Showing papers in "Health in 2009"

Communities of clinical practice: the social organization of clinical learning

Abstract: The social organization of clinical learning is under-theorized in the sociological literature on the social organization of health care. Professional scopes of practice and jurisdictions are formally defined by professional principles and standards and reflected in legislation; however, these are mediated through the day-to-day clinical activities of social groupings of clinical teams. The activities of health service providers typically occur within communities of clinical practice. These are also major sites for clinical curriculum delivery, where clinical students learn not only clinical skills but also how to be health professionals. In this article, we apply Wenger's model of social learning within organizations to curriculum delivery within a health service setting. Here, social participation is the basis of learning. We suggest that it offers a powerful framework for recognizing and explaining paradox and incongruence in clinical teaching and learning, and also for recognizing opportunities, and devising means, to add value to students' learning experiences.

Electrospun nanofiber-based drug delivery systems

Abstract: Electrospinning is a very simple and versatile process by which polymer nanofibers with di-ameters ranging from a few nanometers to sev-eral micrometers can be produced using an electrostatically driven jet of polymer solution or polymer melt. Significant progress has been made in this process throughout the past few years and electrospinning has advanced its ap-plications in many fields, including pharmaceu-tics. Electrospun nanofibers show great prom-ise for developing many types of novel drug delivery systems (DDS) due to their special characteristics and the simple but useful and effective top-down fabricating process. The current state of electrospun nanofiber-based DDS is focused on drug-loaded nanofiber preparation from pharmaceutical and biode-gradable polymers and different types of DDS. However, there are more opportunities to be exploited from the electrospinning process and the corresponding drug-loaded nanofibers for drug delivery. Additionally, some other related challenges and the possible resolutions are outlined in this review.

Accounts of disruptions to sexuality following cancer: the perspective of informal carers who are partners of a person with cancer.

Abstract: There is a growing body of research showing that cancer impacts upon the sexuality of informal carers in a couple relationship with a person with cancer. However, this research is primarily focused on partners of a person with gynaecological or breast cancer, within a framework where the physiological effects of cancer on sexual performance are the focus. We conducted semi-structured interviews with 20 informal carers in a couple relationship with a person with cancer, across a range of cancer types. The aim was to explore accounts of changes to sexuality and intimacy post-cancer, in the context of discursive constructions of sexuality and the caring role. Our findings show that partners' sexual experiences were shaped by absence of desire in the person with cancer; the stress and exhaustion associated with caring tasks; the repositioning of the person with cancer as childlike or as an asexual 'sick patient'; and the belief that there were expectations about 'acceptable' sexual conduct in the context of cancer caring. Carers accepted the diminishment of their sexual relationship, but expressed feelings of disappointment, anger and sadness about this loss. It is concluded that it is vital that support services are developed, so that couples may develop new sexual strategies, and cope more effectively with potential disruptions to their sexual and intimate relationship.

A metasynthesis of midwives' experience of hospital practice in publicly funded settings: compliance, resistance and authenticity.

Abstract: Worldwide, increasing percentages of women are giving birth in centralized hospitals in the belief that this maximizes safety for themselves and their babies. In parallel, there is international recognition that the number of birth interventions used in the routine care of labouring women is rising. This is fuelling concern about iatrogenesis, and, particularly, maternal and infant morbidity and mortality. It also has an adverse impact on the economics of health care. National and international policy characterizes midwives as the guardians of normal childbirth. This guardianship appears to be failing. The objective of this metasynthesis is to explore midwives’ perceptions of hospital midwifery with a focus on labour ward practice to examine professional discourses around midwifery work in the current modernist, risk averse and consumerist childbirth context. Based on an iterative search strategy, 14 studies were selected for the metasynthesis. Three overarching themes were identified: ‘power and control’...

Implementation of a patient safety incident management system as viewed by doctors, nurses and allied health professionals.

Abstract: Incident reporting systems have become a central mechanism of most health services patient safety strategies. In this article we compare health professionals' anonymous, free text responses in an evaluation of a newly implemented electronic incident management system. The professions' answers were compared using classic content analysis and Leximancer, a computer assisted text analysis package. The classic analysis identified issues which differentiated the professions. More doctors commented on lack of feedback following incidents and evaluated the system negatively. More allied health staff found that the system lacked fields necessary to report incidents. More nurses complained incident reporting was time consuming. The Leximancer analysis revealed that while the professions all used the more frequently employed concepts (which described basic components of the reporting system), nurses and allied health shared many additional concepts concerned with actual reporting. Doctors applied fewer and more unique (used only by one profession) concepts when writing about the system. Doctors' unique concepts centred on criticism of the incident management system and the broader implications of safety issues, while the other professions' unique concepts focused on more practical issues. The classic analysis identified specific problems needing to be targeted in ongoing modifications of the system. The Leximancer findings, while complementing the classical analysis results, gave greater insight into professional groups' attitudes that relate to use of the system, e.g. doctors' relatively limited conceptual vocabulary regarding the system was consistent with their lower incident reporting rates. Such professional differences in reaction to healthcare innovations may constrain inter-disciplinary communication and cooperation.

Refusing the information paradigm: informed consent, medical research, and patient participation

Abstract: This article challenges the assumption that patient autonomy can best be assured by providing proper information through formalized procedures such as informed consent. We suggest that to understand and consider laypeople's ways of knowing and decision making, one has to move beyond the information paradigm and take into account a much broader context. Concretely, we investigate informed consent in connection with donating skin tissue remaining from medically indicated surgery. We use interviews with patients and observation protocols to analyse patients' perceptions and ways of making sense of informed consent beyond its bioethical ideal. Patients situate themselves in a larger system of solidarity, enrol in an overall positive image of science as a linear process of innovation oriented towards output, and simultaneously take a pragmatic stance towards hospital routines as a necessary passage point towards receiving good treatment. Because informed consent is one of the central articulations between the ...

The centrality of personal relationships in the creation and amelioration of mental health problems: the current interdisciplinary case:

Abstract: An interdisciplinary case is made for the centrality of personal relationships in the creation and amelioration of mental health problems. Taking the work of John Bowlby as a starting point, the article summarizes accumulating evidence from the past 50 years about the link between childhood adversity and adult mental health problems. Evidence is also reviewed about contemporary interpersonal impacts on adult mental health from natural social settings and in professional therapy. These empirical summaries are then discussed in the context of dominant trends in professional knowledge about bio-determinism within psychiatry and the emphasis upon models and techniques in professional and political advocates of the psychological therapies. It is concluded that the latter trends are diverting us from policies, which properly concede the importance of relationships for improving the mental health of the population.

Oncology clinicians' accounts of discussing complementary and alternative medicine with their patients.

Abstract: The profile of complementary and alternative medicine (CAM) has risen dramatically over recent years, with cancer patients representing some of the highest users of any patient group. This article reports the results from a series of in-depth interviews with oncology consultants and oncology nurses in two hospitals in Australia. Analysis identifies a range of self-reported approaches with which oncology clinicians discuss CAM, highlighting the potential implications for patient care and inter-professional dynamics. The interview data suggest that, whilst there are a range of consultant approaches to CAM, ;risk' is consistently deployed rhetorically as a key regulatory strategy to frame CAM issues and potentially direct patient behaviour. Moreover, ;irrationality', ;seeking control', and ;desperation' were viewed by consultants as the main drivers of CAM use, presenting potential difficulties for effective doctor-patient dialogue about CAM. In contrast, oncology nurses appear to perceive their role as that of CAM and patient advocate - an approach disapproved of by the consultants on their respective teams, presenting implications for oncology teamwork. CAM education emerged as a contentious and crucial issue for oncology clinicians. Yet, while viewed as a key barrier to clinician-patient communication about CAM, various forms of individual and organizational resistance to CAM education were evident. A number of core issues for clinical practice and broader work in the sociology of CAM are discussed in light of these findings.

Active volatiles of cabernet sauvignon wine from Changli County

Abstract: This study investigated the contribution of vola-tile compounds to the overall aroma of Cabernet Sauvignon wines from Changli County (China). Wine samples were collected from vintages from 2000 to 2005. Volatile compounds were ex-tracted by PDMS solid-phase micro-extraction fi- bers and identified by Gas Chromatography-Ma- ss Spectrometry (GC-MS). A total of 65 volatile compounds were identified and quantified, in-cluding higher alcohols, ethyl and acetate esters, and fatty acids. According to their odor active values (OA-Vs), 21 volatile compounds were con- sidered to be the powerful impact odorants of Cabernet Sauvignon wines from Changli. Odor descriptions of impact volatiles suggested Cab-ernet Sauvignon red wines from Changli County as having a complex aroma, which included not only pleasant floral and fruity odors, but also cheese, clove flavors, and grassy and smoky aromas.

Negotiating the neurochemical self: anti-depressant consumption in women's recovery from depression.

Abstract: Anti-depressant treatment can be viewed as an exercise of biopower that is articulated through policies and practices aimed at the reduction of depression, population healthcare costs and effects on labour force productivity. Drawing upon a feminist governmentality perspective, this article examines the discourses that shaped women's experiences of anti-depressant medication in an Australian qualitative study on recovery from depression. The majority of women had been prescribed anti-depressants to treat a chemical imbalance in the brain, manage symptoms and restore normal functioning. One-third of participants identified anti-depressants as helpful in their recovery, while two-thirds were either highly ambivalent about, or critical of, medication as a solution to depression. Thirty-one women who identified the ;positive' benefits of anti-depressants actively constituted themselves as biomedical consumers seeking to redress a chemical imbalance. The problem of depression, the emergence of molecular science and the push for pharmacological solutions are contributing to the discursive formation of new subject positions - such as the neurochemically deficient self. Three themes were identified in relation to medication use, namely restoring normality, signifying recovery success and control/uncertainty. Anti-depressant medication offered women a normalized pathway to successful recovery that stood in stark contrast to the biologically deficient and morally failing self. These women's stories importantly reveal the gender relations and paradoxes arising from biopolitical technologies that shape selfhood for women in advanced liberal societies.

'Islands' and 'doctor's tool': the ethical significance of isolation and subordination in UK community pharmacy.

Abstract: Empirical ethics research is increasingly valued in offering insights into how ethical problems and decision-making occur in healthcare. In this article, the findings of a qualitative study of the ethical problems and decision-making of UK community pharmacists are presented, and it is argued that the identified themes of pharmacists' relative isolation from others and their subordination to doctors are ethically significant. Semi-structured interviews were conducted with 23 community pharmacists in England, UK. Analysis of interviews revealed that isolation involved separation of pharmacists from their peers, other healthcare professionals, patients and customers. Such isolation is argued to be inimical to ethical practice - impeding ethical discourse as understood by Habermas, resulting in a form of anomie that inhibits the transmission of professional values, leading to a lack of proximity between pharmacist and patient or customer that may impede ethical relationships and resulting, psychologically, in less ethical concern for those who are less close. Pharmacists' subordination to doctors not only precipitated some ethical problems but also allowed some pharmacists to shift ethical responsibility to a prescribing doctor, as in the case of emergency hormonal contraception. The emergence of atrocity stories further supports a culture of subordination that may cause ethical problems. The study has implications for community pharmacy practice in terms of supervision issues, developments such as prescribing responsibilities and how ethical values can be taught and communicated. The potential for isolation and subordination in other healthcare professions, and resultant ethical problems, may also need to be addressed and researched.

Illness explanations among patients with medically unexplained symptoms: different idioms for different contexts.

Abstract: Patients with medically unexplained symptoms (MUS) are often considered to be strictly confined to thinking about their symptoms as having only a physical etiology. However, several studies have shown, that the patients also apply other explanations for their sufferings. The aim of this study is to analyse the social construction of illness explanations among patients with MUS, and to illustrate the use of explanatory idioms as being dependent on space, time and setting, legitimizing each idiom. The study is based on repeated, semi-structured, qualitative interviews with nine informants during a period of 1.5 years. A thematic content analysis was performed on a pragmatic and phenomenological basis. We found, that patients with MUS employ at least four different explanatory idioms defined as: (1) the symptomatic idiom; (2) the personal idiom; (3) the social idiom; and (4) the moral idiom. All idioms play an important role in the process of creating meaning in the patients' everyday life. The symptomatic idiom is mainly used at clinical consultations in primary care, but it is not the only idiom of significance for the patients. Simultaneously other idioms exist and gradually become important for especially patients with MUS due to the lack of valid diagnoses and treatment opportunities. Clinical settings, however, call for the employment of the symptomatic idiom and a discrepancy is found between the general practitioners' notion of the bio-psycho-social model and the patients' everyday life idioms.

Food allergy and food intolerance: towards a sociological agenda.

Abstract: This article asks what sociological insights an analysis of food allergy and food intolerance might afford. We outline the parameters of debates around food allergy and food intolerance in the immunological, clinical and epidemiological literatures in order to identify analytic strands which might illuminate our sociological understanding of the supposed increase in both. Food allergy and food intolerance are contested and contingent terms and it is salient that the term true food allergy is replete throughout medico-scientific, epidemiological and popular discourses in order to rebuff spurious or ‘nonallergic’ claims of food-related symptoms. Complexity theory is introduced as a means of gaining analytic purchase on the food allergy debate. The article concludes that the use of this perspective provides a contemporary example of the ‘double hermeneutic’, in that the meanings and interpretations of contemporary explanations of food allergy are both permeated by, and can be made sense of, through recourse ...

Does continuity of care matter in a healthcare system that lacks referral arrangements

Abstract: INTRODUCTION Numerous studies have suggested that better continuity of care (COC) can lead to fewer emergency department (ED) visits and fewer hospital admissions. However, these studies were conducted in countries where patients have their own family physician or in countries with referral systems. This study aimed to determine whether the association between lower COC and increased health care utilization may be apparent in a health care system that lacks a family physician or a referral system. METHODS The study population included a total of 134 422 subjects who made four or more visits to physicians in 2005. Negative binominal regressions were performed to examine the effects of three different COC indices on the numbers of hospital admissions and ED visits in 2005 and in the subsequent year (2006). RESULTS The data suggest that lower COC was associated with increased hospital admissions and ED visits in our study population. Compared with the high COC group, subjects in the low and medium COC groups had 42-82% and 39-46% more hospital admissions, respectively, as well as 75-102% and 41-45% more ED visits, respectively, in 2005. Weaker protective effects of COC were also observed in the subsequent year. CONCLUSIONS This study indicates that lower COC is associated with increased hospital admissions and ED visits, even in a health care system that lacks a referral arrangement framework. This suggests that improving the COC is beneficial both for patients and for the health care system.

The untenable boundaries of biomedical knowledge: epistemologies and rhetoric strategies in the debate over evaluating complementary and alternative medicine

Abstract: The article addresses contemporary epistemologies in examining struggles between the proponents of diverse medical approaches - some accepted as scientific and others that have not gained this status. It is based on research that investigated one of the central questions raised as a result of the growing popularity of complementary and alternative medicine (CAM) in western countries during the past three decades, namely: How can we know if CAM treatments are effective and beneficial? Discourse analysis was conducted on publications written by medical knowledge producers - experts participating in different professional groups addressing controversies over questions such as the desirability of researching CAM treatment effects, the appropriate methodology to be employed and the appropriate criteria for evaluating these effects. Some central debates are presented in the article. Examination of these controversies indicates that diverse kinds of knowledge are held by different groups of medical professionals. The ways in which they justify their knowledge and the rhetoric strategies they use for legitimizing it are specified. The great variety found among the different kinds of medical knowledge and rhetoric strategies and their dispersal along a ;scientific'-'nonscientific' continuum, highlight the untenable and ambiguous boundaries of orthodox institutionalized biomedical knowledge.

Intimate relationships and women involved in the sex trade: perceptions and experiences of inclusion and exclusion

Abstract: This article reports on a qualitative study exploring the intimate (non-work) relationships of women involved in the sex trade. Women working in the sex industry and intimate partners of women in the industry were interviewed in order to understand how intimate relationships are perceived as influencing the women's general health and well-being. The research suggests that intimate relationships can, and do, provide a space for feelings of inclusion and safety that are perceived as positive forces in women's general health and well-being. At the same time, however, feelings and experiences of exclusion (fuelled by the dominant stigmatizing discourse related to prostitution) can enter into intimate relationships, and are perceived as having a negative impact on the women's well-being, particularly their emotional health. Although there are attempts to keep the women's work separate from the intimate relationship, cross-over between the two spheres does occur. The research suggests that health care and service providers need to look beyond the women's working lives, and understand the relationships between work and home, as well as the ways in which intimate relationships can influence women's lives and health through both positive and negative forces.

Automatically you become a polygamist': 'culture' and 'norms' as resources for normalization and managing accountability in talk about responses to infertility.

Abstract: In the developing world, infertility is a serious problem. It leads to both psychological and social hardship, in part because childless marriages often result in divorce, men taking another wife or extramarital relationships. Such responses have been attributed to cultural norms that mandate procreation. However, there are theoretical, methodological and moral issues with treating cultural norms as behavioural determinants. They have been insufficiently acknowledged in health research. Therefore, I demonstrate an alternative discursive approach, which examines how people actively mobilize 'culture' or 'norms' in interactions, and the interpersonal functions thereby fulfilled (e.g. blaming or justifying). Analysis is presented of interviews on (responses to) infertility in Malawi. I show how respondents construct polygamy and extramarital affairs as culturally and normatively required, 'automatic' and normal solutions for fertility problems and play down people's accountability for these practices. These accounts and constructions appear to facilitate engagement in affairs and polygamy when people face fertility problems, which seems problematic from a health and gender perspective. Thus, detailed analysis of how people use 'culture' and 'norms' in situ is important because it provides insights into its potentially undesirable consequences. Moreover, such analysis provides a starting point for culturally and gender sensitive interventions, since it highlights people's agency, and creates a space to re-construct and change practices. © 2009 SAGE Publications.

Review: effect of environmental cadmium pollution on human health

Abstract: Based on the available data obtained from the population investigating, the authors reviewed research articles of the study on analytical me- thods and exposure levels of cadmium (Cd) in population, the injury of target organ, the evol- vement of sensitive index for surveillance, the study on effects of human disease and death for environmental Cd exposure, and the study on priority surveillance of human health risk.

Spaces of care in the third sector: understanding the effects of professionalization.

Abstract: Increasingly the health and welfare needs of individuals and communities are being met by third sector, or not-for-profit, organizations. Since the 1980s third sector organizations have been subject to significant, sector-wide changes, such as the development of contractual funding and an increasing need to collaborate with governments and other sectors. In particular, the processes of ‘professionalization’ and ‘bureaucratization’ have received significant attention and are now well documented in third sector literature. These processes are often understood to create barriers between organizations and their community groups and neutralize alternative forms of service provision. In this article we provide a case study of an Australian third sector organization undergoing professionalization. The case study draws on ethnographic and qualitative interviews with staff and volunteers at a health-based third sector organization involved in service provision to marginalized community groups. We examine how professionalization alters organizational spaces and dynamics and conclude that professionalized third sector spaces may still be ‘community’ spaces where individuals may give and receive care and services. Moreover, we suggest that these community spaces hold potential for resisting the neutralizing effects of contracting.

The tenacity of the coronary candidate: how people with familial hypercholesterolaemia construct raised cholesterol and coronary heart disease.

Abstract: This article considers how people with familial hypercholesterolaemia (FH), an inherited high cholesterol condition, construct FH, high cholesterol and coronary heart disease (CHD). These data are used to explore some of the more prevalent claims about the expansion of genetic explanations for health and illness and its implications. The article draws on 31 interviews with people with FH undertaken at a large lipid clinic, a specialist outpatient clinic, in the north of England. I argue that interviewees tended to distinguish between their own ;hereditary' high cholesterol and other people's ;lifestyle induced' high cholesterol as a way to establish their own lack of culpability for their condition. At the same time, however, they strongly emphasized the need to take care of themselves, in particular by adhering to appropriate dietary and lifestyle regimes. Interviewees' accounts of CHD were not strongly framed in genetic terms, but tended to conform to established lay notions encapsulated by the idea of the ;coronary candidate'. In sum, having FH does not seem to transform these people's understandings of the causes of high cholesterol or CHD. Their experiences were largely accommodated within existing lay frameworks. The analysis contributes to a growing reappraisal of transformative narratives about genetic knowledge.

Characterization of in vitro and in vivo metabolism of AG-024322, a novel cyclin-dependent kinase (CDK)

Abstract: Uncontrolled cell proliferation is the hall mark of many cancers, and is typically manifested by a deregulation of the cell-division cycle. CDKs play critical roles in regulating cell cycle, apop- tosis and cell differentiation. AG-024322 is a multitargeted CDK inhibitor that has been shown to induce cancer cell apoptosis and de- monstrate significant antitumor activity in hu-man tumor xenograft models. This compound is under clinical development as an intravenous anticancer agent. AG-024322 exhibited moder-ate to high systemic clearance across preclini-cal species. In vitro metabolism in human liver microsomes and hepatocytes demonstrates that glucuronidation and oxidation represent the major metabolic pathways of AG-024322. The experiments of chemical inhibition and micro-somes containing individual CYP or UGT iso-forms revealed that CYP3A and UGT1A1 appear to predominantly mediate AG-024322 oxidation and glucuronidation, respectively. Formation kinetics of the two pathways in human liver mi-crosomes suggested that the glucuronidation activity of AG-024322 was approximately 3-fold higher as compared to CYP-mediated oxidation, contributing approximately 37% and 13% of the total clearance, respectively, based on the pro-jected human clearance. UGT1A1 is a poly-morphic isoform involved in glucuronidation of bilirubin. It is of concern if glucuronidation via UGT1A1 plays a major role in the elimination of AG-024322 in humans as competitive inhibition of UGT1A1 has been associated with toxicity (Gilbert and Crigler-Najjar syndromes). There-fore, this information was used to influence the clinical study design to only include subjects having constitutive expression of UGT1A1 in the first human study, thereby decreasing the potential risk of toxicity to patients.

Enacting death in the intensive care unit: medical technology and the multiple ontologies of death.

Abstract: This article explores various ways health personnel enact death in connection with mechanical ventilation treatment withdrawal in the intensive care unit (ICU) at Trondheim University Hospital. The main focus is on sedated terminal patients who undergo mechanical ventilator treatment withdrawal and relatives’ presence at this time. Mol’s (2002) praxiographic orientation of the actor-network approach is followed while exploring this medical practice. Utilizing this interdisciplinary science and technology studies approach this article describes what Timmermans and Berg (2003) have called ‘ technology-in-practice’. Thus the main focus of the analysis is on medical interventions, and enactments of death within medical practice. The article argues against a ‘social essentialist’ approach to medical technology, which views technology as a passive force empowered by social relations. It explores how various enactments of death are intrinsically linked with and shaped by the use of medical technology within clin...

Holding onto womanhood: a qualitative study of heterosexual women with sexual desire loss.

Abstract: This article explores heterosexual women's accounts of sexual desire loss, particularly the ways in which it can affect their sense of themselves as women. In-depth interviews were conducted with 17 participants recruited through a psychosexual clinic in England, and the data analysed using a material-discursive approach. The findings showed that having sexual desire loss often challenged participants' perceptions of themselves as women. Specific challenges related to dealing with isolation and `otherness', addressing their own feelings of not being `proper wives' because they did not sexually satisfy their partners and maintaining a sense of sexual attractiveness in the absence of sexual desire. Participants responded to these challenges in various ways, often renegotiating their identities as women. The findings are discussed in relation to theorizing women's sexuality and their implications for health care.

Diaries from cannabis users: an interpretative phenomenological analysis.

Abstract: This article is based on research, which aimed to uncover the meanings behind the experience of cannabis use. Six participants were recruited and asked to keep a diary for 15 days. Data were analysed using Interpretative Phenomenological Analysis (IPA). Four master themes emerged and were explored in detail. These were: 'Withdrawing from everyday life', 'Indulging in the here-and-now of the emotional body', 'The containment of the sacred space' and 'Living the addiction'. The author draws on the theoretical insights of Analytical Psychology in an attempt to capture and explain the dynamics emerging from participants' experiences. Throughout the narratives the use of cannabis, commonly regarded as a risky practice, appears to incarnate an attempt to reconnect with the here-and-now of the emotional body, as a way to escape from a convulsive consumeristic society. However, as the author argues, the lack of a conscious integration of the same convulsive consumeristic aspects within the psyche, leads participants into being ;possessed' by these same forces, ultimately leading to a repetitive and compulsive addictive behaviour.

Whose body is it anyway? Verbalization, embodiment, and the creation of narratives

Abstract: This article examines the creation of narratives between people with severe disabilities and the personnel working with them. It shows that although a co-created narrative of what it means to be severely disabled (the story of dependence) seems to prevail, another narrative (the story of autonomy) is also told, where the story of dependence is rejected by the person with disabilities. However, this story of autonomy only becomes clear if we recognize three central claims: (1) there is a connection between where the physical body of the person with disabilities is positioned in space and what he or she is allowed or able to be and do; (2) since the body is a communicative tool, the moving of the body could be interpreted as a narrative, told through the embodiment of space; and (3) the embodied story can challenge existing social structures. The article highlights the inherent struggle for power within narrations and how the creation of alternative narratives can contest existing social structures.

Organizing allergy and being a `good' parent: parents' narratives about their children's emerging problems

Abstract: The article focuses on the early and problem-solving phases of the child's illness trajectory and on how child allergies are constructed and organized by the parents in a moral everyday context. The parents' narratives were reconstructed as narratives, describing the pathways parents take before they decide to seek professional medical aid as well as showing how they construct themselves as responsible parents. Before consulting health professionals the parents have often tried a range of different ways to define, control and manage their children's various problems. Allergy problems were interpreted and responded to differently, depending on the way they emerged in everyday life. Acute reactions quickly led to an illness definition and a diagnosis. Gradual and diffuse problems were not so easily defined. They were at first interpreted and responded to as normal infant problems, but, through the parents' readiness and various situational and temporal clues, they were organized as symptoms of illness. Parents seek medical aid when their own strategies fail or do not fully work, but their decisions are also formed within a pre-problem context of their moral accountability as parents.

Therapeutic properties of honey

Abstract: Honey has been successfully used in medicine since antiquity. However, with the advent of modern medicine it has been less used, espe-cially in the English-speaking world. Its benefi-cial effects in different disorders, rediscovered in recent decades, will be discussed below on the basis of a series of international scientific studies conducted to investigate the therapeutic properties of this natural product and published on Medline. It should be noted, however, that the therapeutic use of honey in everyday clinical practice needs to be validated by relevant guidelines and should only be adopted under medical prescription, in accordance with criteria of efficacy and safety for both patients and healthcare providers.

Identities under construction: Women hailed as addicts

Abstract: Despite continuing investigations of the efficacy of Canadian addiction treatment services and supports across a range of health care settings and socio-cultural groups, many systemic, geographic and ideological barriers to service provision for women still exist. Determining how current services and supports can become more congruent with women’s gender-specific needs is a current research focus. Drawing on Butler’s reformulation of Althusser’s interpellation, this article explores the power of hailing, where hailing power lies, and how hailing operates in discourses about addiction that appear in women’s talk of their encounters with addiction services and supports. The article briefly outlines Butler’s understanding of interpellation and examines ways by which gender operates as both condition and effect in women becoming addicts. I argue that women’s narratives reveal patterns of interaction that intersect and generate complex social meanings and identities, and serve to get women’s attention in terms...

Isolation and identification of an isomer of β-sitosterol by HPLC and GC-MS

Abstract: Phytosterols are a group of steroids alcohols which had been regarded as a functional factor. An unknown compound in phytosterol samples and phytosterol standard samples was detected by HPLC using symmetry C18 column. The quan- tity of the compound was increased with the enrichment of β-sitosterol. After being collected and analyzed by GC-MS and compared with standard diagram from Wiley and Nist standard chart library, it proved to be γ-sitosterol, a 24β epimer of β-sitosterol.

Fear, complacency and the spectacle of risk: the making of HIV as a public concern in Australia.

Abstract: This article explores how HIV is constituted as a matter of public concern in Australia, where — unlike much of the rest of the world — there is a continuing low incidence of heterosexual transmiss...