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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1559-1816.2009.00515.x Byline: Katy Greenland (*), Jonathan Scourfield (*), Nina Maxwell ([dagger]), Lindsay Prior ([double dagger]), Jane Scourfield (s.) Abstract: The Distress Disclosure Index (Kahn & Hessling, 2001) measures the tendency to disclose psychological distress and is important in understanding psychological well-being, interpersonal relationships, and help seeking. This paper used the disclosure decision model (Omarzu, 2000) to explore the theoretical antecedents of distress disclosure. Results of a community-based survey of 17-18-year-olds in South Wales (United Kingdom), suggesting that private self-consciousness, social support, and femininity were associated with higher distress disclosure. Shame was associated with lower distress disclosure. Moderating effects of gender and gender identity were also explored. Social support and femininity both interacted with gender to predict distress disclosure. The results suggest a number of interventions to increase distress disclosure in young men and women. Author Affiliation: (*)School of Social SciencesCardiff UniversityCardiff, UK ([dagger])Centre for Social Work and Social Care ResearchSwansea UniversitySwansea, UK ([double dagger])School of Sociology and Social PolicyQueen's UniversityBelfast, UK (s.)Department of Psychological MedicineCardiff UniversityCardiff, UK Article note: (2) Katy Greenland, School of Social Sciences, Cardiff University, Cardiff, UK CF10 3WT. E-mail: GreenlandK@cardiff.ac.uk

The nature and effects of stigma have been widely discussed in the context of mental illness, and references to stigma are commonly used to explain a wide array of social processes. For example, it is often claimed that stigmatisation affects aspects of personal identity, that it underpins unjust and discriminatory behaviour, and that it is responsible for a reluctance among members of the lay public to disclose the presence of treatable psychiatric symptoms and problems to health professionals. A widespread reluctance to disclose symptoms of `emotional problems' to health professionals is in fact well documented. Yet the reasons for such patterns of behaviour are far from clear. However, in this paper, on the basis of qualitative data collected from primary care attendees in Wales (N = 127), the authors suggest that appeals to stigma are inadequate to explain the phenomenon. More likely, it seems, is that members of the lay public have markedly different images from health professionals of what constitutes a mild to moderate psychiatric problem. Consequently, it is argued that the phenomenon of non-disclosure could be viewed more accurately as a problem of alternative taxonomic systems than of fear of stigma. The implications of the argument for health practice and theory are outlined. Keywords: Culture; Depression; Stigma; Primary care; Wales

This article discusses rationing practices in cancer genetics. The author, examining a cancer genetics clinic, argues the allocation of scarce medical resources to needy patients is more than a managerial process, but based upon risk assessment which is arbitrarily defined in relation to economic, social, and political factors.

An examination is presented on health attitudes and behavior among members of Canton-Chinese neighborhoods in England, focusing on mind and body correlations and spiritual agency within Asian culture. Subjects used by Chinese patients to communicate their health status include traditional medicine, demons, spirits, weather and food.

This paper is concerned with the socio-medical organisation of psychiatric disorder. The main line of analysis demonstrates how different psychiatric ideologies produce different objects of professional focus and, consequently, radically different forms of therapy and therapeutic environment. By way of empirical evidence, the paper examines in some detail three contrasting contexts in which psychiatric disorder has been described and organised. The first is represented in Freud and Breuer's Studies on Hysteria, the second in the case books of a turn of the century asylum, and the third in the activities and practices of a modern psychiatric ward. By drawing on these sources of data, it is argued that an understanding of large scale changes in the organisation of psychiatric health care (such as is evident, for example, in modern trends from hospital to community care), firmly depends upon a study of the inner structure of psychiatric ideologies. Furthermore, and as a corollary of this it is chimed that appeals to extra-psychiatric (economic) interests and/or scientific (pharmacological) advances as key factors for explaining processes or organisational change (especially the process of deinstitutionalisation), are essentially misleading., I Explaining Organisational Change The transition from hospital based care for the mentally ill to what is loosely termed 'community care' has been a fact of North American and European [...]

The movement away from hospital-based schemes of care for those with a psychiatric disability in favour of community-based schemes of care constitutes a turning point in the history of psychiatric provision in most Western European societies. The origins and rationale of this movement have sometimes been explained by reference to extra-discursive (economic) interests, and sometimes by reference to a form of technological or scientific determinism in which the discovery of such things as the neuroleptic drugs during the 1950s is said to have played a major role. This paper argues that the impetus for community as against hospital-based care can only be understood in terms of a changing discourse of psychiatry and psychiatric nursing, and especially those forms of thought which have tended to place 'illness' in the wings and set its primary sights on behavioural and social 'deficits'. There is a sense, therefore, in which hospital-based practices of psychiatrists and nurses have constituted the source and origin of their own transformation--a transformation in which the rationale of the psychiatric hospital has been eroded. The arguments in this paper are substantiated by reference to a current study of the forms of knowledge and daily practice which are drawn upon by nurses and psychiatrists in the psychiatric wards of a large Northern Irish hospital. Key words--psychiatry, de-institutionalisation, hospital, community

Abstract Background Head injuries are a common occurrence, with continuing care in the years following injury being provided by primary care teams and a variety of speciality services. The literature on outcome currently reflects areas considered important by health-care professionals, though these may differ in some respects from the views of head injured individuals themselves. Our study aimed to identify aspects of outcome considered important by survivors of traumatic head injury. Methods Thirty-two individuals were interviewed, each of whom had suffered head injury between one and ten years previously from which they still had residual difficulties. Purposive sampling was used in order to ensure that views were represented from individuals of differing age, gender and level of disability. These interviews were fully transcribed and analysed qualitatively by a psychologist, a sociologist and a psychiatrist with regular meetings to discuss the coding. Results Aspects of outcome mentioned by head injury survivors which have received less attention previously included: specific difficulties with group conversations; changes in physical appearance due to scarring or weight change; a sense of loss for the life and sense of self that they had before the injury; and negative reactions of others, often due to lack of understanding of the consequences of injury amongst both family and general public. Conclusion Some aspects of outcome viewed as important by survivors of head injury may be overlooked by health professionals. Consideration of these areas of outcome and the development of suitable interventions should help to improve functional outcome for patients.

Physical inactivity levels are rising globally. In response, public health investigators have sought to design and implement effective interventions to raise levels of physical activity in populations, communities and individuals. Usually, such interventions are built around theories of behaviour change in which notions of motivation and incentivisation loom large. Drawing on focus group evidence derived in the context of a cluster RCT aimed at increasing levels of physical activity in the workplace, this paper offers a critical look at the factors that seemingly stimulate and sustain that activity. In particular, using novel methods of data analysis we illustrate how motives and motivation – often interpreted as a driving force 'in' individuals – can be more usefully seen as distributed; as a property of systems (incorporating technologies, organisational structures, and social interaction) rather than of persons. In our discussion, we outline various theoretical as well as empirical grounds for making such claims and conclude by drawing out the implications of our work for public health policy and research. [ABSTRACT FROM AUTHOR]

This article reports on an ethnography of architectural projects for later life social care in the UK. Informed by recent debates in material studies and "materialities of care" we offer an analysis of a care home project that is sensitive to architectural materials that are not normally associated with care and well‐being. Although the care home design project we focus on in this article was never built, we found that design discussions relating to a curved brick wall and bricks more generally were significant to its architectural "making". The curved wall and the bricks were used by the architects to encode quality and values of care into their design. This was explicit in the design narrative that was core to a successful tender submitted by a consortium comprising architects, developers, contractors, and a care provider to a local authority who commissioned the care home. However, as the project developed, initial consensus for the design features fractured. Using a materialized analysis, we document the tussles generated by the curved wall and the bricks and argue that mundane building materials can be important to, and yet marginalized within, the relations inherent to an "architectural care assemblage." During the design process we saw how decisions about materials are contentious and they act as a catalyst of negotiations that compromise "materialities of care." [ABSTRACT FROM AUTHOR]

Introduction Diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) are the major causes of sight loss in people with diabetes. Due to the increased prevalence of diabetes, the workload related to these complications is increasing making it difficult for Hospital Eye Services (HSE) to meet demands. Methods and analysis Effectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD) is a prospective, case-referent, cross-sectional diagnostic study. It aims at determining the diagnostic performance, cost-effectiveness and acceptability of a new form of surveillance for people with stable DMO and/or PDR, which entails multimodal imaging and image review by an ophthalmic grader, using the current standard of care (evaluation of patients in clinic by an ophthalmologist) as the reference standard. If safe, cost-effective and acceptable, this pathway could help HES by freeing ophthalmologist time. The primary outcome of EMERALD is sensitivity of the new surveillance pathway in detecting active DMO/PDR. Secondary outcomes include specificity, agreement between new and the standard care pathway, positive and negative likelihood ratios, cost-effectiveness, acceptability, proportion of patients requiring subsequent full clinical assessment, unable to undergo imaging, with inadequate quality images or indeterminate findings. Ethics and dissemination Ethical approval was obtained for this study from the Office for Research Ethics Committees Northern Ireland (reference 17/NI/0124). Study results will be published as a Health Technology Assessment monograph, in peer-reviewed national and international journals and presented at national/ international conferences and to patient groups. [ABSTRACT FROM AUTHOR]

The article reports that inclusion of the callipers was intentional a practical instrument necessary to all serious craniologists who believed it possible to read off racial characteristics from the human skull. Topics include important lessons about the practicalities and ethics of fieldwork in the midst of an epidemic; and Boas was travelling from Europe to North America – whilst retaining access to our current technology.

In the light of the 'peak-car' thesis, this paper explores the driving-related desires and practices of adults aged 16-21 and their parents from the UK. Tropes of freedom and independence were commonly evoked; but were pragmatically framed by concerns of finance, utility and risk. Car ownership was prized only for instrumental reasons, and as one tool in a mixed, collective transport network: it had been decoupled from automobility. Environmental sustainability was notably absent from discussions. It may be too early to herald the end of automobility but, for these participants, its seductions have been rendered ironic, rather than aspirational. [ABSTRACT FROM AUTHOR]

Background: Novice drivers are at relatively high risk of road traffic injury. There is good evidence that Graduated Driving Licensing (GDL) schemes reduce collisions rates, by reducing exposure to risk and by extending learning periods. Legislation for a proposed scheme in Northern Ireland was passed in 2016, providing an opportunity for future evaluation of the full public health impacts of a scheme in a European context within a natural experiment. This qualitative study was designed to inform the logic model for such an evaluation, and provide baseline qualitative data on the role of private cars in health and wellbeing.Methods: Nine group interviews with young people aged 16-23 (N = 43) and two group interviews with parents of young people (N = 8) were conducted in a range of settings in Northern Ireland in 2015. Data were analysed using thematic content analysis.Results: Informal car-pooling within and beyond households led to routine expectations of lift provision and uptake. Experiences of risky driving situations were widespread. In rural areas, extensive use of farm vehicles for transport needs meant many learner drivers had both early driving experience and expectations that legislation may have to be locally adapted to meet social needs. Cars were used as a site for socialising, as well as essential means of transport. Alternative modes (public transport, walking and cycling) were held in low esteem, even where available. Recall of other transport-related public health messages and parents' existing use of GDL-type restrictions suggested GDL schemes were acceptable in principle. There was growing awareness and use of in-car technologies (telematics) used by insurance companies to reward good driving.Conclusions: Key issues to consider in evaluating the broader public health impact of GDL will include: changes in injury rates for licensed car occupants and other populations and modes; changes in exposure to risk in the licensed and general population; and impact on transport exclusion. We suggest an important pathway will be change in social norms around offering and accepting lifts and to risk-taking. The growing adoption of in-car telematics will have implications for future GDL programmes and for evaluation. [ABSTRACT FROM AUTHOR]

The article presents the discussion on professional practices within workshops, opticians' salons, theatres, language classes and clinics for people with brain injury as well as a number of design and business settings. Topics include overwhelming proclivity for tying conversation analysis (CA) as the primary method of exploring the data into visual frames; and claiming about the place of documents in social research and the role of documents as observed in everyday settings. .

Background: Increasing physical activity in the workplace can provide employee physical and mental health benefits, and employer economic benefits through reduced absenteeism and increased productivity. The workplace is an opportune setting to encourage habitual activity. However, there is limited evidence on effective behaviour change interventions that lead to maintained physical activity. This study aims to address this gap and help build the necessary evidence base for effective, and cost-effective, workplace interventions.Methods/design: This cluster randomised control trial will recruit 776 office-based employees from public sector organisations in Belfast and Lisburn city centres, Northern Ireland. Participants will be randomly allocated by cluster to either the Intervention Group or Control Group (waiting list control). The 6-month intervention consists of rewards (retail vouchers, based on similar principles to high street loyalty cards), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of participating workplaces will promote and monitor minutes of physical activity undertaken by participants. Both groups will complete all outcome measures. The primary outcome is steps per day recorded using a pedometer (Yamax Digiwalker CW-701) for 7 consecutive days at baseline, 6, 12 and 18 months. Secondary outcomes include health, mental wellbeing, quality of life, work absenteeism and presenteeism, and use of healthcare resources. Process measures will assess intervention "dose", website usage, and intervention fidelity. An economic evaluation will be conducted from the National Health Service, employer and retailer perspective using both a cost-utility and cost-effectiveness framework. The inclusion of a discrete choice experiment will further generate values for a cost-benefit analysis. Participant focus groups will explore who the intervention worked for and why, and interviews with retailers will elucidate their views on the sustainability of a public health focused loyalty card scheme.Discussion: The study is designed to maximise the potential for roll-out in similar settings, by engaging the public sector and business community in designing and delivering the intervention. We have developed a sustainable business model using a 'points' based loyalty platform, whereby local businesses 'sponsor' the incentive (retail vouchers) in return for increased footfall to their business.Trial Registration: ISRCTN17975376 (Registered 19/09/2014). [ABSTRACT FROM AUTHOR]

This is an interesting and useful little book -- well worth buying for anyone even vaguely interested in recent trends in the sociology of health and illness. It comprises ten [...]