6,110 research outputs found
The New Sociology of the Health Service
No full textHealth service policy and health policy have changed considerably over the past fifteen years and there is a pressing need for an up-to-date sociological analysis of health policy. Not only have policies themselves changed but new policy themes – such as evidence-based policy and practice, an increasing focus on a primary care led health service, a growing recognition of the need to address inequalities through public health policies and a focus on the views and the voice of the user and the public– have emerged alongside some of the old.
Following up the very successful The Sociology of the Health Service, this all-new volume covers a broad range of key contemporary health services issues. It includes chapters on consumerism, technology, evidence-based practice, public health, managerialism and social care among others, and incorporates references to new developments, such as regulation and incentivization, throughout.
The New Sociology of the Health Service provides a vital new sociological framework for analyzing health policy and healthcare. It is an important read for all students and researchers of medical sociology and health policy
Trust, regulatory processes and NICE decision-making: Appraising cost-effectiveness models through appraising people and systems.
No full textThis article presents an ethnographic study of regulatory decision-making regarding the cost-effectiveness of expensive medicines at the National Institute for Health and Care Excellence (NICE) in England. We explored trust as one important mechanism by which problems of complexity and uncertainty were resolved. Existing studies note the salience of trust for regulatory decisions, by which the appraisal of people becomes a proxy for appraising technologies themselves. Although such (dis)trust in manufacturers was one important influence, we describe a more intricate web of (dis)trust relations also involving various expert advisors, fellow committee members and committee Chairs. Within these complex chains of relations, we found examples of both more blind-acquiescent and more critical-investigative forms of trust as well as, at times, pronounced distrust. Difficulties in overcoming uncertainty through other means obliged trust in some contexts, although not in others. (Dis)trust was constructed through inferences involving abstract systems alongside actors’ oral and written presentations-of-self. Systemic features and ‘forced options’ to trust indicate potential insidious processes of regulatory capture
Dr. Michael Janis, Morehouse College, August 2011, August 2011
No full textThis video is a conversation with Dr. Michael Janis. Dr. Janis talks about his book, "Africa After Modernism: Transitions in Literature, Media and Philosophy". Yolanda Gilmore-Bivins, AUC Woodruff Library, is the interviewer
Correspondence: George Kephart to Michael Frome
No full textThis 1960s correspondence, from George S. Kephart to Michael Frome, discusses what the author considers misinformation about his father, Horace Kephart. Horace Kephart (1862-1931) was a noted naturalist, woodsman, journalist, and author and promoter of the Great Smoky Mountains National Park
Trusting on the Edge: Managing Uncertainty and Vulnerability in the Midst of Serious Mental Health
No full textTrust is fundamental to everyday interactions and the functioning of society. How trust develops, or fails to develop, within contexts of severe mental illness is a pertinent topic for social scientists and healthcare professionals, not simply because it is an under-researched area but because heightened uncertainty and amplified vulnerability amidst psychosis represent a crucible of the conditions where trust becomes relevant. Grounded in research within this crucible, this book explores a number of questions which are central to contemporary theoretical debates around the nature of trust. The authors link these abstract concerns to empirical analysis, involving interviews with service-users, practitioners and managers. This book will appeal to anyone interested in the concept of trust, including social science researchers and students, as well as practitioners, managers and policy makers working with vulnerable people
Healthcare choice: Discourses, perceptions, experiences and practices
No full textPolicy discourse shaped by neoliberal ideology, with its emphasis on marketisation and competition, has highlighted the importance of choice in the context of healthcare and health systems globally. Yet, evidence about how so-called consumers perceive and experience healthcare choice is in short supply and limited to specific healthcare systems, primarily in the Global North. This special issue aims to explore how choice is perceived and utilised in the context of different systems of healthcare throughout the world, where choice, at least in policy and organisational terms, has been embedded for some time. The articles are divided into those emphasising: embodiment and the meaning of choice; social processes associated with choice; the uncertainties, risks and trust involved in making choices; and issues of access and inequality associated with enacting choice. These sociological studies reveal complexities not always captured in policy discourse and suggest that the commodification of healthcare is particularly problematic
Correspondence and Photograph from Ernest W. Wright to Dr. C. A. Bacote, August 30, 1977
No full textCorrespondence between Ernest W. Wright (Employment Security Agency, Georgia Department of Labor) and Dr. C. A. Bacote, 30 August 1977. Enclosed 8"x10" photograph circa 1955, depicting voter registration participants. Written on Verso: "Left to Right: (Seated): Dr. Clarence A. Bacote, Dr. William Hale, Mr. Ron Harris? Dr. Robert Brisbane (Standing): Mr. Michael? Mr. C. A. Scott? Mr. Milton White"
Exploring the role of Approved Mental Health Professionals in relation to the detention of people from Black and Minority Ethnic groups under the Mental Health Act (MHA) 1983
No full textPersistent inequalities in mental healthcare have contributed to the over-representation of people from Black and Minority Ethnic (BME) groups being assessed under the MHA. This was reinforced as recently as 2018 by the Independent Review of the Mental Health Act 1983, detailing how BME communities - especially people with African and Caribbean heritage - are less likely to receive person-centred or community-based social care, and likelier to be compulsorily admitted to psychiatric hospitals than white people. Despite the longstanding nature of the problem, little has been researched about the role of one of the two key professionals responsible for decision-making about compulsory admission: the Approved Mental Health Professional (AMHP). Under the Mental Health Act, AMHPs possess overriding responsibility for deciding whether someone should be detained for compulsory treatment. While the institutional dimensions of this problem have been highlighted in earlier research, this thesis focuses on the use of power and discretion in AMHP decision-making. This research's objectives were to explore the key influences professionals consider when forming judgements about compulsory detention, to examine how practitioners construct risk when arriving at a decision, and to investigate the views and accounts of Black service users concerning their detention experiences, and their level of involvement or participation in decisions determining their care and treatment. This thesis employs empirical data from an ethnographic study conducted in two London Boroughs, involving observations of professional practice and follow-up interviews with 14 AMHPs and 8 Black service users purposively selected across the two sites. Fricker's theory of epistemic injustice and the applied sociological concept of risk work provided a useful theoretical basis for developing an understanding of AMHP decision-making and Black service users' detention experiences. My analysis reveals a mutually constitutive relationship between risk and ethnicity during detention-based decision-making, describing the racialised categorisation of risk, and how AMHP decision-making continues to be shaped by a risk or public safety agenda. The analysis of my observational data generated a nuanced and complex relationship between the diagnostic practices and lower risk threshold operationalised by professionals when working with Black people. This thesis demonstrates the tensions emanating from risk work and suggests that the bureaucratic emphasis on risk management strategies designed to improve safety is paradoxically affecting trust and relationship-based practice, both of which are essential for reducing risk to Black service users. My analysis discloses that most AMHP practitioners doubt their capacity to apply social perspectives or exercise independent decisions within the context of multiagency working, organisational factors, resource implications, the dominance of risk, and "blame culture". AMHPs' inability to exercise autonomy and apply social perspectives presents profound implications for Black service users overwhelmingly faced with multiple social issues or disadvantages such as isolation, unemployment, marginalisation, low income, and social exclusion. This study provides further understanding of how epistemic injustice manifests itself within the mental health service, revealing how Black service users are more susceptible than their white counterparts because of the dual difficulties of experiencing stigma and the negative stereotypes attached to being Black and receiving a mental disorder diagnosis. There is further evidence of AMHPs from Black communities experiencing testimonial injustice from white colleagues ascribing lower credibility to their knowledge and competence due to prejudice associated with their racial identity. This study suggests numerous ways of enhancing epistemic justice, including the provision of IMHA services during MHA assessments in both the community and hospitals. It highlights that rather than adopting a position of 'knowing best', professionals must value and listen to Black service users' accounts to help reverse the stigma, sense of exclusion, and diminished control and choice that Black people with mental health problems continue to experience
Pathways in the diagnosis and treatment of breast cancer: the significance of delay
No full textDelay in the diagnosis and treatment of all types of cancer is now on the policy agenda. A recent government directive compels hospitals to ensure that all patients with a suspected breast cancer see a specialist within two weeks of an urgent referral from their General Practitioner. However the impact of system delay (the time taken for a women to be evaluated, diagnosed and treated once she has sought help) on the stage of disease and outcome in terms of survival is thought to be negligible.
This empirical study aimed to explore the pathways that women followed in the process of diagnosis and treatment of breast cancer to determine how long each stage of the process took. To achieve this a prospective quantitative survey was undertaken that plotted the pathways of 300 women referred to three hospitals breast clinics, to determine whether differences in the organisations of services could explain any variations in the length of the process. The data was collected during observation of active clinics, and in addition interviews with health professionals and patients explored their perceptions of the process.
The study found that there were differences in the way that services for patients with symptomatic breast problems were organised at each of the research sites. Variations were also found in the length of time taken for each stage of the process of diagnosis and treatment both within and between the sites. The variations in the time taken for the process appeared to reflect the differences in the way in which the sites were organised. Although the study did not explore the clinical outcome of delay, it was found to be important because of the anxiety experienced by women waiting for appointments and results. Minimising delay would reduce the length of time women suffer the anxiety of uncertainty
O (nieco zapomnianym) mistrzu fantastyki. Sprawozdanie z konferencji Niekończący się Michael Ende – sylwetka, sygnatura, strategie fantastyczne (Kraków, 8 listopada 2019 roku)
No full textNiniejszy tekst jest sprawozdaniem z konferencji Niekończący się Michael Ende – sylwetka, syg-natura, strategie fantastyczne, która odbyła się 8 listopada 2019 roku w Krakowie. Autorka przedstawia w nim wyznaczone przez organizatorów cele, z których najważniejszym wydaje się przypomnienie postaci oraz twórczości tego wybitnego, a jednocześnie nieco zapomnianego nad Wisłą klasyka literatury fantastycznej. Najwięcej uwagi poświęca przebiegowi konferencji, krótko omawiając wszystkie wygłoszone podczas sesji referaty. Zwraca uwagę na interdyscyplinarny charakter spotkania, wskazując ponadto możliwe kierunki poszerzenia refleksji dotyczącej twórczości niemieckiego pisarza wyznaczane przez przywoływaną literaturę przedmiotu.The text summarizes the conference “The NeverEnding Michael Ende – profile, signature, fantasy strategies”, which took place on 8 November 2019 in Kraków. The author describes the organizers’ objectives, among which the main aim was to remind attendees of the profile and work of Michael Ende – a remarkable fantasy writer who is nowadays somewhat forgotten in Poland. The paper focuses in particular on the course of the conference, briefly summing up all the presentations and emphasizing the interdisciplinary nature of the meeting. Based on the critical studies and further source literature, the author indicates some potential ways in which the reception of Ende’s work could develop
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