143 results
Search Results
52. Visibilising clinical work: Video ethnography in the contemporary hospital.
- Author
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Iedema, Rick, Long, Debbi, Forsyth, Rowena, and Lee, Bonne Bonsan
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HOSPITAL care , *INSTITUTIONAL care , *MEDICAL care , *PRIMARY care , *RESEARCH - Abstract
This paper discusses the role of video-based research methods in social research. The paper situates these methods in the context of rising levels of visibility of professionals in government-funded organisations. The paper argues that while visual research may appear to play an ambiguous role in these organisations, it can also enable practitioners to confront the encroaching demands of post-bureaucratic work. To ground its argument, the paper presents an account of a video-ethnographic project currently underway in a local metropolitan hospital. This project focuses on negotiating understandings about existing care practices among a team of multi-disciplinary clinicians. Visual data gathered as part of that project are presented to specify issues which have thus far arisen during the project. Against this empirical background, the paper turns to considering the ambiguous potential of video-based research. The argument developed here is that, besides potentially exacerbating the pressure already imposed on clinicians - thanks to audit, surveillance and risk minimisation - video-based research may provide staff with new resources and opportunities for shaping their increasingly public and visible work practices. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
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53. The interaction of gender and class in nursing: appropriating Bourdieu and adding Butler.
- Author
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Huppatz, Kate
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NURSING , *SOCIAL classes , *GENDER , *OCCUPATIONS , *INTERPERSONAL relations - Abstract
The aim of this paper is to propose a conceptual framework for exploring the ways in which class and gender interact in occupational fields. In recent years, very little research has been specifically concerned with the relationship between gender and class. Much of the literature which grapples with the question of how gender and class interact contains theoretical limitations which appear to stem from a reliance on categorical theories of both class and gender. In this paper it is proposed that, when used in conjunction, the approaches of Bourdieu and Butler provide a framework for exploring class and gender in terms of embodied practice. In order to illustrate the possibilities enabled by 'appropriating Bourdieu and adding Butler', the paper suggests ways in which this conceptual framework makes possible the examination of the complex relations between gender and class within one particular area of 'women's work': the field of nursing. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
54. 'The best friend Medicare ever had'? Policy narratives and changes in Coalition health policy.
- Author
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Elliot, Amanda
- Subjects
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MEDICARE , *HEALTH insurance , *PUBLIC health - Abstract
As Leader of the Opposition in 1987, the current Prime Minister of Australia John Howard, stated unequivocally that he would dismantle Medicare at his first opportunity. By April 2000, the Health Minister in a Howard-led government proudly proclaimed to the Australian Parliament the Coalition was 'the best friend Medicare ever had'. Such a shift in ideology and policy position appears remarkable, overturning more than 60 years of conservative opposition to a universal, publicly funded, health care system. This paper traces the shift from the lead-up to the 1996 election until 2000, interrogating official policy texts to map how the Coalition reconfigured its own policy narrative about the Australian health care system. This paper argues that in order to understand contemporary reforms to the health care system, we must consider the way in which those reforms provide solutions to discursively, rather than objectively constructed, policy problems. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
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55. 'Merging' the Aboriginal population: Welfare, justice, power and the separation of Aboriginal children in Victoria.
- Author
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McCallum, David
- Subjects
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FAMILIES , *INDIGENOUS peoples , *REASONING , *LEGISLATORS - Abstract
This paper sets out some of the parameters of social intervention in the family in Australia around the turn of the 20th century in ways which permit interventions in Aboriginal and non-Aboriginal populations to be broadly compared and contrasted. It focuses on forms of intervention underpinned by the kind of liberal political reasoning that allowed administrators to intervene on the basis of assessments of the capacity of families to govern themselves (Hindess 2000, 2001). The paper draws on archival material in Victoria, and the evidence of interventions in Aboriginal populations focuses on the removal of Aboriginal children from their communities in various parts of the state during this period. 'Race' comes to be constructed in terms that allow legislators and administrators to make discriminations within Aboriginal populations in order to manage them. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
56. Health lifestyle theory in an Asian context.
- Author
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Cockerham, William C
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WESTERN society , *QUALITY of life , *CHRONIC diseases , *DEATH , *HEALTH attitudes - Abstract
Health in Western society has become viewed as an achievement: something people are supposed to work at to enhance their quality of life or risk chronic illness and premature death. This is evident in the research documenting the close connection between chronic illnesses and health lifestyles. Almost all of this research is based on Western populations and much of it treats health behaviour and lifestyles as matters of individual choice or agency. While agency is important, structural conditions can 'act back' on individuals to configure their lifestyles in particular ways. The focus of this paper is to apply a new theoretical model to an Asian context. This model features a convergence between agency and structure and is supported by studies in Western countries. If the model is to have global relevance, it needs to be representative of health lifestyles in Asia as well. Unfortunately, there very few relevant studies available in Asia. Consequently, the intent of this paper is to not only present an initial theoretical framework for such studies, but also to call attention to the need for research in Asia on this topic. Everyone has a health lifestyle and Asians are no exception, as their lifestyles undoubtedly play a decisive role in determining health in the Pacific region. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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57. The experience of living with chronic illness for the haemodialysis patient: An interpretative phenomenological analysis.
- Author
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Lindsay, Heather, MacGregor, Casimir, and Fry, Margaret
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TREATMENT of chronic kidney failure , *CONTROL (Psychology) , *BODY image , *EXPERIENCE , *HEMODIALYSIS patients , *INTERVIEWING , *PHENOMENOLOGY , *SOCIAL skills , *DISEASE management , *QUALITATIVE research , *THEMATIC analysis , *BODY burden , *DESCRIPTIVE statistics - Abstract
This study examines experiences of living with chronic illness for haemodialysis patients. In order to understand these experiences the paper takes an existential-phenomenological approach. Interviews of seven participants (five males, two females) were collected in a haemodialysis clinic. Based upon the participants experiences three core themes emerged: (1) the challenges of living with chronic renal failure; (2) body changes and embodiment; (3) their illness experience and social relationships. The findings suggest that the illness experience of chronic renal failure is an on-going struggle to attain a sense of control. We suggest that where a sense of control is limited this can create a sense of powerlessness. Further, the illness experience was not solely restricted to the individual, but also affected wider social relationships. It is only through taking into account the context of patients experience of illness that clinicians/nurses can meaningfully draw on all aspects of evidence to reach integrated clinical judgement. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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58. Gender specific effects of financial and housework contributions on depression: A multi-actor study among three household types in Belgium.
- Author
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Dereuddre, Rozemarijn, Missinne, Sarah, Buffel, Veerle, and Bracke, Piet
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MENTAL depression risk factors , *ANALYSIS of variance , *CLUSTER analysis (Statistics) , *COMPARATIVE studies , *STATISTICAL correlation , *EMPLOYMENT , *FAMILIES , *FATHERS , *MOTHERS , *PANEL analysis , *PART-time employment , *REGRESSION analysis , *STATISTICAL sampling , *SEX distribution , *GENDER role , *WAGES , *WORKING mothers , *HOUSEKEEPING , *SECONDARY analysis , *STATISTICAL models , *DESCRIPTIVE statistics - Abstract
Studies that focus on the effects of both the division of household chores and of financial contributions on the mental health of couples are scarce. This paper expands on previous research by paying attention to the variation of this relationship among three types of households: Male breadwinner, one-and-a-half-earner and dual-earner. Using paired data from the 10th wave of the Panel Study of Belgian Households, collected in 2001, we perform separate linear regressions for men (N = 1054) and women (N = 1054). The results suggest that in one-and-a-half-earner households, women's employment has a negative effect on their partner's depression level and that in dual-earner households, the effect of women's employment is only negative if men are not the major breadwinner. Crossover effects of depression between partners seem to mediate part of the aforementioned associations. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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- View/download PDF
59. Intergenerational solidarity: An investigation of attitudes towards the responsibility for formal and informal elder care in Australia.
- Author
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Hodgkin, Suzanne
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ADULT children , *AGE distribution , *AGING , *ATTITUDE (Psychology) , *CHI-squared test , *COST control , *INSURANCE , *INTERGENERATIONAL relations , *LONG-term health care , *MEDICAL care costs , *SEX distribution , *GOVERNMENT aid , *SOCIAL responsibility , *SECONDARY analysis , *SOCIAL attitudes , *RESIDENTIAL care , *FAMILY roles , *BURDEN of care , *CROSS-sectional method - Abstract
This paper sets out to explore the Australian instance of a significant international problem: Intergenerational solidarity and the willingness of younger generations to support the future care of older people. It draws on Bengston's intergenerational solidarity theory, in particular his conception of normative solidarity relative to filial obligations, to analyse data from the Australian Survey of Social Attitudes. This data demonstrates evidence of intergenerational solidarity at the policy level and a need for a continued role for government in the provision of residential care, insurance schemes, and the payment of income to full time and occasional carers. At the family level there is less support for the role of adult children in the payment of formal care or the provision of informal care. There is also a significant difference between men and women concerning the direct provision of informal care to ageing parents. Suggestions for future research are highlighted. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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60. 'Ageing-in-place': Frontline experiences of intergenerational family carers of people with dementia.
- Author
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Vreugdenhil, Anthea
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TREATMENT of dementia , *ADULT children , *CAREGIVERS , *HOME care services , *INTERGENERATIONAL relations , *LONG-term health care , *HEALTH policy , *NEGOTIATION , *HEALTH self-care , *LABELING theory , *SOCIAL attitudes , *RESIDENTIAL care , *FAMILY roles , *BURDEN of care , *INDEPENDENT living - Abstract
The success of 'ageing-in-place' aged care policy in Australia relies heavily on the unpaid work of informal carers. While there is a wealth of research regarding informal carers more generally, we know relatively little about the experiences of the 'sandwich generation': Adult children (mainly daughters) who provide care for a parent while often juggling paid work and the care of their own children or grandchildren. In this paper I undertake a critical analysis of 'ageing-in-place' policy through the lens of 'sandwich generation' carers of people with dementia. Drawing from a composite case study, I argue that these carers are located at the interstices of powerful discourses such as 'individualisation' and 'care' and explore how the everyday practice of care is negotiated within these spaces. Inhabiting these spaces can be costly for carers and we need to consider how policies can better support intergenerational carers if 'ageing-in-place' is to be sustainable. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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61. Schools of sociology? The structuring of sociological knowledge in the sociology of health and medicine since 1960.
- Author
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Collyer, Fran
- Subjects
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AUTHORSHIP , *PUBLISHING , *SERIAL publications , *UNIVERSITIES & colleges , *BUSINESS networks , *CHI-squared test , *CONTENT analysis , *FACTOR analysis , *SCHOLARLY method , *RESEARCH methodology , *MEDICAL care , *MEDICINE , *OCCUPATIONAL prestige , *KNOWLEDGE management , *EMPIRICAL research , *LABELING theory , *RETROSPECTIVE studies , *EVALUATION - Abstract
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]
- Published
- 2013
- Full Text
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62. A critical discourse analysis of Canadian and Australian public health recommendations promoting physical activity to children.
- Author
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Alexander, Stephanie A and Coveney, John
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PREVENTION of obesity , *DOCUMENTATION , *WORLD Wide Web , *HEALTH policy , *BODY image , *CHILDREN'S health , *COMPARATIVE studies , *DISCOURSE analysis , *EPIDEMICS , *HEALTH promotion , *MENTAL orientation , *PROBLEM solving , *SOCIAL values , *QUALITATIVE research , *PHYSICAL activity - Abstract
In the past decades, public health has increasingly addressed what has been called the children's obesity 'epidemic', most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children's health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi's (2009) 'What's the problem represented to be?' approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children's physical and leisure activities are being advanced. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
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63. Body as choice or body as compulsion: An experiential perspective on body-self relations and the boundary between normal and pathological.
- Author
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Underwood, Mair
- Subjects
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PREVENTION of eating disorders , *PREVENTION of obesity , *CONTROL (Psychology) , *ANALYSIS of variance , *BODY image , *DECISION making , *DIET , *EXERCISE , *GROUNDED theory , *HEALTH behavior , *INTERVIEWING , *RESEARCH methodology , *PATHOLOGICAL psychology , *REFERENCE values , *RESEARCH , *SELF-perception , *QUALITATIVE research , *THEMATIC analysis , *UNDERGRADUATES - Abstract
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]
- Published
- 2013
- Full Text
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64. The subjective experience of Polynesians in the Australian health system.
- Author
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Rodriguez, Lena
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CHRONIC disease risk factors , *FOCUS groups , *IMMIGRANTS , *INTERVIEWING , *RESEARCH methodology , *MEDICAL care use , *NURSES' attitudes , *PATIENT compliance , *CULTURAL pluralism , *QUALITATIVE research , *CULTURAL awareness , *SOCIOECONOMIC factors , *COMMUNICATION barriers , *EDUCATIONAL attainment , *HEALTH equity , *HEALTH literacy , *PATIENTS' attitudes - Abstract
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]
- Published
- 2013
- Full Text
- View/download PDF
65. Challenging homogenous representations of rural youth through a reconceptualisation of young rural Tasmanian's sexual health strategies.
- Author
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Bishop, Emily
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AGE distribution , *SEXUAL health , *INTERPERSONAL relations , *INTERVIEWING , *INTIMACY (Psychology) , *RISK management in business , *RISK-taking behavior , *RURAL population , *STEREOTYPES , *QUALITATIVE research , *JUDGMENT sampling , *SAFE sex , *HEALTH equity , *ATTITUDES toward sex - Abstract
Dominant explanations of young people's health risk behaviours echo essentialist notions of perceived invulnerability and risk misperception. Rural youth, however, are considered particularly 'at-risk'. In this paper I argue for a need to challenge rural youth discourses, as they can have counterproductive implications. To evidence this need I draw on interview data from research that examined sexual (and other) risk perceptions among young rural Tasmanians. Findings revealed that participants were aware of rural youth stereotypes and often sought to distinguish themselves from these; were cognisant of their susceptibility to risk; and employed particular strategies to reduce the risks they faced. While these strategies are not perfect or foolproof, they nonetheless signify young people's efforts to mitigate health risks. It is important to recognise this. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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66. Development of an ethical methodology for post-bushfire research with children.
- Author
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Gibbs, Lisa, MacDougall, Colin, and Harden, Jeni
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EXPERIMENTAL design , *CONTENT mining , *ACTION research , *CHILD development , *CHILDREN'S accident prevention , *CHILDREN'S rights , *CITIZENSHIP , *CONVALESCENCE , *EXPERTISE , *FIRES , *INFORMED consent (Medical law) , *MEDICAL personnel , *NATURAL disasters , *RESEARCH , *RISK management in business , *QUALITATIVE research , *LABELING theory , *HUMAN research subjects , *ETHICS - Abstract
There has been a tendency for researchers and practitioners to overlook the needs and experiences of children and young people in relation to disasters. In this paper, we report on our exploration of the question of whether to involve children and young people in post-bushfire research, and if so how? In considering children's rights in this context we were guided by a number of conceptions of the child (reflecting research debates within the Sociology of Childhood): The citizen child; the child at risk; and the developing child. We engaged in formal, progressive consultations with experts internationally and with bushfire affected community partners. This study determined that research with children post-bushfires was an important, ethical and appropriate activity, provided the methodology was sensitive and allowed children to provide informed consent and to have a sense of control over the issues being discussed. We conclude that carefully considering a rights approach materially changed the final methodology that includes the perspectives of children and young people in research about recovery from traumatic disasters, while still respecting their right to be safe and supported. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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67. Specialization training programs for physician assistants: Symbolic violence in the medical field?
- Author
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Hlavin, Joseph A and Callahan, Jamie L
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CONFLICT management , *HOSPITAL medical staff , *LABOR mobility , *SYMBOLISM (Psychology) , *MEDICAL practice , *MEDICAL specialties & specialists , *MOTIVATION (Psychology) , *PHYSICIANS' assistants , *POWER (Social sciences) , *RECOGNITION (Psychology) , *JOB qualifications , *SOCIAL capital , *HEALTH insurance reimbursement , *CULTURAL values , *LABELING theory , *ACCREDITATION , *EDUCATIONAL outcomes ,STUDY & teaching of medicine - Abstract
Postgraduate physician assistant (PA) programs designed to train individuals for the workplace have existed since the advent of the profession itself. These residency programs continue to grow in number despite the lack of outcome data supporting improvements in PA learning, effects on career development, or improved patient care. Leadership bodies of the PA profession in the US have been at odds regarding the meaning and ramification of postgraduate programs on specialty credentialing, accreditation standards, insurance reimbursement, and employment. Using Bourdieu's cultural conflict theory as a framework, we analyze the issues confronting postgraduate PA training programs. Our paper discusses implications related to shifts in power amongst the different stakeholders concluding that, although formal postgraduate PA training can be beneficial to both the PA and the medicine, considerations related to underlying agendas need attention. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
68. Tensions in compliance for renal patients - how renal discussion groups conceive knowledge and safe care.
- Author
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Godbold, Natalya Jane
- Subjects
- *
AUTHORITY , *CAREGIVERS , *CONCEPTS , *DISCOURSE analysis , *FISTULA , *HEMODIALYSIS patients , *ONLINE information services , *PATIENT compliance , *PATIENT safety , *PERINEAL care , *PHYSICIAN-patient relations , *POWER (Social sciences) , *RESEARCH , *HEALTH self-care , *SUPPORT groups , *SOCIAL role , *KNOWLEDGE management , *QUALITATIVE research , *INFORMATION-seeking behavior - Abstract
Much of the medical literature on patient compliance explores why patients fail to follow practitioners' instructions. This paper explores perspectives on 'compliance' expressed in online discussion groups for kidney patients. Discourse analysis was used to investigate how contributors conceptualise knowledge and the role of the renal patient. In the discussion groups, patients were sometimes seen to have better understanding of the details of their illness than some practitioners, a focus born of inhabiting their situation and therefore having more at stake. Some patients set themselves the task of supervising their own care, double checking the work of practitioners. This did not threaten biomedical knowledge, but these counter-discourses challenge professional boundaries by making it the prerogative of patients to obtain biomedical knowledge. I explore issues of surveillance and frustration, and the potential usefulness of patients' overseeing their own safety, while flagging the potential plight of less 'empowered' or motivated patients. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
69. 'You can name her': Ritualised grieving by an Australian woman for her stillborn twin.
- Author
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Rosenberg, John P.
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SIBLINGS , *INTERMENT , *GRIEF , *PERINATAL death , *RECOGNITION (Psychology) , *RITES & ceremonies , *TWINS - Abstract
The stillbirth of an Australian infant in the mid-2Oth Century was an event often left unacknowledged. Mothers of stillborn babies were often told to 'forget about it and have another baby'. Siblings of these babies were often not encouraged to discuss them, and were even left unaware of their birth and death. This paper explores this phenomenon in an Australian case study. When Nancy was born in 1937, her twin sister was stillborn. As was customary at that time, the deceased baby was buried unnamed in an unmarked plot without ceremony. Little was said of her thereafter. Seventy-three years later, Nancy finally undertook a number of activities with ritualised features that acknowledged, named, mourned and honoured her sister. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
70. Death, working-class culture and social distinction.
- Author
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Conway, Steve
- Subjects
- *
DEATH & psychology , *PSYCHOLOGICAL adaptation , *ATTITUDE (Psychology) , *INTERMENT , *CONCEPTS , *GROUP identity , *RESOURCE allocation , *SELF-perception , *SOCIAL classes , *SOCIAL skills , *STEREOTYPES , *SUFFERING , *SOCIAL capital , *CULTURAL values , *ATTITUDES toward death - Abstract
Following Howarth (2007), this paper examines the relationship between class culture and social distinction in the empirical area of death and dying. For Howarth (2007), the sociological neglect of the end-of-life cultural practices of working-class people carries the danger 'of privileging middle-class agendas for change, [t]here is an urgent need for further studies and a refinement of existing research to draw out social class distinctions' (p. 433). Drawing on Howarth (2007), and Bourdieu (1984), it is argued below that the connexion between death and class reflects and helps to reproduce class-based identities, advantages and conflicts. Whilst class culture can be a supportive resource for working-class people, for example, in ways which reflect solidarity, more typically the classed nature of death brings acute suffering. Relatedly, it is proposed that stereotypes of declining respectability are reflected in some middle-class conceptions of working-class practices and identity connected to death. Such thinking socially positions working-class tastes as objects of disgust, and working-class people as disgusting subjects. It is concluded that, whilst Howarth's call is much warranted, the debate also needs to problematise the normalisation of middle-class ways to die and grieve. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
71. Cochrane reviews and the behavioural turn in evidence-based medicine.
- Author
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Bell, Kirsten
- Subjects
- *
BEHAVIOR modification , *HEALTH attitudes , *RESEARCH methodology , *PHYSICIANS , *SMOKING cessation , *SYSTEMATIC reviews , *EVIDENCE-based medicine , *OCCUPATIONAL roles , *SOCIAL attitudes , *SOCIAL context , *STANDARDS - Abstract
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]
- Published
- 2012
- Full Text
- View/download PDF
72. Intercultural communications in remote Aboriginal Australian communities: What works in dementia education and management?
- Author
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Taylor, Kerry A., Lindeman, Melissa A., Stothers, Kylie, Piper, Karen, and Kuipers, Pim
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COMMUNICATION methodology , *INDIGENOUS peoples , *ATTITUDE (Psychology) , *DEMENTIA , *DISEASES , *FOCUS groups , *SCIENTIFIC observation , *CULTURAL pluralism , *RESEARCH funding , *RURAL conditions , *TRANSCULTURAL medical care , *TRANSLATIONS , *DVD-Video discs , *PILOT projects , *CULTURAL identity , *CLIENT relations , *COMMUNICATION barriers , *EDUCATIONAL outcomes , *HEALTH literacy - Abstract
Dementia education and management is a major challenge nationally. However in the remote Aboriginal context, where the prevalence of dementia is five times greater than the national rate, the challenge is made more complex by cultural and linguistic differences between providers and consumers. Tins paper presents findings from the evaluation of a targeted dementia awareness resource piloted in three Aboriginal languages as well as English. It focuses on the intercultural communication aspects of the evaluation adding to the limited body of knowledge about communications with speakers of Australian Aboriginal languages. It identifies elements of effective intercultural communication in dementia education, implications for health literacy and considers the difference that culturally safe intercultural communication can make to a single issue such as dementia awareness. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
73. It hinges on the door: Time, spaces and identity in Australian Aboriginal Health Services.
- Author
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Jowsey, Tanisha, Yen, Laurann, Ward, Nathaniel, Mcnab, Justin, Aspin, Clive, and Usherwood, Tim
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ATTITUDE (Psychology) , *CONTENT analysis , *DIABETES , *GROUP identity , *HEART failure , *INDIGENOUS peoples , *INTERIOR decoration , *INTERVIEWING , *OBSTRUCTIVE lung diseases , *RESEARCH methodology , *MEDICAL quality control , *PATIENT-professional relations , *PATIENT satisfaction , *RESEARCH , *RESEARCH funding , *RESPECT , *SOCIALIZATION , *TIME , *TRANSCULTURAL medical care , *DISEASE management , *MEDICAL care of indigenous peoples , *CULTURAL identity , *DESCRIPTIVE statistics - Abstract
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]
- Published
- 2012
74. The birth of a speciality: The sociology of health and medicine in Australia.
- Author
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Collyer, Fran
- Subjects
- *
HISTORY of sociology , *LABOR discipline , *MEDICAL specialties & specialists , *INTERPROFESSIONAL relations , *PROFESSIONS , *OCCUPATIONAL achievement , *MEDICINE , *CULTURAL pluralism , *RESOURCE allocation , *SOCIAL networks , *UNIVERSITIES & colleges , *KNOWLEDGE management , *HISTORY - Abstract
This paper offers a study of the specialist field of the sociology of health and medicine, and examines its institutional development in Australia. A thesis is developed about the relationship between the field and the parent discipline of sociology. The formation of the discipline and the specialist field are proposed to have occurred in stages: the formative years, a period of inter-disciplinarity and collaboration, a stage of intensification and organisation, the years of institutional growth and specialisation, the decade of consolidation and fragmentation, and, its most recent phase, a time of 'new' internationalisation. Moreover, the institutionalisation of the sociology of health and medicine has closely followed the developmental trajectory of its parent discipline, even though its disciplinary boundaries have been, and continue to be, less rigid. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
75. Health, freedom and work in rural Victoria: The impact of labour market casualisation on health and wellbeing.
- Author
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Mcgann, Michael, Moss, Jeremy, and White, Kevin
- Subjects
- *
TEMPORARY employment , *BLUE collar workers , *CONTRACTS , *HEALTH status indicators , *INTERVIEWING , *JOB descriptions , *JOB security , *LABOR market , *RESEARCH funding , *RURAL population , *SELF-perception , *SHIFT systems , *SOCIAL classes , *UNCERTAINTY , *WAGES , *QUALITATIVE research , *WELL-being , *DESCRIPTIVE statistics , *PSYCHOLOGY - Abstract
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]
- Published
- 2012
- Full Text
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76. The dark side of hope and trust: Constructed expectations and the value-for-money regulation of new medicines.
- Author
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Brown, Patrick R.
- Subjects
- *
GOVERNMENT agencies , *CONCEPTUAL structures , *COST effectiveness , *DEBATE , *DECISION making , *GROUP decision making , *DRUG design , *HOPE , *LOBBYING , *MASS media , *MEDICAL care costs , *MOTIVATION (Psychology) , *HEALTH outcome assessment , *PHARMACEUTICAL industry , *PRACTICAL politics , *QUALITY of life , *TRUST , *UNCERTAINTY , *DRUG approval , *TREATMENT effectiveness - Abstract
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]
- Published
- 2011
- Full Text
- View/download PDF
77. The sociology of cognitive enhancement: Medicalisation and beyond.
- Author
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Coveney, Catherine, Gabe, Jonathan, and Williams, Simon
- Subjects
- *
BIOTECHNOLOGY ethics , *DRUG utilization , *MARKETING , *DRUG therapy , *COGNITION , *DRUG design , *PHARMACEUTICAL industry , *POWER (Social sciences) , *PROFIT , *QUALITY of life , *SOCIAL control , *SOCIAL values , *SOCIOLOGY , *ETHICS - Abstract
To date, sociology of health and medicine has engaged in only a limited way in debates about cognitive enhancement drugs and how they might affect or change the way we live our lives. In this review we explore the implications of the development of such drugs, both now and in the future, with particular reference to the changing drivers and dynamics of medicalisation or biomedicalisation over time. Whilst both concepts shed important light on these developments, pharmaceuticalisation provides a more precise sociological term of reference we suggest for tracing and tracking these trends in cognitive enhancing drugs over time. The paper ends with some further suggestions for a research agenda in this domain, drawing on concepts located at the nexus between science and technology studies (STS) and the sociology of health and biomedicine. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
78. Contracts in the English NHS: Market levers and social embeddedness.
- Author
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Hughes, David, Petsoulas, Christina, Allen, Pauline, Doheny, Shane, and Vincent-Jones, Peter
- Subjects
- *
RISK management in business , *GOVERNMENT agencies , *CONTRACTING out , *COOPERATIVENESS , *DECENTRALIZATION in management , *LABOR incentives , *MEDICAL databases , *INFORMATION storage & retrieval systems , *INTERVIEWING , *RESEARCH methodology , *NATIONAL health services , *MEETINGS , *PAY for performance , *NEGOTIATION , *ORGANIZATIONAL change , *EVALUATION of organizational effectiveness , *RESEARCH funding , *QUALITATIVE research , *ORGANIZATIONAL structure , *THEORY , *SECONDARY analysis , *SOCIAL context , *INSTITUTIONAL cooperation , *ECONOMIC competition - Abstract
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]
- Published
- 2011
- Full Text
- View/download PDF
79. The final frontier: The UK's new coalition government turns the English National Health Service over to the global health care market.
- Author
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Pollock, Allyson M. and Price, David
- Subjects
- *
GOVERNMENT aid , *HEALTH care rationing , *FAMILY medicine , *INTEGRATED health care delivery , *CONSORTIA , *CONTRACTING out , *CORPORATIONS , *DECENTRALIZATION in management , *FEDERAL government , *HEALTH services administration , *INVESTMENTS , *MEDICAL needs assessment , *NATIONAL health services , *PRACTICAL politics , *RESPONSIBILITY , *SOCIAL control , *USER charges , *PRIVATE sector , *GOVERNMENT regulation , *ECONOMIC competition , *ECONOMICS , *LAW - Abstract
The authors describe the incremental approach to the marketisation of the English National Health Service (NHS) since the introduction of an 'internal market' in 1990 until the 2010 White Paper, 'Equity and Excellence: Liberating the NHS', and the subsequent Health and Social Care Bill published in January 2011. The introduction of a competitive market for a universal, tax-financed health system requires fundamental changes in regulation in order that market bureaucracy can be substituted for direct management. The components of reform are insufficiently captured by the framework of hierarchies and networks in new public management theories of decentralisation. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
80. The work of nurses in private health: Accounting for the intangibles in care delivery.
- Author
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Toffoli, Luisa, Rudge, Trudy, and Barnes, Lynne
- Subjects
- *
NURSING services administration , *NURSING standards , *MEDICAL care , *MARKETING , *HOSPITALS , *BUSINESS , *DISCOURSE analysis , *PROPRIETARY health facilities , *INTENSIVE care nursing , *INTERVIEWING , *JOB security , *MEDICAL quality control , *NURSES , *NURSES' attitudes , *PATIENT satisfaction , *PROFIT , *RESPONSIBILITY , *WORK environment , *ETHNOLOGY research , *ORGANIZATIONAL structure , *OCCUPATIONAL roles , *SECONDARY analysis - Abstract
With the commodification of healthcare in general and of private health in particular, it is difficult not to acknowledge the growing influence of competition and 'the market' in shaping the way that nurses' work is managed by private hospitals and by nurses themselves. This paper explores the discourses shaping nurses' work in private healthcare, drawing upon data from an ethnographic study conducted in one Australian acute care private hospital. The framework for analysis relies on an exploration of the mentalities and governance of nurses' work in such a setting. The study shows how marketing and performance measures are believed to ensure the viability of the enterprise while simultaneously commodifying nurses' caring work. It is this work that remains invisible to the healthcare system and the hospitals where they work. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
81. Multinational corporations, the state, and contemporary medicine.
- Author
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Jasso-Aguilar, Rebeca and Waitzkin, Howard
- Subjects
- *
MENTAL illness drug therapy , *MEDICAL screening , *BEHAVIOR disorders in children , *CONFLICT of interests , *ECONOMICS , *FEDERAL government , *HEALTH services administration , *INSURANCE companies , *INTERNATIONAL business enterprises , *PHARMACEUTICAL industry , *PRACTICAL politics , *POWER (Social sciences) , *PROFIT , *SOCIAL classes , *SOCIAL justice , *PRIVATE sector , *THEORY , *PUBLIC sector - Abstract
In this paper we explore the ways in which corporations have become powerful actors in the political and economic landscapes, and the role the state has played in this development. Focusing on the pharmaceutical industry, we find that revolving door practices have been a key instrument in furthering the growth of corporate power, leading us to a reconsideration of the concepts of class struggle and the role of the state in the maintenance of the dominant class' privileges. We conclude that our findings lend support to Harvey's theory of neoliberalism as a specific project to restore power to the dominant class, and also to Marx's conception of state power subordinated to capitalist economic power. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
82. Legislative hegemony and nurse practitioner practice in rural and remote Australia.
- Author
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Harvey, Clare
- Subjects
- *
MEDICARE laws , *HEALTH care reform , *RURAL health services , *COST control , *CLINICAL pathology , *HEALTH services accessibility , *LOBBYING , *MEDICAL societies , *NURSE practitioners , *NURSES , *POWER (Social sciences) , *PRIMARY health care , *DISEASE management , *NURSE prescribing , *HEALTH insurance reimbursement , *ELIGIBILITY (Social aspects) , *OCCUPATIONAL roles ,MEDICARE (Australia) - Abstract
Nurse practitioners were introduced into Australia in 1990 to improve access to health care in isolated communities where medical doctors are scarce. The slow uptake of nurse practitioners in these areas has largely been the result of legislation not affording them access to provider numbers through the Medicare Australia Act 1973. This has denied nurse practitioners the opportunity to become primary care providers because they cannot prescribe medications and order diagnostic tests at rebated costs. Recently this Act changed, making provision for nurse practitioners. Ironically the enactment of the new legislation still prevents nurse practitioners from practicing effectively. This paper describes the discursive practices in legislation, driven by traditional power brokers, which perpetuate the traditional role of nurses as care givers and fails to support the evolution of nurse practitioners as care providers. These continued practices effectively prevent nurse practitioners from working to their potential, despite government reassurance under recent health care reform in Australia. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
83. Unhealthy policy: The political economy of Canadian public--private partnership hospitals.
- Author
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Whiteside, Heather
- Subjects
- *
COST control , *ECONOMICS , *HEALTH facility administration , *INVESTMENTS , *ORGANIZATIONAL effectiveness , *PRACTICAL politics , *PROFIT , *RESPONSIBILITY , *RISK management in business , *STATE governments , *GOVERNMENT aid , *PRIVATE sector , *PUBLIC sector ,CANADIAN politics & government - Abstract
Public--private partnerships (P3s) with the for-profit private sector are increasingly used in Canada to deliver public infrastructure and support services within the health care sector (e.g., hospitals, clinics, community health centres). This paper examines the emergence and legacy of P3s in the Canadian health care sector, classifying them as a form of neoliberal accumulation by dispossession and discussing their inability to live up to proponents' promises. Economic and social costs are examined, and examples are drawn from operational P3 hospitals in Canada. The article also briefly examines how P3s have been affected by the recent global financial crisis, arguing that despite serious problems with the private finance component of these projects, ultimately the policy is poised to weather the storm. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
84. The origins of a New Zealand suicidal cohort: 1970-2007.
- Author
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Curtis, Cate and Curtis, Bruce
- Subjects
- *
SUICIDE prevention , *AGE distribution , *ATTRIBUTION (Social psychology) , *HEALTH policy , *SOCIAL psychology , *SUICIDE , *UNEMPLOYMENT , *SOCIOECONOMIC factors - Abstract
Many western countries have experienced increased rates of youth suicide over recent years. This has been an issue of particular concern in New Zealand, since it had the highest rate of youth suicide among OECD countries in the mid-1990s. However, while attention is drawn to the now declining youth suicide rate by politicians and policy-makers, what is obscured is a cohort effect. In this paper we will argue that a cohort effect is clearly visible; suicide rates among 15-24 year olds came to the fore in the mid-1980s, peaking 10 years later, and were displaced by that among 25-35 year olds by the late-1990s. Further, this century has been characterised by the rise of suicide rates among 35-44 year olds. This effect correlates with a dramatic downturn in the New Zealand economy in a five-year period bracketing 1970. We argue for an increased focus on social and economic factors underlying suicide. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
85. Medicalisation or under-treatment? Psychotropic medication use by elderly people in New Zealand.
- Author
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Norris, Pauline, Horsburgh, Simon, Lovelock, Kirsten, Becket, Gordon, Keown, Shirley, Arroll, Bruce, Cumming, Jackie, Herbison, Peter, and Crampton, Peter
- Subjects
- *
MENTAL illness drug therapy , *PSYCHIATRIC drugs , *AGE distribution , *ANALYSIS of variance , *DRUG prescribing , *ETHNIC groups , *HEALTH services accessibility , *HEALTH status indicators , *PHARMACY databases , *LONGITUDINAL method , *MAORI (New Zealand people) , *MEDICALLY underserved areas , *NURSING home patients , *RESEARCH funding , *SEX distribution , *PHYSICIAN practice patterns , *SOCIOECONOMIC factors , *DESCRIPTIVE statistics , *OLD age - Abstract
The increased use of information technology in health care allows researchers to generate data on rates of medication use among population groups, raising questions as to whether these rates are too high or too low. This paper presents findings from a study of records of all prescription medication dispensed in one New Zealand region (Te Tāirawhiti) over a one year period. The study examined patterns of psychotropic medication use amongst older people, by age, gender, ethnicity and socio-economic position. It concludes that the chances of being defined as needing psychotropic medication, that is, of being 'medicalised', are not evenly spread through the elderly population. Gender, age and ethnicity impacted significantly on whether prescriptions were received. Our results suggest the need for a nuanced understanding of the medicalisation of unhappiness and deviant behaviour amongst the elderly which takes into account barriers to treatment for some social groups. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
86. Encounters with the 'dark side': New graduate nurses' experiences in a mental health service.
- Author
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Hazelton, Michael, Morrall, Peter, Rossiter, Rachel, and Sinclair, Ellen
- Subjects
- *
ATTITUDE (Psychology) , *CORPORATE culture , *EMPLOYEES , *EXPERIENCE , *MEDICAL personnel , *MENTORING , *PATIENT abuse , *PSYCHIATRIC hospitals , *PSYCHIATRIC nursing , *RESEARCH , *RESEARCH funding , *RISK management in business , *QUALITATIVE research , *GROUP process , *GRADUATES , *THEMATIC analysis , *ATTITUDES toward mental illness - Abstract
Despite almost two decades of reform under Australia's National Mental Health Strategy, the life circumstances of many people with mental illness seem little improved. While lack of rehabilitation, housing and community support services have been blamed for policy shortfalls, there is also concern that mental health services may impede rather than facilitate recovery from mental illness. To explore this particular concern, this paper reports data from a project which evaluated a group mentorship programme for new graduate nurses working in an Australian public mental health service. Prominent among the problems raised in mentorship group discussions were: the arduous nature of mental health work; the uncaring attitudes and practices of many veteran nursing staff; and the maltreatment and neglect of service users. These participants characterised mental health facilities as tough security-minded places, where staff act more as risk-managers rather than therapists, and all service users are treated as if they might be dangerous. They also perceived a connection between the dismissive ways in which they were often treated by veteran colleagues and the widespread mistreatment of service users. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
87. The slide to pragmatism: A values-based understanding of 'dangerous' personality disorders.
- Author
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Scott, Susie, Jones, Debbie, Ballinger, Rachel, Bendelow, Gillian, and Fulford, Bill
- Subjects
- *
PERSONALITY disorder treatment , *ATTITUDE (Psychology) , *CONCEPTUAL structures , *CONFLICT (Psychology) , *HEALTH care teams , *INTERVIEWING , *RESEARCH methodology , *CASE studies , *MEDICAL personnel , *PATIENT-professional relations , *MENTAL health personnel , *HEALTH outcome assessment , *PROFESSIONAL ethics , *RESEARCH funding , *RISK assessment , *VALUES (Ethics) , *DECISION making in clinical medicine , *QUALITATIVE research , *CRIMINALS with mental illness , *TREATMENT effectiveness - Abstract
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]
- Published
- 2011
- Full Text
- View/download PDF
88. 'Culture it's a big term isn't it'? An analysis of child and family health nurses' understandings of culture and intercultural communication.
- Author
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Grant, Julian and Luxford, Yoni
- Subjects
- *
COMMUNICATION methodology , *ATTITUDE (Psychology) , *COMMUNITY health services , *DISCOURSE analysis , *FEMINIST criticism , *GROUP identity , *IMMIGRANTS , *INTERVIEWING , *RESEARCH methodology , *PATIENT-professional relations , *PARENTING , *PARTICIPANT observation , *CULTURAL pluralism , *POWER (Social sciences) , *RACISM , *VIDEO recording , *ETHNOLOGY research , *QUALITATIVE research , *CULTURAL values - Abstract
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]
- Published
- 2011
- Full Text
- View/download PDF
89. 'The 'buck' stops with me' - reconciling men's lay conceptualisations of responsibility for health with men's health policy.
- Author
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Richardson, Noel
- Subjects
- *
AGING , *BEHAVIOR modification , *FATHERHOOD , *GROUNDED theory , *HEALTH attitudes , *HEALTH behavior , *INTENTION , *INTERVIEWING , *RESEARCH methodology , *HEALTH policy , *MEN'S health , *POWER (Social sciences) , *RISK-taking behavior , *HEALTH self-care , *GENDER role , *QUALITATIVE research , *SOCIAL responsibility , *JUDGMENT sampling , *DATA analysis , *HEALTH literacy - Abstract
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]
- Published
- 2010
- Full Text
- View/download PDF
90. Embodying the gay self: Body image, reflexivity and embodied identity.
- Author
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Duncan, Duane
- Subjects
- *
CONTROL (Psychology) , *ATTITUDE (Psychology) , *BODY image , *BODYBUILDING , *DISCOURSE analysis , *GROUP identity , *HOMOSEXUALITY , *SATISFACTION , *SELF-efficacy , *SELF-perception , *GENDER role , *SOCIAL classes , *QUALITATIVE research , *CULTURAL values - Abstract
The emphasis on a sexualised muscular body ideal in gay social and cultural settings has been described as facilitating body image dissatisfaction among gay men. Drawing on a concept of reflexive embodiment, this paper uses qualitative interviews to analyse gay men's embodiment practices in relation to discourses and norms that can be found across and beyond any coherent notion of 'gay subculture'. The findings reveal body image to be more complex than a limited focus on subculture or dissatisfaction can account for. In particular, gay men negotiate a gay pride discourse in which the muscular male body generates both social status and self-esteem, and deploy notions of everyday masculinity that imply rationality and control to resist gendered assumptions about gay men's body image relationships. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
91. Being 'thick' indicates you are eating, you are healthy and you have an attractive body shape: Perspectives on fatness and food choice amongst Black and White men and women in Canada.
- Author
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Ristovski-Slijepcevic, Svetlana, Bell, Kirsten, Chapman, Gwen E., and Beagan, Brenda L.
- Subjects
- *
ADIPOSE tissues , *BLACK people , *BODY image , *CULTURE , *DIET , *FEAR , *FOOD habits , *HEALTH , *INTERVIEWING , *OBESITY , *PRACTICAL politics , *POPULATION geography , *SEX distribution , *SOCIAL role , *SOCIOLOGY , *WHITE people , *LIFESTYLES , *STANDARDS - Abstract
Despite recent critiques of contemporary obesity discourses that link 'modern Western lifestyles' to an 'obesity epidemic', the population's weight remains a central concern of current dietary guidelines. Food choices that are considered beneficial to maintaining a certain weight are understood to play a key role in one's health. This concern reflects medico-moral assumptions about the properties of food and what people should eat. However, the impact of obesity discourses on different individuals and social groups is rarely considered, although there is some evidence that people do generate, reflect and resist the norms and standards set for them, including those that relate to food/weight. In this paper, we will examine the perspectives on fatness and food choice amongst Black and White women and men living in Vancouver and Halifax, Canada. With this examination, we will challenge conventional assumptions about the singular 'modern Western lifestyle' that leads to obesity concerns by teasing out some of the social, cultural and political contexts within which people conceptualise issues regarding weight and make their food choices. By examining the experiences of both women and men we will also provide important insights into the gendered ways in which people engage with obesity discourses and the injunction to 'eat healthily' as a form of weight management. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
92. 'God is a vegetarian': The food, health and bio-spirituality of Hare Krishna, Buddhist and Seventh-Day Adventist devotees.
- Author
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Nath, Jemál
- Subjects
- *
BUDDHISM , *CHRISTIANITY , *FOOD , *HEALTH , *HINDUISM , *PUBLIC health , *RELIGION , *SPIRITUALITY , *VEGETARIANISM , *QUALITATIVE research - Abstract
Food is a significant part of the daily worship, health and social life of individuals across cultures and religions. This is especially the case for vegetarian religious minorities such as the Indian sub-continental borne Hare Krishna movement, the Christian Seventh-Day Adventist Church and various Buddhist groups. These devotees define spirituality as more than simply the state or quality of being committed to 'God', religion and immaterial spiritual concerns. This paper argues that there are visible, tangible and even biological frames of reference from which spirituality within the aforementioned religious groups should be considered. The concept of bio-spirituality introduced here, embodies and grounds matters pertinent to faith, health and worship in the everyday social actions and interactions of devotees both inside and outside the sphere of the temple or church. Bio-spirituality is a conceptual tool that accounts for the relationship between supernatural belief, and the natural physical environment. It was formulated to encapsulate the social, nutritional and spiritual dimensions of 18 self-identified religious vegetarians who were interviewed as part of larger qualitative study of alternative food habits and practices. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
93. Framing disease: The avian influenza pandemic in Australia.
- Author
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Abeysinghe, Sudeepa and White, Kevin
- Subjects
- *
AVIAN influenza , *COMMUNICATION , *EPIDEMICS , *MASS media , *PUBLIC administration , *UNCERTAINTY - Abstract
Since 2003, avian influenza has recently spread around the world sparking fears of a potential pandemic. As a result of this, a range of explanations and expectations surrounding the phenomenon were generated. Such social representations of disease depict the issue under discussion and frame reactions to the event. This paper explores the social representations surrounding avian influenza in Australia. Methodologically, a textual analysis of media and government documents was conducted in order to uncover the social representations implicit in these accounts. This demonstrated a symbolic framing of avian influenza with reference to the Spanish Influenza pandemic (1918). Analytically, the study draws upon the concepts of social representations from Durkheim and of risk and symbolic risk in the work of Beck. Overall, it is argued that the framing of avian influenza as a risk, mediated through the collective memory of Spanish Influenza, characterised the nature of the social representations surrounding the phenomenon. This resulted in the production of symbolic solutions to the threat. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
94. Between provisioning and consuming?: Children, mothers and 'childhood obesity'.
- Author
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Maher, JaneMaree, Fraser, Suzanne, and Lindsay, Jo
- Subjects
- *
CONFLICT (Psychology) , *FOOD habits , *MOTHERS , *OBESITY , *RESPONSIBILITY , *THEORY , *GOVERNMENT policy , *CHILDREN - Abstract
Contemporary Western societies focus considerable policy and media attention on the 'epidemic of childhood obesity'. In this paper we examine the mobilisation of notions of responsibility and consumption in these discussions, and consider the implications they have for women as mothers. In particular, we are interested to explore the potential conflicts mothers face as care providers and nurturers when responsible care is framed as withholding or managing the food consumption of children. We argue that the competing discursive frameworks around mothers' food provision invite further theorisation that explicitly addresses nourishment and consumption as elements of maternal practice and care. We draw on the work of Neysmith and Reitsma-Street (2005) regarding 'provisioning' to undertake a critical examination of the discourses in the 'childhood obesity' epidemic, with particular attention to Australian media and policy discussions. According to Neysmith and Reitsma-Street, mothers are central to social 'provisioning', that is, the labour that secures the necessities of life. This provisioning framework captures paid market work and unpaid caring labour, policy settings and social locations, allowing for a rich conceptualisation of the conditions mothers negotiate as they provide for their children. Taking up the possibilities of this framework, we argue that, insofar as health risks and responsibilities are largely individualised, mothering is framed as primarily about giving, and childhood obesity is considered a disease of affluence and over-consumption, imperatives for maternal provisioning and nurture are potentially in conflict with critiques of consumption and excess. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
95. More than one and less than many: Materialising hepatitis C and injecting drug use in self-help literature and beyond.
- Author
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Fraser, Suzanne
- Subjects
- *
HEPATITIS C , *DRUG administration , *SOCIOLOGY , *THERAPEUTICS , *HIV , *IATROGENIC diseases , *SOCIAL stigma , *DISCURSIVE psychology - Abstract
Knowledge about disease and illness usually emerges as a result of complex social negotiations among those with a stake in the outcomes of this knowledge. These negotiations can involve a range of agents and discursive avenues, some of which are contradictory and paradoxical. This is especially true for the blood-borne virus hepatitis C, the medical, social and political features of which – associations with injecting drug use, ‘tainted blood’ scandals and HIV – render it a controversial disease involving a range of highly motivated stakeholders. In this paper I analyse one such set of agents in the process of disease knowledge negotiation: self-help books on hepatitis C. In conducting this analysis I offer insights into the content of the books and the way they construct hepatitis C and those who have it. I do this by mapping three key issues helping to shape the way hepatitis C is constituted in these books: HIV, injecting drug use and iatrogenic (medically caused) transmission, and by exploring the implications of the themes of emotion, risk and guilt that arise in the playing out of these issues. In the process I aim to make sense of the complexity of disease, its social constitution and its role in shaping social phenomena such as stigma. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
96. Images of the desire for drugs.
- Author
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Fitzgerald, John
- Subjects
- *
ESSAYS , *DRUGS & crime -- Social aspects , *DESIRE , *DRUG abusers , *SYRINGES , *PHARMACOLOGY - Abstract
The pharmacologically addicted body has emerged in recent times as a dominant image shaping drug discourse. Implicit in this image is a drug desire that overpowers and over-determines the individual. A key feature of this particular drug user body is the body as degenerative with drugs as the cause of social suffering through reducing the social agency of the drug user. Likewise the image of the addict with a hardwired primitive desire for drugs use has also gained some ascendancy in scientific literature. Film, popular culture, ethnographic and scientific research can all draw on these images of desire to structure their narratives of drug use. In this paper I explore a different reading of two portrayals of drug desire. Using a range of analytic tools such as narrative analysis, semiotic and post-structuralist analysis I suggest an alternative way to engage with images of desire. Without arguing for a particular way of thinking about the desire to use drugs, this piece illuminates some key questions about images of drug desire. Through being performative, drug icons are productive; they make possible ways of conceptualising the drug user and the drug-using body. The performativity of the image can be thought through traditional semiotics, narrative performativity or, in a more abstract manner with contemporary theories of affect. The point of this essay is to open up another way of thinking about how images might create that of which they speak and in the process suggest a different configuration of desire to the primitive desire of the pharmacologically addicted body. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
97. ‘It blasted me into space’: Intoxication and an ethics of pleasure.
- Author
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Zajdow, Grazyna
- Subjects
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ALCOHOLISM , *PLEASURE , *DRUG abuse , *MODERATION , *PEOPLE with heroin addiction , *RESISTANCE (Philosophy) - Abstract
O'Malley and Valverde point out that in the 21st century, pleasure is a warrantable motive for drug and alcohol use only when it is attached to the idea of moderation. This presents a problem for those researchers who wish to theorise about those individuals who use drugs deliberately to induce intoxication. This paper uses unconventional means to come to an understanding of intoxication. It uses the stories of interviewed former heroin addicts, published autobiographies, biographies and even some fictional accounts to come to an understanding of the difficulties of dealing with intoxication and the drug-using subject. It also uses the accounts that Michel Foucault gave about his own use of drugs and its relationship to an ethics of pleasure and resistance. The article uses theories of risk and edgework to understand the underlying meanings of intoxication to many drug users. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
98. ‘Muzzas’ and ‘Old Skool Ravers’: Ethnicity, drugs and the changing face of Melbourne's dance party/club scene.
- Author
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Siokou, Christine, Moore, David, and Lee, Helen
- Subjects
- *
ETHNICITY , *DRUG abuse & society , *METHAMPHETAMINE , *ECSTASY (Drug) , *DANCE parties , *CLUBS , *COCAINE - Abstract
The relationship between ethnicity and the use of ‘party drugs’ (e.g., methamphetamine and ecstasy) has received little attention in Australia. This paper focuses on ethnicity and party drug use within the context of dance parties and clubs in Melbourne, Australia's second largest city. The young people who participated in our research, many of whom are long-time dance party attendees, or ‘old skool ravers’, frequently made claims to the possession of subcultural capital by labelling as ‘muzzas’ those they perceived to be outsiders to the dance scene. Muzzas are defined as heavily muscled young men, commonly of Southern European or Middle Eastern background, who use cocaine and steroids, have ‘no class’ and dance in an overly aggressive way. Although the old skool ravers were often from similar ethnic backgrounds to muzzas, they rarely drew on ethnicity in forming their own identities. They did, however, explicitly invoke ethnicity in the distinctions they created between themselves and muzzas. Their claims to subcultural capital are based on notions of nostalgia and an authentic involvement in the dance scene, and on their perceived distance from a mainstream culture consisting of ‘normal people’. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
99. ‘Anti-ageing medicine’ in Australia: Global trends and local practices to redefine ageing.
- Author
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Cardona, Beatriz
- Subjects
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AGING prevention , *WEBSITES , *PERIODICALS , *ALTERNATIVE medicine , *VITAMINS , *ANTIOXIDANTS , *SELENIUM , *COENZYMES - Abstract
Through interviews with users and providers of anti-ageing medicine in Australia as well as the analysis of various internet sites, anti-ageing clinics, journals and magazines dealing with anti-ageing medicine, this paper will argue that the anti-ageing industry in Australia is an example of how ‘mediascapes’ operate, seeking in this case to replicate the American model while developing a more localized practice meeting local needs, cultural orientations and regulatory frameworks. The products being studied here include some which have been on the market for many years in the Complementary and Alternative Medicine (CAM) industry, but have only recently been rebranded as ‘anti-ageing’. These include vitamins, anti-oxidants, supplements such as beta-carotene, selenium and coenzyme Q10, homeopathic products, exercise and diet programs. Other products that have been recently labelled as ‘anti-ageing’ and are included in this study are hormone therapies, testosterone, melatonin, Human Growth Hormone (HGH), and Dehydroepiandrosterone (DHEA). These products have been previously trialled and used in the treatment of medical problems such as heart disease, sexual dysfunction, cognitive and memory loss problems, and hormonal deficiency. Current medical research on stem cells, particularly embryonic stem cells, has also fallen within the realm of anti-ageing treatments developed from this research area and available primarily in countries with limited regulation and control over the use and availability of embryonic stem cells in the context of the private anti-ageing clinic. The differences and similarities between the practice of anti-ageing medicine in Australia and in America highlight current tensions and correspondences in the manner in which ageing is being constructed, managed and experienced. They are indicative of the impact that social policy directions, regulatory frameworks and economic policies have on the way in which ageing individuals and society at large approach the experience of old age. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
100. ‘Healthy Senior Citizenship’ in voluntary and community organisations: A study in governmentality.
- Author
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Conway, Steve and Crawshaw, Paul
- Subjects
- *
CITIZENSHIP , *GOVERNMENTALITY , *AGING , *POWER (Social sciences) , *COMMUNITY organization , *OLDER people , *SOCIOLOGY , *SOCIAL participation - Abstract
This essay critically examines the process of governmentality as revealed in the construction and resistance to the categorisation and classification of ‘Healthy Senior Citizenship’. This also includes an illustrative analysis of data from a national UK qualitative interview study of the input into the policy process of older adults in voluntary and community organisations. The paper demonstrates how governmentality finds its expression within the construction of healthy senior citizenship as synonymous with activity and participation within the technologies of collaboration and consultation. The conclusion reflects upon developing a critical sociology of old age in order to scrutinize conceptions of the ‘problems’ of governing an ageing population in post-welfarist or advanced liberal states. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
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