Social Science & Medicine最新文献

{"title":"GBTQ+ safe sex entanglements: Finding the bacterial in the age of resistant STIs and prevention innovation","authors":"Shiva Chandra ,&nbsp;Alex Broom ,&nbsp;Damien Ridge ,&nbsp;Katherine Kenny ,&nbsp;Michelle Peterie ,&nbsp;Jennifer Broom ,&nbsp;Bridget Haire ,&nbsp;Lise Lafferty ,&nbsp;Carla Treloar ,&nbsp;Stephanie Raymond ,&nbsp;Catriona Bradshaw ,&nbsp;Tanya Applegate ,&nbsp;Rebecca Guy","doi":"10.1016/j.socscimed.2025.118162","DOIUrl":"10.1016/j.socscimed.2025.118162","url":null,"abstract":"<div><div>Few studies have explored community experiences of our increasingly resistant bacterial landscape, and, in the sphere of sexually transmissible infections (STIs) and antimicrobial resistance, there is even greater absence of community-centred research. This is despite a growth in STI transmission worldwide, which, alongside accelerated resistance, will disproportionately affect GBTQ+ (gay, bisexual, trans, queer+) populations. In this article, drawing on semi-structured interviews conducted in 2024 with 49 cisgender and trans gay and bisexual men, trans women and gender diverse people, we explore contemporary GBTQ+ safe sex practices as they relate to the growing threat of antibiotic resistant STIs in Australia. Key themes identified where the pharmaceutical turn in safe sex practices, the tensions this produced, the complexities of condom use, and the influence of biographies on safe sex practices. We illustrate how the turn toward pharmaceutical solutions have reconfigured and continues to reconfigure safe sex, giving rise to pleasures that were hitherto ‘off-limits’ to many. However, escalating antibiotic resistance threatens to again alter community practices and relationships to STI prevention measures. Drawing on Barad, we develop these themes to theoretically conceptualise safe sex as not fixed, but as an <em>entanglement</em> that is relationally and iteratively (re)configured through the connections between objects, subjectivities, practices, temporalities, and the human-microbial dynamics entailed therein. Findings suggest public health and clinical communication about resistance should speak to population concerns about gut health, resistance vis-à-vis Doxy-PEP, changing definitions of safe sex, and the importance of pleasure.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118162"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gendered knowledge practices and human-animal-ecological health in Papua New Guinea: a qualitative study during a zoonotic tuberculosis investigation","authors":"Benjamin Hegarty ,&nbsp;Paula Jops ,&nbsp;Janet Gare ,&nbsp;Jane Greig ,&nbsp;Herick Aeno ,&nbsp;Somu Nosi ,&nbsp;April Holmes ,&nbsp;Priscah Hezeri ,&nbsp;Dukduk Kabiu ,&nbsp;Pele Ursula Melepia ,&nbsp;Suman S. Majumdar ,&nbsp;Margaret Kal ,&nbsp;Philipp du Cros ,&nbsp;Angela Kelly-Hanku","doi":"10.1016/j.socscimed.2025.118151","DOIUrl":"10.1016/j.socscimed.2025.118151","url":null,"abstract":"<div><div>There have been consistent calls to incorporate gender frameworks into One Health research and policy. Men's and women's roles in relation to animals in many rural and agricultural communities may influence potential pathogen exposure and transmission patterns of zoonotic infectious diseases. However, men's and women's roles related to animals in rural societies are not static but change over time. This article draws on the results of qualitative research about perceptions and practices related to animal species and animal products in five sites located in Eastern Highlands Province and East New Britain, two provinces in Papua New Guinea (PNG). The qualitative research, which aimed to explore animal-human interactions that may pose a risk of zoonotic infections through focus group discussions, formed part of a broader study of zoonotic association and risks for extrapulmonary tuberculosis in PNG. We first introduce participants' descriptions of symptoms of illness that they attributed to zoonotic disease, as well as the animals that they attributed those diseases to. We then draw on an in-depth case study of practices related to rearing pigs — animals with important economic and social value in PNG — to illustrate the impact of social and ecological change on the interplay of gender and relationships with animals. One Health strategies at the community level can focus on gender as a way to understand changes underway in the type and intensity of interactions with animals in rural communities, including their potential impact on zoonotic diseases.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118151"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicalizing violence: The institutional politics of trauma in Veterans Treatment Courts","authors":"Victoria Piehowski","doi":"10.1016/j.socscimed.2025.118170","DOIUrl":"10.1016/j.socscimed.2025.118170","url":null,"abstract":"<div><div>Criminal court actors engage in medicalization as they negotiate the balance of punitive and rehabilitative responses in their work, particularly in cases of low-level drug crime. Often, however, these legal actors regard violent crime as untreatable. This paper examines an exception to this assemblage of practice and policy: Veterans Treatment Courts (VTCs). VTCs combine judges, prosecutors, public defenders, and Veterans Affairs' (VA) professionals to provide treatment-based supervision in lieu of incarceration. In Minnesotan VTCs, court actors regard violent crime as treatable—for this population. Using interview data, I analyze how court actors medicalize violence as they legitimate veterans’ eligibility for the court and design their supervision. I find that court actors establish trauma as an institutional logic in ways that enable them to negotiate contradictions of contemporary rehabilitative punishment. This institutional logic is patterned by two core assumptions: first, that trauma presents a <em>latent risk</em> for crime, necessitating the extensive surveillance of this resource-intensive court; and second, that veteran trauma is particularly distinct from that of others in the criminal justice system, thereby justifying the provision of sentencing incentives and treatment resources to someone who would otherwise be deemed a violent offender. Viewing this dynamic as a process of stratified medicalization, I show how conflicts in contemporary criminal justice politics shape medicalization processes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118170"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nothing is so impactful as good theory: Evidence for the impact of the social identity approach to health on policy and practice","authors":"Tegan Cruwys ,&nbsp;S. Alexander Haslam ,&nbsp;Niklas K. Steffens ,&nbsp;Catherine Haslam ,&nbsp;Stephen D. Reicher","doi":"10.1016/j.socscimed.2025.118164","DOIUrl":"10.1016/j.socscimed.2025.118164","url":null,"abstract":"<div><div>This research sought to evaluate the uptake of research on social identity and health among policymakers and practitioners. It also sought to identify the research outputs that have had the greatest impact and to understand the nature of their impact. Policy impact tools in Elsevier's SciVal institutional subscription were utilised in combination with Overton. We extracted all articles within the social identity approach to health topic 1996–2023 as defined by SciVal, along with all citing policy documents as captured by Overton. Summary statistics and trends for this topic along with seven comparable topics were also extracted. More than 1 in 5 articles on the social identity approach to health are cited in policy documents, a proportion that is greater than that reported in other areas of applied psychology; for example, theory of planned behaviour, self-determination theory, and ego-depletion. Policy documents that advocated for community and social interventions to improve population mental health were particularly likely to draw on this research. Overall, the paper makes two general contributions. First we demonstrate the importance of social identity approach to health research for social/community interventions. We found that social identity and health research has had an outsized impact on policy and discuss several features of the theory and literature that may underpin this impact. Second, we provide a novel method for evaluating research impact that could be utilised across disciplines.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118164"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How concepts guide policy: an ethnographic study of the meaning making of ‘appropriate care’ in Dutch healthcare","authors":"Britt Kraaijeveld ,&nbsp;Sietse Wieringa ,&nbsp;Eivind Engebretsen ,&nbsp;Jet Bussemaker","doi":"10.1016/j.socscimed.2025.118152","DOIUrl":"10.1016/j.socscimed.2025.118152","url":null,"abstract":"<div><div>Concepts, such as value-based healthcare, patient-centered care and integrated care, are used to guide and govern healthcare structures and services. Although prior research has pointed us towards the multiplicity of interpretations of these concepts, there is little understanding of how a concept gets attributed a particular meaning from its various understandings. This paper describes how healthcare actors engage in the meaning-making of the concept of appropriate care in a policy process in Dutch healthcare by employing the discourse-analytical lens of Laclau &amp; Mouffe. The policy process was studied from February 2022 to July 2022 by taking on an ethnographic approach, comprising fieldnotes (92 days of observation), drafts of the policy document (N = 77), interviews (N = 4), and documents (N = 88). Data analysis suggested that meaning was attributed to appropriate care through three strategies: hegemonizing (prevailing of discourses), compromising (merging of discourses), and co-existing (discourses put alongside each other). We argue that from the interplay between these three strategies appropriate care and similar concepts attain a meaning which might be able to productively guide and govern care proposing healthcare actors to actively engage with the ambiguity of concepts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118152"},"PeriodicalIF":4.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between severity of physical intimate partner violence and neonatal mortality in Afghanistan: Survival analysis using Cox proportional hazard model","authors":"Abdul Ghani Khatir ,&nbsp;Negina Rahman ,&nbsp;Tolulope Ariyo ,&nbsp;Quanbao Jiang","doi":"10.1016/j.socscimed.2025.118160","DOIUrl":"10.1016/j.socscimed.2025.118160","url":null,"abstract":"<div><h3>Background</h3><div>Child survival and the prevalence of intimate partner violence (IPV) are critical global health concerns. The Sustainable Development Goals (SDGs) emphasize reducing IPV prevalence and child mortality rates as essential objectives in global health and development. The study investigates the relationship between the severity of physical IPV experienced by women and neonatal mortality in Afghanistan, focusing on the moderating role of antenatal care (ANC) visits and skilled birth attendants (SBA) in this association.</div></div><div><h3>Methods</h3><div>Our study utilized data from Afghanistan's most recent 2015 demographic and health survey (AfDHS). We employed Cox proportional hazard analysis to measure the potential association between the severity of physical IPV experienced by women and neonatal mortality. The severity of physical IPV was categorized as no IPV, less severe physical IPV, or severe physical IPV. Moreover, to assess the moderating effects of ANC and SBA in the relationship between the severity of physical IPV and neonatal mortality, we conducted a moderation analysis. Additionally, a sensitivity analysis using Weibull proportional hazards and accelerated failure time analyses was conducted to assess the robustness of the findings.</div></div><div><h3>Results</h3><div>In total, 17.26 % of women experienced severe physical IPV, while 48.07 % experienced less severe physical IPV. The Cox model indicated that, after adjusting for control variables, the hazard of neonatal mortality was significantly higher among women who experienced severe physical IPV (aHR = 1.67; 95 % CI; p &lt; 0.001) compared to those who experienced no or less severe physical IPV.</div></div><div><h3>Conclusion</h3><div>This study highlights the significant association between the severity of physical intimate partner violence experienced by women and increased neonatal mortality in Afghanistan, highlighting the urgent need for targeted interventions and policies to address the issue of IPV in order to improve mother (maternal) and child health outcomes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118160"},"PeriodicalIF":4.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I continue to consult remotely”: The trans/national practices of war-related migrant doctors in Israel and professional boundaries","authors":"Anna Temkina ,&nbsp;Svetlana Chachashvili-Bolotin","doi":"10.1016/j.socscimed.2025.118154","DOIUrl":"10.1016/j.socscimed.2025.118154","url":null,"abstract":"<div><div>This study examines the professional practices of doctors who emigrated from Russia to Israel following the invasion of Ukraine and its aftermath. It focuses on the national and transnational dimensions of their work, exploring how these medical professionals navigate their careers in the early years of migration. We analyze these practices as both shaped by and shaping national, professional, and institutional boundaries, highlighting the dynamic interplay between migration, professional identity, and systemic constraints. Local rootedness and national exclusivity present significant barriers to the development of transnational medical work. While a growing body of research has examined the cross-border professional activities of physicians, considerably less attention has been paid to those of doctors who are forced to migrate due to war, persecution, or political instability. Additionally, we know little about how the war has impacted Russian migrant doctors and their professional practices, especially in relation to the opportunities for global online medical work. The results of our study based on 21 in-depth interviews add to understanding of the diverse practices involved in professional restructuring, as opposed to a unidirectional model of integration. Our findings highlight the flexibility of professional boundaries, which are often assumed to be rigid and opaque.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118154"},"PeriodicalIF":4.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic area deprivation and its relationship with dementia, Parkinson's Disease and all-cause mortality among UK older adults: a multistate modeling approach","authors":"May A. Beydoun ,&nbsp;Michael F. Georgescu ,&nbsp;Jordan Weiss ,&nbsp;Nicole Noren Hooten ,&nbsp;Hind A. Beydoun ,&nbsp;Jack Tsai ,&nbsp;Christian A. Maino Vieytes ,&nbsp;Michele K. Evans ,&nbsp;Alan B. Zonderman","doi":"10.1016/j.socscimed.2025.118137","DOIUrl":"10.1016/j.socscimed.2025.118137","url":null,"abstract":"<div><div>The study analyzed the association of area-level socioeconomic status (SES) with the risk of all-cause dementia, Parkinson's Disease (PD), and all-cause mortality using a multistate approach. Data from the UK Biobank were used (N = 363,663 50+y individuals, ≤15y follow-up), and Cox proportional hazards and multistate parametric models including Weibull regression were conducted, while cardiovascular health was tested as a potential mediator. In multistate models, socioeconomic area-level deprivation, measured by the Townsend Deprivation Index (TDI) z-score, was positively associated with the hazard of going from healthy into the 3 states of PD, dementia, and all-cause mortality (i.e. transitions 1: HR = 1.06, 95 % CI:1.02–1.10, P = 0.005, 2: HR = 1.19, 95 % CI: 1.16–1.22, P &lt; 0.001 and 3: HR = 1.19, 95 % CI: 1.18–1.21, P &lt; 0.001), with no association detected for transitions 4 (PD→Dementia), 5 (PD→Death), or 6 (Dementia→Death). Cardiovascular health did not mediate these associations. Socioeconomic area-level deprivation was directly associated with reduced survival rates from Healthy into Dementia, PD and Death.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118137"},"PeriodicalIF":4.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#diabetictoddlers and #type1moms: Visibilizing parent-child interembodiment on TikTok","authors":"Erin V. Moore,&nbsp;Kelsey Shearer,&nbsp;Seneba Thiam,&nbsp;Zahra Ramakdawala,&nbsp;Luxin Yin,&nbsp;Génesis Alvelo Colon","doi":"10.1016/j.socscimed.2025.118095","DOIUrl":"10.1016/j.socscimed.2025.118095","url":null,"abstract":"<div><div>Parents of children with type 1 diabetes, a deadly illness made chronic through its management, have posted thousands of videos on the social media platform TikTok with hashtags such as #diabetictoddler, #type1mom, and #type1family. Filmed in different styles and set to different music, these videos all feature parents caring for their children by acting upon their bodies as they insert, inject, remove, and reconfigure the biotechnologies of diabetes management. Building from recent studies that show that parents share the embodiment of their children's type 1 diabetes as stress and anxiety related to managing a potentially fatal condition, this article explores how parents use TikTok to visibilize interembodiment. In TikTok videos, interembodiment hinges on shared disease management rather than shared disease symptom or etiology. Moving from the position that people do not simply possess bodies but continually enact them, we explore how parents and children jointly enact diabetes through an entanglement of bodies, voices, medical technologies, and social media personae that appear in #diabetictoddler and #type1mom TikToks. Given some of these videos have circulated to millions of people, we propose that TikTok and other social media platforms provide unique forums for type 1 parents to make their interembodiment visible, perhaps even as a salve for the distress they suffer as they manage their children's illnesses.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118095"},"PeriodicalIF":4.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting healthcare costs with diagnoses recorded in primary and secondary care: an analysis of linked records","authors":"Shaolin Wang ,&nbsp;Laura Anselmi ,&nbsp;Yiu-Shing Lau ,&nbsp;Matt Sutton","doi":"10.1016/j.socscimed.2025.118157","DOIUrl":"10.1016/j.socscimed.2025.118157","url":null,"abstract":"<div><div>Most risk-adjustment models rely on diagnoses recorded during previous contacts in the same care setting to predict service use and cost. When diagnostic information from multiple settings has been used, studies have not examined how diagnoses recorded in different care settings influence model performance. Using a single set of diagnostic indicators recorded in primary or secondary care can incentivise case-finding and treatment outside hospital, but may reduce model fit if secondary care diagnosis indicates higher levels of severity. Using linked primary and secondary care records for 12.8 million patients in England, we used 205 chronic conditions recorded in primary care to complement those recorded during recent hospital admissions. We examined predictions of hospital use and cost for different population groups and considered the related incentives and implications for efficiency and fairness. Most patients (56 %) had at least one condition ever recorded in primary care, while only 15 % had at least one recorded in secondary care in the previous two years. Adding diagnoses recorded only in primary care as a separate additional set of predictors improved the model fit for total costs, planned and unplanned costs, elective and emergency admissions, outpatient visits, and emergency department attendances. Using a single set of diagnoses recorded in either setting did not improve model fit, except for outpatient visits. Including primary care diagnoses reduced under and over-compensation and increased the predicted service needs of younger patients in less deprived areas and older patients in more deprived areas.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118157"},"PeriodicalIF":4.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}