Health Sociology Review最新文献

The health implications of prolonged wildfire smoke exposure - such as that seen during the 2019-2020 Australian bushfires - are a major concern in public health, not only in Australia but in many fire-prone areas globally. One group identified as potentially more susceptible to smoke exposure than the general population are pregnant women. Based on a study of how pregnant women and parents with newborn babies experienced the bushfire smoke event in Canberra and the NSW southeast coast, the paper examines how the placenta was figured across two domains during this time. The first domain considers how the placenta became prominent in the context of public and medical concerns about the immediate and long-term impacts of the bushfire smoke, focusing on pregnant women as a 'vulnerable' population. Secondly, we explore how the placenta figured in the narratives of women in our study: how they imagined their bodies responding to smoke exposure and how the smoke made more visible the interiority of their bodies. We argue that these narratives illustrate how environmental crises can reshape experiences of (pregnant) embodiment, imaginaries of future health, and our place in an increasingly uncertain world.

This essay provides a critical overview of historical and contemporary conceptualisations of selfhood in dementia. We explore the intersections of psychological and sociological research, as well as care practices, in dementia scholarship and how these have evolved in the years leading to and proceeding the start of the twenty-first century. Focusing on historical discourses of dementia and the metaphor of dementia as a 'living death', this essay maps the development of prominent conceptualisations of dementia in western cultures, from their roots in Cartesian philosophy to modernist values and existential anxieties. We firstly explore historical notions of selfhood in people living with dementia and the presumed erosion of the self that culminates in a so-called living death. Then, we discuss the radical shift in attitudes that arose around the start of the twenty-first century towards perseverance of selfhood in dementia and person-centred care. We finally consider whether our current understanding of selfhood in dementia could benefit from a posthuman approach, which requires a radical shift towards a more relational, multiple, and ultimately affirmative ways of caring for dementia.

In the UK, a range of everyday activities are being re-framed as interventions to promote public mental health. Drivers of this include the rising burden of mental ill-health and constrained funding for community-based arts and educational provision, in the context of austerity. A consequent interest in evaluating the health and wellbeing benefits of 'non-pharmacological' interventions has brought into play some diverse logics of effect. Taking Creative Bibliotherapy - reading and discussing fiction for therapeutic ends - as a case study, we explore what happens when these logics intersect. Our analysis draws on qualitative data on how reading is understood as therapy by those involved in one area of the UK. In accounting for what it was and how it worked, these actors negotiated a series of tensions in advocating for bibliotherapy. These included: reading is inherently worthy, but has instrumental benefits; reading is universally therapeutic, yet implicated in signalling social distinction; Bibliotherapy demands a widened vision of the 'therapeutic', yet resists medicalisation. These ambiguities, we suggest, means that Creative Bibliotherapy troubles biomedicine, in foregrounding its limitations for addressing contemporary public mental health crises, and the paucity of its dominant models of therapeutic effect.

The COVID-19 pandemic has raised probing questions about the politics that underly health governance. This article engages with recent sociological and political analyses in this regard and offers a reconsideration of what the pandemic represents for global health governance: a moment of reconfiguration rather than continuity or fundamental change. Drawing on Paul Rabinow's notion of 'the contemporary' as a mode of analysis, we conceptualise global health governance as a 'contemporary configuration' and analyse publicly available data from sources documenting the international response to COVID-19. We identify the appearance of a specific kind of problematisation of solidarity in the light of perceived disarray and fragmentation in global health governance. A perception related to the dynamics that evolved in the international political system during the emergency. Further, we discern processes of remediation in global health governance that unfolded around that problematisation of solidarity. We argue that global health governance, as it emerged in the COVID-19 emergency, should not simply be understood as bounded by the past nor as dramatically altered in the present. Instead, it had undergone a reconfiguration wherein solidarity may potentially become the crux of its politics.

Sociologists are increasingly interested in exploring the role of time in relation to illness, disability, and care. However, the question of how individuals experience and navigate the temporal dimensions of sleep in their everyday and everynight lives requires further empirical research. The present study addresses this question using in-depth semi-structured interviews with 66 employed midlife Israelis from diverse sociodemographic backgrounds. The findings indicate that sleep experiences are shaped by a complex interplay of biological, social, and seasonal rhythms. Sleep patterns recur nightly, weekly, seasonally, and following major life events and transitions, combining to create what I call sleepscapes - the evolving rhythmic patterns and disruptions that characterise the lived dynamics of sleep throughout a person's lifecourse. The study underscores the concept of polyrhythmia - multiple rhythms - in everyday and everynight life and shows how various rhythms can either harmonise or clash, often co-producing each other. The study explores individuals' efforts to negotiate these rhythms, illustrating how all these processes profoundly impact human experiences, social relationships, and health.

This article delves into the underexplored relationship between lay expertise and temporality by analysing semi-structured interviews with parents who treat their autistic children using complementary and alternative medicine (CAM). The analysis indicates that time and temporalities play a significant role in how parents construct and enact their expertise. Faced with uncertainty, urgency, and inadequate support from medical and educational systems, parents assumed crucial responsibilities in managing their children's therapies. Over time, they acquired knowledge and skills, ultimately claiming expertise in caring for their children, making therapy decisions and administering treatments. Parents engaged in complex time work as they attempted to orchestrate everyday, developmental, therapeutic, and social rhythms, alternating their focus between future and present. They endeavoured to synchronise their children's rhythms with those of peers by using CAM therapies not yet adopted into conventional medicine, which they perceived as slow and outdated. This study contributes novel insights into autism care, temporalities of care, and the under-examined nexus between lay expertise and temporality.

This article focuses on the workplace experiences of peer workers with a diagnosis of borderline personality disorder (BPD) in mental healthcare settings in Australia. Our article is located at the intersection of political, social, cultural, and legislative forces that have fostered the development of peer work as a paid profession. We draw on the concept of stigma to analyse findings from qualitative interviews with peer workers conducted in [state], Australia. By examining peer work in the broader context of lifeworlds of BPD, we address the interplay of work and professional identity, and the experience of a profoundly stigmatised diagnosis at this intersection.Our findings demonstrate the physical and emotional effects of stigma and how it produces boundaries and inequalities between peer workers and other health practitioners. These boundaries are reinforced by invisible markers that delineate what is expected, 'normal' and deemed professional in the workplace. Moreover, these same medico-socio-political relations help shape peer workers' identities and experiences. The development of peer workforces in mental healthcare service delivery is a prominent area of reform in Australia and internationally. Our research highlights the urgency of efforts to transform current socio-cultural-political relations that inhibit peer workers in their roles and impact workplace experiences.

We draw on the concept of 'biopedagogies' to explore the effects of 'living skills' training for young people in alcohol and other drug (AOD) treatment; that is, the knowledge and skill needed for everyday living to manage work, relationships and self-care. In-depth interviews conducted longitudinally with 38 young people explored how these pedagogies regulated participants' everyday practices and also produced unanticipated outcomes. We found that 'pedagogies for living well' governed in predictable ways by setting up norms promoting self-management and affording subjectivities as 'healthy' rather than 'addicted' and responsible rather than compulsive. Importantly, there were transformative effects whereby pedagogies for living well, especially the skill-building around paid work, produced new orientations to the future in which young people felt that reduction and cessation of substance use was achievable and that they had promising futures if the correct conditions were present. Thus, pedagogies for living well achieved their goal - to reduce substance use - but not through rationalist logics that assume young people straightforwardly take up information about 'living skills' and enact desired behaviours. Instead, pedagogies reap benefits for young people when they embrace a relational understanding of substance use as a practice that emerges from the social conditions of young people's lives.

This research examines image and performance-enhancing drug (IPED) use, specifically focusing on the emerging role of IPED coaches. Situating drug use within broader assemblage theory, we investigated how these coaches, often operating in an online context, function as enabling environments, influencing practices, and contributing to harm reduction in a broader social context within and for IPED communities. Ten IPED coaches were interviewed, with this work focusing on their legal, ethical, and moral considerations, risk assessment, and harm reduction strategies of their practices. We employed a critical realist approach, following flexible coding to identify and develop themes which were further framed an enabling environments framework. Coaches operated along an ethical tightrope, emphasising the conscious regulation of conduct within established norms and the nuanced assessment of risks aligned with individual goals and motivations. Power dynamics and responsibility concerns unfolded through the lens of collaborative decision-making, where trust emerged as an essential element of these relations within contextual risk assessments. IPED coaches play a role in harm reduction by fostering trust and informed decision-making, balancing clients' goals with health considerations. These findings emphasise the potential for collaboration between IPED coaches and the health workforce to enhance health promotion and support within IPED communities.

Critiques of healthcare often focus on negative experiences to address gaps, issues, and problems. While important, this often obscures care that exceeds expectation - that is, brilliant care. This article centres brilliant care by considering the questions that might be asked to surface it, and what might happen when brilliant care is centred. Specifically, a conceptual understanding of brilliant care is extended within health sociology. In doing so, the article draws on Mol's research on the logic of care, Fredrickson's broaden-and-build theory, and Hochschild's notion of emotion work. Through an application of this conceptual framework to secondary data - namely, reported stories of healthcare experiences from the series 'What's right in health care' - the article demonstrates how the framework surfaces and illuminates aspects of brilliance and its emergence. The article concludes by considering the implications this has on how we make sense of healthcare and the positive, social, and relational aspects that might be surfaced in current and future practices.