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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]

In this brief paper, I argue that the coronavirus pandemic is functioning like an ethnomethodological 'breaching experiment'. In short, it is putting a gigantic spanner in the works of neoliberal governance, in the process exposing the widening cracks and fissures of what I have called the 'fractured society'. I begin by recalling Garfinkel's notion of the breaching experiment and by listing the principal attributes of the fractured society. I then explore the response to the coronavirus in the UK, from the government's initial commitment to 'herd immunity' to its present policy of 'muddling through'. The bulk of the remainder of this contribution addresses precisely how this global health crisis shines a harsh and unforgiving searchlight on the strategies and policies pursued by governments in the UK since 2010, and most especially after the passing of the Health and Social Care Act of 2012. In the closing paragraphs, I examine possible scenarios for a post-fractured society, making particular use of Fraser's concepts on 'reactionary' versus 'progressive populism', and conclude with a comment on sociology and engagement. [ABSTRACT FROM AUTHOR]

While recognition of transgender people has increased in Vietnam, this population continues to face significant stigma and discrimination within their families and in public, including in medical settings. Understanding of transgender health is limited, especially regarding the provision of care to transgender people. This paper explores providers' preparedness for delivering transgender care using data from qualitative interviews with twelve healthcare professionals in Hanoi and Ho Chi Minh City. Drawing on the socio-ecological model, we illustrated multi-level factors that influenced the provision of medical services to transgender people, including restrictive legislation (policy level); shortage of transgender-specific services, and lack of training and guidelines (organisational level); and ambiguous perceptions, inappropriate provider-patient communication, and medical knowledge gaps (individual level). Overall, our study has identified a healthcare environment that is under-prepared to meet the complex health needs of transgender individuals. With this study, we call for intervention strategies beyond individual-level support and emphasise the urgency of allowing medical institutions to provide transgender-specific health services including gender-affirming surgery and hormonal treatments. [ABSTRACT FROM AUTHOR]

In this paper we report on the findings from six focus groups conducted with Australian medical students. The focus groups discussed students' perceptions of conflicts of interest and the influence of commercial values in health care and medical education. Our research revealed that students were aware of a number of structural influences that affected the medical education they received and that had the potential to shape their attitudes and practices as they progressed in becoming a doctor. We found that the pressures of educational workload and anticipated career trajectories tended to have an individualising effect that limited the perceived possibility of collective action and response to structural influences. We interpreted these findings through the lens of neoliberal governmentality to articulate the way commercial interests are negotiated and normalised by medical students. Based on these findings, we suggest that medical education should not only explicitly alert students to effects of political and commercial influences on the healthcare system, but also encourage the collective agency of students and strategies that do not place unrealistic expectations on individuals to effect structural change. [ABSTRACT FROM AUTHOR]

This paper compares the advocacy of mothers and intended mothers in the fields of autism and infertility. Mothers and intended mothers have developed a special competence in dealing with professionals, and in negotiating the delicate balance between expert medical discourses and expertise grounded in their situated knowledge and experiences. Drawing on the social movement and public policy literature, we seek to disrupt taken-for-granted assumptions about the gendered role of women and mothers in these complex and emotionally charged policy fields. We argue that (intended) mothers are far more likely than other women to take on the major advocacy role considering their need to respond to bodily, social, and/or cultural 'failures' imposed on them by the medical establishment. Issues of access to fertility treatments and care for autistic children not only provide a vantage point from which to study their experience in the policy arena, but also to ask broader questions about the role of the welfare state and the shifting authority of experts in policy processes. [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]

The paper presents an historical critical policy analysis of deinstitutionalisation and the introduction of neoliberal forms of governance in mental health policy. It focuses particularly on a major period of policy reform in the 1980s and 1990s in Victoria, Australia. Many of the particularities of the Victorian experience can be generally observed with deinstitutionalisation throughout the world. In particular, the policy discourse of rights and entitlements, consumer choice and empowerment, at times stood in tension with the service void created by the transition from large, stand-alone psychiatric institutions, to dispersed forms of service provision outside the hospital. Further, certain policy features could be seen to perpetuate patterns of coercion, abuse and neglect. This article offers a number of potential lessons for mental health law, policy and practice today, which is poised for further advances of neoliberal governance, including through the policy of personalised services, individualised disability funding and human rights-based reform. [ABSTRACT FROM AUTHOR]

Objectives: This paper examines social inequality in children's health following the election of Evo Morales. Bolivia is marked by dramatic socioeconomic, ethnic and geographic inequality in children's health. The Morales government initiated several public health reforms designed to provide more equal access to public health services. Methods: Analysis was conducted using Bolivia Demographic and Health Survey data from 2003 to 2008. Results: The analysis shows some improvements in children's health. However, inequality in access to doctors, child mortality and child nutritional status did not diminish. In contrast, inequalities in immunization declined dramatically. Conclusions: Results suggest that aspects of health that are easier to implement such as immunization are more accessible to public policy than are more complex health problems like malnutrition and high child mortality. [ABSTRACT FROM AUTHOR]

Routinely positioned as the 'first-line option' for contraceptive choice-making, long-acting reversible contraception (LARC) promotion efforts have come under critical scrutiny by reproductive justice advocates for the extent to which public health actors' preference for LARC devices may override potential users' ability to freely (not) choose to use contraception among an array of options. We identify LARC promotion discourse as constituting 'The Age of LARC': multifarious strategies for producing responsible sexual citizens whose health behaviours are empowered via a LARC-only approach to contraceptive use. We suggest that immediate postpartum LARC insertion policies, which have proliferated in the U.S. since 2012, exemplify the new era of LARC hegemony, in which urgency, efficiency, cost-effectiveness, and outcomes dominate both health policy and clinical practice around these contraceptive technologies. By following these efforts to facilitate access to and use of immediate postpartum LARC, we find a discourse on sexual citizenship that paradoxically constructs sexual health freedom through the use of a single class of contraceptive technologies. [ABSTRACT FROM AUTHOR]

Previous research has illustrated that journalists play an active role in the production of health news. The current study explores the relationship between the fields of healthcare and journalism from a healthcare perspective. Drawing on Bourdieu's theory of fields and Gieryn's concept of boundary-work, this study employed elite interviewing to analyse how the relations between these two fields were reflected and negotiated in the discourses of Belgian health-policy stakeholders. Our analysis illustrated that health-policy stakeholders perceived medicine and the news media as two different cultures and, therefore, discursively positioned news media actors as outsiders. Additionally, we showed that the nature of the relationship between health-policy stakeholders and the news media was linked to health-policy stakeholders' position within the healthcare field. Through this analysis, we illustrate the value of using the concept of boundary-work as an analytical instrument to study the relationships between fields. [ABSTRACT FROM AUTHOR]

In this article, we review critical research on mobile and wearable health technologies focused on the promotion of 'healthy lifestyles'. We begin by discussing key governmental and policy interests which indicate a shift towards greater digital integration in health care. Subsequently, we review relevant research literature, which highlights concerns about inclusion, social justice, and ownership of mobile health data, which we argue, provoke a series of key sociological questions that are in need of additional investigation. We examine the expansion of what counts as health data, as a basis for advocating the need for greater research into this area. Finally, we consider how digital devices raise questions about the reconfiguration of relationships, behaviours, and concepts of individuality. [ABSTRACT FROM AUTHOR]

The care of a person living at home near the end of their life is predominantly provided by family carers with the support of health services such as palliative care. In addition, informal caring networks also contribute at times to the support provided to the dying person and their carer. In this way, these networks can promote social capital in the communities from which they are drawn. This social approach to end of life care enhances community capacity to provide support to those dying at home and their carers. This article examines relevant published literature to explore the conceptual foundations of informal caring networks, examining the place of social capital and community development in the provision of end of life care at home, particularly in the Australian context. [ABSTRACT FROM AUTHOR]

Management of a pandemic engages multiple sites where previously settled or uncontroversial understandings may be transformed by global and domestic forces. This article examines the iconography of social distancing implicated in the discourses of 'quarantine' and 'risk control' in public health, and the tension between scientific and popular media readings of the contours of acceptable public health models for managing particular pandemics. The role of culture in shaping and reshaping borders at an operational level is explored as a basis for explaining the apparent paradoxes in the way historic and contemporary pandemics are actually managed, and the different ways particular pandemics are framed. The article argues that a rational-scientific approach to pandemic management is insufficient and that a more nuanced socio-political blend of science, culture and public perceptions offers a more substantial basis for public health policy. [ABSTRACT FROM AUTHOR]