Corporal diagnostic work and diagnostic spaces: Clinicians' use of space and bodies during diagnosis

© 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.An emerging body of literature in sociology has demonstrated that diagnosis is a useful focal point for understanding the social dimensions of health and illness. This article contributes to this work by drawing attention to the relationship between diagnostic spaces and the way in which clinicians use their own bodies during the diagnostic process. As a case study, we draw upon fieldwork conducted with a multidisciplinary clinical team providing deep brain stimulation (DBS) to treat children with a movement disorder called dystonia. Interviews were conducted with team members and diagnostic examinations were observed. We illustrate that clinicians use communicative body work and verbal communication to transform a material terrain into diagnostic space, and we illustrate how this diagnostic space configures forms of embodied 'sensing-and-acting' within. We argue that a 'diagnosis' can be conceptualised as emerging from an interaction in which space, the clinician-body, and the patient-body (or body-part) mutually configure one another. By conceptualising diagnosis in this way, this article draws attention to the corporal bases of diagnostic power and counters Cartesian-like accounts of clinical work in which the patient-body is objectified by a disembodied medical discourse.The Wellcome Trust (Wellcome Trust Biomedical Strategic Award 086034

STS in management education: connecting theory and practice

This paper explores the value of science and technology studies (STS) to management education. The work draws on an ethnographic study of second year management undergraduates studying decision making. The nature and delivery of the decision making module is outlined and the value of STS is demonstrated in terms of both teaching method and module content. Three particular STS contributions are identified and described: the social construction of technological systems; actor network theory; and ontological politics. Affordances and sensibilities are identified for each contribution and a discussion is developed that illustrates how these versions of STS are put to use in management education. It is concluded that STS has a pivotal role to play in critical management (education) and in the process offers opportunities for new forms of managin

The hospital building as project and matter of concern: the role of representations in negotiating patient room designs and bodies

Mock-ups, scale models and drawings are ubiquitous in building design processes, circulating between various stakeholders. They contribute to the gradual evolution of design, but what else can specific material forms of representations do for the building design and project? The full-scale model of a hospital single-bed room can be different in terms of detail and medium, but in what sense might it perform different and similar functions? The mobilization of multiple forms of representations and visualizations suggest that design materialization might have several important roles to play in negotiating the building design and project, including the exposition and resolution of controversy concerning size of spaces and bodies. The paper compares the use of two different forms of representation of the same imagined space—a single-bed room in a hospital, and produced for similar purposes—to ascertain what the optimum (or minimum) spatial requirements should be to allow effective care of patients. The first representations are physical mock-ups of a single-bed room for Danish hospitals where actual medical and logistical procedures are simulated using real equipment and real people. The second is a three-dimensional augmented reality model of a single-bed room for a new hospital in the UK, using a Cave Automatic Virtual Environment where the room is reproduced virtually at one-to-one scale, and which can be explored or navigated using head-tracker technology and a joystick controller. Drawing on Latour's concepts of matters of concern and matters of fact, we compare these two cases to provide insights into the way different media produce specific senses of the design or imagined space, with consequences for on-going design work, and for the settling of controversy over the sizes of spaces and bodies

The golden circle: A way of arguing and acting about technology in the London ambulance service

This paper analyses the way in which the London Ambulance Service recovered from the events of October 1992, when it implemented a computer-aided despatch system (LASCAD) that remained in service for less than two weeks. It examines the enactment of a programme of long-term organizational change, focusing on the implementation of an alternative computer system in 1996. The analysis in this paper is informed by actor-network theory, both by an early statement of this approach developed by Callon in the sociology of translation, and also by concepts and ideas from Latour’s more recent restatement of his own position. The paper examines how alternative interests emerged and were stabilized over time, in a way of arguing and acting among key players in the change programme, christened the Golden Circle. The story traces four years in the history of the London Ambulance Service, from the aftermath of October 1992 through the birth of the Golden Circle to the achievement of National Health Service (NHS) trust status. LASCAD was the beginning of the story, this is the middle, an end lies in the future, when the remaining elements of the change programme are enacted beyond the Golden Circle

Scraping the Social? Issues in live social research

What makes scraping methodologically interesting for social and cultural research? This paper seeks to contribute to debates about digital social research by exploring how a ‘medium-specific’ technique for online data capture may be rendered analytically productive for social research. As a device that is currently being imported into social research, scraping has the capacity to re-structure social research, and this in at least two ways. Firstly, as a technique that is not native to social research, scraping risks to introduce ‘alien’ methodological assumptions into social research (such as an pre-occupation with freshness). Secondly, to scrape is to risk importing into our inquiry categories that are prevalent in the social practices enabled by the media: scraping makes available already formatted data for social research. Scraped data, and online social data more generally, tend to come with ‘external’ analytics already built-in. This circumstance is often approached as a ‘problem’ with online data capture, but we propose it may be turned into virtue, insofar as data formats that have currency in the areas under scrutiny may serve as a source of social data themselves. Scraping, we propose, makes it possible to render traffic between the object and process of social research analytically productive. It enables a form of ‘real-time’ social research, in which the formats and life cycles of online data may lend structure to the analytic objects and findings of social research. By way of a conclusion, we demonstrate this point in an exercise of online issue profiling, and more particularly, by relying on Twitter to profile the issue of ‘austerity’. Here we distinguish between two forms of real-time research, those dedicated to monitoring live content (which terms are current?) and those concerned with analysing the liveliness of issues (which topics are happening?)

Towards practice-based studies of HRM: an actor-network and communities of practice informed approach

HRM may have become co-terminus with the new managerialism in the rhetorical orthodoxies of the HRM textbooks and other platforms for its professional claims. However, we have detailed case-study data showing that HR practices can be much more complicated, nuanced and indeed resistive toward management within organizational settings. Our study is based on ethnographic research, informed by actor-network theory and community of practice theory conducted by one of the authors over an 18-month period. Using actor-network theory in a descriptive and critical way, we analyse practices of managerial resistance, enrolment and counter-enrolment through which an unofficial network of managers used a formal HRM practice to successfully counteract the official strategy of the firm, which was to close parts of a production site. As a consequence, this network of middle managers effectively changed top management strategy and did so through official HRM practices, coupled with other actor-network building processes, arguably for the ultimate benefit of the organization, though against the initial views of the top management. The research reported here, may be characterized as a situated study of HRM-in-practice and we draw conclusions which problematize the concept of HRM in contemporary management literature

Globalising assessment: an ethnography of literacy assessment, camels and fast food in the Mongolian Gobi

What happens when standardised literacy assessments travel globally? The paper presents an ethnographic account of adult literacy assessment events in rural Mongolia. It examines the dynamics of literacy assessment in terms of the movement and re-contextualisation of test items as they travel globally and are received locally by Mongolian respondents. The analysis of literacy assessment events is informed by Goodwin’s ‘participation framework’ on language as embodied and situated interactive phenomena and by Actor Network Theory. Actor Network Theory (ANT) is applied to examine literacy assessment events as processes of translation shaped by an ‘assemblage’ of human and non-human actors (including the assessment texts)

Up the ANTe: Understanding Entrepreneurial Leadership Learning through Actor-network Theory

This paper explores the role of educators in supporting the development of entrepreneurial leadership learning though creating peer learning networks of owner-managers of small businesses. Using actor-network theory as a lens we think through the process of constructing and maintaining a peer learning network (conceived of as an actor-network) and frame entrepreneurial leadership learning as a network effect. Our paper is of significance to theory and practice in terms of understanding the dynamics, challenges and opportunities surrounding the construction and ongoing maintenance of networks and how to stimulate entrepreneurial leadership learning

The articulation of enkinaesthetic entanglement

In this article I present an argument for the necessary co-articulation of meaning within our felt enkinaesthetic engagement with our world. The argument will be developed through a series of stages, the first of which will be an elaboration of the notion of articulation of and through the body. This will be followed by an examination of enkinaesthetic experiential entanglement and the role it plays in rendering our world meaningful and our actions values-realising. At this stage I will begin to extend Husserl’s notion of intentional transgression to the enkinaesthetic sphere of lived experience, and in support of this claim I will examine the theoretical and practical work of osteopathic manual listening [Gens & Roche 2014] and the ‘felt sense’ in focusing [Gendlin] which makes possible a shift from a somatic articulation to a semantic, and potentially conceptual, one. Throughout, my position will be compatible with Merleau-Ponty’s claim that “Whenever I try to understand myself, the whole fabric of the perceptible world comes too, and with it comes the others who are caught in it.” [Merleau-Ponty 1964a, p.15]