Social Theory & Health最新文献

How 'evidence' is conceptualised, generated and deployed in meso-level policy implementation on the ground is critical to health delivery. Using the case of a large-scale health service reconfiguration in northwest England, this study began as a narrative investigation into how different data types and sources are prioritised as NHS administrative structures change over time. During the research, one unpopular reconfiguration decision, the downgrading of a hospital, was challenged using judicial review. Suddenly, a key decision was being based not upon 'facts and data' type evidence but upon evidence of adherence to administrative procedure. This transferred focus away from the ever-shifting categories and hierarchies of data 'types' towards an emphasis on process. By comparing two deliberative contexts-committee and judicial review-this article proposes that evidence can be understood as simultaneously entity and process. As health service reconfigurations continue in response to austerity, integration agendas, evolving organisational landscapes, and demographic and political change, it is increasingly important to recognise the different meanings and uses of evidence.

This paper revisits Jessop's governance of welfare framework, suggesting that in the post-financial crisis era of austerity we need to look again at its analytical dimensions. The paper reformulates Jessop's Schumpeterian Welfare Postnational Regime ideal-type framework through critique, and then applies its reformulated Galbrathian, Affluent Postnational Oligarchy ideal-type to the case of the English NHS to present a new political economy of health.

Healthcare on both sides of the Atlantic is a highly charged political and economic subject. This work considers US media coverage of the UK's National Health Service (NHS), an under-researched area. We assess the framing of the NHS in editorials, opinion and feature articles during the time of the Obama administration to show how media can perform the role of lesson-drawing, a theory adopted from public policy research. The study also applies the notion of journalistic habitus in this context. Using these ideas, we address a hypothesis which holds that US coverage is framed around the flaws of the UK's NHS. The paper considers how intermedia editorial and news values operate, with commentators drawing a range of negative lessons in both the Democrat- and Republican-supporting press. We find that the NHS was often posited as a flawed international variant of the single-payer model, where newspapers employed an ahistoric explanation of failure and decline.

In this paper, we argue that the notion of a clinically-situated empathy (e.g. physician empathy), is potentially problematic as it perpetuates an emotion-deficient version of empathy within medicine and medicine education research. Utilizing classic and contemporary empathy theory from various social science disciplines, we discuss how empathy in the general sense differs conceptually from clinically-situated empathy-paying particular attention to the role of emotional contagion. To highlight this contrast, we draw upon Hojat et al.'s model of physician empathy and how this body of work reflects broader medical-cultural norms that problematize the role and impact of emotions within the clinical encounter. Alternatively, we present a more encompassing model of empathy drawing upon the fields of social-psychology and social-neuroscience in order to bring the notion of "feeling with" and emotional contagion more specifically, into medical education, medical education research, and medicine more generally.

Ambivalence, the vacillation between conflicting feelings and thoughts, is a key characteristic of scientific knowledge production and emergent biomedical technology. Drawing from sociological theory on ambivalence, we have examined three areas of debate surrounding the early implementation of HIV pre-exposure prophylaxis, or PrEP, for gay, bisexual, queer, and other men who have sex with men in Canada, including epistemology and praxis, clinical and epidemiological implications, and sexual politics. These debates are not focused on the science or efficacy of PrEP to prevent HIV, but rather represent contradictory feelings and opinions about the biopolitics of PrEP and health inequities. Emphasizing how scientists and health practitioners may feel conflicted about the biopolitics of novel biomedical technologies opens up opportunities to consider how a scientific field is or is not adequately advancing issues of equity. Scientists ignoring their ambivalence over the state of their research field may be deemed necessary to achieve a specific implementation goal, but this emotion management work can lead to alienation. We argue that recognizing the emotional dimensions of doing HIV research is not a distraction from "real" science, but can instead be a reflexive site to develop pertinent lines of inquiry better suited at addressing health inequities.

This paper establishes a relational, post-anthropocentric and materialist approach to the Covid-19 coronavirus pandemic. Analysis of the 'pandemic assemblage' reveals that the virus has subverted the social and economic relations of capitalism, enabling its global spread. This insight establishes a materialist framework for exploring socio-economic disparities in Covid-19 incidence and death rates, via a more-than-human and monist analysis of capitalist production and markets. Disparities derive from the 'thousand tiny dis/advantages' produced by people's daily interactions with human and non-human matter, making sense of the unequal occupational patterning of coronavirus incidence. This more-than-human approach supplies a critical alternative to the mainstream public health and scientific perspectives on the pandemic, with important implications for current and future policy to counter future microbiological outbreaks.

Interviewing 67 primarily middle-class parents and children in a southern U.S. city, we learned that families know a great deal about the dangers of excess sugar consumption. However, in the private spaces of family life, families let down their guard and enjoy sugary treats, often treating them as symbolic markers of love and comfort. Theoretical concepts emerging from the dramaturgical perspective of Erving Goffman (1959) and from contemporary symbolic interactionists illuminate how sugar consumption is simultaneously shunned and celebrated in private family life. Moving beyond previous research, we track the ways sugary products facilitate love, sanity, and privacy to make daily family life bearable for both parents and children. We call the rhetorical and physical practices that enable excusable sugar indulgence Health Performance Strategies. Our findings on how families engage in these health performance strategies have broader implications for many other efforts to govern the health habits of families.