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In this article, we critically discuss a Swedish hospital foodservice reform by putting foodservice in a historical and social context and analyzing a case, "the most flexible patient foodservice system in Sweden," by using Bacchi's what's the problem represented to be (WPR) approach. We show how hospital foodservice governance in Sweden has become more focused on the individual patient as a consumer. Our analysis points out how in political protocols and related policy materials freedom of choice, flexibility, and efficiency were articulated as drivers of change. Freedom of choice was argued to enhance quality, increase food intake, diminish demand for special diets and lower costs. This can be seen as empowering patients, but also shifting part of the responsibility of nutrition care and health over to individuals, whether they want it or not. Flexibility was seen as beneficial for patient logistics regarding medical treatment and argued to improve allocation of staff resources. Inefficiency was a characteristic attributed to the old system, while the reform was an opportunity to modernize and be more cost-efficient. The new organizational structures may lead to tensions between foodservice and healthcare. The changes, system flexibility and patient freedom of choice, are salient within a broader neoliberal discourse.

This paper takes a common concept in Foucault and governmentality studies, problematization, to demonstrate its operational usefulness for analyzing public health crises. Social scientists have draw on this concept to discuss how phenomena become named as problems or issues of significance. We draw on a methodological use of the concept of problematization, to describe the process by which events become "problems" for governing; doing so enables critical sociologists to examine the nuanced ways that problems are defined, and, importantly, how solutions are proposed as a consequence of this process. We contend that the process of problematization, in two cases of public health crises, opioid overdose deaths, and "premature" coronary heart disease deaths, tends to describe the problem as a result of individual choices, which is used to justify intervention at the individual level. The paper concludes with a discussion of the normative upshots of using this concept for critical sociological analysis of public health issues.

The article 'Power, position and social relations: Is the espoused absence of hierarchy in Open Dialogue naïve?' (DOI: 10.1177/13634593241249101) by Einboden et al. criticized our work (Jaakko Seikkula and Tom Erik Arnkil, Dialogical Meetings in Social Networks, Karnak Books, 2006) in ways that confuse rather than clarify concepts. Reflection on power relations in dialogical practices is most welcome. We wish to promote clarity in the critical discussion.

Despite extensive research on Western breast cancer (BC) memoirs highlighting how shame profoundly impacts patients' lives making them more vulnerable, Indian BC memoirs remain underexplored, especially in understanding the challenges of shame. This article examines the unique struggles of Indian female BC patients, focusing on their experiences of biographical disruption, the guilt-ridden consciousness of their altered body image, and the shame-induced actions that shape their narratives. Through an analysis of three Indian BC memoirs, Sunshine (2011), To Cancer, with Love (2015) and Cancer, You Picked the Wrong Girl (2021), this article explores how Indian female BC narrators comprehend and articulate their lived experiences of shame and self-perception. The analysis also highlights the diverse coping strategies such as doing humour, normalising breast talk, practising spirituality, and sharing survival lessons employed by these narrators to offer a deeper understanding of the intersection of shame, identity, and healing, and to transcend moments of shame through acts of reconstruction. More importantly, the analysis underscores how these acts of reconstruction provide empowering strategies for navigating the challenges of BC and accentuate the possibility of an autobiographical reconstruction mechanism.

Patients' online information-seeking and sharing has sparked worries about medical misinformation and declining trust in biomedical professionals. At the same time, scholars advocate for including patients as knowers in the clinical encounter. Yet we lack empirical insights into the differing ways care providers and patients substantiate health-related knowledge. This article thus examines (1) how both groups substantiate claims about contraceptive side-effects, (2) the ways their substantiation processes differ and (3) how we can navigate this epistemic tension in contraceptive care. I draw on data from nine interviews with Dutch contraceptive care providers (one nurse practitioner, one gynaecologist and seven general practitioners) and 17 contraceptive users, observations of 11 contraceptive consultations in the Netherlands and analysis of Dutch clinical guidelines. Results reveal that patients substantiate their claims through combining embodied modes of knowing with self-experimentation as well as validation through social media exchanges. Care providers switch between two complementary approaches: demarcating biomedical knowledge from non-scientific claims and clinical tinkering. I show that epistemic tensions between provider and patient may arise because the two groups have differing definitions of what a side-effect is and differing evaluations of information shared online. Based on these findings, I argue that care providers invalidating information shared online may contribute to patients' growing distrust in biomedical authority while collaborative tinkering may provide a common ground for care providers and patients to co-create knowledge.

This paper is intended as a contribution to the social science literature on Patient Advocacy Groups (PAGs). It examines the recent emergence and development of cancer patient organizations that self-define as "oncogene-focused," that is, as centered on tumor-driving genetic mutations that offer novel therapeutic opportunities for tumors to be targeted by precision drugs. Drawing on qualitative methods including interviews with representatives of oncogene focused PAGs, analysis of the groups' publications (biomedical journals, eNewsletters), websites, and social media activity, the paper explores the characteristics of these PAGs' forms of activism. It shows that their common denominator is a focus on patient survival. This shared goal translates into a form of activism that centers on therapeutic actionability, that is, a set of initiatives aiming at the articulation of research, clinical trials, and care to improve the patients' quality of life and maximize survival thanks to awareness of and access to the latest therapies. Beyond individual differences between PAGs, we observe the increasingly seamless entanglement of their activities. Their mutually supportive interventions result in the establishment of an ecosystemic form of activism that also succeeds in mobilizing clinicians and researchers at the increasingly porous interface between research and care.

The US Anti-Doping Agency (USADA) and Ultimate Fighting Championship (UFC) recently ended their anti-doping partnership amidst controversy. We treat this decision, and the motivations underpinning it, as a means of exploring the complexities of anti-doping norms and the blurred lines between image and performance enhancing drug (IPED) use in sport and wider society. Drawing ideas from assemblage thinking, we analyse the evolving power dynamics surrounding IPED use, anti-doping policy, and the role of popular athletes in shaping societal perceptions of the use of, and potential harms associated with IPEDs. The study offers a case analysis of recent controversies in the UFC to investigate the entanglements of biomedicine, technology and celebrity culture in what we call the IPED assemblage. The 2023 termination of the USADA-UFC partnership has sparked debates about shifts in anti-doping standards, raising concerns about weaker testing protocols and perceptions of IPED normalisation. The case of Conor McGregor's injury recovery and alleged IPED use underscores the blurred lines between therapeutic and enhancement drug use within the IPED assemblage, challenging conventional distinctions between 'good' and 'bad' drugs in the context of sports management and anti-doping policy making. We highlight the inadequacy of current doping policies in responding to the IPED assemblage and highlight the need to shift public discourse to foster a more critical understanding of therapeutic and enhancement strategies to drive innovation in anti-doping frameworks.

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.

In the context of bariatric surgery, negative social support has recently been conceptualized in terms of sabotage, feeding behaviour and collusion undermining a person's effort to lose or maintain weight. While sabotage and feeding behaviour are thought to be motivated consciously, collusion is understood as a bond, by which protagonists are tied together sharing an unresolved and unconscious psychological issue such as dependency, domination and submission, and so on. Drawing upon a systemic and psychodynamic understanding, we analysed interviews with patients (n = 10) who had undergone bariatric surgery and their partners (n = 10) focusing on support. We selected interviews (n = 4 + 4), illustrative of sabotage, feeding, collusion and co-evolution based on the comprehensiveness of information, their emblematic quality and suitability to delineate these phenomena. Our analysis confirms that negative social support can be considered as an attempt to reestablish a level of homeostasis within the couple. However, rather than being intentional, we consider that sabotage and feeding behaviour are better conceptualised as consequences of collusive relationships.