1,721,048 research outputs found
Time, Risk and Health
No full textTime is a key element of social life. Yet it has been relatively neglected in social theory and in the study of health and risk. In this chapter we show how interrogating understandings of time provides insights into how uncertainty and risk shape the ways in which organisations and individuals respond to illness. While individuals have their own personal ‘my’ time, if they want to engage with others they need to recognize and align their personal time with others and this alignment involves implicit agreements about and standardisation of time between members of a community. In premodern societies such standardisation was localised however in modern society this standardisation has become abstracted from specific social setting and universalised and globalised. The development of abstract times has implication for the ways in which individuals think about and organise their personal time and the ways in which time is used to organise activities in modern bureaucratic organisations. The development of abstract time has created the possibility for individuals to view their own lives through the lens of risk. The accumulation of epidemiological knowledge about the ways in which adverse events are distributed across the life course creates a generalised life timetable in which there are designated time-periods for particular life activities or events and individuals are considered to be at-risk, or exposed to harm, if they do not undertake normal activities in these periods. In modern society, bureaucratic organisations play a key role in the creation and management of uncertainty, for example hospitals claim to provide a safe environment which individuals can rely on during fateful moments, when their very existence is under threat. Such organisation use abstract time embedded in institutional routines to manage uncertainty. While such routines may appear to be rational and technically neutral, they do in practice contain irrational elements and are used as a form of social control. There is tension between the abstract time imposed by organisations and institutions and personal timings which form an important locus of power relations. Personal time is often colonised by those in more powerful positions and by organisations, while resistance to such colonisation requires both determination and subterfuge
Integrated health and social care for older persons: Theoretical and conceptual issues
Get PDFThis paper provides the theoretical and conceptual framework to the fieldwork component of the PROCARE programme. The first section explores the need for and impediments to providing integrated care for older people in Europe. The second section is a discussion of the alternative approaches and definitions of integrated care, which emphasises the importance of a person- centred approach. The third section examines the alternative ways in which the impediments to integrated care can be overcome. The last section considers ways in which integrated care can be evaluate
Risk, Uncertainty and Life Threatening Trauma: Analysing Stroke Survivor's Accounts of Life after Stroke
Get PDFThis paper examines the ways in which
stroke survivors identify and manage the risks and
uncertainties of their situation. It draws on
interview data from a UK study in East Kent of 31
stroke survivors (aged between 38 and 89 years).
The interviews created accounts based on the
experience of stroke and post stroke recovery.
Stroke survivors experienced their stroke as an
unanticipated event in which there was a failure of
foresight. The stroke undermined their ontological
security and increased their awareness of and
anxiety about everyday activities both in and
outside the home, created awareness of a new
danger, that of having another potentially fatal
stroke, and could damage their social standing.
Survivors used a variety of strategies to manage
such uncertainties. They shortened their time
horizons, either abandoning longer-term plans or
discussing them in very vague and general terms.
They concentrated either on the present, "taking
each day as it comes" or developed goals to
structure the short-term future. These short-term
goals involved challenges and there was in some
cases the possibility of a harmful outcome. Such
voluntary risk-taking provided an opportunity for
"centre work" which could re-establish the stroke
survivors social standing
The influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia
Get PDFIn this thesis I examine the influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia. There are four main parts and a conclusion. In Part One I review the situation in developing countries. Many commentators have argued that economic factors, and to some extent political factors, are the main determinant of health services development in developing countries. Socio-cultural factors are generally neglected in these analysis. In this thesis I redress the balance by examining the relationship between economic, political and socio-cultural factors in the development of the Saudi health care system.In Part Two I analyse the Saudi resource situation. Although the health service is not considered a priority in the overall Saudi development strategy, the government provides generous financial resources for its development. However, non-financial resources remain a problem. Relatively abundant financial resources can provide a short-term solution to some of the resource shortages, such as the lack of skilled manpower, but the use of expatriate health personnel may have unanticipated negative consequences.In Part Three I examine the resource allocation process. The Saudi political system contains a mixture of modern and traditional elements, and the decision making process is affected by traditional social relationships. The King and public bureaucrats play a key role in the allocation process, but local leaders and Governors have wide scope to influence their decisions. While health provision is not a political issue in the country, it contributes to the social cohesion between the government and the general public.In Part Four I examine the influence of socio-cultural factors on the development of the Saudi health service. In the Saudi society socio-cultural factors affect the behaviour of individuals in their interaction with the health system. For example, the annual pilgrimage to Mecca by millions of moslems from all over the world presents a formidable challenge to health authorities. Health authorities accept the importance of socio-cultural factors, and respond by compromising policies. In the conclusion I consider the policy and theoretical implications of the study. In particular I examine the need for the formal recongnition and incorporation of socio-cultural factors into health policy decision making. This would lead to the generation of alternative policy options which complement other options based on economic and political considerations. The socio-cultural oriented approach can contribute significantly to the improvement of the long term prospect for health services in Saudi Arabia, and developing countries generally
The influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia
No full textIn this thesis I examine the influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia. There are four main parts and a conclusion. In Part One I review the situation in developing countries. Many commentators have argued that economic factors, and to some extent political factors, are the main determinant of health services development in developing countries. Socio-cultural factors are generally neglected in these analysis. In this thesis I redress the balance by examining the relationship between economic, political and socio-cultural factors in the development of the Saudi health care system.In Part Two I analyse the Saudi resource situation. Although the health service is not considered a priority in the overall Saudi development strategy, the government provides generous financial resources for its development. However, non-financial resources remain a problem. Relatively abundant financial resources can provide a short-term solution to some of the resource shortages, such as the lack of skilled manpower, but the use of expatriate health personnel may have unanticipated negative consequences.In Part Three I examine the resource allocation process. The Saudi political system contains a mixture of modern and traditional elements, and the decision making process is affected by traditional social relationships. The King and public bureaucrats play a key role in the allocation process, but local leaders and Governors have wide scope to influence their decisions. While health provision is not a political issue in the country, it contributes to the social cohesion between the government and the general public.In Part Four I examine the influence of socio-cultural factors on the development of the Saudi health service. In the Saudi society socio-cultural factors affect the behaviour of individuals in their interaction with the health system. For example, the annual pilgrimage to Mecca by millions of moslems from all over the world presents a formidable challenge to health authorities. Health authorities accept the importance of socio-cultural factors, and respond by compromising policies. In the conclusion I consider the policy and theoretical implications of the study. In particular I examine the need for the formal recongnition and incorporation of socio-cultural factors into health policy decision making. This would lead to the generation of alternative policy options which complement other options based on economic and political considerations. The socio-cultural oriented approach can contribute significantly to the improvement of the long term prospect for health services in Saudi Arabia, and developing countries generally
Providing integrated health and social care for older persons: A European overview of issues at stake
No full textProviding integrated health and social care for older people in the United Kingdom
No full textThis report provides an overview of the development of integrated health and social care provision for older people in the UK. It explore why integration is important,
identifies the main impediments to effective integration, considers failed past attempts and current initiatives designed to promote joined-up thinking and seamless care for older people, identifying the main models.
In the first two sections of this national report, we examine the national context within which health and social care provision has developed, and consider the extent to which recent policy changes encourage the move towards seamless health and social care. In the third section we review existing models that have evolved in response to the challenges facing these services today. In the annex we provide more detailed
descriptions of specific initiatives that provide exemplars of the main models identified in the third section
Charterism and charterization within health services : a public choice analysis of the implementation of patients' charters in England and Hong Kong
Get PDFPatients' charters have been incorporated in health services systems among various countries including the United Kingdom and Hong Kong. By means of a comparative case study, this research looked at the implementation of patients' charters in the National Health Service in England and the Hospital Authority in Hong Kong from the perspectives of staff at different levels as well as patients' groups and their representative bodies. Points of convergence and different approaches have been illustrated in both locations from their experiences in implementing the charter. Together with the positive and negative impacts learned, it is argued that current knowledge about 'Charterism' is limited to the UK context and this should be interpreted within the international arena as shown from a bundle of tenets and principles of the Hong Kong experience. By means of analyzing the case study, the utility of Pubic Choice Theory is demonstrated in understanding the self-interest behaviours among the actors involved in patient's charter in both locations. It is also argued that patients' charters can be effective Public Choice remedy tools to shift provider-led health services into consumer-led health services
A Person-Centred Approach to Communicating Risk
Get PDFDoctors and other health professionals play a key role in communicating risk information. They are advisers to patients, especially when patients have to make fateful decisions that can irrevocably change their lives. There is a developing body of literature on the ways in which risk information can be effectively communicated [1,2]. However, much of this literature focuses on the nature of risk information and ways in which the transfer of this information can be improved. It does not fully take into account the complexity of the real world of clinical practice, nor the importance of considering patients as active partners in communication
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