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Poor health and disease and the nature of interventions to ameliorate them typically generate opportunities and costs. What diseases are prevalent, which interventions are favoured and what factors fuel the nature of health interventions are recurrent concerns for political economists. This paper examines the prevailing viewpoints about what health policy works and what does not. Drawing on evidence from developing countries, it shows that there are many deficiencies in the prevailing orthodoxy which emphasises state, market, and civil society solutions. The paper suggests that health policy debate must be refrained around poverty and social inequality, constructs which are often subordinated to attaining grand ideological goals. [ABSTRACT FROM AUTHOR]

People with contested illnesses such as Gulf War Syndrome and multiple chemical sensitivities (MCS) have struggled to have their claims to chemical injury recognised as scientifically valid. Patients have thus built on shared experiences and formed 'embodied health movements', to challenge mainstream scientific understandings of toxicity and disease causality. Digital technologies have changed the scale and scope of patient sharing and collaboration, yet little attention has been paid to how patients govern each others' scientific claims. This paper draws from an online qualitative survey of forum users with self-reported MCS (N = 186) to investigate how patient groups internally debate scientificity – in this case over a controversial new 'neural retraining' treatment. Despite their own scientific marginalisation, MCS patients conducted 'boundary-work' to demarcate scientifically legitimate claims from 'pseudo-science' in their analysis of peer theories, and used scientific criteria as a powerful tool to claim and dispute epistemic authority. Moreover, this inter-patient boundary-work had profound social and therapeutic implications in the movement, particularly with respect to the politics of recognition, community solidarity and peer support. [ABSTRACT FROM AUTHOR]

New medicines represent exciting possibilities to individual patients for improved futures through reduced morbidity, as well as the potential for disappointment where promised outcomes are not forthcoming. For healthcare systems these technologies can enable enhanced effectiveness as well as spiralling costs, depending on value-for-money offered. Amidst uncertainty over efficacy and pricing, institutions such as the National Institute for Health and Clinical Excellence have been set up to regulate the cost-effectiveness of new products. The increased transparency of this new regulation, combined with inescapable uncertainties, leads to the heightened politicisation of decision-making and an insidious subjectivity beneath a veneer of rational-bureaucracy. This paper develops a theoretical framework for understanding the influence of hope within such contexts. Conceptualised here as ideological, affective and prone to lapsing into trust, hope is considered to shape the lifeworld-background of regulatory decisions and mask uncertainty around effectiveness. These processes challenge regulator legitimacy and effectiveness within polycentric regimes, through the distortion of communication and the manipulation of blame. [ABSTRACT FROM AUTHOR]

Choice and control for birthing women have recently come under the global spotlight as a human rights issue, and are likely to remain so while midwives are being targetted for providing home birth care. While focussing on these issues appears to further widen the dichotomy between medicine and midwifery, understanding how this divide is maintained is necessary if we are to move beyond it. This article, utilising Foucault's theory of genealogy, recapitulates how midwifery knowledge came to be subjugated by a dominant medical discourse, particularly through the process of hospitalising birth. The submission of the Australian Medical Association to a government enquiry into maternity services is then examined to illustrate how discourse is perpetuated, and how medicine still configures itself as the dominant birth discourse in Australia. The importance of focussing on midwifery specific knowledge, using the notion of embodiment, is put forward. [ABSTRACT FROM AUTHOR]

In France, the last decade has been marked by an extensive development of public interventions in the field of mental health. The political investment in mental health has been the object of a public debate in which prevention was perceived by professional opinion leaders as a mean for politics to implement social control policies. However, it seems that the vigor of these condemnations has jeopardized the opportunity to initiate a debate on the ethical, sociological and epistemological foundations of prevention in mental health. Aim and method: EPIONE study was set up to meet the need for psychosocial research to evaluate the social representations of prevention in mental health professionals in charge of prevention, within the French context. Using one open-ended question ('What do you think about prevention in mental health?'), representations from 616 professionals were analyzed through a computer-assisted process (Alceste software) and according to Denise Jodelet and Serge Moscovici models of social representations. Results: Results pointed out an important discrepancy between the political discourse and the social representations of professionals, who understand the field of prevention as intimately related to curative practices. Professionals do not seem concerned by preventive 'top-down' policies, which they perceive as technocrats' issues. Finally, only a third of the total responses was related to the criticisms addressed to prevention, suggesting that mistrust toward prevention was not as developed among field professionals as it might seem when reading the most visible critical publications. Conclusion: We suggest that, in order to adapt public health and prevention policies, decision makers will have to rely on professionals' background and on the field reality, as well as the epistemological, sociological and ethical problems raised by public prevention in mental health. [ABSTRACT FROM AUTHOR]

Explaining the trajectory of Australian health policies over the last century requires an analysis of different political regimes and their dreams of order for managing risk. Crook reverses the Beckian axiom that risk is the unintended outcome of the failure of industrial societies, arguing for an understanding of risk within a Foucauldian and Actor Network Theory of governmentality. Risk becomes a mechanism for the realisation of different dreams of order. The welfare state was the risk management mechanism of organised capitalism. Individual aspirations of reflexive individuals form the risk management mechanism of neo-liberal regimes. As competing risk discourses destabilise the field of maternity care, key actors (including doctors, midwives, women and policymakers) form themselves into neo-traditional communities in ongoing struggles to have their risk claims institutionalised within policies and protocols that further legitimise their interests. These struggles around risk and power are evident in recent debates over maternity policy in the context of the 2009 Maternity Services Review and the policy aftermath. [ABSTRACT FROM AUTHOR]

Cognitive-behaviour therapy (CBT) has been a central plank in the mental health policies of many Anglophone countries in recent years. This emphasis reflects the triumph of modern rationalism in two senses. First, the appeal of CBT to policy makers rests largely on its claims of being evidenced-based and quickly effective. Second, it is committed to a view of eudemonia (the good life) in which rationality predominates over non-rationality to generate the greatest happiness for the greatest number. Both aspects, which appeal to policy makers, warrant sociological interrogation. This article provides a brief history of CBT to highlight the rhetoric of rationalism it has espoused successfully. Then, using the UK Depression Report as a point of departure, it compares this success of CBT with the criticisms it has encountered. Both positions of advocacy and critique are examined in relation to disciplinary knowledge and professional interest work. These orientations from poststructuralist accounts of the modern episteme, on the one hand, and neo-Weberian sociology of the professions, on the other, help us understand the current controversy surrounding CBT. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses Health Sociology Review (HSR) Culture, death and dying with dignity' within the issue.