Health最新文献

Caring practices during vaccination encounters are deeply interwoven with materiality, encompassing everyday objects and elements that play a crucial role for all actors involved. However, the significance of these materialities in shaping caring relationships within vaccination practices has been largely overlooked. This research seeks to fill that gap by exploring how mundane elements, such as the objects present during vaccination, contribute to the relational dynamics of the experience. Through a qualitative approach involving participant observation of vaccination encounters and interviews with 30 healthcare professionals, four key themes emerged: (i) objects as comfort devices, (ii) caring as gifts, (iii) reinvented medical instruments, and (iv) creating a friendly environment. These findings suggest that material elements are not merely passive tools but active "co-participants" in the vaccination process, influencing the interactions and emotional exchanges that occur. By acknowledging the role of materiality, this research enhances our understanding of vaccination as a relational experience, highlighting the importance of considering these often-overlooked factors in both practice and policy. The study offers valuable insights into how healthcare professionals can utilize materialities to foster more empathetic and supportive vaccination environments.

Corporate Social Responsibility (CSR) refers to initiatives undertaken by corporations that aim to make a positive impact on society. It is unclear to what extent these aims are achieved in relation to population health. We explored the evidence for mechanisms by which CSR has positive or negative effects on population health through a systematic-narrative hybrid review of 97 relevant articles. We found few examples overall that could trace a CSR initiative through to verifiable impacts on the population. Our review found that generally the evidence for the impacts of CSR on population health was patchy, highly heterogenous and of varying quality. We found some potential positive impacts of CSR on health; including on poverty alleviation, development, health care, the environment and the health and wellbeing of workers. Some CSR initiatives were rebranding of core functions, such as HR practices and employee wellbeing strategies, or were a partial redressing of the problems the corporation itself is creating, such as CSR initiatives that sought to improve workplace safety, reduce corporate environmental footprints or relocate people displaced by mining activities. We situate these impacts in relation to the role and intent of CSR, and argue that meaningful progress on CSR can only be made with greater transparency and reporting of initiatives to more fulsomely evaluate their impacts - as well as the political economy in which these sit. It is further critical to strengthen government regulation and oversight to maximise any public good that can come from CSR, and minimise the negative consequences reported in research literature.

The present study examined how individuals who have been clinically diagnosed as obese explain their decision to undergo bariatric surgery and how they deal with the stigmatization that such a decision may entail. A total of 23 participants (15 women and 8 men) who were awaiting bariatric surgery within the Spanish healthcare system, were interviewed about their weight trajectory and their decision to undergo this surgery. In order to examine the participants' stories, a narrative analysis of the interviews was conducted, with attention to both content (what they told) and structure (how they told) and examining the stories in line with the socially and culturally available narratives that they had access to, and the context in which the stories were produced. The participants explained their weight trajectory through the origin of their weight, the failure to control it, and their decision to have surgery to solve the weight problem. The narrative of a sick body that needs to be restored appeared to function as a schema or script through which participants attempted to defend themselves from anti-fat narratives that assume personal failure while at the same time presenting themselves as deserving to be operated on. Through their narratives, they positioned themselves as undeserving of stigma but did not challenge the stigma itself.

This paper explores temporalities and experiences of time drawn from an analysis of interview data from a critical narrative inquiry of the experiences of young adults living with home mechanical ventilation (HMV). The analysis centers the ideological effects of dominant discourses that shape understandings of time in the Euro-Western world and the ways in which young adults' stories prompt a rethinking of time in health research and praxis. Data generation involved interviews and photo-elicitation with five young adults (ages 18-40). A critical narrative analysis of participants' stories surfaced the influence of ableist, developmentalist, and neoliberal discourses of time and the creative resistance that points to the potential of crip orientations to time in opening up possibilities for living. Implications for practice and research are offered.

To reduce morbidity and mortality of cancer, more countries have implemented strategies to detect cancer, based on the logic of 'the sooner the better'. Time is thereby an essential component in how cancer research, policies, and prevention are practiced today. Where the logic of early diagnosis benefits some, the logic also produces harms. In this article, we use a cross-disciplinary case-study design to discuss how different notions of time and linearity are essential in today's research ontology of cancer, describe the individual and societal consequences of such ontology, and invite a rethinking of time in cancer. Drawing on theoretical concepts of time together with cancer epidemiological, historical and ethnographical data, we analyse how the logic of early diagnosis has been established as a stable concept. Although evidence supporting the logic points in different directions, the message 'the sooner the better' is currently not being challenged by research, policy or society. This at least partly, can be explained by a linear perception of time and societal traces of neoliberalism and acceleration in our society together with cancer still being a somewhat enigmatic disease that requires acute action. To support a sustainable healthcare sector, we argue there is a need to nuance the logic of early diagnosis. Continuing the linear perception of symptoms and cancer, risks doing more harm than good by making more people patients unnecessarily and by spending health resources on those with the least need.

Yoga has become a popular health and wellbeing practice that draws on ancient philosophy. Pratyahara is a core tenet of yoga practice and is often translated to mean withdrawal of the senses. Withdrawing from the senses plays a key role in aiding yoga practitioners to find spiritual enlightenment by transcending the worldly. Withdrawing from the material world, however, does not neatly fit within the parameters of the contemporary postural yoga industry. This paper looks at the conceptual origins of pratyahara through stances relevant to health research. The author weaves biomedical, esthetic, and neoliberal onto-epistemological stances through health discourse to discuss how postural yoga both resists and replicates power imbalances. In so doing the author emphasizes the paradoxical nature of pratyahara as it is reflected in socio-political tensions of the yoga industry. To conclude, the author suggests that pratyahara itself can be useful in resolving this tension as yoga fulfills a philosophical prerogative for social change.

The promotion of health literacy was a key public health strategy during the COVID-19 pandemic. However, the role of social networks and relationships for support with health literacy-related tasks in the context of the COVID-19 pandemic is scarcely understood. Moving beyond traditional notions of health literacy, which focus on individual skills and knowledge, this study uses the concept of distributed health literacy to explore how individuals make meaning of and respond to health literacy and make their literacy skills available to others through their relational and socially situated and lived experiences of the COVID-19 pandemic. Drawing on 89 semi-structured interviews conducted in three European countries (Italy, Portugal, and Switzerland) between October and December 2021, we found narratives of stabilization, hybridization, and disruption that show how health literacy concerning COVID-19 is a complex social construct intertwined with emotional, cognitive, and behavioral responses distributed among individuals, communities, and institutions within socioeconomic and political contexts that affect their existence. This paper opens new empirical directions to understand the critical engagement of individuals and communities toward health information aimed at making sense of a complex and prolonged situation of uncertainty in a pandemic.

Service-based caring sectors like disability are increasingly being operated via market logic, including shifts towards personalised funding. These shifts must be brought to life in/through people already located in relation to ideas and values that underpin historical policies. Our manuscript examines how identities are re/shaped in relation to marketised policy change and explores how identity change unfolds (or not) during periods of transition: situated within the transition to the National Disability Insurance Scheme executed in Australia as a major disability funding reform. Our qualitative dataset involves interview and focus group data collected with service recipients/carers (n = 28), providers/managers (n = 17) and advocates (n = 2) during shift from government- to personally-controlled funding of allied health services for people with disability in Australia (2017-2020). We used layered sociological inference to develop and interrogate processes of tension and identity change amidst lived experience(s) of policy change. Our analysis elucidates how various identities were encouraged, desired, resisted and constrained in relation to the policy transition. We bring together sub-themes from analysis of recipient/carer data (getting value-for-money; critiquing service quality; and experiencing system shortfalls) and manager/provider data (learning to transact; the call to care; and structural frictions in/and identity transitions) to interpret that recipients/carers are Feeling (like) the dollar sign and that managers/providers are Troubling profits. In both cases 'hearts' and 'minds' are perceived to be diametrically opposed and symbolic in/against processes of marketisation. We synthesise our data into an illustrative framework that facilitates understanding of how this perception of opposed 'hearts' and 'minds' seems to constrain the identity transitions encouraged by personalised funding, and explore ways in which desired identities might be supported amidst marketising policy transition.

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or "non-ideal" contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18-30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men's alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla's non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: careful connections, watering it down, and blurred lines. In careful connections young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in watering it down young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized blurred lines through a continuum of consent and of "meeting (masculine) expectations" when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.