Réalisme, sociologie et concepts de relations

Le mot « relations » se réfère à de nombreux concepts qui sont parfois peu compatibles entre eux en sociologie contemporaine. Compte tenu de la brièveté de la contribution que nous offrons ici, aucun effort ne sera fait pour modifier cette situation. Je présenterai plutôt une interprétation générale, une sorte de dénominateur commun, puis j’illustrerai la manière dont j’ai cherché à utiliser ces termes dans mes propres travaux sur les stigmates et sur les inégalités en matière de santé au Royaume-Uni - dans mes écrits, les termes relations et structures sont plus ou moins traités en tant que synonymes. Je terminerai avec une réflexion sur ce que j’appelle le modèle jigsaw, un outil heuristique susceptible de faciliter l’étude sociologique des relations qui se manifestent dans le monde social que nous habitons.The word ‘relations’ stands for any number of different and sometimes barely compatible concepts in contemporary sociology. No attempt will be made in this brief contribution to tidy things up. Rather I will proffer a general interpretation, a kind of common denominator, then introduce and illustrate how I have sought to use the term in my own work on health-related stigma and health inequalities in the UK. In my writings the terms relations and structures are treated largely as synonyms. I end with a consideration of what I call the ‘jigsaw model’, a heuristic device to facilitate the sociological study of relations in the social worlds we inhabit

The relationship between medicine and the public: the challenge of concordance

Concordance is based on the idea that patients and practitioners should work together towards an agreement on treatment choice. This requires a redefinition of the relations and encounters between doctors and their patients. This redefinition emphasizes the need for patient involvement and participation. In this article we examine concordance against the background of wider social change, structural as well as interpersonal. We focus in particular on challenges to trust, noting that the almost instinctive trust that people formerly had for professional experts has for many reasons diminished. One consequence of this, we suggest, is that concordance is being espoused at a time when its accomplishment may be particularly threatened. In fact there are strong grounds for claiming that support for the notion of concordance could possibly result in a growth of ‘hidden’ communication pathologies by means of what the social theorist Habermas (1984) has termed ‘systematically distorted communication’

Epilepsy, stigma and quality of life

Abstract Epilepsy is a psychological and social as well as a biological phenomenon. Just why and how this is the case is discussed in the opening section of this contribution. The rest of the paper is committed to the social in general, and to the stigma often associated with epilepsy in particular. The concluding paragraphs commend a future social research programme, and discuss its salience for stigma reduction programmes

Systematic survey of variants in TBX1 in non-syndromic tetralogy of Fallot identifies a novel 57 base pair deletion that reduces transcriptional activity but finds no evidence for association with common variants

Background Tetralogy of Fallot (TOF) is common in individuals with hemizygous deletions of chromosome 22q11.2 that remove the cardiac transcription factor TBX1.Objective To assess the contribution of common and rare TBX1 genetic variants to TOF.Design Rare TBX1 variants were sought by resequencing coding exons and splice-site boundaries. Common TBX1 variants were investigated by genotyping 20 haplotype-tagging SNPs capturing all the common variations present at the locus. Association analysis was performed using the program UNPHASED.Patients TBX1 exons were sequenced in 93 patients with non-syndromic TOF. Single nucleotide polymorphism analysis was performed in 356 patients with TOF, their parents and healthy controls.Results Three novel variants not present in 1000 chromosomes from healthy ethnically matched controls were identified. One of these variants, an in-frame 57 base-pair deletion in the third exon which removed 19 evolutionarily conserved residues, decreased transcriptional activity by 40% in a dual luciferase assay (p=0.008). Protein expression studies demonstrated that this mutation affected TBX1 protein stability. After correction for multiple comparisons, no significant associations between common genetic variants and TOF susceptibility were found.Conclusion This study demonstrates that rare TBX1 variants with functional consequences are present in a small proportion of non-syndromic TOF

Do those over 80 years of age seek more or less medical help? A qualitative study of health and illness beliefs and behaviour of the oldest old

Increasing longevity and prevalence of long-term conditions contribute to older adults being the greatest users of health services. However, relatively little is known about the health and illness beliefs of the oldest old or how they decide to seek help in response to symptoms. Through analysis of in-depth interviews with day centre attendees aged 80-93, we find that a moral, hierarchical approach to health problems and help-seeking exists; similar to Cornwell's. findings among 50-60 year-olds of a similar social group 30 years ago. However, when acting independently, those in their eighties and nineties report modifying their health and illness beliefs and behaviour, in response to their own perceived old age. Some health problems are 'demedicalised', being increasingly attributed to age and by being self-managed. Others are perceived as potentially more serious, leading to increased consultation with medical services. When obliged to act outside their moral belief-behaviour framework by others, the participants expressed feelings of disempowerment, yet resisted modifying their moral beliefs. This may represent resistance to adopt the 'sick role', while seeking to maintain control over uncertain health as functional dependence and frailty increases. This study furthers theoretical understanding of the health and illness beliefs and behaviour of the oldest old, with important practical implications

Beyond the therapeutic: a Habermasian view of self-help groups’ place in the public sphere

Self-help groups in the United Kingdom continue to grow in number and address virtually every conceivable health condition, but they remain the subject of very little theoretical analysis. The literature to date has predominantly focused on their therapeutic effects on individual members. And yet they are widely presumed to fulfil a broader civic role and to encourage democratic citizenship. The article uses Habermas’ model of the public sphere as an analytical tool with which to reconsider the literature on self-help groups in order to increase our knowledge of their civic functions. In doing this it also aims to illustrate the continuing relevance of Habermas’ work to our understanding of issues in health and social care. We consider, within the context of current health policies and practices, the extent to which self-help groups with a range of different forms and functions operate according to the principles of communicative rationality that Habermas deemed key to democratic legitimacy. We conclude that self-help groups’ civic role is more complex than is usually presumed and that various factors including groups’ leadership, organisational structure and links with public agencies can affect their efficacy within the public sphere

Systematic survey of variants in TBX1 in non-syndromic tetralogy of Fallot identifies a novel 57 base pair deletion that reduces transcriptional activity but finds no evidence for association with common variants

Background Tetralogy of Fallot (TOF) is common in individuals with hemizygous deletions of chromosome 22q11.2 that remove the cardiac transcription factor TBX1. Objective To assess the contribution of common and rare TBX1 genetic variants to TOF. Design Rare TBX1 variants were sought by resequencing coding exons and splice-site boundaries. Common TBX1 variants were investigated by genotyping 20 haplotype-tagging SNPs capturing all the common variations present at the locus. Association analysis was performed using the program UNPHASED. Patients TBX1 exons were sequenced in 93 patients with non-syndromic TOF. Single nucleotide polymorphism analysis was performed in 356 patients with TOF, their parents and healthy controls. Results Three novel variants not present in 1000 chromosomes from healthy ethnically matched controls were identified. One of these variants, an in-frame 57 base-pair deletion in the third exon which removed 19 evolutionarily conserved residues, decreased transcriptional activity by 40% in a dual luciferase assay (p=0.008). Protein expression studies demonstrated that this mutation affected TBX1 protein stability. After correction for multiple comparisons, no significant associations between common genetic variants and TOF susceptibility were found. Conclusion This study demonstrates that rare TBX1 variants with functional consequences are present in a small proportion of non-syndromic TOF

Teaching sociology to undergraduate medical students

Understanding the social basis of health and medicine and the contexts of clinical care are essential components of good medical practice. This includes the ways in which social factors such as class, ethnicity and gender influence health outcomes and how people experience health, illness and healthcare. In our Guide we describe what sociology is and what it brings to medicine, beginning with the nature of the ‘sociological imagination’. Sociological theory and methods are reviewed in order to explain and illustrate the role of sociology in the context of undergraduate medical education. Reference is made to A Core Curriculum for Sociology in UK Undergraduate Medical Education by Collett et al. (2016). Teaching and student learning are discussed in terms of organisation and delivery, with an emphasis on practice. Sections are also included on assessment, evaluation, opportunities and challenges and the value of a ‘community of practice’ for sociology teachers in medical education. <br/