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

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

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

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?)

Comparing Performance Category Criteria for U.S. Navy Alternate Physical Readiness Tests

The current Navy Physical Readiness Test (PRT) allows for several alternative methods, in lieu of the 1.5-mile run, with which to assess aerobic fitness. Two of these methods (elliptical trainer and stationary bike) and two additional devices (2-Km rower and 5-Km bike) were evaluated to determine if maximal effort on all devices produced the same performance category as the 1.5-mile run. One hundred thirty-two active-duty military and midshipmen were recruited from the United States Naval Academy and Naval Support Activity Annapolis. Subjects participated in six testing sessions over a six-week period. Subjects performed a 1.5-mile run (n = 118), 12-minute elliptical trainer test (n = 108), 12-minute stationary bike test (n = 115), 2-Km rower test (n = 115), and 5-Km bike test (n = 114). Each performance category attained from the alternate aerobic test device was compared to the performance category attained for the 1.5-mile run. None of the aerobic testing devices performance categories matched well to the 1.5-mile run. The results of the testing sessions support the mandated use of the 1.5-mile run as the sole method of assessing aerobic fitness. Additionally, if an alternate method must be used, the 12-minute stationary bike test using the revised Naval Health Research Center (NHRC) performance categories might be the best option because it has the largest number of performance matching categories. Finally, the results do not support the use of the 12-minute elliptical test, as an authorized alternative, due to its minimal number of matching categories

Towards a new theory of practice for community health psychology

The article sets out the value of theorizing collective action from a social science perspective that engages with the messy actuality of practice. It argues that community health psychology relies on an abstract version of Paulo Freire’s earlier writing, the Pedagogy of the Oppressed, which provides scholar-activists with a ‘map’ approach to collective action. The article revisits Freire’s later work, the Pedagogy of Hope, and argues for the importance of developing a ‘journey’ approach to collective action. Theories of practice are discussed for their value in theorizing such journeys, and in bringing maps (intentions) and journeys (actuality) closer together

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

Retreating to nature : rethinking 'therapeutic landscapes'

There is a long history of removing oneself from ‘society’ in order to recuperate or repair. This paper considers a yoga and massage retreat in Southern Spain, and what opportunities this retreat experience might offer for recuperation and the creation of healthy bodies. The paper positions ‘nature’ as an active participant, and as ‘enrolled’ in the experiences of the retreat as a ‘therapeutic landscape’, and questions how and what particular aspects of yoga practice (in intimate relation with place) give rise to therapeutic experiences