Architecture and health care: a place for sociology.

Sociologists of health and illness have tended to overlook the architecture and buildings used in health care. This contrasts with medical geographers who have yielded a body of work on the significance of places and spaces in the experience of health and illness. A review of sociological studies of the role of the built environment in the performance of medical practice uncovers an important vein of work, worthy of further study. Through the historically situated example of hospital architecture, this article seeks to tease out substantive and methodological issues that can inform a distinctive sociology of healthcare architecture. Contemporary healthcare buildings manifest design models developed for hotels, shopping malls and homes. These design features are congruent with neoliberal forms of subjectivity in which patients are constituted as consumers and responsibilised citizens. We conclude that an adequate sociology of healthcare architecture necessitates an appreciation of both the construction and experience of buildings, exploring the briefs and plans of their designers, and observing their everyday uses. Combining approaches and methods from the sociology of health and illness and science and technology studies offers potential for a novel research agenda that takes healthcare buildings as its substantive focus.

Disorder and disconnection: parent experiences of liminality when caring for a dying child

Parents caring for a child with a life threatening or life limiting illness experience a protracted and largely unknown journey, as they and their child oscillate somewhere between life and death. Using an interpretive qualitative approach, interviews were conducted with parents (n = 25) of children who had died. Findings reveal parents’ experiences to be characterised by personal disorder and transformation as well as social marginalisation and disconnection. As such they confirm the validity of understanding these experiences as, fundamentally, one of liminality, in terms of both individual and collective response. In dissecting two inter-related dimensions of liminality, an underlying tension between how transition is subjectively experienced and how it is socially regulated is exposed. In particular, a structural failure to recognise the chronic nature of felt liminality can impede parents’ effective transition.

The Moderating Effects of Emotions on Cognitive Skills

An important challenge in higher education today is the growing tutor -student ratio that diminishes the ‘human touch’. As learning and teaching is ultimately an interpersonal process, this will lead to student discontent and impact on the ir learning. Whilst there is little that teaching practitioners can do in terms of the growing student numbers they have to tutor , they may however influence student learning by enhancing their positive emotions. This study examines the importance of emotion s in improving cognitive skills and how it interacts with knowledge and reflection. This research contributes to theory by examining the role of emotions as a moderating factor in the lear ning process. Our findings reveal that emotions moderate the direct relationship between knowledge and cognitive skills , and the indirect relationship between knowledge and cognitive skills via reflection. The findings demonstrate the critical role that emotions play in student learning. Implications for theory and practice are discussed.

Widening participation in higher education: the role of professional and social class identities and commitments

Since the neoliberal reforms to British education in the 1980s, education debates have been saturated with claims to the efficacy of the market as a mechanism for improving the content and delivery of state education. In recent decades with the expansion and ‘massification’ of higher education, widening participation (WP) has acquired an increasingly important role in redressing the under-representation of certain social groups in universities. Taken together, these trends neatly capture the twin goals of New Labour’s programme for education reform: economic competitiveness and social justice. But how do WP professionals negotiate competing demands of social equity and economic incentive? In this paper we explore how the hegemony of neoliberal discourse – of which the student as consumer is possibly the most pervasive – can be usefully disentangled from socially progressive, professional discourses exemplified through the speech and actions of WP practitioners and managers working in British higher education institutions.

A Game of Horns: Transnational Flows of Rhino Horn

A multi-sectorial regime of protection including international treaties, conservation and security measures, demand reduction campaigns and quasi-military interventions has been established to protect rhinos. Despite these efforts, the poaching of rhinos and trafficking of rhino horn continue unabated. This dissertation asks why the illegal market in rhinoceros horn is so resilient in spite of the myriad measures employed to disrupt it. A theoretical approach grounded in the sociology of markets is applied to explain the structure and functioning of the illegal market. The project follows flows of rhino horn from the source in southern Africa to illegal markets in Southeast Asia. The multi-sited ethnography included participant observations, interviews and focus groups with 416 informants during fourteen months of fieldwork. The sample comprised of, amongst others, convicted and active rhino poachers, smugglers and kingpins, private rhino breeders and hunting outfitters, African and Asian law enforcement officials, as well as affected local communities and Asian consumers. Court files, CITES trade data, archival materials, newspaper reports and social media posts were also analysed to supplement findings and to verify and triangulate data from interviews, focus groups and observations. Central to the analysis is the concept of “contested illegality”, a legitimization mechanism employed by market participants along the different segments of the horn supply chain. These actors' implicit or explicit contestation of the state-sponsored label of illegality serves as a legitimising and enabling mechanism, facilitating participation in gray or illegal markets for rhino horn. The research identified fluid interfaces between legal, illegal and gray markets, with recurring actors who have access to transnational trade structures, and who also possess market and product knowledge, as well as information about the regulatory regime and its loopholes. It is against the background of colonial, apartheid and neoliberal exploitation and marginalization of local communities that a second argument is introduced: the path dependency of conservation paradigms. Underpinning rhino conservation and regulation are archaic and elitist conservation regimes that discount the potential for harmonious relationships between local communities and wildlife. The increasing militarization of anti-poaching measures and green land grabs are exacerbating the rhino problem by alienating communities further from conservation areas and wild animals. The third argument looks at how actors deal with coordination problems in transnational illegal markets. Resolving the coordination problems of cooperation, value and competition are considered essential to the operation of formal markets. It is argued that the problem of security provides an additional and crucial obstacle to actors transacting in markets. The systematic analysis of flows between the researched sites of production, distribution and consumption of rhino horn shows that the social embeddedness of actors facilitates the flourishing of illegal markets in ways that escape an effective enforcement of CITES regulations.

Sensory work of diagnosis : a crisis of legitimacy

The effects of emotional awareness training on teachers' ability to manage the emotions of preschool children: an experimental study

This article describes the process and results of a Randomized Controlled Trial (RCT) on teachers' ability to manage the emotions of preschool children during a constrained play activity. Thirty early childhood education teachers participated in the study. Half of the participants were taught strategies to enhance their own emotional competence. The control group was provided with standard information on child development. The experimental group was trained in active strategies on emotion coaching, emotional schemas, reflective practice focused on emotions, and mindfulness training. The teachers' outcomes were assessed in situ during a pretend play session with small groups of preschoolers. The dependent variables were observed occurrences of different components of emotional competence in teachers. Significant statistical differences were found between the two groups across the three different emotional competence skills (regulation, expression, and knowledge) demonstrated by the early childhood teachers during a game situation. This experimental study highlights the processes through which teachers support the emotional competence of young children, and the importance of the role of early childhood teachers' own emotional competence on the socialisation of children's emotions. Most importantly, it provides evidence, based on the influence of emotion-focused teacher-training and reflective practices, that teachers' emotional skills should be supported such that they can optimally meet the emotional needs of young children.

Whiteness and news: the interlocking social construction of "realities"

This dissertation examines how mainstream U.S. journalism consistently serves white racial interests and the racial status quo, or what I call white incumbency, despite its push for diversity and its stated aims to improve coverage of nonwhite communities. It is based on an in-depth ethnographic study of two daily newspapers and extensive one-on-one interviews with 61 journalists. I found that although journalists strongly identify with the need for more diverse coverage in newspapers, they emphasize individual and personal stories that avoid recognition of historical racial power imbalances, exhibiting what Ruth Frankenberg calls power-evasive race cognizance. Journalists also demonstrate a number of often contradictory identifications and self-understandings about themselves and their work, such as commitments to diversity and not taking sides, but these conflicts are almost always resolved in favor of white incumbency. Journalistic conventions and practices, such as the watchdog function and its emphasis on public institutions, routinely produce stories that replay and reinforce racial hegemony by portraying nonwhites as problems or people seeking “special privileges.” Also, journalistic repertoires about those conventions and practices avoid interrogations of journalists’ ongoing complicity in the maintenance of white incumbency.

Adaptive regulation or governmentality: patient safety and the changing regulation of medicine

Studies from across the world have shown that clinical mistakes are a major threat to the safety of patient care (World Health Organisation 2004). For the National Health Service (NHS) of England and Wales it is estimated that one in ten hospital patients experience some form of error, and each year these cost the service over £2billion in remedial care (Department of Health 2000). Unsurprisingly, ‘patient safety’ is now a major international health policy priority, questioning the efficacy of existing regulatory practices and proposing a new ethos of learning. Within England and Wales, the National Patient Safety Agency (NPSA) has been created to lead policy development and champion service-wide learning, whilst throughout the NHS the National Reporting and Learning System (NRLS) has been introduced to enable this learning (NPSA 2003). This paper investigates the extent to which, in seeking to better manage the threats to patient safety, this policy agenda represents a transition in medical regulation.

"Ordinary people only": knowledge, representativeness and the publics of public participation in healthcare

Public involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self-selecting members of the public, and those including a more broad-based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople’s expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social-theoretical perspectives on the relationship between governmental authority and citizens in late-modern society.

Emotional Theory of Rationality

In recent decades, it has been definitely established the existence of a close relationship between the emotional phenomena and rational processes, but we still do not have a unified definition, or effective models to describe any of them well. To advance our understanding of the mechanisms governing the behavior of living beings we must integrate multiple theories, experiments and models from both fields. In this paper we propose a new theoretical framework that allows integrating and understanding, from a functional point of view, the emotion-cognition duality. Our reasoning, based on evolutionary principles, add to the definition and understanding of emotion, justifying its origin, explaining its mission and dynamics, and linking it to higher cognitive processes, mainly with attention, cognition, decision-making and consciousness. According to our theory, emotions are the mechanism for brain function optimization, besides being the contingency and stimuli prioritization system. As a result of this approach, we have developed a dynamic systems-level model capable of providing plausible explanations for some psychological and behavioral phenomena, and establish a new framework for scientific definition of some fundamental psychological terms.

Traditions and contradictions of sexual function definitions for portuguese heterosexual men and women: medicalization and socially constructed gender effects

© 2015 College of Sexual and Relationship Therapists

Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation the medical profession and other health-related occupations. In this paper we address this gap by considering the experience of newly instituted general practitioners (family physicians) with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and GPs—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.

Avian flu: the creation of expectations in the interplay between science and the media

This paper examines the emerging cultural patterns and interpretative repertoires in reports of an impending pandemic of avian flu in the UK mass media and scientific journals at the beginning of 2005, paying particular attention to metaphors, pragmatic markers ('risk signals'), symbolic dates and scare statistics used by scientists and the media to create expectations and elicit actions. This study complements other work on the metaphorical framing of infectious disease, such as foot and mouth disease and SARS, tries to link it to developments in the sociology of expectations and applies insights from pragmatics both to the sociology of metaphor and the sociology of expectations.

Emotion in Cervantes and Shakespeare

Early modern thought found in emotion a key to explaining human behaviour, highlighting the powerful way in which it can influence and disturb human life. Shakespeare’s and Cervantes’s treatment of emotion includes a full acknowledgement of its mental and bodily aspects and functions. But emotion rarely comes in a pure state. Character and emotion interact and their responses are often contradictory. Since emotions are sentiments that we feel and actions that we perform, it is worth inquiring into how, in Cervantes and Shakespeare, emotion affects their characters in different ways.