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Recent political processes have rendered people with dementia an increasingly surveilled population. Surveillance is a contentious issue within dementia research, spanning technological monitoring, biomarker research and epidemiological data gathering. This paper explores surveillance in the relationships of people affected by dementia, how older relatives both with and without diagnoses are surveilled in everyday interactions, and the importance of expectations in guiding surveillance. This paper presents data from 41 in-depth interviews with people affected by dementia living in the community in the United Kingdom. Agedness was a key contributor to expectations that a person may have dementia, based on previous experiences, media accounts and wider awareness. Expectations provoked surveillance in interactions, with participants looking for signs of dementia when interacting with older relatives. Older people also enacted self-surveillance, monitoring their own behaviour. Various actions could be attributed to dementia because interpretation is malleable, partly vindicating expectations while leaving some uncertainties. Expectant surveillance transformed people's experiences because they organised their own actions, and interpreted those of others, in line with pre-existing meanings. The ability to interpret behaviours to fit expectations can bring coherence to uncertainties of ageing, cognition and dementia, but risks ascribing dementia to many older people who straddle those uncertainties. [ABSTRACT FROM AUTHOR]

This paper explores the symbolic and boundary object value of the traditional paper prescription in the context of the planned move to the wider use of electronic prescribing in primary care in the UK and many other countries. It is argued that the traditional paper prescription possesses symbolic value and has been occasionally recognised but more often ignored in favour of the ultimate social object that is the medicine. This paper argues that considering the physical prescription as a boundary object within Star and Griesemer's typology as a 'standardised form' recognises its significance for a range of actors, including not just doctors and patients, but also pharmacists and other stakeholders, in areas such as professional authority, the ceremony of the medical consultation, patient autonomy, surveillance, financial income, as well as medicine supply. The paper goes on to reflect on this boundary object interpretation in the context of the current move to the electronic transfer of prescriptions and it is argued that this may threaten the existing boundary object and its associated value. It also raises broader concerns as to what happens when boundary objects are modified or replaced. [ABSTRACT FROM AUTHOR]

An introduction to the articles within the issue of the journal on topics including need post-structuralist concerns of Deleuze and Guattari, sociological commentary on new developments in drugs and historical perspective on the development of anorexia nervosa, is presented.

Complementary and alternative medicine (CAM) degrees in Australian and British universities have come under attack from sceptics who argue that such courses teach only 'pseudoscience'. Moreover, CAM academics have themselves been publicly labelled 'quacks'. Comparatively little is known about this group of health professionals who span the two worlds of CAM practice and academia. How do they navigate between these domains, and how are their collective and individual professional identities constructed? Drawing on 47 semi-structured interviews, this paper explores the professional identities of academics working in three university-based CAM disciplines in Australia and the UK: osteopathy, chiropractic and Chinese medicine. By analysing these individuals' accounts, and building on prior research on health professions in the academy, the paper contributes to understanding how contests about professionalism and professional knowledge take place against the academic-practice divide. By focussing on a domain where knowledge claims are conspicuously contested, it highlights the salience of navigating 'epistemic stress' for both group and individual professional identity. [ABSTRACT FROM AUTHOR]

This paper presents findings from a UK mixed-method study that aimed to understand parents/carers' views and experiences of support received from health services for primary school age (4–11) gender diverse children and their families. Data was collected via an e-survey including 10 open-ended questions with 75 parents/carers addressing experiences with (i) primary health services, including general practice (GP) clinics and child and adolescent mental health services (CAMHS) (ii) specialist gender identity development services (GIDS) (iii) non-health related support including transgender groups and online resources. Findings are organised into four themes: 'journey to health service provision', 'view on health services used', 'waiting' and 'isolation'. Discourses about gender diversity, childhood and the validity of trans healthcare shape parental experiences, including their desire for better information, more certainty in healthcare pathways and more expedient access to support services to reduce anxiety, distress and isolation. The emotional costs of waiting are compounded by the material costs of accessing the limited number of specialist services. Experiences could be improved through ensuring GPs and CAMHS are better prepared, expanding access to trans-specific support groups for those caring for children and young people, and exploring the provision of school-based support for gender diverse primary-age children. [ABSTRACT FROM AUTHOR]

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

Scientific-bureaucratic medicine (SBM) has been the dominant discourse on evidence-based medicine in the English National Health System (NHS). It has being claimed that SBM has led to new forms of medical professionalism with an emphasis on organisational values and the control of autonomy. This paper explores the medical professions' response to SBM, where SBM is manifested in the form of National Institute of Health and Clinical Excellence (NICE) guidelines. Seventy-four face-to-face informal interviews were carried out with clinicians and managers between 2007 and 2009. Three major themes emerged from the analysis each of which was linked to doctors' receptiveness to NICE guidelines implementation. The first emphasised organisational values, which accounted for conditional acceptance of NICE guidelines. The second was proactive professionalism or entrepreneurial professionalism, which was linked to the rejection of NICE guidelines and the emergence of alternative forms of introducing new ideas for the expansion of their clinical practice. The third was related to the prominence of clinical autonomy linked with doctors' resistance to the use of NICE guidelines. It is argued that this evidence does not reflect a significant emergence of new forms of professionalism but the development of multiple occupational identities. [ABSTRACT FROM AUTHOR]

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]

The increase of chronic illness as a leading cause of death has given rise to self-care and expert patient initiatives. Caring for chronically ill people places a tremendous economic burden on the health care system, informal carers, the labour market and benefit system (Department of Health 2001, 2004, 2005). Thus, in many countries health policy encourages patients to become ‘experts’ in the self-management of their conditions in the belief that it will help save money and improve health and well-being (Wanless 2002). For example, the notion of ‘expert patients’ has emerged in UK policy and is pivotal to government plans to modernise the National Health Service (NHS) by linking patient expertise to ideas of empowerment, a better quality of life, self-esteem and a user-driven NHS (Department of Health 2001; Fox et al 2005). Self-management and expert patient initiatives aim to encourage chronically ill patients to become more actively involved in decisions concerning their care and well-being (Lorig and Holman 2003; Lorig et al 1985, 1999, 2001). [ABSTRACT FROM AUTHOR]

Shortages of personal protective equipment (PPE) and medical devices needed during the COVID-19 pandemic were widely reported in early 2020. In response, civic DIY volunteers explored how they could produce the required equipment. Members of communities such as hacker- and makerspaces employed their skills and tools to manufacture, for example, face shields and masks. The article discusses these civic innovation practices and their broader social implications by relating them to critical making theory. Methodologically, it is based on a digital ethnography approach, focusing on hacker and maker communities in the UK. Communities' DIY initiatives display characteristics of critical making and 'craftivism', as they assessed and counteracted politicised healthcare supply shortages. It is argued that their manufacturing activities during the COVID pandemic relate to UK austerity politics' effects on healthcare and government failure to ensure medical crisis supplies. Facilitated by open source design, communities' innovation enabled healthcare emergency equipment. At the same time, their DIY manufacturing raises practical as well as ethical issues concerning, among other things, efficacy and safety of use. [ABSTRACT FROM AUTHOR]

Interprofessional conflict has largely been understood in terms of jurisdictional disputes centred on contested task domains and role boundaries, with less attention paid to the symbolic value associated with specific professional titles. Bourdieu's concepts of symbolic power and capital help to shed light on the opposition of the medical profession in the UK to the adoption of the title "podiatric surgeon" by non-medically qualified podiatrists undertaking foot surgery. Focusing on the medical discourse evident in press and media coverage of the dispute over a 12-year period gives insights into the use of strategies of symbolic violence aimed at retaining control over the exclusive use of prestigious forms of professional title. Titles, as symbolic capital, are understood as central to professions' struggle for legitimacy and recognition. [ABSTRACT FROM AUTHOR]

Sperm donor profiles in catalogues exhibited in commercial sperm bank websites provide health information about each donor, both explicitly and implicitly. Donors' anonymity poses a great challenge to signalling credibility. Inspired by both Spence's signalling theory and Walther and Park's warranting theory, the study explores the way sperm donors add credibility to their self-presentations. Profiles of 135 donors from nine sperm banks in Europe and North America were content analysed; 36 of these donors' baby photos were visually analysed. Donors compensated for the paucity of usable warrants by adding intensified emotional context to the profile and inviting potential recipients to join a fantasy family. The article concludes with some practical recommendations aimed at facilitating the process of donor selection for the benefit of donor insemination users, as well as fertility practitioners, and sperm donors. [ABSTRACT FROM AUTHOR]

The ageing of the HIV population is unfolding within the context of a politicised history of medical care, medical breakthroughs changing HIV from a fatal to a chronic illness, and a long-standing treatment partnership between medical professionals and HIV patients. This article draws on in-depth interviews with those living with HIV in later life (aged 50 and over), as well as those working with them, to uncover how these various actors understand the nature and consequences of this new phenomenon, and whether their understandings and approaches vary according to the individual's connection to it. All informants described the interaction between ageing and HIV as complex and incompletely understood, and accounted for their own uncertainties about this interplay as due to a global knowledge gap produced by the novelty of ageing with HIV. In these data, working in the area of, or being personally affected by, ageing with HIV emerged as 'experiments in living,' with those variously involved in the phenomenon forced to take tentative, exploratory steps while navigating 'uncharted territory.' Yet, the poorly-understood nature of the ageing/HIV interplay was framed differently, with clinicians and scientists constructing it as a temporary gap in technical knowledge (a scientific puzzle), and non-medical stakeholders and older people living with HIV describing it as an anxiety-provoking source of chronic uncertainty permeating daily life. These differences and similarities can help us to reformulate what medical sociology has often constructed as a static 'gulf' between the clinical and the lifeworlds as, instead, gravitational pulls towards clinical and experiential dimensions of chronic illness as it unfolds in later life. [ABSTRACT FROM AUTHOR]

Signifi cant transformations of the health care services sector over the past three decades have seen an increasing reliance on the private provision of health care services mediated through private health insurance. In countries such as Australia and the UK, private health insurance is promoted as providing a greater choice for individuals and easing the burden on the public system. While these claims, the policy contexts and the decision-making processes of individual consumers have attracted some sociological attention, little has been said about the role of private insurers. In this article we present a comparative analysis of the websites of private health insurers in Australia and the UK. Our analysis highlights adoption by private health insurers of neoliberal discourses of choice and individual responsibility, partnership and healthy lifestyles. In these respects, similarities between the discourses over-ride national differences which might otherwise be expected given their contrasting health care traditions and contexts. [ABSTRACT FROM AUTHOR]

The integration of complementary and alternative medicine into cancer care is widely debated. Advocates of integration frequently cite the popularity of such therapies amongst patients in support of their case. However, little specific empirical attention has been given to how integration is actually regarded by these patients. Based on semi structured interviews with 80 cancer patients in the UK, this article examines the assumption of a link between use and support for integration. On the basis of this study we argue that: 1. A characterisation of unequivocal cancer patients' support for integration (even amongst those who use CAM) is an over-simplification and distortion of the situation 2. It is inappropriate to conflate 'use' with 'advocacy' 3. Patients' engagement with the idea of integration is complex and multi-layered; and 4. This complexity can be explicated by looking at key dimensions of an integrative process: evidence and risk, cost, and provider legitimacy. [ABSTRACT FROM AUTHOR]