Health最新文献

{"title":"Rethinking the logic of early diagnosis in cancer.","authors":"Christina Sadolin Damhus, Mette Bech Risør, John Brandt Brodersen, Alexandra Brandt Ryborg Jønsson","doi":"10.1177/13634593241234481","DOIUrl":"10.1177/13634593241234481","url":null,"abstract":"<p><p>To reduce morbidity and mortality of cancer, more countries have implemented strategies to detect cancer, based on the logic of 'the sooner the better'. <i>Time</i> is thereby an essential component in how cancer research, policies, and prevention are practiced today. Where the logic of early diagnosis benefits some, the logic also produces harms. In this article, we use a cross-disciplinary case-study design to discuss how different notions of time and linearity are essential in today's research ontology of cancer, describe the individual and societal consequences of such ontology, and invite a rethinking of time in cancer. Drawing on theoretical concepts of time together with cancer epidemiological, historical and ethnographical data, we analyse how the logic of early diagnosis has been established as a stable concept. Although evidence supporting the logic points in different directions, the message 'the sooner the better' is currently not being challenged by research, policy or society. This at least partly, can be explained by a linear perception of time and societal traces of neoliberalism and acceleration in our society together with cancer still being a somewhat enigmatic disease that requires acute action. To support a sustainable healthcare sector, we argue there is a need to nuance the logic of early diagnosis. Continuing the linear perception of symptoms and cancer, risks doing more harm than good by making more people patients unnecessarily and by spending health resources on those with the least need.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"3-22"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind-Stuff and Withdrawal of the Senses: Toward an Interpretation of Pratyahara in Contemporary Postural Yoga.","authors":"Elizabeth McKibben","doi":"10.1177/13634593231222450","DOIUrl":"10.1177/13634593231222450","url":null,"abstract":"<p><p>Yoga has become a popular health and wellbeing practice that draws on ancient philosophy. Pratyahara is a core tenet of yoga practice and is often translated to mean withdrawal of the senses. Withdrawing from the senses plays a key role in aiding yoga practitioners to find spiritual enlightenment by transcending the worldly. Withdrawing from the material world, however, does not neatly fit within the parameters of the contemporary postural yoga industry. This paper looks at the conceptual origins of pratyahara through stances relevant to health research. The author weaves biomedical, esthetic, and neoliberal onto-epistemological stances through health discourse to discuss how postural yoga both resists and replicates power imbalances. In so doing the author emphasizes the paradoxical nature of pratyahara as it is reflected in socio-political tensions of the yoga industry. To conclude, the author suggests that pratyahara itself can be useful in resolving this tension as yoga fulfills a philosophical prerogative for social change.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"83-99"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narratives about distributed health literacy during the COVID-19 pandemic.","authors":"Susana Silva, Helena Machado, Ilaria Galasso, Bettina M Zimmermann, Carlo Botrugno","doi":"10.1177/13634593231215715","DOIUrl":"10.1177/13634593231215715","url":null,"abstract":"<p><p>The promotion of health literacy was a key public health strategy during the COVID-19 pandemic. However, the role of social networks and relationships for support with health literacy-related tasks in the context of the COVID-19 pandemic is scarcely understood. Moving beyond traditional notions of health literacy, which focus on individual skills and knowledge, this study uses the concept of distributed health literacy to explore how individuals make meaning of and respond to health literacy and make their literacy skills available to others through their relational and socially situated and lived experiences of the COVID-19 pandemic. Drawing on 89 semi-structured interviews conducted in three European countries (Italy, Portugal, and Switzerland) between October and December 2021, we found narratives of stabilization, hybridization, and disruption that show how health literacy concerning COVID-19 is a complex social construct intertwined with emotional, cognitive, and behavioral responses distributed among individuals, communities, and institutions within socioeconomic and political contexts that affect their existence. This paper opens new empirical directions to understand the critical engagement of individuals and communities toward health information aimed at making sense of a complex and prolonged situation of uncertainty in a pandemic.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"100-117"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: How do we avoid polarization of interdisciplinary research on cancer diagnosis?","authors":"Christina Sadolin Damhus, Mette Bech Risør, John Brandt Brodersen, Alexandra Brandt Ryborg Jønsson","doi":"10.1177/13634593241258410","DOIUrl":"10.1177/13634593241258410","url":null,"abstract":"","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"34-38"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"You kind of blame it on the alcohol, but. . .\": A discourse analysis of alcohol use and sexual consent among young men in Vancouver, Canada.","authors":"Trevor Goodyear, John L Oliffe, Hannah Kia, Emily K Jenkins, Rod Knight","doi":"10.1177/13634593231214942","DOIUrl":"10.1177/13634593231214942","url":null,"abstract":"<p><p>There is growing awareness about issues of sexual consent, especially in autonomy-compromising or \"non-ideal\" contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18-30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men's alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla's non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: <i>careful connections, watering it down</i>, and <i>blurred lines</i>. In <i>careful connections</i> young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in <i>watering it down</i> young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized <i>blurred lines</i> through a continuum of consent and of \"meeting (masculine) expectations\" when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"118-139"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Hearts' and 'minds': Illustrating identity tensions of people living and working through marketising policy change of allied health disability services in Australia.","authors":"Kristen Foley, Stacie Attrill, Chris Brebner","doi":"10.1177/13634593241230018","DOIUrl":"10.1177/13634593241230018","url":null,"abstract":"<p><p>Service-based caring sectors like disability are increasingly being operated via market logic, including shifts towards personalised funding. These shifts must be brought to life in/through people already located in relation to ideas and values that underpin historical policies. Our manuscript examines how identities are re/shaped in relation to marketised policy change and explores how identity change unfolds (or not) during periods of transition: situated within the transition to the National Disability Insurance Scheme executed in Australia as a major disability funding reform. Our qualitative dataset involves interview and focus group data collected with service recipients/carers (<i>n</i> = 28), providers/managers (<i>n</i> = 17) and advocates (<i>n</i> = 2) during shift from government- to personally-controlled funding of allied health services for people with disability in Australia (2017-2020). We used layered sociological inference to develop and interrogate processes of tension and identity change amidst lived experience(s) of policy change. Our analysis elucidates how various identities were encouraged, desired, resisted and constrained in relation to the policy transition. We bring together sub-themes from analysis of recipient/carer data (getting value-for-money; critiquing service quality; and experiencing system shortfalls) and manager/provider data (learning to transact; the call to care; and structural frictions in/and identity transitions) to interpret that recipients/carers are <i>Feeling (like) the dollar sign</i> and that managers/providers are <i>Troubling profits.</i> In both cases 'hearts' and 'minds' are perceived to be diametrically opposed and symbolic in/against processes of marketisation. We synthesise our data into an illustrative framework that facilitates understanding of how this perception of opposed 'hearts' and 'minds' seems to constrain the identity transitions encouraged by personalised funding, and explore ways in which desired identities might be supported amidst marketising policy transition.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"39-61"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do we avoid polarization of interdisciplinary research on cancer diagnosis? A critical comment to: \"Rethinking the Logic of Early Diagnosis in Cancer\" by Damhus, Risør, Brodersen, and Jønsson (2024).","authors":"Rikke Sand Andersen, Michal Frumer, Camilla Hoffmann Merrild, Sara Marie Hebsgaard Offersen, Rikke Aarhus, Marie Louise Tørring","doi":"10.1177/13634593241258392","DOIUrl":"10.1177/13634593241258392","url":null,"abstract":"","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"23-33"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare seeking for people diagnosed with severe mental illness: Sensations, symptoms and diagnostic work.","authors":"Iben Emilie Christensen, Susanne Reventlow, Lone Grøn, Mette Bech Risør","doi":"10.1177/13634593241308497","DOIUrl":"https://doi.org/10.1177/13634593241308497","url":null,"abstract":"<p><p>For people with mental and somatic illnesses, the interpretive process of attending to a multitude of bodily sensations and recognising them as potential symptoms represents daily and 'chronic homework'. Based on 16 months of ethnographic fieldwork in Denmark, this study explores diagnostic work and healthcare seeking among people with severe mental and somatic illnesses. As multiple studies have shown, the transformation process for a perceived sensation to become a symptom is a socially constructed interpretative process highly dependent on social legitimisation and shaped by prior cultural knowledge. We found that people with severe mental and somatic illnesses often struggle to 'read' the body and its boundaries and to define and distinguish when a symptom becomes a potential sign of illness. Furthermore, they often lack opportunities for social recognition of symptoms due to the absence of social relations. Finally, lifelong experiences with the healthcare system have taught them that they must distinguish between 'mental' and 'somatic' symptoms to fit the systemic organisation of the healthcare system. This deeply rooted mind-body dualism in the organisation of healthcare services and the daily struggles of diagnostic work to comply with this organisation impacted the interlocutors' healthcare seeking strategies. Moreover, even though they 'make up their minds' to seek healthcare, they risk being met with diagnostic overshadowing and reductionist clinical approaches.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241308497"},"PeriodicalIF":1.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring remotely through 'fitting': Video consultation use in Danish general practice.","authors":"Elle Christine Lüchau, Finn Olesen, Helen Atherton, Jens Søndergaard, Elisabeth Assing Hvidt","doi":"10.1177/13634593241306577","DOIUrl":"https://doi.org/10.1177/13634593241306577","url":null,"abstract":"<p><p>In this study, we examine how Danish general practitioners (GPs) and general practice staff have fitted their use of video consultation to align with their conceptualisations of good care. Political stakeholders are repeatedly encouraging the use of video consultation in the healthcare sector, discursively referring to optimised use of healthcare resources, increased efficiency and flexibility for and geographical equality among patients. By the end of 2024, it will be mandatory for GPs to offer video consultations to patients in Danish general practice. This raises important questions about the implications of video consultation on the care provided in general practice. Our data consists of 30 semi-structured interviews with GPs and 132 hours of fieldwork conducted across seven clinics from August 2021 to August 2022. We analysed the data following the principles of reflexive thematic analysis and inspired by an abductive approach. Drawing on Annemarie Mol's and Jeanette Pols' conceptualisations of care and fitting, we identified common rationalisations articulated and observed in practice that highlight how fitting video consultation into the care provided in a general practice setting can enable (1) optimised use of busy patients' time), (2) optimised use of clinician and clinic resources, (3) enhanced connection of 'harder to reach' patients and (4) better work experiences for GPs and staff. Our findings demonstrate the variety of video consultation use potentials, contributing to our understanding of the implications of video consultation on the provision of care.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241306577"},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bad migrant: An autoethnographic case study of racism in Australian HIV care.","authors":"Satrio Nindyo Istiko","doi":"10.1177/13634593241306578","DOIUrl":"https://doi.org/10.1177/13634593241306578","url":null,"abstract":"<p><p>Australia is world renowned when it comes to its successful response to HIV prevention, but their HIV epidemiological trend has shifted towards the increase of new HIV diagnoses among migrants. This paper reveals a neglected determinant of migrants' health within Australian HIV care, and that is: racism. To provoke a debate on the saliency of racism, I used autoethnographic case study to analyse my encounter with racism in Australian HIV care. I argue migrants who live with HIV can be racially classified by health care professionals into 'good' or 'bad migrants' based on biomedical measures, neoliberal values and dehumanising health care provision. A migrant patient becomes a bad migrant if the person is perceived to be incapable of taking personal responsibility over their treatment, is a burden to the health system and deserving of poor HIV care. Decolonising HIV care is a necessity to stop the subtle yet insidious social reproduction of racism.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241306578"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}