particular types
of
caring
relationships.
Joan
Mancher
Ibllocm
(‚mit
for
the
I-listory
of mdicine
45-47
mnlaury
aoad
Ocford
0x2 SPE
AIDS
AM)
IDOSEKUALITY
IN
ÜITAIN:
AN
HISTURICAL
PEISPHYPIVE
A
signifi cant. feature
of
the current
AIDS
epidanic
is
the
association
that
has
bem
rrade
between sex
and diwase.
The fact
that the
transnission
0E
the
virus
in
developed
muntries
has
occurred
in
the
nain
in
male
Ixmosatuals
and
in
intravenonß
drug
users, both qroups
who
a r e
already the
subject
of
deeply rooted
h o s t i l i t i e s
and
discrimination, has had
a
profound inpact
on
the social,
political,
econanic, and even
clinical
responses
to
the
disease.
‘rhis
paper
examines
the h i s t o r i c a l precedents
to
such responses
by
discussing the canpaigns
to
ecmbat
the
venereal
diseases
in
the
late 19th and
e a r l y 20th centuries.
lt also
considers
mat
lessons
these
e a r l i e r canpaigns might have
for
the
current.
AIDS
c r i s i s .
Hildred
Blaxter
Dqnaruant of
Psychiatry
University
of
Cauntridge
Cliniml
school
Arflenbroolnew
Hospital
(hmlridge
ÜUJLD
YGJ
(‘ALL
YCIR
HEAIJHI EXCEILENT,
(III),
FAIR G?
PC111?
Varients of this qmestion
are camot:
in
health surveys. What
(b
the
answers
that people give
man? ‘rhis 1s
explored within the data
of
the
Health
and Lifestyle
Survey,
a
rational.
survey
of
9000
respondents.
An
examination
is
made
of the
relationship
of
self-assessnent
to
health
Status
(incluviing
Still-I
physiological
neasures),
social
circmstances,
social
s t p p o r t ,
psychological neasures,
attitudes
t0 health and health
naintenance,
and
expressed
defi nitions of
what
‘health’ neans.
lt
is
sugqested
that
this
analysis
may
not
only
help
to
evaluate
the
usefulness
of
the Standard question, but may also
oontrimte to
an
understanding
oE
the
ways in
which people conceive of health.
.38
Jean
msfleld
xartmut
o6
staclology
uflversity
cf
man
Ilivemoe
Park
(tolerant: a)!
IQ
SUISG
All)
PSYCHIATRY
In
a
recent inportant paper, ‘Psychiatry
und
the
fenlnine‘.
M181’?
R113"
d i r e c t l y oonfronts
the
question
of
the
reiationsnip
sexian und
psychiatry.
Taking
issue
with
a
nulher
of
fatimst
wnterg,
she arguas
that rather than
sexian
being
i t s e i f
eonstxtucive
ofpsycniatry
(bei:
portrayal 0E
the
connon
Eeminist
position) the relationship
i:
gontmqent
and
there is
a
general
marginalization 0E
issms
of
withm
psychiatry.
In t h i s
paper
I
shall
argue that the relatxonship
begween
sexisn
and
psychiatry
is
in part caotxstitutive
gnd
not
nereiy
contmggnt.
Hodever, rather than
sexism
constituting
gsycluatry,
psychiatry
and
its
a l l i e d
disciplines help t0
caonstitute
sexisn.
David
( n :
lmnrmnt
of
Ilealth
sciaces
Biminghn
Polytechnic
Perty
ßrr
Birninghn
H2 280
MANGERIALISI
AM)
CITIZENSHIP:
T
PS1‘ GIIFFITIS
DILBHAS
This
paper
explores
issues
that were the Starting point
for
an
etpiriml
study
of
ehe Griffi ths inplenentatim.
P o : Maclntyre
nnragerialisn
1s
ehe
product
of
the fragnentation
of
camon
values.
Hanaqerial actions are
only
the
triunph of
will
and
paar.
Many
health
Service professionals
haue
reacted
s i m i l a r l y
t0
general nanagatent.
mitiquas of
public
service
mnaganerxt
are sustairaed by theorists fran
the left
and
the riqht.
Can
there
be
a
conscientious
r o l e
Eor public servants
which is
m:
grourxied
in
the ecploitation
and
danination of
consuners,
workers,
and
walten?
One
uay
towards
positive
c r i t e r i a
f o r assessing public servioe nanaqerent
is
t0
l i n k these debates with the
ne-evaluation
of citizerxship by Turner and
Walzer.
Peter
mvia
011x110; cf G — m i t y
Ihnlth
school
o!
mdicine
utiversity of Amkluld
Amldand,
neu
aealand
‘A
ooLoNIAL
souamuum":
m:
uns:
am
FALL u’
w a r m
IN
was
z w a r ! )
within
HE
spvan of
a
oentmy
European
rau
zenlatlders have
passed
{ran
a
“canes
explosion"
0E
o r a l norbidity
to a
position
of
rapidly
inprovirl;
dental health.
Neu
zealanders of
indigerms
and
migrant Polynesian
ancestry
are
gxperiemirx;
the
satne
cycle
of chantp, tut
a:
a
substantial
tue-lag
and
m
a
greatly ompressed tine-span.
‘mis
period has
witnessed
the
amrgeme
in
Neu
zealand of
a
distinctive
ooctpationnl division of
labour
arxd
a
unique cultural preference f o r e a r l y extraction and
the
uearing
of denturäs:
There
are
issues of both
theory am] policy
conoerning the future
occtpatioml division of
labour, appropriate
strategies for public
dental
health, and the position
of
socially
vulnerable groups.
39
‘mny
man
Sockel
neuesten
Uni:
lmiversity
mllege
9 . 0 .
Ex
78
mrdiff
CF].
1x1.
"SXEPHHE
SEISATICXML
.
..
"‘
‘IHE SEZUAL DIARY
l8
A
‘KDL
F0?
HAPPUG (ETAILED SEXUAL
UEHAVIUR
Reliable infonmtion
about
the d e t a i l
and context
of
sexual
behaviotxr is
crucial
for describing high-risk
behaviours for
the
transmission
of
Aids/HIV,
and
Eo:
estimting
paraneters
of
epideniological models.
lt
is
possible
to
adapt the
nvethod of
systanatic diary-keeping
to
this
end
and
develop
a
tool
whlch is also
close
to
the subject's conoeptiors
of
the
"chunks"
of
sexual
bemviour.
‘He
structure
of
teports
of
sexual
behavioxzr
is viewed as
akin
to
l i n g u i s t i c
stmcture. wich a
basic
unit of
the sexual act
bunt
into
a
"Session".
‘Buch structure
leads raturally
to
a
unding
system
mich allows
natural lanquaqe
accounts
t0
be
represented syunholically, and parsed and
analysed
fomally. ‘Ehe
ooded
Version
is easily learnt and Lvsed, and
is
totally irloarprehensible
to
outsiders.
Ebxanples are given
0E
l t s
use
in
the Project
to
collect systexatic data
on
hanosexual and
bisexual behaviour.
"
"I
never
travel
without my diary. 0te
should always have sarething
sensational
t0
read
on the train".
Oscar
Hilde
The
Igrtatne
of
Beigg
ürnest.
Je"!!!
0WD"!!!
nduxxtloml
savloes
Unit
‘Ehe
mdical
school
miversity
cf
Bimindum
Binninghm
B15
2N
Q 4 1 1 6
'10
TERE
HITH CHRGHC
HJNESS: ‘PHB
EKPERIEÜPG EI’
PATIENPS WITH
‘ZARLY
RHEIMNIOID ARPI-RITIS
People uho have
been
referred
to a
specialist
rheumtology
unit
by
their
GPS are
the
Eocus
of
an
ethnographic study.
Patients
have
been
interviewed
in-depth
at
haue
before attendirxg the
clinic,
and then
folloded
througlm
their
axperiemes
as i n -
or
out-patients.
The paper
focusses
on
those who suffer frcm
a
chronic
und incurable
disease.
rheunatoid arthritis.
Particular comerns include hou
they
cone to
terms
with the diagnosis and
disease, the influence of
the
clinic
on
their
lay
perceptions
cf
health, and
their
opinions about the sort
of information
they require about the disease and
its
treatments.
40
"max-mit
o!
m a n ’ ;
n a c h :
s:
m11‘:
mqaital
Praad
atmet
lonhn
l2
III!
HANAGIRS PKFBSSIOPHL
P065!
-
DIflRICl‘
GRBML
M a m a s
All)
KCIGS
Hospital
cbctors are
powerful
imiviüaalists,
üeply
suspicioun of
manaqers
am
y e t
imispensable
to
the
nanaganenl:
of
the
ms.
‘rhe
G r i f fi t h s report
called
for
g r e a t e r
involvalaem.
by
cbctots
in Ianaqaent,
laut
said
little
about how
the neu
district
gerxeral
Inanaqers
( u m s )
should
achieve
that.
aim.
He
r e p o r t
on
Ilow
a
sanple
of 20
nass
have been faring.
He ecplore
ehe
underlying tenaions,
the
d i f f e r i n g
cultural
noms,
the
ums‘ ains
am
strategies,
am
the
reasons f o r
progress
am
setbacks.
Drawing
on
the
literature
about the
nanaqanent
of
change,
we
suqqest how
cbctors
miqht
be
better engaged
in
a
more
‘unnagerial’
MS.
Rmaellnoob
llclhdlalswiologymlt
G u l y h a n k a r h n
Glasgow
6 1 2 m
ARM
PRGILIIG G‘
PBALEH
IN
61.6%:
5E
Pflüüflls
BASE)
(N
KIYPALITY
mTA
Yearly death r a t e :
by
age gronp
am
qemer,
b o t ) :
for
all causes
am
partlcular
major
oauses
of
äath
by local
govermmt distrlcts
in
the
Central Clymside
Oonurbation,
are
being
collated for
the
period
1974
to
1985.
Same
initial
attaupts,
using diese data,
to
establish
area
profila
of health for
looal govermuent districts
w i l l
t2 reported.
Oaumnly
used
Eonns
of sumarisation
oE
auch
data, euch
as
ehe
Stamardised
norballty
Ratio
am
the Proportional
mrtality
Ratio,
will
be
atatnined, focussinq
attention
on
sociologically meaningful aspects
of
the
data
mich
are
not
revealed
by these
neasures.
How
can
diese
I n s t
l2
illustrated
am
im
n
auch profi les usefully
relate
t0 notbidity
profi les chrivable
Eton
aqe-specifi c cohorts being investigated
in
the
satte
region?
mvid
Held
umarmt
cf
soclology
utivarsity
of mioeste:
leiseste:
m1
7m
WEATH I5
(D
FAILURE’:
MRSIIC
111B
OHNE
m
A
GRUB!!!
CARE
UNI?
111e first
p a r t
of this
paper
reports
on
marses‘
acmnnts
of
nursing the
dying in
a
cororiaty care
u n i t .
It Inight be presuned Chat. deaths
m
the
u n i t
would
be
problematic for
marsing
staff, but
t h i s daes
mt
seem
t0
k:
the
case.
The organization of uork, staff relations,
am
cannunncatior:
about.
death
am
dying a r e
examined. ‘lmsions
between the
ideal
of hemg
open
am
revealing
am
reported nursing ptactice were
discerned. The
second
p a r t
of
the paper
attaupts
to
elucidate
sonne of
the key
elanents
in
the orqanization
of
nursing uork uhich bear
upon
nursing the dymg.
41.
“ c m 1 ”
au;
15
mqent street
C l i f t a :
a r i s t o l
RITUAL
MD
IMDVATIGI IN fi
OPERATIm THEATER
How
does
the ethnographic
f ieldmrker
analyse apparently ‘technicar ’
aspects
of
the
wedical environnent? ‘rhis
study draws
on fi e l d data
gathered
in
a
variety
of
surgical operating
theatres.
Focussing
on
practices surrourdirxg
sterility
and hyqiene,
‘technical’
explanatiorxs a r e
reconsidered
in the
light
of
the sylnbolic
or
ritual nessages the practices
transnit.
0o these
r i t u a l
aspects a f f e c t
the
extent
to
which innovative
practices
are
adopvted? ‘rhe potential
Eor
further
innovation in
surgical (and
nedical)
practice
is considered.
Centre
cf
malen
social
Anthrwology
uüverslty
of Reale
Staffordshire
S15
5m
Ronald
Pranlnenberg
THE
5021M;
G’ EPIDBIICS: ‘HE
(HALLE!!!)
(P
Alm
taedical
social
Anthropologists have
allowed
AIDS
t0 take them
by
surprise
although
theoretimlly
eoological
anthropology, the
anthropoloqy
of risk
and sickness
and
death
a3
c u l t u r a l perfomance are
all
specifi c
anthropological approaches which
have
much
to
o f f e r.
‘rhis
paper
w i l l
seek
to
introdnxce advantages and
limitations
of
each approach
and
to
provoke
a
sharing of
ideas.
It
will sedt,
_inter
alia,
t0 argue Chat stuiies tseful
for AIDS sufferers stnuld
not
only avoid isolating and
stigtatising
them
but
also
the
researcl-uers.
Studies
should be
designed
to benefi t
anyone
facing
‘time
tnnb‘
sickness with
grave
outcoutes.
Lars
Reden
(Haut-mm:
of
malt]: i soclety
u m h i n ;
University
3-581
83
uhhäxing
Sieden
[EPRESSICN
All)
AUIIDLIS
-
A
( E P A R R T I V E
51'011}!
The paper
focusses
on
aloohol
abuse
and
depression
as
two separate paths
t0
fi r d
neaning.
An
analysis
of interviews
with
13
out-patients
(diagnosed
as
alooholics
or
depressives
or
alcoholic and depressive)
suggests that.
depressives am‘!
alcol-nlic
depressives
are not
provided with
a
social nooring
at
uork
o:
by the family and
lack close
Eriends.
Both
groups
also live
t0
a
great
extent.
in telationships characterized
by
rigid
action
patterns
that
reflect
rigid patterns
of
thought.
lt
appears
that
f o r
those
individuals
alcohol
and
depression have
an
adaptive
function.
The
seoond stage
of
the research will be
to
t e s t
these findings against
questionraaire data Eton
a
sanple
of 26 patients matched
with
26
control
subjects
{ran t h e
general
population.
42
man!
nxlop
‘nun:
Garn
neueren
mit.
u t i v a s l t y
ot
landet:
I m t i t u t e
cf
matter!
41
tundck
spare
Ion-dm
Ich!
IAZ
‘(D
I HAVE
1U
PILL
IN NUPHH
(IG
G
TEE!
E1187‘:
( B U G GEN}!!!
DIARIES
IN
A
S'I'UDY
0F P0111885
AM)
PATHERS
The
use
of
health
diaries
as a man:
of
collecting
data
on
funily
Inealth
has
been surprisirxgly
limited.
Hhere
diaries
have been used,
they have
xsually been ccnpleted by the
Irother.
‘rhis
paper
b r i e fl y revieue
the
past
use
of
health
diaries and descrlbes
their
use
in
a
study
of
gender
differences in
patente].
IIeaIth und health
care.
A
sanple
of
t h i r t y unrking-class
patente
are beim;
interviewed
separately
three
Eures over
the
course
0E
a
y e a r,
und
a f t e r each
intervlew
they are asked
to
carplete
their
oun 7-day
health
diary.
A
prelinninary amlysis of
the
dlfferenees betweenm the nothers‘ und the
fathers’ health diaries w i l l be discussed.
Nigel cbldie’, mvld
Pilgrin"
‘wuth
mnk
Polytedmlc
i Anne
ungern
brav:
kund
Iawbn
SEI
0M
“ w r x t
o! Pnydnlogy
Hangman
I m t l t u t e
nodtqahon Inne
Inmbn
S115
PRO! RBSEAIClEl
‘I0
EVALUMTR: THE
OIIDHBS G
{
K
}
AN INVBTICHHR
FG!
A
EIEAUITI AUHKRIT’!
The
reeent changee
in
the
nanaqement
of
the
henlth services
1s
l i k e l y
t0
lead t0 increasing mmbers
of social ecientiets
being ashed
to umiertake
evaluations as
indepenient
outsiders of Services. ‘rhis
paper
w i l l
explore
the
political,
methodologieal
arId ethical issxns
(ahnt
t h i s develqmmt
poses
f o r sociologists
who
have previotasly had
a
nore traditional
researcher relationship t0
the subjects of
t h e i r
stundy.
‘rhe
paper
arises
out
oE
the expetience
of
undertakirxg
an
evaluation
of two oonlmmity mental
health centres, for
t u e
different health authorities
having differing
political
reasons
f o r
this
work
to
be
undertaken.
Unamstafeea:
(nnuefortmstuiyotvrinrymre
384698
mnnrcinl
man!
Lenin
B1
an
111B PRIMA!!! HFAIJM
CARIPTEM: m fi l fl l w G’ KRKIIG
REIZATIGBHIPS
(I!
A
FANPAQY?
mring
the
murse
0E
a
project
intended
to
p r a t o t e
teamork
lntueen
primry
health
care
professionals uorkmg
in
I n n e :
Lordm
it
becane
evident that
temls
auch
as
"oollaboration"
and
‘prinary
health
rare
heult‘
have catpletely
different
neanirxgs
to different
groups
oE workers.
In
addition, defi nitions
presented
in o f fi c i a l
documnts
in Order
t0
‘decide’
what
a
primary health
care
team is, are abstract and obecure.
‘rhis paper
w i l l examine
such
diverse
perceptions
of
the neaning
of this
construct and challenge the possibility
oE its existence.
43
of
sociology
university
of Stirling
Stirling
m
4m
Erlen Haines‘ n
'
John
lauten
"
5
Paula Davis
‘W
‘Wisting Pelloua
_
Ilenlth
mre
aesenrch
Umt
nenncastle
Lhiversity
lbacastle
HIIAT
[S G fl )
HEIDE?
THE ANKLYSIS
G‘
HAMJARD-SEITIE
IN GENERAL
PRACPICE
-
esem;
rtative
analysis
of groqas of general
setting
Eor
the care
cf
W0
6 0 m 0 "
Chi1m°°d
P
“ i m
wg},
3nd
i t c h y rash.
This
is
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