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Genital fashioning practices, such as Brazilian waxing and female genital cosmetic surgery, have become increasingly prevalent within contemporary western societies. This paper explores the role of genital fashioning in the construction of contemporary femininity. It uses in-depth interviews and focus groups with Australian women aged 18–30 to investigate female genitalia as a site of alteration. Drawing on broader understandings of the body as socially mediated, this paper contends that multiple modification practices are employed to produce genital appearance. It departs from previous investigations which consider genital fashioning practices in isolation. In identifying the scope of genital fashioning, this research reveals a continuum of genital fashioning practices, both physically and discursively mobilised by women to negotiate their identity, sexuality, and femininity. [ABSTRACT FROM AUTHOR]

The need for the poor, the marginalised and socially excluded to live healthier and longer lives has in recent times become paramount in the development literature and policy discussions seeking to achieve the Millennium Development Goals (MDGs). In response to this, attempts are being made to redirect the research focus to examine socio-economic factors underpinning disease occurrence and ill health for health planning policies and practices to benefit the poor and vulnerable in society. Tliis paper explores the relationship between socio-economic conditions and health outcomes. It identifies and examines through participatory rural assessment techniques, basic socio- economic factors acting as significant pathways through which poverty increases the susceptibility of rural households to diseases. It seeks to address the reasons why the poor are poorer in health in rural communities of the Amansie West district of Ghana. This paper thus emphasises how social stratification and inequalities could affect quality of life of people in any given society, hence supporting the theory of social suffering and its implications on societal health. [ABSTRACT FROM AUTHOR]

This paper draws upon literature from economics, and the human capital and equity fields in order to present a theoretical framework for a new multidimensional measure of poverty for Australia. Poverty is about having low living standards; but its measurement has traditionally focused only on an individual's income or on other dimensions of living standards that are not appropriate for contemporary Australian society, such as calorie intake. There are two additional capabilities individuals require for adequate living standards: health and education. Each of these is required for basic functioning within modern society, but have traditionally been ignored by measures of poverty. This paper argues that health is a basic capability people need for a fulfilling life, allowing individuals to participate in activities essential in modern society, and that education can also be seen in this light. As such it is vital that health and education be included in measures of poverty. In order to move Australian poverty measurement forward and build upon the work of the past, poverty measurement must move its focus away from only looking at low income, and take a holistic focus on the living standards of individuals by incorporating assessments of health and education. [ABSTRACT FROM AUTHOR]

This paper explores the intersection of gender and class concerning welfare clients with medically unexplained symptoms. The study is conducted in Denmark using qualitative interviews with welfare officers and clients. The paper's focus is on how issues of gender and class intersect in the negotiation of illness among welfare officers and clients. The particular client group in question consists of individuals that are defined by their lack of a bio-medical diagnosis. Their 'lack' of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological problems. The paper shows that it is predominantly poorly educated women without a bio-medical diagnosis that welfare officers describe as suffering from psychological problems despite the fact that the women themselves focus on physical ailments in their illness stories. Men and better-educated women are described by the welfare officers as tired and exhausted or truly stressed after a long working life. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of the onset of acquired hearing impairment. The focus of attention is why a person seeks treatment. The Danish welfare state serves the population 'in need' such as those with an audiological need and gives them guidance on becoming hearing aid wearers in order to rehabilitate them back to 'normalcy'. However, within audiological research, noncompliance has attracted much attention as investigations have shown that more than 20 percent of hearing aids are very seldom, if ever, in use and 19 percent are used only occasionally. As shown in the paper the form a problem takes is in large part a product of micro-political struggles. Hence, at the onset 'need' is often embedded in social pressure from significant others. The paper examines these two discursive frameworks and their constitution of (hearing) problems and concludes that norms of disease are complex and epistemologically contested and can help explain why noncompliance is dominant when it comes to hearing rehabilitation for hearing impaired adults. [ABSTRACT FROM AUTHOR]

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]

There has been much talk in sociological circles of bodies as 'projects' or 'choices,' but surprisingly little examination of how these projects and choices are experienced. Consumer culture has been described as heralding a new era in body-self relations, but few have explored the experience of body-self relations. Body-self relations emerged as central to understanding in this study of the experience of the body at different ages (20-30, 45-55 and 70+ years), demonstrating the utility of empirical investigations in this area. This paper describes an orientation to the body that was common to the sample of 20 young people (aged 20-30 years) interviewed as part of this study. This orientation informed their health-related behaviours such as diet and exercise, but some participants found it to be problematic. Their voices demonstrate that bodily 'choices' may actually be experienced as irrational and even psychopathological compulsions. This experiential perspective suggests that normality may be continuous with pathology, and that differences are of degree rather than kind. The findings have implications for the treatment and prevention of eating disorders and obesity. [ABSTRACT FROM AUTHOR]

Australia is rapidly becoming home to an increasing number of Polynesians. While the Maori/Pacific Islander 'economic migrant' may appear fit and healthy, statistically the incidence of diabetes, hypertension and cardiovascular disease is extremely high. When this profile is coupled with family reunion migration of older relatives who are living longer, it represents an escalation of current and future outlay for Australian health services. Qualitative semi-structured interviews were conducted with 67 Polynesian migrants in regard to their perceptions of health and illness, and their experience of health services in Sydney and the Hunter region of New South Wales. Three key respondents, all Polynesian nurses practising in Australia, were also interviewed. The findings indicate a concentration of disadvantage concerning educational achievement, skill levels and health literacy that reinforce the process whereby social disadvantage impacts on health outcomes. This study also reveals a nexus of issues around cultural behaviours and poverty that contribute to the incidence of obesity-related illness and limit compliance with recommended preventative measures and treatments. This paper includes a discussion of the socio-political context of health delivery to Maori and Pacific Islander migrants and how the contraction of services under neoliberal 'belt tightening' undermines potential capacity to treat culturally and linguistically diverse (CALD) populations effectively. As Australian scholarship has traditionally concentrated on Melanesia, there is very little research on Polynesians who are one of our burgeoning migrant groups. This study therefore makes a timely contribution to redressing the lack of literature on Polynesian health, cultural practices and socio-economic positioning in this country. [ABSTRACT FROM AUTHOR]

Evidence-based medicine (EBM) has been one of the most important movements in clinical medicine and public health in recent years. At the heart of the EBM movement lies the Cochrane Collaboration, an infl uential organisation that produces systematic assessments of healthcare interventions known as Cochrane reviews. Although Cochrane methods were initially designed to test the efficacy of medical therapies, the desire for 'evidence-based' practice has pushed the movement far beyond its initial scope into the assessment of complex social phenomena. Through an examination of one particular Cochrane review -- Physician advice for smoking cessation -- this paper highlights the limitations of EBM 'creep', and some of the more problematic conceptions of human nature underwriting Cochrane principles and methodologies. [ABSTRACT FROM AUTHOR]

This paper explores how the structuring of places and time influence Aboriginal and Torres Strait Islander patient and carer experiences of health services. Face-to-face in-depth interviews were conducted with urban Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease as well as family carers (N = 19). Content analysis was undertaken. Participants report that each element of the time spent in Aboriginal Medical Services is seen as more valuable and worthwhile than in mainstream health services, from social and health sharing experiences in the waiting room to health care in clinical places; and that users feel they can rely on sufficient time and respectful care in their clinical consultation. Purposeful design of both physical and temporal aspects of health services is called for. We suggest re-introducing opportunities for spatiotemporal design in health care that have been limited by the segmented 'person as illness' design features of Australia's current mainstream health system. [ABSTRACT FROM AUTHOR]

This paper draws parallels between the market trend in the English NHS and Polanyi's (1957) The Great Transformation: The political and economic origins of our time, Beacon Press: Boston (originally published in 1944 in the United States as The Great Transformation, Rinehart: and Co: New York, and in 1945 in England as Origins of our time, Gollancz: London) account of how the rise of markets provokes a self-protective counter-reaction that tries to re-embed economic relations in social relations. We report findings from a qualitative study of NHS contracting, which examines the recent move to harder-edged contracts with greater use of financial penalties and incentives. In practice, use of these techniques tended to be confined to nationally-mandated sections of the contract rather than emerging from local bilateral agreements, and when things went wrong the parties relied more on cooperative behaviour than on the provisions of the contract to find solutions. Making the current contracting system work depended more on existing relational networks than on the incentive structures created by recent 'marketisation' initiatives, but the inability of the market to evolve as expected has encouraged policy makers to publish plans for further radical reforms. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of UK mental health practitioners' experiences of working with the contested condition, dangerous and severe personality disorder (DSPD). Our interviews focused on the issues of treatability, risk assessment and decision-making in multi-disciplinary teams. We discuss the approach of values-based medicine (VBM) as a useful framework for interpreting the data: respondents cited both explicit values (based on occupational training) and implicit values (based on personal beliefs and subjective perceptions). There was evidence of conflicting values -- within individuals, between occupational groups, and between individuals in occupational groups -- which led to widespread uncertainty and caution about whether and how those with 'dangerous' personality disorders could be treated. These disputes were resolved by a 'slide to pragmatism', whereby practitioners, reluctantly acknowledging their own empowerment in the process, sought to make whichever choice was least risky for their own professional reputation, and most pragmatic, given the resources available. [ABSTRACT FROM AUTHOR]

Understandings of culture and multiculture are broad and deeply embedded in every day talk and practices. In an increasingly globalised world, how we understand and work with these terms affects how parents and their families experience health care services and the support intended by health care professionals. This is particularly important for parents who are new to Australia. In this paper we report on findings from an ethnographic study undertaken across two community child and family health nursing sites in South Australia. Using examples, we explore how child and family health nurses appear to understand and use constructs of culture and multiculture during everyday, intercultural communication with parents who are new to Australia and Australian health services. By analysing these understandings through postcolonial and feminist theories we found pervading evidence that neo-colonial constructs of a white western monoculture shaped intercultural communication practice. We conclude by reflecting on how these constructs might be addressed to improve intercultural communication in child and family health settings. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]