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The production of sociological knowledge in Australian universities is explored through an empirical study of research papers published in a selection of academic outlets between 1960 and 2011. Drawing on theories concerning scholarly practices, institutional formation and the sociology of knowledge, questions are posed about the factors that shape and structure the production of sociological knowledge about health and medicine. The concept of intellectual schools is examined, with evidence sought for the presence of these 'knowledge networks' in the Australian context. The study suggests the formation and maintenance of schools are subject to structural factors within the university sector, specifically the relative wealth and prestige of the university and the dictates of the higher education market. [ABSTRACT FROM AUTHOR]

Hepatitis C has long been a public health problem in Australia. 'Revolutionary' new drugs with the potential to cure hepatitis C have now emerged. The Australian government has invested heavily in them, and has an ambitious goal to eliminate hepatitis C by 2030. Numerous shifts in policy and practice are required if the elimination agenda is to be realised. This paper explores the significance of these shifts. We ask: what is the race to elimination doing with the subject? We argue that the race to elimination can be understood, simultaneously, as a product of posthuman forces, capable of being analysed using the theoretical tools made available via the posthuman turn; producing an intervention in what it means to be human; and generating a dilemma for people who use (or used) drugs, people with hepatitis C, and posthuman scholarship. In drawing out these issues, we aim to: trace the significant developments underway in hepatitis C medicine and raise awareness of them; encourage reflection on the consequences of these developments; and invite reflections on what might be lost when the human is remade by hepatitis C medicine. [ABSTRACT FROM AUTHOR]

Despite the frequent occurrence of unwanted disclosure of HIV status in Australia, there is little understanding of its determinants and consequences. This paper offers an analysis of lived experiences of unwanted disclosure amongst 28 people with HIV in urban settings in Australia. Of the 28 individuals interviewed, 17 men and 8 women had experienced unwanted disclosure of their HIV status by other people in work, health, social and other settings. Through the lenses provided by the concepts of habitus and agentic practice, this paper focuses on unintentional and deliberate practices of unwanted disclosure, and the consequences that may arise from this. Findings reveal how unwanted disclosure may lead to reflexive and agentic action among people with HIV as they struggle to reclaim control over their lives and how they are perceived. Despite what is sometimes assumed, the negative social responses the HIV epidemic has given rise to persist in Australia. Some 30 years into the epidemic, findings highlight the need to establish a social climate that is intolerant of unwanted disclosure, and which recognises the damage it may cause. [ABSTRACT FROM AUTHOR]

Although abortion rates appear to be declining in high-income nations, there is still a need for accessible, safe abortion services. However, limited attention has been paid to understanding the social contexts which shape access to abortion information and services for communities who are less engaged with sexual and reproductive health care more generally. This paper explores the views and experiences of 27 migrant and refugee young people (16–24 years old) living in Sydney, Australia, regarding unintended pregnancy and abortion. Pregnancy outside marriage was described by all participants as a shameful prospect as it revealed pre-marital sexual activity. Even when abortion was described as culturally and/or religiously unacceptable, it was believed many families would find an abortion preferable to continuing an unintended pregnancy outside marriage. However, a pervasive culture of silence regarding sexual and reproductive health may limit access to quality information and support in this area. To better meet the needs of these young people, greater attention must be paid to strengthening youth and community awareness of the availability of contraception including emergency contraception, pregnancy options, and access to abortion information and services. [ABSTRACT FROM AUTHOR]

This paper starts from the premise that embodied knowledge is critical to understanding health policy implementation. We explore this notion through a qualitative investigation of the way that knowledge has functioned in the implementation of an Australian mental health policy, Partners in Recovery (PIR). Analysis uses the theoretical lens of interpretive policy analysis and the 'embodied, inscribed, enacted' knowledge schema developed by Freeman and Sturdy [(2014a). Introduction: Knowledge in policy – embodied, inscribed, enacted. In R. Freeman & S. Sturdy (Eds.), Knowledge in policy: Embodied, inscribed, enacted (pp. 1–19). Bristol: Policy Press]. Our analysis reveals a policy problem centred around difficulties of coordination where the inscribed solution lies in individuals who must implement the PIR program in local areas. Our interviews with PIR consortium members and stakeholders show that this implementation happens through the enactment of embodied knowledge. However this implementation is not straightforward and we point to difficulties arising from the centrality of embodied processes in implementation, related to the localisation of systems knowledge in individuals and structural devaluation of certain types of knowledge over others. [ABSTRACT FROM AUTHOR]

Over the past decade, consumers in Australia and elsewhere have increasingly been confronted with a fast growing number of health food products. This profusion of health foods is accompanied by a proliferation in popular culture of professional nutritional advice on 'what is good to eat'. The genre of lifestyle magazines is one popular medium via which healthy eating practices and health foods are frequently reported. In this paper we use a visual discourse analysis of food-related editorial and advertorial content sourced from the long running and popular The Australian Women's Weekly to investigate how lifestyle magazines have been one important locus for constituting health conscious consumers. Taking up a Foucauldian governmentality perspective we trace how this active, responsible conceptualisation of the consumer, which we refer to as 'healthy food consumer', has increased in prevalence in the pages of The Australian Women's Weekly over time. Based on our analysis we suggest that the editorial and advertorial content offers models of conduct to individuals about what possible preventative activities in which to engage, and plays an important role in shaping how we think about taking care of our health through eating. [ABSTRACT FROM AUTHOR]

There is evidence to suggest that illicit drug use is increasingly a ‘normal’ part of the lives of many young people in Australia. The normalisation framework has been applied in limited contexts in Australia, and has not been assessed using longitudinal data. This paper uses cross-sectional periodic data collected at the Sydney Big Day Out music festival between 2006 and 2009 to examine several aspects of normalisation among festival patrons. Over the 4-year period high proportions of respondents reported that cannabis and ecstasy were ‘very easy’ or ‘fairly easy’ to obtain. In most years, over half the respondents reported ‘any illicit drug use’ in the past 12 months. A statistically significant relationship was found between recent illicit drug use and degree of contact with other people who use drugs (χ2 = 64.391, df = 4, p = 0.001). Such results suggest that certain aspects of drug use are normalised among festival patrons and that these are particularly concentrated among certain groups of young people. These groups could to be targeted when delivering drug education and prevention activities. [ABSTRACT FROM AUTHOR]

In Australia, fluoridation was first endorsed as an effective, safe and equitable means of improving population oral health over fifty years ago. However, recent opposition to attempts to introduce the measure in several regional Victorian towns has demonstrated that it remains a highly controversial health policy. This paper investigates the history of the Victorian fluoridation debate within a national and international context. It finds that although the evidence concerning fluoridation has advanced considerably, the essential arguments put forward by proponents and opponents have remained largely unchanged over that time. Protagonists incorporate the same scientific evidence yet come to polarised and unshakeable conclusions. I argue that the concept of deep structure ideation is a useful means to understand how this occurs. Furthermore, analysis of the ideas and social processes that determine a partisan position in the fluoridation debate makes this an important case study for approaching other durable scientific controversies. [ABSTRACT FROM AUTHOR]

Current Australian maternity policy, while fragmented and uneven, is moving in new directions. Alliances between consumers, sympathetic health professionals and bureaucrats have placed the objectives of improving women's choices, increasing their control over decision-making and providing continuity of care firmly on the agenda. The state arena is a central space for articulating such demands and policy support has been critical to implementing changes in service delivery. Along with steps forward, though, steps sideways and backwards indicate the contingent character of the late modern state as it responds to social changes at the same time as advancing particular political goals. This paper argues that impediments towards making services more 'women-friendly' lie not only in the historical location of childbirth management in the medically-driven acute sector but in contemporary neoliberal political and economic pressures that both promote and yet constrain change. Research in selected Victorian hospitals suggests that desirable goals are compromised by working realities in contemporary public hospitals. Political mobilisation in the community and around the state remain necessary to encourage further change in childbirth management, but continuing critical assessment of the structural context and human challenges of maternity reform is also essential. [ABSTRACT FROM AUTHOR]

Access to medical care is significant for many transgender young people and their families, which involves interactions with healthcare professionals. While a trans affirming model is used across Australian paediatric gender clinics, this does not automatically mean that all transgender young people and their parents experience the care they receive as affirming. This article considers the experiences and views of transgender young people (aged 11–17) and their parents in relation to healthcare professionals inside and outside of gender clinics in Australia. Ten qualitative interviews were conducted with parent–child dyads in two Australian states. Key themes relating to healthcare professionals were: differing levels of healthcare professional knowledge and affirmation, quality of service is dependent on individual healthcare professionals, and lack of connected services and referral pathways. The discussion explores specific issues arising from the findings that suggest implications for training for healthcare professionals so as to be better equipped to provide trans affirming clinical care. [ABSTRACT FROM AUTHOR]

Lactation is a potent signifier of maternal love and care commonly associated with early motherhood and infant survival. It is common, however, for bereaved mothers who have recently undergone miscarriage, stillbirth or infant death to produce breastmilk. Drawing on a critical feminist lens that seeks to understand how maternal subjectivities and lactation norms are constructed through public and reproductive health information, this article tests whether lactation management options after stillbirth and infant death are comprehensively covered in Australia's health organisations' online information. A qualitative directed content analysis was conducted to critique the information provided on 21 Australian websites. Information extracted from websites was compared to a 'best-practice' Lactation After Infant Death (AID) Framework developed by the research team for the review. We found a notable absence of comprehensive lactation management information targeted directly to bereaved mothers. Moreover, the most common lactation option presented for women without a living infant was lactation suppression. This dearth of appropriate and comprehensive lactation information curtails maternal subjectivies and diverse lactation practices and further isolates women dealing with the painful contradictions of lactation after loss. [ABSTRACT FROM AUTHOR]

Cancer is a multifaceted entity with recent developments in treatment only increasing this diversification. Yet, some cancers are less common, lesswell understood, and receive less attention. Taking neuroendocrine tumours (NETs) as a case study, we explore the lived experience of people with a type of cancer that is virtually unknown among the general population. Drawing on interviews with 30 people living with NETs in Australia, we explored how their experiences are shaped by social and cultural understandings of cancer, and the tensions between chronicity and terminality. We found that people with NETs draw on common narratives around cancer to make sense of their diagnosis. However, NETs were understood as atypical, because they are often incurable, slowly progressing and not associated with treatment side effects such as hair or weight loss. The embodied effects of NETs made them unrecognisable as cancer to participants and community. The specificities of the NET illness experience resulted in the need to reframe narratives around agency and positivity. This hindered social recognition but also provided opportunities to bracket illness and gain some control over the illness experience. The findings of this study highlight the importance of recognising multiple modes of living with cancer. [ABSTRACT FROM AUTHOR]

Drawn from a sample of 88 Indigenous young people in five locations in urban and remote Northern Australia, this research utilised a combination of qualitative approaches to encourage young people to discuss their ideas about sexual relationships and violence. Indigenous youth discussed highly public displays of violence, as well as violence within intimate settings and the interrelationships between these two arenas. A key finding of this research was that young people described violence as an accepted part of their sexual relationships and this normalisation led to significant tensions in their experiences and management of their everyday relationships. While violence around young people's relationships in remote communities was reported to some extent as being controlled through both the public and controlled form they take, we found that the increasing mobility of young people from remote to urban locations due to education opportunities and the impact of social media can lead to more serious forms of violence and tension in the maintenance of young people's sexual relationships. This contributes new findings to the literature on Indigenous young people's experiences in relationship forming and management, an area that has received little attention in the academic literature. [ABSTRACT FROM AUTHOR]

Clinical practice guidelines (CPGs) are a central technique within the evidence-based medicine (EBM) movement. General practice is an area of medicine that seems to be particularly resistant to the use of CPGs. This article contributes to the debates about GPs and CPGs by reflecting on three different Australian studies conducted by the authors in an attempt to better understand variations between GPs' practices and the recommendations found in relevant CPGs. These projects focused on dementia, chronic obstructive pulmonary disease and hypertension (high blood pressure). A common finding across the three studies was that GPs described how their focus on the whole person and their patients' priorities and needs meant that the recommendations found in CPGs were not always appropriate or easy to apply. In doing this, our study participants were describing tensions between the holistic/whole person and patient-centred approach of GPs and the narrow disease-specific focus of guidelines. Our work provides insight into the rationality of GPs and illustrates some of the ways that whole person care and patient-centred care create operational challenges to the application of EBM in the form of CPGs. [ABSTRACT FROM AUTHOR]

Hepatitis C (HCV) is a stigmatised disease due, in part, to an association with injecting drug use. Aboriginal Australians, a stigmatised group, are over-represented in patterns of HCV infections. We examined the experience of Aboriginal Australians living with HCV using qualitative in-depth interviews, paying particular attention to instances where multiple stigma mechanisms (relating to HCV, injecting drug use and Aboriginal identity) overlapped. Stigma held a central role in the experience of most of the 39 participants with reports of exclusion and alienation from families and communities. HCV-related stigma was accompanied by the notion of 'shame' which holds deep cultural significance for Aboriginal people. Participants' accounts revealed overlapping stigma in their perception that others 'automatically' expect Aboriginal people to have a stigmatised disease such as HCV. HCV as a contemporary expression of colonisation was also woven into accounts of HCV-related stigma. Interventions to reduce HCV stigma should be specifically designed for minority populations to account for multiple, overlapping sources of stigma. [ABSTRACT FROM AUTHOR]

The dominant understandings of suicide have privileged the professional observations of health professionals and sociologists over the lived experiences of persons who have reported feeling suicidal. The current study explores what it is like to feel suicidal by examining comments posted voluntarily in an online forum. Adopting an inductive thematic analysis, a number of themes were uncovered which shed light on the following questions: Who has suicidal thoughts? What triggers suicidal thoughts? What is it like to feel suicidal? Also drawn from the data, was information relating to the types of treatments that people received, as well as ongoing survival strategies that people have relied on. The findings indicated people with suicidal thoughts form a heterogeneous group with mixed opinions about the causes of suicidal thoughts. The findings also highlighted a variety of experiences, descriptions and means for survival highlighting the depth of insight that those with first-hand experience have about suicidal thoughts, highlighting also the deep gap in knowledge and understanding in the existing literature about suicide and suicidal ideation. The recommendations for future direction in practice and research include, listening to, and valuing more, the voices and perspectives of suicidal people themselves. [ABSTRACT FROM AUTHOR]

Like other professionalized heterodox medical systems in Western societies, naturopathic practitioners and the leaders of naturopathic professional associations historically appear to have been predominantly males. Conversely, this situation appears to have started to change in the 1970s. Today the vast majority of naturopathic students and naturopathic practitioners in the United States and Australia, are women. While women have moved into positions of leadership in the American Association of Naturopathic Physicians, various Australian naturopathic professional associations, and naturopathic training programs in both the US and Australia, the presence of men in positions of organizational and education leadership appears to exceed their diminished numbers as practitioners. Bearing these thoughts in mind, this essay explores why women have been drawn to naturopathy in great numbers and the political-economic and socio-cultural forces that still hinder their professional development as practitioners and professional leaders within the contexts of the American and Australian dominative medical systems. [ABSTRACT FROM AUTHOR]

Many countries, including Australia, are currently experiencing severe shortages of professional, para-professional, and semi-professional workers in their health care systems. This is generally conceived as a problem stemming from rising demand in health care services or the production of inadequate numbers of health related graduates. A qualitative study of health care workers in the Australian context challenges the adequacy of this supply-demand approach to the health care system; and demonstrates that solutions lie in the conceptualisation of the health sector as a socio-cultural system. Findings indicate the extent to which policies independently formulated for the health, education, finance, and industry sectors have, in combination, inadvertently impacted on the functioning of the health care system, and some policy mechanisms, such as privatisation and marketisation, have fundamentally eroded its structural framework. Conclusions can therefore be drawn about the relationship between workforce shortages and the neo-liberal orientation of recent governments. [ABSTRACT FROM AUTHOR]