IF 2 4区医学

Health Pub Date : 2026-08-07 DOI: 10.1177/13634593261461493

Robyn Mayes, Alicia Feldman, Paula McDonald, Christina Malatzky, Diana Leon-Espinoza, Peter Frederiksen, Janet Davies

{"title":"Gender inequality in clinician-scientist research careers: Evidence from a large Australian hospital network.","authors":"Robyn Mayes, Alicia Feldman, Paula McDonald, Christina Malatzky, Diana Leon-Espinoza, Peter Frederiksen, Janet Davies","doi":"10.1177/13634593261461493","DOIUrl":"https://doi.org/10.1177/13634593261461493","url":null,"abstract":"This article addresses the lack of empirical evidence about how gender dynamics shape clinical research careers within health service environments. Informed by a feminist organisational theoretical perspective, this paper advances evidence-based understandings of systemic gender inequalities. The research generates knowledge of the extent to which core dimensions of clinician research activity in a large Australian hospital network varied by gender, clinical speciality, and/or health discipline. A survey instrument was iteratively developed with input from a clinician-scientist reference group and distributed to employees who had undertaken research in the past 5 years. The survey covered demographics, role, and research activities, outputs, support, and barriers. The 268 valid respondents (67.5% women) included medical (25.4%), allied health (44.8%), and nursing (22.8%) researchers. Analysis comprised descriptive statistics, non-parametric comparisons, regression models, and thematic coding of open-text questions. Substantive and systemic gendered differences were evident in opportunities, experiences, and outcomes, irrespective of level of experience or employment duration. Gendered differences were evident across key markers of research performance and reputation. Hours spent on research and employment duration both positively predicted publications for men but not women. Women were significantly more likely to adopt what are often seen as less prestigious methodologies. Importantly, men's and women's experiences of research processes, cultures and interactions differed, as was particularly evident in medicine, where women also reported significantly lower levels of workplace belonging. This research provides robust empirical evidence necessary for the development of effective organisational responses to address gender inequalities in research practices, cultures, and interactions.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261461493"},"PeriodicalIF":2.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689266","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}

引用次数: 0

Health for all? From lifestyle risk to genomic governance: The enduring logics of individualisation in an age of inequality. 人人享有健康？从生活方式风险到基因治理：不平等时代个体化的持久逻辑。

IF 2 4区医学

Health Pub Date : 2026-07-31 DOI: 10.1177/13634593261473159

Paul Crawshaw

{"title":"Health for all? From lifestyle risk to genomic governance: The enduring logics of individualisation in an age of inequality.","authors":"Paul Crawshaw","doi":"10.1177/13634593261473159","DOIUrl":"https://doi.org/10.1177/13634593261473159","url":null,"abstract":"In 1997, 3 years ahead of WHO's target of delivering Health for All, critical health scholarship was energised by the mainstreaming of social determinants and the optimism of the new public health. Yet alongside these collective ambitions, lifestyle discourses, rooted in 1970s healthism, proliferated across consumer cultures, framing health as a matter of personal responsibility. Over the past three decades, these individualising logics have intensified. Initially expressed through behavioural risk management, they now extend into molecular and algorithmic regimes, producing the 'genomic citizen', tasked with managing biological futures via data-driven infrastructures and market-mediated technologies. Framed as empowering, these paradigms obscure structural determinants and embed health within a political economy of anticipation, where promissory narratives justify investment while deepening responsibilisation. The COVID-19 syndemic exposed the fragility of individualised discourses, reaffirming the salience of systemic inequality. In response, this paper reflects on the concept of metabolic justice, a framework that reframes the relationship between behavioural and biological discourses while foregrounding redistribution, ecological embeddedness and systemic reform. By situating health within networks of exposure and dependency rather than individual optimisation, metabolic justice revives the ambitions of Health for All and its descendants as a materially grounded, politically transformative project for an era of social inequality and stratified medicine.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261473159"},"PeriodicalIF":2.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648475","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}

引用次数: 0

Adapting to expectancy violations during telehealth interactions with clients: Communication and technological implications for counselors. 在与客户的远程医疗互动中适应期望违反：对辅导员的沟通和技术影响。

IF 2 4区医学

Health Pub Date : 2026-07-30 DOI: 10.1177/13634593261471913

Karishma Chatterjee, Damla Ricks

{"title":"Adapting to expectancy violations during telehealth interactions with clients: Communication and technological implications for counselors.","authors":"Karishma Chatterjee, Damla Ricks","doi":"10.1177/13634593261471913","DOIUrl":"https://doi.org/10.1177/13634593261471913","url":null,"abstract":"Counselors used mediated channels to offer therapy to clients during the COVID-19 Pandemic. Virtual therapy is convenient, yet recent research suggests it may not be an appropriate modality for all clients. In this study, we interviewed counselors to learn about their experiences of challenging or confronting clients virtually in the United States by integrating interaction adaption theory with frameworks of technological affordances of care. In-depth interview data from 31 counselors suggest their ability to read body language cues, a need for privacy, and lack of distractions are requirements when issuing challenges. Counselors' experienced expectancy violations such as clients walking away from the camera, shouting, making faces, and being silent. Counselors' desire to build rapport, have therapeutic sessions, and to want to be in control while helping clients navigate turbulent emotions during a challenge were often thwarted due to the online modality. Counselors adjusted to telehealth limitations while challenging clients by focusing on visual cues such as facial expressions and tone of voice, which are technological affordances in virtual therapy. Other counselors sought clarification regarding non-verbal cues such as silence and facial expressions. Counselors adapted to expected violations using compensation and reciprocity. Counselors' requirements, expectancies and desires seem to inform their interactional position toward issuing a challenge. Counselors who understand and adapt to the affordances of technology during virtual therapy may be in a better position to successfully challenge clients. Thus, this study extends previous research on mental telehealth care during the pandemic by integrating a communication lens of interaction adaptation theory with the literature on the role of technology in virtual therapy to examine the technological affordances during counselor and client interactions.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261471913"},"PeriodicalIF":2.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619752","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}

引用次数: 0

Stigma as evidence: A critical discourse analysis of research on MSM HIV PrEP stigma. 污名作为证据：男男性接触者HIV PrEP污名研究的批判性话语分析。

IF 2 4区医学

Health Pub Date : 2026-07-30 DOI: 10.1177/13634593261470326

Adam Christianson

{"title":"Stigma as evidence: A critical discourse analysis of research on MSM HIV PrEP stigma.","authors":"Adam Christianson","doi":"10.1177/13634593261470326","DOIUrl":"https://doi.org/10.1177/13634593261470326","url":null,"abstract":"While stigma is often theorized relationally, in evidence-based paradigms it is treated as a factor. How does this objectification of inequalities function within healthcare discourses and what effects does it have? This article makes the case that stigma when treated as evidence operates as an empty signifier. Beyond strictly indexing inclusion and equity issues facing men who have sex with men (MSM), \"stigma as evidence\" may play a transformational role in the governance and sexual health politics of the LGBT* community. An analysis of 57 academic articles on PrEP stigma affecting MSM between 2011 and 2022 illustrates how stigma, when treated as a factor, capitalizes on the abstraction and generalization processes common in evidence-based medicine to depersonalize and fragment the values and practices deemed problematic by health researchers. These abstractions are then used to critique those values, and valourizing those that support implementation. The result is an apparent reshaping of the community through this discourse. The article explains why stigma may persist as a valuable term in healthcare, despite its placeholder-like quality with implications for research and policy on stigma in healthcare.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261470326"},"PeriodicalIF":2.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629938","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}

引用次数: 0

Accomplished normalization, enduring exceptionalism: Aging with HIV in the era of antiretroviral treatment. 完成正常化，持久例外：抗逆转录病毒治疗时代的艾滋病患者。

IF 2 4区医学

Health Pub Date : 2026-07-29 DOI: 10.1177/13634593261469818

Tony Sandset

{"title":"Accomplished normalization, enduring exceptionalism: Aging with HIV in the era of antiretroviral treatment.","authors":"Tony Sandset","doi":"10.1177/13634593261469818","DOIUrl":"https://doi.org/10.1177/13634593261469818","url":null,"abstract":"This article examines how adults aged 50 years and older living with HIV in Norway negotiate the contemporary shift from AIDS exceptionalism to biomedical normalization, and what this reveal about the endurance of exceptionalism \"by other means.\" Drawing on 21 semi-structured life-course interviews with people living with HIV, including long-term survivors diagnosed prior to combination ART in 1996, and analyzed through reflexive thematic analysis, the study identifies three patterned meanings. First, participants described \"accomplished normalization\": HIV was narrated as clinically stable and increasingly comparable to other age-related conditions, supported by simplified ART routines and routinized follow-up care. Second, normalization was \"disrupted\" and at times actively contested, through stigma encounters, disclosure dilemmas, and especially sexuality and intimacy reactivated HIV as exceptional despite biomedical control. Third, participants articulated \"discursive undetectability\": viral suppression was experienced as a biomedical achievement, yet many perceived declining public and professional knowledge about contemporary HIV, producing renewed fear, misrecognition, and incentives to conceal serostatus. The findings suggest that later-life HIV is characterized by an ambivalent coexistence of clinical normalization and social exceptionalism, and that meaningful normalization requires sustained public education and recognition alongside pharmaceutical efficacy.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261469818"},"PeriodicalIF":2.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602002","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}

引用次数: 0

Practitioner narratives on health data management for sexuality and gender diverse people: Benefits, drawbacks, data fixity and the exposure/erasure duality in the clinical encounter. 从业人员叙述的健康数据管理的性和性别多样化的人：好处，缺点，数据固定和暴露/消除二元性在临床遭遇。

IF 2 4区医学

Health Pub Date : 2026-07-28 DOI: 10.1177/13634593261472140

Mark D M Davis, Jessica Grahame, Clue Coman, Ellen Sargent, Anthony K J Smith

{"title":"Practitioner narratives on health data management for sexuality and gender diverse people: Benefits, drawbacks, data fixity and the exposure/erasure duality in the clinical encounter.","authors":"Mark D M Davis, Jessica Grahame, Clue Coman, Ellen Sargent, Anthony K J Smith","doi":"10.1177/13634593261472140","DOIUrl":"https://doi.org/10.1177/13634593261472140","url":null,"abstract":"There is fervent support among some for the expansion of data-driven healthcare for improved economic efficiency, patient safety, personalised care and knowledge discovery. Yet, these promises have failed to properly consider the impact of health data in the healthcare for LGBTQ+ people. Uncritical use of health data systems can expose LGBTQ+ people to homo-, trans-, bi-, HIV- and sex worker-phobic prejudice. It may also erase their identities and data needs in ways that compromise their care. Drawing on sociomaterial analysis and in-depth interviews, we consider how providers in Australia manage data in healthcare for LGBTQ+ people. We consider how they managed the benefits and pitfalls of health data systems, including Australia's, My Health Record. Some frustration was expressed with poorly implemented and resourced data systems that were imposed on providers. Inflexible gender coding systems, for example, were reported to harm care rather than support it. Providers indicated that knowledge of sexuality and gender diversity was needed to use data systems safely and usefully. They also suggested that both providers and patients self-organise into queer affirmative clinic settings in ways that have the effect of obviating the problems of exposure and erasure tied to data systems. We discuss how health data policy and healthcare for LGBTQ+ people needs to support providers in their efforts to advance healthcare while accounting for what datafied medicine can and cannot do for them.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261472140"},"PeriodicalIF":2.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602088","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}

引用次数: 0

Beyond reflection: Diffractive and intra-active interventions in health knowledge. 超越反思：对健康知识的间接和主动干预。

IF 2 4区医学

Health Pub Date : 2026-07-22 DOI: 10.1177/13634593261468036

Adele Moore

引用次数: 0

Exploring ethical, social, and political dimensions in the lives of children with medical complexity through Charles Taylor's hermeneutical framework. 通过查尔斯·泰勒的解释学框架，探索具有医学复杂性的儿童生活中的伦理、社会和政治维度。

IF 2 4区医学

Health Pub Date : 2026-07-22 DOI: 10.1177/13634593261465556

Raíssa Passos Dos Santos, Mary Ellen Macdonald, Eliane Tatsch Neves, Franco Carnevale

{"title":"Exploring ethical, social, and political dimensions in the lives of children with medical complexity through Charles Taylor's hermeneutical framework.","authors":"Raíssa Passos Dos Santos, Mary Ellen Macdonald, Eliane Tatsch Neves, Franco Carnevale","doi":"10.1177/13634593261465556","DOIUrl":"https://doi.org/10.1177/13634593261465556","url":null,"abstract":"This study explores the ethical, social, and political perspectives surrounding the lives of children with medical complexity using Charles Taylor's hermeneutical framework. Children with medical complexity are often defined by their clinical conditions, functional limitations, and the extensive healthcare services they require. This research aims to uncover the broader social imaginaries and horizons of significance that shape these children's lives and care experiences. Through a detailed hermeneutical analysis of legal documents, media reports, medical records, and interviews with key informants, the study reveals that societal expectations prioritize saving these children's lives \"at all costs,\" often overlooking children's experiences, specific contexts and challenges faced by their families. The desire to normalize these children according to typical developmental outlooks and the significant responsibility placed on mothers as primary caregivers were prominent themes. Ethical aspects were also identified, highlighting conflicts faced by healthcare professionals and the limited participation of children in decision-making processes due to their medical conditions. These findings illustrate the complex interplay of societal values, ethical perspectives, and caregiver roles in pediatric care, emphasizing the need for more inclusive and contextually sensitive approaches to support the well-being and decision-making processes of children with medical complexity.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261465556"},"PeriodicalIF":2.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561810","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}

引用次数: 0

Rethinking health care cultures in community services: Towards an operational five-criteria framework. 重新思考社区服务中的保健文化：朝向可操作的五标准框架。

IF 2 4区医学

Health Pub Date : 2026-07-02 DOI: 10.1177/13634593261463790

Ángel Martínez-Hernáez

{"title":"Rethinking health care cultures in community services: Towards an operational five-criteria framework.","authors":"Ángel Martínez-Hernáez","doi":"10.1177/13634593261463790","DOIUrl":"https://doi.org/10.1177/13634593261463790","url":null,"abstract":"Calls for cultural change in health services often remain confined to managerial or ethical discourse, lacking critical depth and operational clarity. This article develops the concept of health care cultures (HCCs) as an analytical category in its own right: dynamic configurations of power, knowledge and practice that actively shape how care is conceived, delivered and governed. Drawing on a Gramscian framework, feminist care theory, and the literature on structural competency, I conceptualise HCCs as sites of tension between hegemonic and subaltern forms of knowledge and practice. This reframing has direct implications for how community health and mental health services are analysed, evaluated and transformed: it moves beyond treating culture as a background variable to be managed, or as a property of patients and professional encounters, to examining how the institutional organisation of care itself produces and reproduces inequalities. On this theoretical basis and drawing on three research projects conducted in Brazil and Spain, I propose a five-criteria framework for analysing and transforming HCCs: structural competency, community participation, recognition of experiential knowledge of illness, shared and supported decision-making and the safeguarding of users' rights. These criteria are interdependent rather than parallel. Structural competency provides the conditions of possibility for the other four, which together constitute a way of asking what kind of institution a community health service is and what kind it might become.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261463790"},"PeriodicalIF":2.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375260","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}

引用次数: 0

Experiences of living with, managing, and preventing reoccurrence of Diabetic Foot Ulcers: Restoring context and complexity to health and illness research. 生活、管理和预防糖尿病足溃疡复发的经验：恢复健康和疾病研究的背景和复杂性。

IF 2 4区医学

Health Pub Date : 2026-07-01 Epub Date: 2025-11-08 DOI: 10.1177/13634593251387548

Ruth I Hart, David Rankin, Fran Game, Kavita Vedhara, Julia Lawton

{"title":"Experiences of living with, managing, and preventing reoccurrence of Diabetic Foot Ulcers: Restoring context and complexity to health and illness research.","authors":"Ruth I Hart, David Rankin, Fran Game, Kavita Vedhara, Julia Lawton","doi":"10.1177/13634593251387548","DOIUrl":"10.1177/13634593251387548","url":null,"abstract":"Diabetes is a major global health concern, with diabetic foot ulcers (DFUs) presenting a common complication. Interest is growing in people's lived experiences of DFUs, including their management and prevention. Typically, research has highlighted the disruptive and extended impact of DFUs, and has focused on the role of intrinsic, individual factors (e.g. knowledge, physical capabilities and personal choices) in their development and management. The influence of extrinsic, contextual factors, has received comparatively limited attention. To address this potentially important gap in the literature we set out to explore people's experiences of DFUs, using a distinctive, contextually-sensitive, analytical lens. Our analysis led us to identify three over-arching themes: a spectrum of embodied experiences of DFUs; intersection with wider experiences of ill-health; and, framing of (DFU) experiences by broader life circumstances. Within these themes, considerable diversity was evident. Broader life circumstances, in particular, shaped experiences of living with, managing, and preventing reoccurrence of DFUs in markedly different, and previously unacknowledged, ways. We conclude that experiences of DFUs are far more nuanced and contextually-mediated than previously reported, and identify important practical implications for the provision of sensitive and effective support and clinical care. Moreover, we suggest that identifying these sorts of complexities in illness experiences may require larger, and more varied samples and data-sets than have become the norm in qualitative health research, as well as more expansive disciplinary lenses.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"558-577"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471021","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}

引用次数: 0

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