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In a 2010 online Reuter's news article, Andrew Stern claimed that Tiger Woods placed the condition known as 'sex addiction' in the spotlight. Accordingly, this article discusses the extent to which 'sex addiction' is discursively produced within, and by, the media and explores the extent to which Stern's claim can be substantiated. This paper presents an analysis of articles retrieved from nytimes.com that were published between February 18th, 2009, and February 20th, 2011. It goes on to summarize four key findings: (1) 'sex addiction' was more directly and openly discussed as a concept in the year following Stern's article than it was in the year prior; (2) 'sex addiction' was discursively constructed as a male problem and regarded as an underlying reason for them to commit extramarital affairs; (3) in the year before Stern's article 'sex addiction' was discursively positioned as a social problem; and (4) in the year following Stern's article, 'sex addiction' was also discursively positioned as a medical problem. The paper concludes that the concept of 'sex addiction' is discursively constructed, and that Tiger Woods did, indeed, place a spotlight on the topic. As a result, the author argues that the media has a significant impact on the production, interpretation, and understanding of what many consider to be a sexual problem. [ABSTRACT FROM AUTHOR]

Chronic pain is a debilitating condition that profoundly and persistently affects individuals' lives. Managing chronic pain presents complex challenges, and a growing body of literature underscores the pivotal role of social support in its management and its implications for treatment and rehabilitation. Gaining an understanding of the multifaceted aspects of social support in chronic pain management can contribute to the development of more effective interventions and strategies to enhance the lives of those impacted by chronic pain. However, at present, systematic reviews that investigate the correlation between social support and chronic pain are lacking. This paper presents a scoping review of 56 relevant literature sources, with the aim of improving our comprehension of the relationship between chronic pain and social support. The review comprehensively examines common types of evidence, particularly on inconsistencies in research tools within this field of study and divergent concepts of social support related to chronic pain. The paper delves into the correlation model between social support and chronic pain, explores relevant mechanisms, and emphasizes the differences found among relevant studies. By synthesizing these findings, the review emphasizes potential areas for further research and exploration, facilitating future studies and the development of new approaches in this field. [ABSTRACT FROM AUTHOR]

The minimum sum-of-squares clustering problem is a very important problem in data mining and machine learning with very many applications in, e.g., medicine or social sciences. However, it is known to be NP-hard in all relevant cases and to be notoriously hard to be solved to global optimality in practice. In this paper, we develop and test different tailored mixed-integer programming techniques to improve the performance of state-of-the-art MINLP solvers when applied to the problem—among them are cutting planes, propagation techniques, branching rules, or primal heuristics. Our extensive numerical study shows that our techniques significantly improve the performance of the open-source MINLP solver SCIP. Consequently, using our novel techniques, we can solve many instances that are not solvable with SCIP without our techniques and we obtain much smaller gaps for those instances that can still not be solved to global optimality. [ABSTRACT FROM AUTHOR]

This paper argues that the colonial experience was never just "out there" but was a constitutive feature of the global development of psychiatry and, indeed, of social medicine itself. I show how regional knowledge about psychiatry, produced in scientific exchanges across colonial Southeast Asia over four decades and culminating with the 1937 Bandung Conference, became part of new international approaches to health care in rural areas, and later, in developing nations. In particular, I discuss how the embrace of the agricultural colony as a solution to the problem of asylum overcrowding occurred at the same moment that colonial public health experts and officials were moving away from expensive, technocratic fixes to address indigenous health needs. Yet in the search for alternatives to institutionalized care, including forms of family and community support, colonial psychiatrists were increasingly drawn into unpredictable and unwieldy networks of care and economy. Drawing on research from Vietnam, this paper decenters the asylum so as to recast the history of colonial and postcolonial psychiatry as integral to the history of social medicine and global health. The paper then returns to Bandung in 1955, the site of another famous meeting in the history of Third World solidarity, to consider how the embrace of the "Bandung spirit" may provide new avenues for decolonizing the history of colonial and postcolonial psychiatry. [ABSTRACT FROM AUTHOR]

Purpose: Novels and autopathographies that employ cancer as a central theme offer a wealth of opportunities for researching the way patients with cancer make sense of their illness and its treatment. Such literatures can also inform clinical care, because they can support patients in living with their illness. The use of novels and autopathographies for research and care in persons with cancer fits within the framework of 'Health Humanities', the interdisciplinary field where medicine and social science meet. This paper presents a concise overview of novels and autopathographies that explore cancer as their theme. Methods: Literature searches were conducted using PubMed, major scientific journals of medicine and clinical oncology, and databases in the Health Humanities. Searches focused on novels and autopathographies where cancer is the central theme, which are available in English, and which can be considered to represent 'high literature'. Results: Twenty-nine books were identified. The majority of the books were written originally in English, and breast cancer and lung cancer were the most frequently discussed types of cancer. The core themes identified were giving meaning to illness; coping with medical treatment; and the psychological and social consequences of illness. Conclusion: Novels and autopathographies about cancer represent an innovative base for research on living with cancer and offer rich data on how people make sense of cancer and its medical treatment. Clinical implications of this review pertain to interventions based on bibliotherapy and expressive writing. Novels and autopathographies are just part of the Health Humanities context: a wide range of art genres may prove helpful in improving the quality of life of persons with cancer. [ABSTRACT FROM AUTHOR]

The Pacific Sociological Association annual meeting recently added a new session type called the Research-in-Progress (RIP) session. The purpose of adding these sessions was to provide an opportunity for attendees to present research still in formative stages of completion in order to get useful feedback. Presentations ranged from doctoral dissertation proposals to nearly completed research. Early experience from RIP session organizers and discussants is that these sessions were lively and engaging, sparking a great deal of audience participation. Feedback from presenters indicated that they received useful feedback. Based on our initial experience with the RIP sessions, we believe they are a beneficial addition to the meetings. [ABSTRACT FROM AUTHOR]

Personal responsibility has emerged as an important element in many countries' public health planning, and has attracted substantial debate in public health discourse. Contemporary medical sociology typically resists such "responsibilization" as victim-blaming, by privileged elites, that obscures important structural factors and inequities. This paper, based primarily on a broad review of how contemporary Anglophone medical sociology literatures treat responsibility and blame, points out advantages of taking responsibility seriously, particularly from the individual's perspective. These advantages include: empowerment; responsibility-as-coping-mechanism; moral dignity; and the pragmatic logic of doing for oneself, rather than passively awaiting societal reforms. We also offer possible reasons why sociologists and their subjects view these issues so differently, and suggest some areas for future research. [ABSTRACT FROM AUTHOR]

Text classification is an important topic in natural language processing, with the development of social network, many question-and-answer pairs regarding health-care and medicine flood social platforms. It is of great social value to mine and classify medical text and provide targeted medical services for patients. The existing algorithms of text classification can deal with simple semantic text, especially in the field of Chinese medical text, the text structure is complex and includes a large number of medical nomenclature and professional terms, which are difficult for patients to understand. We propose a Chinese medical text classification model using a BERT-based Chinese text encoder by N-gram representations (ZEN) and capsule network, which represent feature uses the ZEN model and extract the features by capsule network, we also design a N-gram medical dictionary to enhance medical text representation and feature extraction. The experimental results show that the precision, recall and F1-score of our model are improved by 10.25%, 11.13% and 12.29%, respectively, compared with the baseline models in average, which proves that our model has better performance. [ABSTRACT FROM AUTHOR]

This paper examines the trends in economic inequalities with respect to infant and child mortality in India using three rounds of the Indian National Family Health Survey conducted in 1992–1993, 1998–1999, and 2005–2006. The paper uses concentration index, and pooled discrete-time survival regression model to examine the aforementioned trends and regional patterns. The findings suggest a decreasing trend in economic inequality in infant mortality but an upward trend in economic inequality in child mortality in India. Economic inequalities in infant mortality have narrowed in the southern region, whereas they have widened in the western region and risen in the northern region. However, mixed trends in concentration indices were found in the different regions of India in the case of child mortality. [ABSTRACT FROM AUTHOR]

The article presents various updates from the American Sociological Association. These are as annual meeting, publications, medical sociology, program announcement, submission of papers, thematic sessions et al. Papers may be submitted directly to the session organizers or, if there is doubt as to the appropriate session, to Professor Dennis Wrong, Department of Sociology, New York University, Washington Square, New York, New York. The executive committee of the International Sociological Association has announced that the working group on Armed Forces and Society has been recognized as a standing research committee by the International Sociological Association. The library of the newly established University of the South Pacific indicates a dire need of gifts of books, research reports, back issues of journals, and reprints of articles in sociology, and social and cultural anthropology.

The imperative for all healthcare professionals to partake in quality improvement (QI) has resulted in the development of QI education programs with participants from different professional backgrounds. However, there is limited empirical and theoretical examination as to why, when and how interprofessional and multiprofessional education occurs in QI and the outcomes of these approaches. This paper reports on a qualitative collective case study of interprofessional and multiprofessional education in three longitudinal QI education programs. We conducted 58 interviews with learners, QI project coaches, program directors and institutional leads and 135 h of observations of in-class education sessions, and collected relevant documents such as course syllabi and handouts. We used an interpretive thematic analysis using a conventional and directed content analysis approach. In the directed content approach, we used sociology of professions theory with particular attention to professional socialization, hierarchies and boundaries in QI, to understand the ways in which individuals' professional backgrounds informed the planning and experiences of the QI education programs. Findings demonstrated that both interprofessional and multiprofessional education approaches were being used to achieve different education objectives. While each approach demonstrated positive learning and practice outcomes, tensions related to the different ways in which professional groups are engaging in QI, power dynamics between professional groups, and disconnects between curricula and practice existed. Further conceptual clarity is essential for a more informed discussion about interprofessional and multiprofessional education approaches in QI and explicit attention is needed to professional processes and tensions, to optimize the impact of education on practice. [ABSTRACT FROM AUTHOR]

Issues of race have traditionally been addressed in medical school curricula in a didactic manner. However, medical school curricula often lack adequate opportunity for the application of learning material relating to race and culture. When confronted with acts of racism in clinical settings, students are left unprepared to respond appropriately and effectively. Forum Theatre offers a dynamic platform by which participants are empowered to actively engage with and become part of the performance. When used in an educational context, Forum Theatre can be a powerful tool for students to interact with a wide variety of social issues. This paper describes the process by which one medical school designed a workshop in the Forum Theatre style to equip students to respond to racism observed in clinical settings. Based on real student experiences, the Responding to Racism in the Clinical Setting workshop was designed to give students an opportunity to combine cultural humility, communication theory and conflict resolution skills in order to prepare for interactions in clinical stages of medical education. As a result of workshop evaluations, surveys, and written reflections, the authors propose that Forum Theatre is a novel teaching modality for incorporating issues of race and culture into medical curriculum. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses the various topics within the issue, including Israeli sociology, ethnic identification, the sociology of peace, and responsibility in medical sociology.

In medicine and the social sciences, researchers often measure only a handful of variables simultaneously. The underlying assumption behind this methodology is that combining the results of dozens of smaller studies can, in principle, yield as much information as one large study, in which dozens of variables are measured simultaneously. Mayo-Wilson (Philos Sci 78(5):864–874, 2011, Br J Philos Sci 65(2):213–249, 2013. 10.1093/bjps/axs030) shows that assumption is false when causal theories are inferred from observational data. This paper extends Mayo-Wilson's results to cases in which experimental data is available. I prove several new theorems that show that, as the number of variables under investigation grows, experiments do not improve, in the worst-case, one's ability to identify the true causal model if one can measure only a few variables at a time. However, stronger statistical assumptions (e.g., Gaussianity) significantly aid causal discovery in piecemeal inquiry, even if such assumptions are unhelpful when all variables can be measured simultaneously. [ABSTRACT FROM AUTHOR]

Introduces five papers concerned with the role of social psychiatry in bringing about real change. Discussion of creating and maintaining a therapeutic milieu; Studies of the Sanctuary Model used for dealing with traumatized children; Use of the Sanctuary model in a domestic violence shelter; Difficulty of dealing with trauma survivors; Achievement of safety for the patients.

While social medicine education is a long-established field of study within medical education,1 implementation has historically been through elective coursework making integration, assessment, and evaluation challenging. The launch of the novel Washington University in St. Louis School of Medicine Gateway curriculum, with guiding principles that required curriculum content to be integrated, learning-centered, sustainable, competency-based, and outcomes-oriented, supported the creation of the Health Equity and Justice (HEJ) curriculum. This innovative curriculum adhered to the guiding principles, addressed the current limitations in social medicine education, and allowed for the flexibility that social medicine education requires. Additionally, the Gateway HEJ curriculum presented an opportunity to explore novel ways of assessing medical students, as well as illuminating additional opportunities for faculty development to ensure fidelity to the HEJ content. This paper includes the process of development as well as the lessons learned, limitations, and future plans for iterative improvements to the curriculum. [ABSTRACT FROM AUTHOR]

This paper provides an in-depth socio-political analysis of the basis for the limits of family therapy in Africa in the last 40 years. The goal is to make more visible the economic, social, political, and cultural factors that have combined to complicate and frustrate our macro-environments of practice. The conclusion is that family therapy in Africa cannot achieve any meaningful progress in the present millennium unless the structures of underdevelopment under which we live and work are dismantled and in their place the important preconditions for successful practice of modern family therapy are entrenched. The list of imperatives to be addressed is offered to suggest the direction along which we must move if we are to effect this adaptation. [ABSTRACT FROM AUTHOR]

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced. [ABSTRACT FROM AUTHOR]

Social Medicine's emphasis on care would have taken Community Psychiatry into a different place than Public Health's emphasis on prevention and cost containment. It would take a very long essay indeed to respond to the many important questions raised by the contributors to this thought-igniting special issue of CMP: "Psychiatry as Social Medicine". As a consultation-liaison psychiatrist, I saw Psychiatry as an integral part of Medicine; but I also recognized that Psychiatry represented a broad field in itself (Mental Health) which did not always sit comfortably in the Medicine of the 1970s. [Extracted from the article]

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Nanotechnology is an important platform technology which will add new features like improved biocompatibility, smaller size, and more sophisticated electronics to neuro-implants improving their therapeutic potential. Especially in view of possible advantages for patients, research and development of nanotechnologically improved neuro implants is a moral obligation. However, the development of brain implants by itself touches many ethical, social and legal issues, which also apply in a specific way to devices enabled or improved by nanotechnology. For researchers developing nanotechnology such issues are rather distant from their daily work in the lab, but as soon as they use their materials or devices in medical applications such as therapy of brain diseases they have to be aware of and deal with them. This paper is intended to raise sensitivity for the ethical, legal and social aspects (ELSA) involved in applying nanotechnology in brain implants or other devices by highlighting the short term problems of testing and clinical trials within the existing regulatory frameworks (A), the short and medium-term questions of risks in the application of the devices (B) and the long-term perspectives related to problems of enhancement (C). To identify and address such issues properly nanotechnologists should involve ethical, legal and social experts and regulatory bodies in their research as early as possible. This will help to remove pressure from regulatory bodies, to settle public concern and to prevent non-acceptable developments for the benefit of the patients. [ABSTRACT FROM AUTHOR]

Power, dominance, and hierarchy are prevalent analytical terms in social studies of health care. Power is often seen as residing in medical structures, institutions, discourses, or ideologies. While studies of medical power often draw on Michel Foucault, this understanding is quite different from his proposal to study in detail the “strategies, the networks, the mechanisms, all those techniques by which a decision is accepted” [Foucault, M. (1988). In Politics, philosophy, culture: Interviews and other writings 1977–84 (pp. 96–109). New York: Routledge]. This suggestion turns power into a topic worth investigating in its own right rather than a basic analytical resource. It also suggests that technologies form an integral part of the networks and mechanisms, which produce and redistribute power in medical practice. The paper first engages critically with a number of recent discussions of technology and power in health care analysis. It then formulates an alternative conception of this relationship by drawing on Foucault and historian of science and technology Geoffrey C. Bowker’s notions of infrastructural inversion and information mythology. Illustration is provided through a case study of a wireless nursing call system in a Canadian hospital. [ABSTRACT FROM AUTHOR]

Within the fields of social medicine and the medical humanities, chronic illness is acknowledged not just as an individually but as a socially transformative experience. The proliferation of published ‘illness narratives’ in recent years attests to the socially compelling nature of this particular story of transformation. Indeed, illness narratives have, in the past decade or so, become a rich source of interest in sociological and medical anthropological work for their capacity to map the material transformation of person to patient, of an assumed to a newly fluid model of subjectivity. Their significance is particularly visible in the cultural context of the west, where more people live both to be diagnosed with chronic illnesses (such as cancer) and to survive them. With a focus on two recently published Australian works, Eating the Underworld: A Memoir in Three Voices (2001), by the psychologist Doris Brett, and Tiger’s Eye: A Memoir (2001), by the historian Inga Clendinnen, this paper will consider how the illness experience marks a transformation of embodied subjectivity that, in turn, triggers transformations of other kinds. These works have quite different intents, but they provide models for exploring how physical and individual transformation through illness becomes the occasion for reconsidering the body of history, and of the resonances of history in social memory. [ABSTRACT FROM AUTHOR]

This paper presents a review of research addressing religion and family relational health. Strengths of the extant data include the correlation of three dimensions of religious experience (religious practices, religious beliefs, and religious community) with certain aspects of mother–child, father–child, and marital relationships and specific connections between the three dimensions of religious experience and family relationships are identified. Key weaknesses in the research at present include a paucity of research examining the hows, whys, and processes involved behind identified religion–family correlations and a lack of data on non-nuclear families, families of color, interfaith families, and non-Christian religions including Judaism and Islam. Implications for clinical practice and recommendations for future research are offered. [ABSTRACT FROM AUTHOR]

How will sociology fare in the twenty-first century? We love what we do. The problem seems to be in communicating the value of what we do to lay people outside the discipline. Sociology's future in part will be dependent upon its practitioners demonstrating its utility in the marketplace of everyday life, assessment and decision making. This paper offers a twenty-year perspective of one sociology department's work in a rural Appalachian region. While providing a brief overview of a series of initiatives, it explains in depth our involvement and contributions to a community-based health project. [ABSTRACT FROM AUTHOR]

This study investigates the empirical validity of the material deprivation indices (MDIs) using a partial criterion variable, namely UHCNIR (unmet health care need due to inadequate resources). This alternative approach helps to assess absolute validity (Type I and II errors) and sources of error in the measurement of poverty for a specific aspect of poverty (in this case inability to receive adequate health care due to affordability problems). A simple mismatch analysis identifies a sizable group, around 1% of the adult EU population, missed by MDIs despite being in UHCNIR. A majority of this 1% experiences not only UHCNIR but also multiple other deprivations, commonly reports having some difficulties making ends meet, and prevalently has a disability or a chronic health problem. The analysis reveals that MDIs miss specifically those 'unhealthy poor' since these measures do not include a relevant item, and thus cannot adjust for different needs and costs in health care and account for the distinct poverty experiences of these people. Therefore, the main methodological assumption of MDIs, identifying the people in poverty with only a limited set of key deprivation indicators is not supported by this empirical analysis. [ABSTRACT FROM AUTHOR]

In the postmodern information era with its increasing complexity and demands on my time, I find storytelling increasingly attractive. The right story told to the right person(s) at the right time in the right way can powerfully define and shape both individuals and the systems into which they organize themselves. As interventions go, I find stories to be relatively high impact, low-risk, parsimonious, and user-friendly. This paper contains some of my favorite teaching stories and describes why and how I use them as both a family therapist and teacher of family therapy. [ABSTRACT FROM AUTHOR]

This paper argues the need for an increased emphasis on the therapeutic relationship in family therapy. The ways in which the field of family therapy has eschewed the importance of the therapeutic relationship are discussed. Therapeutic alliance research from the field of individual psychotherapy and research on the importance of relationship factors to family therapy are reviewed. Suggestions for family therapy theory, practice, and research are presented. [ABSTRACT FROM AUTHOR]

This paper is an attempt to bridge the two worlds of family therapy and filial play therapy, introducing the complementary idea of play in therapy. Family play therapy challenges the idea that play is only useful in the treatment of children. Clinical examples are given and uses of play are discussed, including evaluation, play as a therapeutic tool, and the development of themes. The authors believe that therapists who are willing to be playful offer their clients a new world of therapeutic experiences. [ABSTRACT FROM AUTHOR]

Several critics have maintained that there are some critical differences between the ethics of medicine and the ethics of business such that health care should remain as free as possible from the influence of business. In particular, it has been suggested that the core moral identity of those in medical practice, and their accompanying institutions, are not only antagonistic, but effectively opposed to their counterparts in business. This paper attempts to challenge such a sharp contrast and suggests that a reformulation, where the two are seen as fundamentally similar is both appropriate and compelling. Indeed, as we contemplate the direction of proposed comprehensive reforms in health care, such an understanding of the moral framework of medicine and business is essential. [ABSTRACT FROM AUTHOR]

Background Confirmatory factory analysis (CFA) and structural equation modelling (SEM) are increasingly used in social pharmacy research. One of the key benefits of CFA is that it allows researchers to provide evidence for the validity of internal factor structure of measurement scales. In particular, CFA can be used to provide evidence for the validity of the assertion that a hypothesized multi-dimensional scale discriminates between sub-scales. Aim This manuscript aims to provide guidance for researchers who wish to use CFA to provide evidence for the internal factor structure of measurement scales. Methods The manuscript places discriminant validity in the context of providing overall validity evidence for measurement scales. Four examples from the recent social pharmacy literature are used to critically examine the various methods which are used to establish discriminant validity. Using a hypothetical scenario, the manuscript demonstrates how commonly used output from CFA computer programs can be used to provide evidence for separateness of sub-scales within a multi-dimensional scale. Conclusion The manuscript concludes with recommendations for the conduct and reporting of studies which use CFA to provide evidence of internal factor structure of measurement scales. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity. Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students' knowledge changes after social medicine training. Methods: This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire. Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities. Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons. Results: All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test. After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities. Conclusions: Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups' knowledge levels. [ABSTRACT FROM AUTHOR]

The effect of education on health has been increasing over the past several decades. We hypothesize that this increasing disparity is related to health-related technical progress: more-educated people are the first to take advantage of technological advances that improve health. We test this hypothesis using data on disease-specific mortality rates for 1980 and 1990, and cancer registry data for 1973-1993. We estimate education gradients in mortality using compulsory schooling as a measure of education. We then relate these gradients to two measures of health-related innovation: the number of active drug ingredients available to treat a disease, and the rate of change in mortality from that disease. We find that more-educated individuals have a greater survival advantage in those diseases for which there has been more health-related technological progress. [ABSTRACT FROM AUTHOR]

This article analyzes how trans health was negotiated on the margins of psychiatry from the late 1970s and early 1980s. In this period, a new model of medical transition was established for trans people in Norway. Psychiatrists and other medical doctors as well as psychologists and social workers with a special interest and training in social medicine created a new diagnostic and therapeutic regime in which the social aspects of transitioning took center stage. The article situates this regime in a long Norwegian tradition of social medicine, including the important political role of social medicine in the creation of the postwar welfare state and its scope of addressing and changing the societal structures involved in disease. By using archival material, medical records and oral history interviews with former patients and health professionals, I demonstrate how social aspects not only underpinned diagnostic evaluations but were an integral component of the entire therapeutic regime. Sex reassignment became an integrative way of imagining and practicing psychiatry as social medicine. The article specifically unpacks the social element of these diagnostic and therapeutic approaches in trans medicine. Because the locus of intervention and treatment remained the individual, an approach with subversive potential ended up reproducing the norms that caused illness in the first place: "the social" became a conformist tool to help the patient integrate, adjust to and transform the pathology-producing forces of society. [ABSTRACT FROM AUTHOR]

This article examines the historiography of depression, with an eye to illuminating wider issues in the social study of psychiatry and depression. It argues that the advent of Prozac caused notable shifts in how scholars in the looked at depression. Far from solidifying the medical status of depression and psychiatry's treatment of it, the spread of pill-oriented depression treatment strengthened social researchers' emphasis on psychiatry's social nature. The article further argues that a depiction of psychiatry as mainly a social phenomenon both unduly diminishes its status as medicine, and implicitly underestimates the social in the rest of medicine. This matters if people can benefit from psychiatric treatment. Put another way, if people taking psychiatric medications are indeed ill, and taking medicines that can help them, social analysis should acknowledge this, even as it rightly investigates psychiatry as embedded in social and cultural contexts, as all of medicine is. Doing so means treating psychiatry, whatever its limitations, as a kind of medicine, not as a special case. [ABSTRACT FROM AUTHOR]

This paper examines the current state of the literature concerning the structure (i.e., conceptualization, taxonomy, and operationalization) of consumers' satisfaction evaluations of a service delivery. In particular, relevant research in medical sociology, community health and marketing is reviewed. In so doing, advances as well as gaps in our current understanding of satisfaction evaluations are delineated. Drawing upon the services marketing, social psychology, and organizational theory literatures, we propose a hypothesis for the multiobject conceptualization of the satisfaction construct. This fills a major gap in previous research. Using data collected from four metropolitan areas, this hypothesis is subjected to empirical verification. Competing hypotheses are explicitly considered. The proposed conceptualization is also tested for convergent, discriminant, and nomological validity. Overall, the results support a multidimensional-multiobject model of the satisfaction construct. However, the objects are the major source of variation in satisfaction evaluations, accounting for about 61% of the total variance. In addition, object-based evaluations yield evidence of convergent, discriminant, and nomological validity. Implications for research into the structure of satisfaction evaluations for health care delivery in particular, and for multidyadic services in general, are discussed. [ABSTRACT FROM AUTHOR]

The author presents his assessment on the interpersonal moral responsibilities of physicians. He contends that physicians often avoid peer review. He says a real abuse in the clinical setting can occur because many medical procedures have been moved from hospitals to doctor's offices. The author believes that physicians do recognize their social responsibility.

Data visualizations are a valuable tool used during both statistical analysis and the interpretation of results as they graphically reveal useful information about the structure, properties and relationships between variables, which may otherwise be concealed in tabulated data. In disciplines like medicine and the social sciences, where collected data include sensitive information about study participants, the sharing and publication of individual-level records is controlled by data protection laws and ethico-legal norms. Thus, as data visualizations – such as graphs and plots – may be linked to other released information and used to identify study participants and their personal attributes, their creation is often prohibited by the terms of data use. These restrictions are enforced to reduce the risk of breaching data subject confidentiality, however they limit analysts from displaying useful descriptive plots for their research features and findings. Here we propose the use of anonymization techniques to generate privacy-preserving visualizations that retain the statistical properties of the underlying data while still adhering to strict data disclosure rules. We demonstrate the use of (i) the well-known k-anonymization process which preserves privacy by reducing the granularity of the data using suppression and generalization, (ii) a novel deterministic approach that replaces individual-level observations with the centroids of each k nearest neighbours, and (iii) a probabilistic procedure that perturbs individual attributes with the addition of random stochastic noise. We apply the proposed methods to generate privacy-preserving data visualizations for exploratory data analysis and inferential regression plot diagnostics, and we discuss their strengths and limitations. [ABSTRACT FROM AUTHOR]

Point process models have been extensively used in many areas of science and engineering, from quantitative sociology to medical imaging. Computing the maximum likelihood estimator of a point process model often leads to a convex optimization problem displaying a challenging feature, namely the lack of Lipschitz-continuity of the objective function. This feature can be a barrier to the application of common first order convex optimization methods. We present an approach where the estimation of a point process model is framed as a saddle point problem instead. This formulation allows us to develop Mirror Prox algorithms to efficiently solve the saddle point problem. We introduce a general Mirror Prox algorithm, as well as a variant appropriate for large-scale problems, and establish worst-case complexity guarantees for both algorithms. We illustrate the performance of the proposed algorithms for point process estimation on real datasets from medical imaging, social networks, and recommender systems. [ABSTRACT FROM AUTHOR]

Drawing on a historical ethnography conducted in Southern Brazil, this article explores how public health programs for adolescent reproductive and mental health have emerged in Brazil and begun to intersect with the growing field of "global mental health" (GMH). The story I recount begins not in the 2010s with the rapid rise of expert interest in adolescent health within GMH, but in the 1990s, the decade when young teens in Brazil were first coming into contact with practices and approaches in research, schools and clinics that have both underpinned and critiqued the production of an adolescent mental and reproductive health sub-field. In parsing what young women's encounters with the then newly-emerging questionnaires, measurement tools, school-based programs and clinical practices came to mean to them, I use a genealogical approach to consider how histories of education reform, population control, psychoanalysis, social medicine, the transition to democracy, feminism and grass-roots politics all entered the fold, shaping the way adolescent sex-and-psyche materialized as a contested object of expertise. I end by exploring what this case can teach global mental health advocates and social theorists about practices of critique. [ABSTRACT FROM AUTHOR]

Originally premiering in 1963, the BBC television series Doctor Who has long been criticized for essentializing colonial scenarios and failing to address issues of race and post-colonial realities. As a white male with the privilege to explore time and space, the titular Doctor stands in contrast to his human companion Martha Jones, a Black woman who represents the first and only main character in the show to be a medical professional of color. The relationship between the Doctor and Martha inherently demands an exploration of the meaning of doctorhood. In studying the ways in which these characters embody the idea of "doctor," we examine how race structures their approach to medicine, heroism, and colonialism. Whereas the Doctor personifies the figure of colonizer and post-colonial white savior, Martha emerges as a radical figure whose doctorhood potentially challenges and dismantles the colonial history of medicine. Through Afrofuturist and Afrosurrealist lenses, Martha represents a potentially subversive figure who offers a visionary medicine rooted in social justice. [ABSTRACT FROM AUTHOR]

The theory of fundamental causes in medical sociology identifies socioeconomic status and racism as fundamental causes of disease and health disparities. We draw on this theory to argue that socioeconomic status and racism are also fundamental causes of violent and property crime. In line with the theory, we argue that criminology should pay increased attention to socioeconomic status and racism for the most far-reaching reductions in street criminality to be achieved. [ABSTRACT FROM AUTHOR]

Drawing on clinical data from 15 months of on-site participant observation in the only public psychiatric hospital in the state of Puebla, Mexico, this article advances our understanding of globalization in relation to psychiatry. I challenge the construction of psychiatry as only treating the individual patient and provide grounded doctor-patient-family member interaction in a Mexican psychiatric clinic in order to review what happens when doctors cannot interact with patients as atomized individuals even though in theory they are trained to think of patients that way. Challenged by severe structural constraints and bolstered by lessons from other nations' efforts at deinstitutionalization, psychiatrists in Puebla push to keep patients out of the inpatient wards and in their respective communities. To this end, psychiatrists call upon co-present kin who are identified both as the customer and part of the caretaking system outside the clinic. This modification to the visit structure changes the dynamic and content of clinical visits while doctors seamlessly respond to unspoken beliefs and values that are central to local life, ultimately showing that efforts to define a "global psychiatry" informed by global policy will fail because it cannot exist in a uniform way-interpersonal interaction and personal experience matters. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editors focus on the philosophy of sex and gender in gender medicine as well as gender and sex stereotypes and biases that obstruct medical progress.

Blended courses supported by digital technology (bLearning) and competency-based medical education can be found in different university curricular reform initiatives around the world. Today, it is essential to implement new technologies and teaching methods that are flexible and encourage students to acquire the necessary professional skills. This article describes how using the bLearning format transformed the Social Medicine course for second-year medical students at Universidad de los Andes (Colombia), particularly their ability to achieve target competencies. A qualitative case study was carried out to explore the curriculum structure, training and skills, educational model and learning environments used during the course. We discuss the methods used, the results achieved, and the challenges encountered during the implementation process. Findings show that bLearning both facilitated the transformation of the course design and promoted flexibility and autonomy in students' learning process. Additionally, the new format facilitated the development of various competencies including: cognitive, technical and procedural, integrative and communicative, reflection, and professional ones. [ABSTRACT FROM AUTHOR]

Background: Return to work (RTW) is a pivotal goal of cardiac rehabilitation (CR) in patients after acute cardiac event. We aimed to evaluate cardiopulmonary exercise testing (CPX) parameters as predictors for RTW at discharge after CR. Methods: We analyzed data from a registry of 489 working-age patients (51.5 ± 6.9 years, 87.9 % men) who had undergone inpatient CR predominantly after percutaneous coronary intervention (PCI 62.6 %), coronary artery bypass graft (CABG 17.2 %), or heart valve replacement (9.0 %). Sociodemographic and clinical parameters, noninvasive cardiac diagnostic (2D echo, exercise ECG, 6MWT) and psychodiagnostic screening data, as well as CPX findings, were merged with RTW data from the German statutory pension insurance program and analyzed for prognostic ability. Results: During a mean follow-up of 26.5 ± 11.9 months, 373 (76.3 %) patients returned to work, 116 (23.7 %) did not, and 60 (12.3 %) retired. After adjustment for covariates, elective CABG (HR 0.68, 95 % CI 0.47-0.98; p = 0.036) and work intensity (per level HR 0.83, 95 % CI 0.73-0.93; p = 0.002) were negatively associated with the probability of RTW. Exercise capacity in CPX (in Watts) and the VE/ VCO-slope had independent prognostic significance for RTW. A higher work load increased (HR 1.17, 95 % CI 1.02-1.35; p = 0.028) the probability of RTW, while a higher VE/ VCO slope decreased (HR 0.85, 95 % CI 0.76-0.96; p = 0.009) it. CPX also had prognostic value for retirement: the likelihood of retirement decreased with increasing exercise capacity (HR 0.50, 95 % CI 0.30-0.82; p = 0.006). Conclusion: CPX is a valid tool for assessing patients' ability to return to work. Therefore, it may be an essential part of functional assessment during CR for predicting participation in employment. [ABSTRACT FROM AUTHOR]

Rescue activities in US acute care settings reaffirm an unspoken belief in an unlimited future for patients, families, clniicians, and the public at large. Reaching for that future erases the patient's experiences in the present, which can be detrimental to her welfare. A case study is used to illustrate how clinicians' urgency to reify their faith in the patient's unlimited future violated her real-world existence. [ABSTRACT FROM AUTHOR]

With the inception of the Affordable Care Act (ACA), colloquially known as ObamaCare, a new class of law breakers was established. Struggling Americans are penalized through fines, masked as taxes, imposed by the IRS, for failing to obtain health insurance. Although Americans cannot be imprisoned for falling to pay the tax, uninsured Americans can be classified as tax evaders, thus, imposing a negative label which serves to impact their financial future. Rather than helping Americans, this new law forces Americans to purchase health insurance and runs the risk of criminalizing them if they are unable to abide by the ACA mandate, creating the Iniquitous Ills, our newest class of tax evading offenders. [ABSTRACT FROM AUTHOR]