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This article uses ethnographic research to reflect upon how the treatment of 'everyday' illnesses in Niger engages concepts of social identity. Inspired by Bourdieu's concept of social distinction, as well as Appadurai's edited volume on the 'social lives' of 'things', I present an analysis of how medications are understood by their users in terms of social and ideological meaning in one rural Hausa village. Decisions about medication choice were framed by three main themes: belonging to the 'modern' world, 'traditional' Hausa culture, and religious identity. This article does not argue that these notions of identity fully explain medication use, nor necessarily predict treatment choices. The purpose of this paper is to reflect on the dynamic meanings given to treatment decisions after they have been made, attributed to the medications themselves and negotiated through their circulation in a context where multiple medical systems are drawn from to manage illness. Producers and sellers of medication also engage these meaning-centred concepts, which have theoretical and practical interest for the social sciences and public health. A virtual abstract for this paper can be viewed at: [ABSTRACT FROM AUTHOR]

Using data collected through semi‐structured interviews and focus group discussions with 37 adult men living in Brunei Darussalam, this paper explores how masculinities and expectations about male roles across the life course influence men's perceptions, of and attitudes towards health and health help‐seeking behaviour. Bruneian men gave accounts that consistently spoke of a series of masculine roles and associated attributes and behaviours, which mapped across the life course. Men described health and the steps that they had taken to protect their health in terms of responsibilities associated with being a breadwinner, provider of support for parents, role model and leader of the family. Whilst adherence to Bruneian norms about masculinity could obstruct men's engagement with health help‐seeking, we also found that men mobilised their understanding of Bruneian masculinity such that it provided culturally legitimate way of engaging in health help‐seeking. We conclude by considering implications for further development of conceptualisations of masculinities, particularly responding to the call to consider Connell's theory of 'hegemonic masculinity' in the context of the Global South. We also consider the implications of the findings of this research for policy and practice in provision of health promotion and services in Brunei. [ABSTRACT FROM AUTHOR]

Medicalisation has been an important concept in sociological discussions of medicine since its adoption by medical sociologists in the early 1970s. Yet it has been criticised by some sociologists, in part because it seems too negative about medicine, and modified or replaced by others with concepts deemed more relevant like biomedicalisation and pharmaceuticalisation. My aim in this paper is to reassess the concept and consider whether it still has value in exploring significant aspects of the role of medicine in present-day society. I start with an archaeology of the concept's development and the different ways it has been used. This covers some familiar ground but is essential to the main task: examining criticisms of the concept and assessing its value. I conclude that the concept continues to have a crucial and productive place in sociological analyses of medicine and that the process of medicalisation is still a key feature of late-modern social life and culture. [ABSTRACT FROM AUTHOR]

Within western cultures, portrayals of dementia as 'a living death' are being challenged by people living with the diagnosis. Yet dementia remains one of the most feared conditions. The sociological lens of citizenship provides a conceptual framework for reviewing the role of society and culture in repositioning dementia away from deficit to a discourse of agency and interdependence. Awareness of cognitive change, and engaging with the diagnostic process, moves people into a transitional, or 'liminal' state of uncertainty. They are no longer able to return to their previous status, but may resist the unwanted status of 'person with dementia'. Drawing on qualitative studies on social participation by people with dementia, we suggest that whether people are able to move beyond the liminal phase depends on acceptance of the diagnosis, social capital, personal and cultural beliefs, the responses of others and comorbidities. Some people publicly embrace a new identity whereas others withdraw, or are withdrawn, from society to live in the shadow of the fourth age. We suggest narratives of deficit fail to reflect the agency people with dementia can enact to shape their social worlds in ways which enable them to establish post-liminal citizen roles. (A Virtual Abstract of this paper can be viewed at: ) [ABSTRACT FROM AUTHOR]

In recent years, American criminal courts have seen the rise of the culture defence strategy or the argument that the defendant’s cultural background should excuse crime, mitigate responsibility or reduce the penalty for criminal behaviour. This paper argues that the rise and success of this strategy in practice reflects not just multiculturalism – as earlier studies contend – but the culturalimpulse known as the ‘therapeutic ethic’. Using the culture defence archive as a valuable and underused sociological resource, it examines the extent to which this legal strategy embodies the therapeutic ethic. Through an analysis of actual cases, the paper traces the medicalisation of culture in courts by which cultural differences are consistently converted into psychological disorders in order to diminish criminal responsibility. It suggests that culture defence must be seen not only against changes in criminal law – such as the increase in legal excuses that rely on the therapeutic ethic – but as an instance of how ‘other’ cultures may be pathologised in multicultural legal arenas. [ABSTRACT FROM AUTHOR]

This paper analyses why HIV risk perceptions vary in a sample of 19-year-old Glaswegian men. The main approaches to explain risk behaviour can be characterised as: individual cognition theories, cultural theories and phenomenology. To date there have been few empirical applications of cultural theory. This paper explores how far a cultural approach can explain the variability in HIV risk perceptions and behaviour, focusing on two key socio-cultural factors: current occupation and stage in partnership career. The analysis shows that young men's perceptions of HIV risk are shaped in part by the cultural meanings associated with their lifestyles and friendship groups, which largely arise from their occupational paths, and in part by the meanings that come with a particular stage of their partnership career. Recognising the role of cultural factors in lay people's response to a new health threat has broader implications for health promotion. [ABSTRACT FROM AUTHOR]

This paper argues that analysis of the ethnic patterning of health has failed adequately to examine the social meaning of ethnicity, while too often becoming enmeshed in unhelpful dualities which counterpose material to cultural explanations, multiculturalism to anti-racism, and sociology to epidemiology. Against the background of anthropological, objectivist and postmodern theories in the broader sociology of 'race' and ethnicity, the paper develops a concept of ethnicity for the purposes of health research. This is used to evaluate biological, migration-based, material, cultural and racism-based explanations for the ethnic patterning of health. It is argued that these types of explanation are best understood within an interactive framework. The methodological implications of this for future research are discussed. [ABSTRACT FROM AUTHOR]

This paper discusses the problem of adjustment to chronic illness in terms of the demands of the patient's body and the constraints of culture. Criticism is offered of explanations which reduce such adjustment to a form of functional adaptation, either to symptoms or to social expectations taken separately. The argument is made that social constraints are embodied in everyday conduct, while bodily changes are made sensible through meanings engendered within discourse. Utilising findings from a study of coronary patients and their spouses the paper describes differences between the situations of those who confront and oppose illness and those who modify their lives as they accommodate to it. A discussion is offered of the different transformations of illness experience as these relate to the role-settings of those concerned. This is used to set out a general thesis on style as a contextualisation of iilnessexperience, articulated in the co-ordination of bodily action and social categories. [ABSTRACT FROM AUTHOR]

This paper puts forward the proposition that modem self-help organizations are the progeny of an uneasy relationship between two ideologies: individualism and collectivism. Within this relationship individualism is the dominant partner. Using a case-study I examine the way in which these ideological influences can be seen to take concrete form in the history and activities of the National Ankylosing Spondylitis Society. I argue that certain characteristics of ankylosing spondylitis itself make it particularly amenable to self-help, but that under pressure from various social and cultural forces this tends to take the form of an emphasis on individual self-reliance rather than mutual aid. This tendency makes it difficult for the Society to respond in a meaningful way to social aspects of disablement. Although these interpretations are necessarily provisional, the paper concludes by suggesting that the tensions and equivocations revealed by the analysis have more general relevance to self-help groups, particularly those which are condition-specific and rely, to some extent, on the patronage of doctors and other health professionals. [ABSTRACT FROM AUTHOR]

Drawing upon data from a qualitative study of persons who are in the early stage of the condition, this paper examines the meaning of Alzheimer's disease. It contrasts the meaning of the disease as portrayed in popular culture with its meaning as interpreted by persons living with it. Findings show that persons with the illness do not necessarily accept the negative cultural meaning of the disease, nor the helpless ‘victim’ role in which they are generally cast. With a determination to ‘make the best of it’, strategies such as humour, normalisation, present-time orientation, and life review are employed to create a meaningful life. [ABSTRACT FROM AUTHOR]

Recent UK health policy initiatives promote a ‘no blame culture’ and learning from adverse events to enhance patient safety in the NHS. Similar initiatives exist in the USA and Australia. Changing the ‘blame culture’ in the NHS has been advocated in policy documents and inquiry reports for over a decade. Some key concepts that are used in the policy discourse –‘blame’; mistakes, errors and misdemeanours; and ‘culture’– are examined and considered in the light of pertinent social science literature to question some of the assumptions concerning these terms in the policy discourse, and to suggest some alternative questions and perspectives. The Three Inquiries, a recent series of statutory inquiries held in the UK, are used as a case study to explore some of the intra- and inter-professional difficulties of reporting errors and misconduct by medical practitioners. The paper offers an interpretive social science perspective as an alternative to more policy oriented and managerial approaches to patient safety issues, focusing on deeper structural aspects of organisational phenomena implicated in the ability or otherwise of medical and other healthcare staff to report mistakes and misconduct as one aspect of patient safety. [ABSTRACT FROM AUTHOR]

In the wake of Peters and Waterman's In Search of Excellence few NHS managers are unaware of culture :management as a tool for shaping organisational change. Yet the first wave of post-Griffiths studies found little evidence of 'culture management' in action. This paper draws on data from an ethnographic study carried out in 1988-90 to suggest that the symbolic facet of management action is an important, though neglected, element in the 1991 NHS reforms. It argues that rhetorical skills were a valuable resource for general managers overseeing the change process, and explores some of the ways in which rhetoric may have influenced cultural adaptation. However, many of the specific claims of the 'excellence genre', including ideas about the importance of strong, homogeneous cultures, are rejected. Rhetoric is an aspect of micro-political struggles over meaning, which rarely result in straightforward cultural 'manipulation', and are more likely to re-shape organisations through pragmatic accommodation than to win the hearts and minds of members. [ABSTRACT FROM AUTHOR]

In this paper a social constructionist approach is used to frame an analysis of the effects of physical impairment on selfperception. The results are reported of a recent study in which questionnaires were mailed to 314 people who were paraplegic and 284 who were post-polio, as well as to a control group of 327 who had no visible physical impairments. While the people who were paraplegic and those who made up the control group gave similar answers to most of the survey questions, those who were post-polio displayed a consistent, but different, way of reporting on their self-representations. Moreover, this discourse, which included such self-described characteristics as self-control, a sense of duty, and a concern for meticulousness, was consistent in the post-polio group across sex and age. It is concluded that the date of onset of physical impairment is significant in influencing the self-representation of persons with physical impairments. The socio-historical evolution of social practices and cultural expectations and norms with respect to persons with disabilities in Western cultures were taken into account in interpreting the results of this survey. [ABSTRACT FROM AUTHOR]

The paper examines how sickness as a cultural performance might be analysed as a dominant symbol within life course transitions. The concept of dominant symbol is taken from Victor Turner's framework for Symbolic Processual Analysis in ritual and pilgrimage and is used to interrogate data collected in an ethnographic study of sickness absence in an English primary school. It is suggested that sickness played a central part in the construction of meaning around the transition from primary to secondary school. The performance of sickness seemed to condense ideological features (especially those of gender and work discipline) and to express modulations in the meaning of the transition in its different phases. The concept of dominant symbol (and the related notion of liminality) illuminate these data but need modification to take account of the unritualised and fragmented character of many life course transitions in contemporary Western societies. It is suggested that with modification these concepts might be applied to the meaning of sickness in other life course transitions. [ABSTRACT FROM AUTHOR]