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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]

Aboriginal and Torres Strait Islander people are the Indigenous people of Australia. The prevalence and burden of chronic disease among them is significantly higher than that of non-Indigenous Australians. This paper describes the chronic illness experiences of 19 Aboriginal and Torres Strait Islander people living in urban areas in terms of their strategic representations of self. Participants in this study used techniques of revealing and concealing chronic illness. These strategies were employed in multiple arenas - among family, among broader community, and in specific spaces including health care services. They highlight tensions that arise through the intersection between the desire to preserve family and community life, and the ways in which the physical body manifests chronic illness. In this paper we bring together notions of time (drawing on Zimbardo's time perspectives theory) and biography (drawing on Bury's disrupted biography theory). Through an analysis of shifting boundaries we conduct an exploratory investigation of the ways in which urban Aboriginal and Torres Strait Islander people in this study weave together elements of both past and future perspectives to mobilise modes of self-representation and agency in their management of chronic illness. We then consider some options for primary health care. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a qualitative study of the impact of casualised and independent contractor work place arrangements on the psycho-social health of 72 workers in regional Victoria. It contributes to our understanding of the crisis in rural Australia in its use of qualitative methods focusing on the impact of work on health and well-being. There is some evidence in the literature that casualised work arrangement enhance the health and well-being of workers by giving them a sense of autonomy and freedom to negotiate their conditions of work. On the other hand, these arrangements may make an already vulnerable group even more vulnerable to uncertain work conditions, poor pay and uncertainty for their future with a significantly negative impact on their health and wellbeing. The results of these interviews support this latter perspective and show that these workers do not experience freedom and autonomy, but rather lowered social status, insecurity and serious limitations to their ability to manage their health, psychological wellbeing and social relations. [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]

Increasingly, people live longer with advanced cancer, despite having no prospect of full recovery. Ongoing survival is owed to early detection and effective disease management, yet experienced as highly precarious. In this article we explore how cancer chronicity brings into effect a pre-occupation with time, what time is to people with advanced cancer, and what socio-cultural norms inflect everyday practices. We analyse 20 interviews conducted in Queensland, Australia with 11 participants with advanced cancer, to trace the intersections of what time means, what people do with time, and what time feels like. Drawing on scholarship on the moralities around ill health, we discuss how awareness of time emerges in cancer chronicity and raises moral questions on how to live well. Here, imperatives of optimisation (urging people with advanced cancer to make the most of limited time) intersect with imperatives of authenticity (marked by emphasis on how to live one's own best life). These dynamics reveal expressions of living with advanced cancer in morally viable ways. Such ontological processes have implications for the lived experience of people with advanced cancer, their families and oncological care. [ABSTRACT FROM AUTHOR]

Food security is an evolving concept with various definitions and associated meanings. The way food security is understood by policy-makers impacts on how it gets addressed in public policy. This research uses an interpretive approach to uncover how food security is represented by stakeholders. Semi-structured interviews were conducted with 24 stakeholders in South Australia between June and September 2010. The findings reveal four dominant representations for food security that locate responsibility for the issue across different stakeholders, namely individuals, governments, communities and private enterprise. These representations hold different underlying assumptions about the role of government in addressing the issue; the neo-liberal perspective supports a reduced role for government whereas the social determinants of health perspective calls for greater government intervention. Food security activists may need a greater awareness of how they represent the issue in order to change public policy action in this area. The approach taken in this research is relevant to other public policy problems and contexts. [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]

Globally there is an urban/rural divide in relation to health and healthcare access. A key strategy for addressing general practitioner shortages in rural areas is GP vocational training in rural places, as this may aid in developing practitioners' scope, values and community orientation, and increase propensity for rural practice. This creates a need for deeper understanding of the nature and quality of this training. Rural GPs are well-positioned to reflect on vocational learning in 'place'. We aimed to explore rural GPs' perceptions and experiences of GP vocational learning in relation to rural places. Semi-structured interviews were conducted with 25 GPs based in smaller rural communities in Tasmania. Inductive and theoretical thematic analysis was undertaken. Rural places provide learning opportunities for GP registrars, which shape the relationships between GPs and registrars and their communities. Rural GPs are committed to developing the next generation and improving access to primary care for their communities. Rural places provide unique learning environments for general practice, including rich learning, relationships and community commitment. [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]

Health and wellbeing is defined internationally as a multi-dimensional and holistic concept, particularly within Indigenous worldviews. However, in Australia there is a lack of detailed frameworks supporting such definitions that are founded on Aboriginal knowledges. Tins study aimed to explore Aboriginal perspectives of child health and wellbeing in an urban setting. Qualitative interviews with 25 care-givers of Aboriginal children living in Melbourne, Australia were conducted. Aboriginal people and community controlled organisations were collaborative partners in all stages of the research. A conceptual fiamework of Aboriginal child health and wellbeing in an urban setting was developed comprising four main themes: Strong Culture; Strong Child; Strong Environment; and Strengths and Challenges. Aboriginal conceptions of culture are considered central to Aboriginal child health and wellbeing in an urban context. A holistic framework that privileges Aboriginal knowledge of child health and wellbeing has not previously been available. Further exploration of socio-ecological models within Aboriginal child health and wellbeing contexts is needed. This study identifies dimensions for further exploration in research, policy and practice. [ABSTRACT FROM AUTHOR]

This qualitative study into Australian manhood featured 63 men discussing 'acceptable' masculinity. Homophobic humour emerged as central to the formation of Australian male identity, but it had the potential to induce violence and emotional damage when the 'humour' moved along a malleable continuum from good-natured banter to abuse. Significantly, it was men of all sexualities who were targeted, indicating that it was non-conformity to gender norms as well as sexuality being policed, as boys and men used humour to control and humiliate each other. Recollections of these instances ranged from 'it was just a joke' for some perpetrators, to 'orchestrated cruelty' for men who had been victimised. Some of the latter group reported depression extending into their adult lives based on their youthful experiences. Understanding the impact when humour goes 'beyond a joke' is important for policy makers, educators and healthcare workers, as a potential for emotional damage and physical violence is highlighted. The study highlights the importance of understanding masculinity as an influence on men's health and wellness. [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]