политике – основные задачи данного исследования. Проведено 2 опроса в Москве в октябре-декабре 2019 г., выборка каждого – 800 человек. Исследование обнаружило рост между волнами числа тех, кто считает, что знает признаки инсульта (до 65%). Несмотря на большинство правильных ответов, данная самооценка не всегда подтверждается реальными знаниями, в т.ч. инсульт путают с ишемической болезнью сердца, инфарктом и эпилепсией. Меньшую компетентность демонстрируют мужчины и люди с начальным/средним образованием, более молодые респонденты. 94% респондентов при появлении признаков инсульта вызовут скорую помощь, 16% начнут самостоятельно оказывать помощь, в основном их действия будут корректными, хотя встречается ряд заблуждений. Среди основных факторов риска инсульта респонденты называют наличие вредных привычек. Население чаще обращается к таким источникам информации, как родственники/знакомые (25%) и интернет (22%). Исследование выявило запрос населения на корректную информацию об инсультах. Желательна большая представленность экспертно рецензируемых материалов в информационном поле.

Sex differentials in infant mortality vary widely across nations. Because newborn girls are biologically advantaged in surviving to their first birthday, sex differentials in infant mortality typically arise from genetic factors that... more

Sex differentials in infant mortality vary widely across nations. Because newborn girls are biologically advantaged in surviving to their first birthday, sex differentials in infant mortality typically arise from genetic factors that result in higher male infant mortality rates. Nonetheless, there are cases where mortality differentials arise from social or behavioral factors reflecting deliberate discrimination by adults in favor of boys over girls, resulting in atypical male to female infant mortality ratios. This cross-national study of 93 developed and developing countries uses such macrosocial theories as modernization theory, gender perspectives, human ecology, and sociobiology/evolutionary psychology to predict gender differentials in infant mortality. We find strong evidence for modernization theory, human ecology, and the evolutionary psychology of group process, but mixed evidence for gender perspectives. r

Me medicine vs. we medicine: reclaiming biotechnology for the common good, by Donna Dickenson, New York, Columbia University Press, 2013, 296 pp., £19.95 (hardback), ISBN 978-0-231-15974-6 “Is personalised medicine replacing public... more

Although texts recommend the generation of rich data from interviews, no empirical evidence base exists for achieving this. This study aimed to operationalise richness and to assess which components of the interview (for example, topic,... more

Although texts recommend the generation of rich data from interviews, no empirical evidence base exists for achieving this. This study aimed to operationalise richness and to assess which components of the interview (for example, topic, interviewee, question) were predictive. A total of 400 interview questions and their corresponding responses were selected from 10 qualitative studies in the area of health identified from university colleagues and the UK Data Archive database. The analysis used the text analysis program, Linguistic Inquiry and Word Count, and additional rating scales. Richness was operationalised along five dimensions. 'Length of response' was predicted by a personal, less specific or positive topic, not being a layperson, later questions, open or double questions; 'personal richness' was predicted by being a healthy participant and questions about the past and future; 'analytical responses' were predicted by a personal or less specific topic, not being a layperson, later questions, questions relating to insight and causation; 'action responses' were predicted by a less specific topic, not being a layperson, being healthy, later and open questions. The model for 'descriptive richness' was not significant. Overall, open questions, located later on and framed in the present or past tense, tended to be most predictive of richness. This could inform improvements in interview technique.

In this article, we review 25 years of sociological scholarship published in Sociology of Health and Illness on medical technologies. We divide the literature into three theoretical perspectives: technological determinism views medical... more

In this article, we review 25 years of sociological scholarship published in Sociology of Health and Illness on medical technologies. We divide the literature into three theoretical perspectives: technological determinism views medical technology as a political force to shape social relationships, social essentialism emphasizes how medical technologies are neutral tools to be interpreted in social interactions, and technology-in-practice highlights the dialectic relationship between technology and its users in health care. While the technology-in-practice orientation allows social scientists to critique the high hopes and dire warnings embedded in medical technologies, we argue that the logical next step of this paradigm is to move beyond criticism and influence the creation and implementation of medical technologies.

Opublikowane w książce: A. Baczyński, M. Drożdż (red.), Wartości w mediach -z dolin na szczyty, BIBLOS, Tarnów 2012, s. 179 -196. Opinie Polaków o wiarygodności informacji zdrowotnych w mediach w zależności od ich nadawcy 1 .

This paper argues that Africa's colonial experience which mediated contact with Western medicine brought about a confrontation of values in the sphere of health, and that this offers some explanation for why the outlook of practitioners... more

This paper argues that Africa's colonial experience which mediated contact with Western medicine brought about a confrontation of values in the sphere of health, and that this offers some explanation for why the outlook of practitioners and, indeed, the practice of health care in Africa remains riddled with subtle colonial trappings. It attempts an analytic and systematic examination of this state of affairs and seeks a critical exploration of where, how and why contemporary medicine in Africa remains largely immune to her endogenous cosmological systems. Since colonialism was also the wheel through which Western medicine gained entry into America, the paper probes why American practitioners were able to incorporate a Western theoretical framework about disease while at the same time maintaining their cultural uniqueness. Ultimately, it suggests feasible ways to amend and address the African situation.

The first social transformation of American medicine institutionally established medicine by the end of World War II. In the next decades, medicalization-the expansion of medical jurisdiction, authority, and practices into new... more

The first social transformation of American medicine institutionally established medicine by the end of World War II. In the next decades, medicalization-the expansion of medical jurisdiction, authority, and practices into new realms-became widespread. Since about 1985, dramatic changes in both the organization and practices of contemporary biomedicine, implemented largely through the integration of technoscientific innovations, have been coalescing into what the authors call biomedicalization, a second "transformation" of American medicine. Biomedicalization describes the increasingly complex, multisited, multidirectional processes of medicalization, both extended and reconstituted through the new social forms of highly technoscientific biomedicine. The historical shift from medicalization to biomedicalization is one from control over biomedical phenomena to transformations of them. Five key interactive processes both engender biomedicalization and are produced through it: (1) the political economic reconstitution of the vast sector of biomedicine; (2) the focus on health itself and the elaboration of risk and surveillance biomedicines; (3) the increasingly technological and scientific nature of biomedicine; (4) transformations in how biomedical knowledges are produced, distributed, and consumed, and in medical information management; and (5) transformations of bodies to include new properties and the production of new individual and collective technoscientific identities.

The book is the result of a postgraduate research study carried out in the academic year 1975/76 at the Institute of Philosophy and Sociology (IFiS) at the Polish Academy of Science (PAN) in Warsaw when I had a scholarship from the German... more

The book is the result of a postgraduate research study carried out in the academic year 1975/76 at the Institute of Philosophy and Sociology (IFiS) at the Polish Academy of Science (PAN) in Warsaw when I had a scholarship from the German Academic Exchange Service (DAAD). The work was done under the guidance of my scientific supervisor, Prof. Magdalena Sokołowska, head of the department of Medical Sociology at the IFiS. The book is divided into four parts. Part I gives an introduction into the specific historical and geopolitical features, traditions and the so called "national character" of the Poles. Part II is focused on the history of medical care in the polish territories since the end of the nineteenth century, exemplified by summaries of selected life stories (pamiętniki) from medical doctors from-than divided-different territories, different social classes and different generations.

The rise of the active health care consumer in the United Kingdom requires a reformulation not only of the traditional relationship between patients and doctors, but also of the macro-politics of health which reflect and service that... more

The rise of the active health care consumer in the United Kingdom requires a reformulation not only of the traditional relationship between patients and doctors, but also of the macro-politics of health which reflect and service that relationship. Market and democratic themes have supplied an ideological impetus to the pressures for change. The well-publicised problems of medical self-regulation have given them practical political expression. However, the response from the policy community still reflects the dominant partners within it, medicine and the state. What neither partner has recognised is that the functionality of the policy community has been undermined by the different and issuebased challenges to the traditional patient-doctor relationship. As a result, the state is likely to remain the lead player in an increasingly unstable politics of health where consumerist issues are on the policy agenda, but patient groups are still excluded from the policy community. r

The objective was to evaluate the associations between older persons' health status and their social integration and social networks (family, children, friends and community), in two French-speaking, Canadian community dwelling... more

The objective was to evaluate the associations between older persons' health status and their social integration and social networks (family, children, friends and community), in two French-speaking, Canadian community dwelling populations aged 65 years and over, using the conceptual framework proposed by Berkman and Thomas. Data were taken from two 1995 surveys conducted in the city of Moncton (n ¼ 1518) and the Montreal neighbourhood of Hochelaga-Maisonneuve (n ¼ 1500). Social engagement (a cumulative index of social activities), networks consisting of friends, family and children and social support were measured using validated scales. Multiple logistic regressions based on structured inclusion of potentially mediating variables were fitted to estimate the associations between health status and social networks. Self-rated health was better for those with a high level of social integration and a strong network of friends in both locations. In addition, in Hochelaga-Maisonneuve family and children networks were positively associated with good health, though the effect of friend networks was attenuated in the presence of disability, good social support from children was associated with good health. Age, sex and education were included as antecedent variables; smoking, alcohol consumption, exercise, locus of control and depressive symptoms were considered intermediary variables between social networks and health. In conclusion, social networks, integration and support demonstrated unique positive associations with health. The nature of these associations may vary between populations and cultures. r

This paper discusses the growth and various iterations of the mental health movements (MHM) in the United States. An analysis of the portrayal of mental illness in popular culture, government institutions, and collective movements... more

This paper discusses the growth and various iterations of the mental health movements (MHM) in the United States. An analysis of the portrayal of mental illness in popular culture, government institutions, and collective movements elucidates how modern discussions of mental health came to be and what progress may be seen in the future.

Physicians and other health care professionals are often urged to provide “culturally sensitive” care. Numerous guidebooks describe how clinicians should provide care to patients from different cultures. Synthesizing survey data, case... more

Physicians and other health care professionals are often urged to provide “culturally sensitive” care. Numerous guidebooks describe how clinicians should provide care to patients from different cultures. Synthesizing survey data, case studies from the medical literature, ethnographic reports, and cultural guides for clinicians offer general standards and practical tips concerning how members of particular ethnic groups should be treated. By now, clinicians will be familiar with many of the assertions made in such guides. Navajos want to hear positive news; they do not want to receive “bad” news about terminal diagnoses. Koreans are highly sociocentric; family members of patients will most likely want to make health-related decisions for these patients when they are seriously ill. Many other standard claims about the values, social practices, family arrangements, and rites of passage of particular cultures could be added to this list. The concept of culture can play a useful role in medical education, medical research, and clinical practice. Attending to the role of culture in various social settings can serve as a useful reminder that what seems obvious to one person might not be obvious at all to someone else. While some scholars argue that it is time to discard the concept of culture, I do not think it is possible to eliminate all references to culture. We need to be cautious, however, when making claims about a particular patient’s “cultural framework.”

This paper analyses the social conditions of emergence of cancer politics in France in the inter-war period. It examines the historical circumstances whereby various segments of the dominant class-surgeons, 'scientist' doctors,... more

This paper analyses the social conditions of emergence of cancer politics in France in the inter-war period. It examines the historical circumstances whereby various segments of the dominant class-surgeons, 'scientist' doctors, philanthropistsand 'society ladies' concurred to create an 'anti-cancer movement' and to found a new discipline, i.e., cancerology, as well as a novel form of organizing medical care, i.e., cancer centres. It then examines the process of construction of a representation of cancer as a scourge disease, combining elements of medical, scientific and lay discourses.

The poor state of maternal and child health (MCH) is one of the greatest challenges menacing social stability in Nigeria as the problem continues unabated in spite of global and local efforts to address the trend. Available literature... more

The poor state of maternal and child health (MCH) is one of the greatest challenges menacing social stability in Nigeria as the problem continues unabated in spite of global and local efforts to address the trend. Available literature indicates that Nigeria has the worst health indicators in the Sub-Saharan African region. This study is a qualitative descriptive effort which attempts to apply the Locus of Control Model of health to Maternal and Child Health challenges in Nigeria. This paper has shown that the determinants of maternal and child health such as family planning, maternity care, immunization coverage, nutrition, prevention and treatment of diseases among nursing mothers lies along bipolar lines of external and internal controls. Findings reveal that majority of women as well as children are characterized by external loci owing socio economic and cultural factors. Hence, utilization family planning, maternity care and immunization services; as well as effective nutrition, prevention and treatment of diseases are given poor attention with implications for poor maternal health and child survival outcomes. However, women with formal education tend to have internal loci with favorable implications for their reproductive lives and the society at large.

To deal with breast cancer, women often break social norms that stress traditionally feminine traits such as compliance and putting the needs of others first. At the same time, many women take on new nurturing roles to support other... more

To deal with breast cancer, women often break social norms that stress traditionally feminine traits such as compliance and putting the needs of others first. At the same time, many women take on new nurturing roles to support other diagnosed women, thereby relinquishing to some degree the individualistic approach they found necessary to cope with the illness in the first place.

The demand for healing appears to produce a kind of ‘market for healing.’ It is often not possible to evaluate healing’s effectiveness, utility, or economic efficiency (‘value for money’), however, The market for healing, therefore, is... more

The demand for healing appears to produce a kind of ‘market for healing.’ It is often not possible to evaluate healing’s effectiveness, utility, or economic efficiency (‘value for money’), however, The market for healing, therefore, is governed less by price than by a parallel market for belief. In the Umjindi (Barberton) municipality, Mpumalanga Province, South Africa, medical choices are made on the basis of belief systems since the effectiveness of therapies is itself contingent on belief (‘placebo/nocebo effect’). Because beliefs change in order to accommodate choice of therapies, and because the perceived effect of therapies often influences belief, ‘markets’ for belief and healing are closely related. But not all ‘healing’ in this market produces health. Healing also offers ‘protection’ from other people, from other healers and from other therapies and their effects or side effects. Since few therapies in this market produce reliable results, belief permits clients to evaluate moral states of being rather than mere evidence of efficacy as they search for healing. Belief in the therapy allows clients to evaluate their choices and participate in healing with a greater sense of certainty. In short, what a person believes is believed to influence how and whether he/she can be healed, and to what extent the therapy has been effective.

Este artigo reflete sobre o acolhimento e a produção de cuidado destinados à população em situação de rua numa perspectiva socioantropológica, a partir de uma observação participante realizada junto a uma equipe de Consultório na Rua.... more

Este artigo reflete sobre o acolhimento e a produção de cuidado destinados à população em situação de rua numa perspectiva socioantropológica, a partir de uma observação participante realizada junto a uma equipe de Consultório na Rua. Observou-se que essa população, historicamente visibilizada como marginal, dificilmente consegue acessar os serviços de saúde, tornando-se invisível ao próprio Sistema Único de Saúde. Embora a Política Nacional para a População em Situação de Rua pretenda assegurar acesso à saúde, o cuidado, no entanto, nem sempre é garantido porque serviços e profissionais de saúde têm pouca experiência para acolher pessoas em situação de rua e atender as suas necessidades. Conclui-se que o desafio é hipervisibilizar as linhas de cuidado para situações impostas pela vida na rua e a construção de vínculo terapêutico desconstrutor da prática estigmatizante.

Aim-To determine the gender using mental foramen as landmark on a panoramic radiographs in selected North Gujarat population. Objective-1. To evaluate and compare the superior border of mental foramen to lower border of mandible(S-L) and... more

Aim-To determine the gender using mental foramen as landmark on a panoramic radiographs in selected North Gujarat population. Objective-1. To evaluate and compare the superior border of mental foramen to lower border of mandible(S-L) and inferior border of mental foramen to lower border of mandible(I-L) value in males and females bilaterally. 2. To compare the S-L and I-L between right and left side in males and female 3. To utilize above measurements for gender determination. Materials and Method-Sixty panoramic radiographs were selected for the analysis of mental foramen. Tangents were drawn through the superior and inferior borders of the foramen (S-L and I-L respectively) and perpendicular from the tangents to the lower border of the mandible bilaterally. Digital verniar caliper was used for the distance measurement from S-L and I-L. The data obtained was tabulated and subjected to statistical analysis. Result-The analyzed data of study showed that the mean values of comparison of S-L as well as I-L in males and females were significantly higher in males as compared to females. The comparison of SL and IL on right and left side in the same patient was without any significant difference. Conclusion-The results of present study concluded a definite sexual dimorphism in the position of the mental foramen from the base of the mandible; this method can applied in mass disaster where the fragments of mandible are available.

This study analyzes the discursive construction of attention deficit hyperactivity disorder (ADHD) and self in relation to a socioculturally shared understanding of moral norms. Thirteen Finnish youth aged 11 to 16 diagnosed with ADHD... more

This study analyzes the discursive construction of attention deficit hyperactivity disorder (ADHD) and self in relation to a socioculturally shared understanding of moral norms. Thirteen Finnish youth aged 11 to 16 diagnosed with ADHD were interviewed during this discourse analysis study. The youth accounted for their culturally undesirable behavior, performance and traits through three different types of accounts: (1) externalizing personal responsibility due to a compelling medical condition, (2) internalizing personal responsibility through moral self-condemnation, and (3) distancing oneself from the socially imposed stereotypes and stigmas related to ADHD. This study challenges dominant understanding of young people with a diagnosis of ADHD and contributes to our understanding of how ADHD is constructed in their lives.

This article has two objectives: the first, to analyze the professionalization process of assisted reproduction (AR) in order to see how AR is consolidating into an independent field within medicine, and the second, to see how AR arrived... more

This article has two objectives: the first, to analyze the professionalization process of assisted reproduction (AR) in order to see how AR is consolidating into an independent field within medicine, and the second, to see how AR arrived and was assimilated into Mexican culture. As opposed to other projects that have traced back the story of a particular specialty to see how it emerged as such, this article looks at an ongoing process: specialization in action. By analyzing the data collected through three years of multisited ethnography using tools offered by the sociology of professions and the history of medical specialization, I identify specific moments in which AR is gaining cognitive, normative, and evaluative consolidation, structure, and independence. This leads me to suggest that AR might separate from gynecology and become an independent specialty within medicine. I offer examples to support this argument and show how AR has developed into a biomedical service, a professional biomedical field, and a biomedical business.

This paper presents the concept of 'risk-medicine' through the analysis of the rejection of prenatal screening among ultra Orthodox Jews in Israel. The foundations of this phenomenon are examined, defining 'risk' as a major socio-cultural... more

This paper presents the concept of 'risk-medicine' through the analysis of the rejection of prenatal screening among ultra Orthodox Jews in Israel. The foundations of this phenomenon are examined, defining 'risk' as a major socio-cultural feature of late modern Western society. The authors describe eight possible components of resistance to biomedicine, some being specifically applicable to risk-medicine: cultural discrepancy, lack of information, religious prohibitions, risk-aversion, incompatible health and illness cosmologies, fear and mistrust, governmental control, and irreconcilable epistemological differences. The analysis identifies two fundamental dimensions associated with risk-medicine: its epistemological basis, and the governmental surveillance that it involves. While the former stems from diverging conceptions on the values of different forms of 'gnosis' (probabilities vs. certainty) the latter draws upon the relationship between the state and risk-medicine, portraying ultra Orthodox women's rejection of prenatal screening as a form of resistance to nationalist, secular forces. The paper advances new concepts (namely 'risk-medicine' and 'gnosis' as related to 'pro-gnosis' and 'dia-gnosis') that may constitute a ground for further research on forms of medical epistemologies and practices and their related forms of resistance, namely in the context of religious and ideological incompatibilities.

Historically, medical sociologists have used the interrelated concepts of objectification, commodification, and standardization to point to the pathologies of modern medicine, such as the depersonalization of care and the effects of... more

Historically, medical sociologists have used the interrelated concepts of objectification, commodification, and standardization to point to the pathologies of modern medicine, such as the depersonalization of care and the effects of bureaucratic control. More recent work in science studies, economic sociology, and sociology of health and illness, however, has begun to explore how the social processes of objectification, commodification, and standardization produce a wide variety of biomedical achievements. We provide a theoretical synthesis of this emerging body of scholarship centered upon the intended and unintended consequences of objectification, commodification, and standardization to improve health. We then outline a research agenda that would result from a more comprehensive assessment of how these processes manifest themselves in clinical care.

The term "evidence-based medicine" (or EBM) was introduced about ten years ago, and there has been considerable debate about the value of EBM. However, this debate has sometimes been obscured by a lack of conceptual clarity... more

The term "evidence-based medicine" (or EBM) was introduced about ten years ago, and there has been considerable debate about the value of EBM. However, this debate has sometimes been obscured by a lack of conceptual clarity concerning the nature and status of EBM. First, we note that EBM proponents have obscured the current debate by defining EBM in an overly broad, indeed almost vacuous, manner; we offer a clearer account of EBM and its relation to the alternative approaches to medicine. Second, while EBM proponents commonly cite the philosophical work of Thomas Kuhn and claim that EBM is a Kuhnian 'paradigm shift,' we argue that such claims are seriously mistaken and unduly polarize the EBM debate. Third, we suggest that it is much more fruitful to understand the relationship between EBM and its alternatives in light of a different philosophical metaphor: W.V. Quine's metaphor of the web of belief. Seen in this way, we argue that EBM is an approach to medical...

1 2 5 4 S e p t e m b e r / O c t o b e r 2 0 0 7 P e r s p e c t i v e s "Many policies establish and reinforce a two-tier 'safety-net' system in which vulnerable populations primarily go to separate institutions or providers for their... more

1 2 5 4 S e p t e m b e r / O c t o b e r 2 0 0 7 P e r s p e c t i v e s "Many policies establish and reinforce a two-tier 'safety-net' system in which vulnerable populations primarily go to separate institutions or providers for their health care." on June 3, 2017 by HW Team Health Affairs by http://content.healthaffairs.org/ Downloaded from 1 2 5 6 S e p t e m b e r / O c t o b e r 2 0 0 7 P e r s p e c t i v e s on June 3, 2017 by HW Team Health Affairs by

Past research yields mixed evidence regarding whether ethnoracial minorities trust physicians less than Whites. Using the 2002 and 2006 General Social Surveys, variegated ethnoracial differences in trust in physicians are identified by... more

Past research yields mixed evidence regarding whether ethnoracial minorities trust physicians less than Whites. Using the 2002 and 2006 General Social Surveys, variegated ethnoracial differences in trust in physicians are identified by disaggregating a multidimensional physician trust scale. Compared to Whites, Blacks are less likely to trust the technical judgment and interpersonal competence of doctors. Latinos are less likely than Whites to trust the fiduciary ethic, technical judgment, and interpersonal competence of doctors. Black-Latino differences in physician trust are a function of ethnoracial differences in parental nativity. The ways ethnoracial hierarchies are inscribed into power-imbalanced clinical exchanges are discussed.

The increasing focus on patient safety in the field of health policy is accompanied by research programs that articulate the role of the social sciences as one of contributing to enhancing safety in healthcare. Through these programs, new... more

The increasing focus on patient safety in the field of health policy is accompanied by research programs that articulate the role of the social sciences as one of contributing to enhancing safety in healthcare. Through these programs, new approaches to studying safety are facing a narrow definition of 'usefulness' in which researchers are to discover the factors that support or hamper the implementation of existing policy agendas. This is unfortunate since such claims for useful involvement in predefined policy agendas may undo one of the strongest assets of good social science research: the capacity to complexify the taken-for-granted conceptualizations of the object of study. As an alternative to this definition of 'usefulness', this article proposes a focus on multiple ontologies in the making when studying patient safety. Through such a focus, the role of social scientists becomes the involvement in refiguring the problem space of patient safety, the relations between research subjects and objects, and the existing policy agendas. This role gives medical sociologists the opportunity to focus on the question of which practices of 'effective care' are being enacted through different approaches for dealing with patient safety and what their consequences are for the care practices under study.

In this paper sociological theories of the professions and the organisation of work are drawn on to explain current developments in the organisation of maternity care. Utilising the literature on the sociology of the professions and... more

In this paper sociological theories of the professions and the organisation of work are drawn on to explain current developments in the organisation of maternity care. Utilising the literature on the sociology of the professions and general trends in health policy and labour markets, possible reasons for the current renaissance in midwifery and some implications for midwives are discussed. Thus, whilst some women and midwives may be building a paradigm of 'womancentred' practice based on an equal partnership, for other midwives, the result may be a divided workforce consisting of an elite core and casualised periphery based on the ability to give a full-time flexible commitment to work. The implications of excluding those midwives who are unable to combine fulltime work with their own domestic commitments are discussed.

Mammograms are known to cause breast cancer. Wearing tight bras for long hours daily is also known to cause breast cancer. Tight bras also worsen the damage caused by radiation from mammograms. Women are advised to not use bras, and to... more

Mammograms are known to cause breast cancer. Wearing tight bras for long hours daily is also known to cause breast cancer. Tight bras also worsen the damage caused by radiation from mammograms. Women are advised to not use bras, and to avoid mammograms, if possible.

A. previously developed a framework that consisted of strategies to enhance treatment fidelity of health behavior interventions. The present study used this framework to (a) develop a measure of treatment fidelity and (b) use the measure... more

A. previously developed a framework that consisted of strategies to enhance treatment fidelity of health behavior interventions. The present study used this framework to (a) develop a measure of treatment fidelity and (b) use the measure to evaluate treatment fidelity in articles published in 5 journals over 10 years. Three hundred forty-two articles met inclusion criteria; 22% reported strategies to maintain provider skills, 27% reported checking adherence to protocol, 35% reported using a treatment manual, 54% reported using none of these strategies, and 12% reported using all 3 strategies. The mean proportion adherence to treatment fidelity strategies was .55; 15.5% of articles achieved greater than or equal to .80. This tool may be useful for researchers, grant reviewers, and editors planning and evaluating trials.

This review traces the literatures in cultural anthropology and neighboring disciplines that are focused on addiction as an object of knowledge and intervention, and as grounds for self-identification, sociality, and action. Highlighting... more

This review traces the literatures in cultural anthropology and neighboring disciplines that are focused on addiction as an object of knowledge and intervention, and as grounds for self-identification, sociality, and action. Highlighting the production of disease categories, the staging of therapeutic interventions, and the ongoing work of governance, this work examines addiction as a key site for the analysis of contemporary life. It likewise showcases a general movement toward accounts of addiction that foreground complexity, contingency, and multiplicity.