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Identity is a complex concept that can be informed by various factors, involving biological, psychological, experiential, and social influences. Specifically, one's social identity refers to the ways in which individuals can adopt attributes from established collective categories, like cultural identities, ethnic identities, gender identities, and class identities, amongst others. Social identity can encompass unique and diverse interactions at an individual level, known as micro-identities, that may be selectively expressed, hidden, or downplayed, contingent on distinct sociocultural settings. However, the formation of social identity is recurrently defined in opposition to perceptions of the Other, which can entail adverse paradigms of marginalisation, stigma, and discrimination. Although this theory of Otherness has been developed across different fields, particularly sociology, it may be important in psychiatric contexts as it can engender inherent risk factors and mental health inequalities. Consequently, this paper seeks to bring attention towards these issues, exploring the construction of Otherness and its detrimental outcomes for psychiatry, such as systemic discrimination and disparities in therapeutic support, alongside recommended initiatives to mitigate against the effects of Otherness. This may require multifactorial approaches that include cultural competency training, interventions informed by micro-identities and intersectionality, patient advocacy, and structural changes to mental health policy. [ABSTRACT FROM AUTHOR]

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

Health promotion, as one tool of hospital managers to reorient hospitals towards more client-oriented healthcare services, has been emphasized for almost three decades. Yet, it is recognized that change in hospitals is challenging and is more desired than substantially enacted. To overcome organizational challenges, health promotion has, so far, adapted organizational change strategies primarily applied in business organizations. However, in this paper, it is argued that such strategies do not adequately reflect the nature of hospitals as 'professional organizations'. To gain a better understanding of the challenges for health promotion reorientation, this paper combines well-established theories from the sociology of professions and organizational science. These theories provide a useful framework that advances the role of professionals as powerful agents within any reorientation efforts in hospitals. This framework guided the narrative review of empirical literature on critical dimensions along which professionals engage with reorientation efforts in hospitals. Accordingly, specific managerial strategies to facilitate health promotion reorientation are formulated. With its theoretical underpinnings and related empirical studies, the paper offers a new perspective on the challenges of implementing health promotion and proposes strategies that may help hospital managers to push forward health promotion reorientation in their organizations. [ABSTRACT FROM AUTHOR]

Individuals are claiming greater scope for choice in their racial identities. But how they are seen and classified by others is not necessarily changing in a similar way. Racial appraisals are the way that people classify the race of others, both particular individuals and larger groups. In this paper, I make a case for the study of racial appraisals as a field of sociological inquiry. I map out the different analytical levels and methodological approaches for this field and discuss how these can be used to understand observed race, norms of racial classification, and societal norms of the racial order. I present an example of how societal norms and logics of racial classification can be analysed in real time through survey research, using 2015-16 data on 866 White Americans’ reactions to Rachel Doležal’s racial identity claims. I present an agenda for studying changes in racial boundaries and classification norms through the longitudinal tracking of racial appraisals. [ABSTRACT FROM AUTHOR]

Once exceptional, a long life is now an everyday expectation for many citizens of the prosperous nations. The consequence of this transformation in life expectancy however has led to a set of contradictory responses, representing threats as much as opportunities. Old age is no longer a stable coherent part of the life course; its future is fragmented by the competing narratives of the third age (opportunity) and the fourth age (threat). While there is a tendency to frame this distinction primarily through the lens of socio-demography and/or 'stages of life,' this paper proposes an alternative model. This model argues that later life is now represented through two different, though not unrelated, paradigms. The first frames the third age as a network of cultural fields dominated by rising consumerism and changing social relationships, while the second frames the fourth age as a negatively developed social imaginary of 'real old age.' The central features of this imaginary, we suggest, are frailty, abjection and the 'othering' of the self. This paper elaborates this theorising of the fourth age, briefly outlining each of these three features before considering in more detail the nature of othering and its consequences for those affected by this particular imaginary. [ABSTRACT FROM AUTHOR]

The advent of post-industrialism in western societies saw social theorists pay greater attention to the blurring of traditional work and life conceptual categories and the growing role of service professions. Further, much of the theorisation around the human service professions has focussed on occupational stress and professional burnout. This focus on the challenges to worker health has limited considerations of how human service professionals can thrive, and not just survive, in demanding employment contexts. In response, the paper considers the 'lifeworld' as a conceptual resource that can encourage new ways of thinking about the work of human service professionals, as well as reworks this resource using the concept of affect to expand consideration of the interconnected, inter-subjective, bodily and emotive nature of human service work. The paper concludes by presenting a heuristic tool that can make these concepts more accessible to professional discourses and can facilitate their use within collaborative research with the human service professions. [ABSTRACT FROM AUTHOR]

This paper deals with the role of earth shrines in generating and maintaining social order and cohesion in a Dogon village on the Bandiagara escarpment (Mali, West Africa), in a context of scarcity. Earth shrines are erected at significant points in the landscape and in remote times symbolised the foundation of the territory. They form part of the ritual control of space by reinforcing, through sacrificial practice, a symbolic boundary that encloses and protects the village space. Through their yearly reactivation, this practice firstly enables the Dogon to strengthen their relationship with their god, their ancestors and the spirits that own the place and, secondly, it aims to renew social relationships and maintain the cohesion and continuity of the society whilst simultaneously conveying a sense of well-being. This paper examines the materiality, efficacy and activation principles of Dogon earth shrines that operate through the intervention of complementary living substances: millet and blood. These earth shrines function on an ontological principle of containment by which people protect themselves, act and dwell in the world. That is to say, they endow active principles and play a part in forming a local cosmology in a harsh and changing world. [ABSTRACT FROM AUTHOR]

This concluding paper draws together the dominant themes across the papers published in this issue. The majority of the papers clearly point to disparities between the aims of policy-makers and mental health workers. Using a variety of perspectives and methods, the authors of these insightful papers argue that modernist, rational approaches to structuring and evaluating services are at odds with the professional needs of mental health workers. At one level this critique is self-evident given the messiness and uncertainties inherent in working with service users whose individual problems require flexible approaches tailored from a broad and evolving practice-base. For some authors, the focus is epistemological and methodological; they offer much needed examples of analysing policy construction, interpreting statistics and the concurrent application of the widely used concepts of medicalisation and structural inequality. Together, the papers indicate that the progress of mental health reform in many western countries remains inconsistent and, in some cases, obstructive to effective professional practice. [ABSTRACT FROM AUTHOR]

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

Considerable attention has been given recently to the perplexing problem of the relationship between attitudes and behavior (Ehrlich, 1969; Deutscher, 1969; Warner and DeFleur, 1969; Ajzen et al., 1970; Lastrucci, 1970; Tarter, 1970). Methodological issues have been debated, the lack of congruence between attitudes and behavior has been examined, and a variety of solutions have been offered. We are told, for example, that the continuing poor correlation between measured attitudes and overt behavior requires us to search for the intervening variable or variables which apparently obtain (Ehrlich, 1969); or to employ the "direct observation" of the phenomenon under investigation rather than try to extrapolate from paper-and-pencil tests to behavior (Deutscher, 1969); or to develop theories that, in turn, enable us to find indicators that are more valid than the paper-and-pencil type (Lastrueci, 1970); or to simply admit that attitudes as "presently conceptualized play no real role in behavior" (Tarter, 1970). A number of important aspects of attitude research, however, have been obscured or omitted in these discussions. For the surprising aspect of the situation is not, as has often been implied, the lack of congruence between attitudes and behavior, but the persistent use of research designs that are inappropriate for the complexity of the subject under investigation. Further, it is surprising that researchers have failed to draw out other important implications of their research. That is, the fact that an attitude does not lead directly to a behavior does not justify the assertion that attitudes play no role in behavior, or that attitude research lacks significant implications for social life. The basis for this latter statement will be shown below in a discussion of the values of attitude research. It may be that inadequate research designs, valued for their simplicity rather than their appropriateness, are a manifestation of the "publish or perish" syndrome. In any ease, this paper attempts to outline the problems and the values of attitude research, and to demonstrate thereby that such research is of great significance for the understanding of social phenomena. If that significance seems minimized by those studies that have found poor correlation between attitudes and behavior, the fault lies both in the failure to create research designs that reflect the complexity of the problem and in the tendency to exalt the importance of the proximate causes of overt behavior. [ABSTRACT FROM AUTHOR]

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]

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]

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]

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]

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]

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

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

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]

The modern social event known as the debut probably had its origin in the seventeenth century practice of presenting young women of marriageable age at European courts for approval of the court ladies and court gentlemen. Its modem popularity is increasingly centered in the United States, and especially among those families desiring to achieve recognition as members of the upper class.In spite of a general knowledge about upper-class life, little is known concerning the socialization of pre-debutantes, particularly from the perspective of the girl herself. The purpose of this paper is to review the circumstances through which the debut of a daughter is achieved and to examine the disciplinary context of socialization by which appropriate attitudes and perspectives are developed. [ABSTRACT FROM AUTHOR]