Medicalisation, pharmaceuticalisation or both? Exploring the medical management of sleeplessness as insomnia

In this paper we examine the medical management of sleeplessness as ‘insomnia’, through the eyes of general practitioners (GPs) and sleep experts in Britain. Three key themes were evident in the data. These related to (i) institutional issues around advocacy and training in sleep medicine (ii) conceptual issues in the diagnosis of insomnia (iii) and how these played out in terms of treatment issues. As a result, the bulk of medical management occurred at the primary rather than secondary care level. These issues are then reflected on in terms of the light they shed on relations between the medicalisation and the pharmaceuticalisation of sleeplessness as insomnia. Sleeplessness, we suggest, is only partially and problematically medicalised as insomnia to date at the conceptual, institutional and interactional levels owing to the foregoing factors. Much of this moreover, on closer inspection, is arguably better captured through recourse to pharmaceuticalisation, including countervailing moves and downward regulatory pressures which suggest a possible degree of depharmaceuticalisation in future, at least as far prescription hypnotics are concerned. Pharmaceuticalisation therefore, we conclude, has distinct analytical value in directing our attention, in this particular case, to important dynamics occurring within if not beyond the medicalisation of sleeplessness as insomnia

The usefulness of Visitor Expectations Type Scales (VETS) for tourist segmentation : the case of cathedral visitors

This study applies Jungian psychological type theory to assess and to interpret the expectations of cathedral visitors. The Visitor Expectations Type Scales were developed among 35 individuals trained and qualified as type practitioners and then tested among a sample of 157 visitors who also completed the Francis Psychological Type Scales. The data demonstrated: the coherence and internal consistency reliability of the Visitor Expectations Type Scales; the particular emphases placed by cathedral visitors on introverted expectations, feeling expectations, and perceiving expectations; and the complex relationship between visitor expectations (conceptualised in psychological type categories) and their personal psychological type profile. The Visitor Expectations Type Scales are commended as providing a more valid assessment of the psychographic segmentation of cathedral visitors than could be provided simply by the administration of a recognised measure of psychological type. Such assessment has implications for the marketing and management of cathedrals within the tourism industry

Medical sociology and the biological body: where are we now and where do we go from here?

In this article I pose the question, 'where is the biological body in medical sociology today?' The first part of the article provides a selective corporeal balance sheet of where we are now in medical sociology, with particular reference to social constructionist and phenomenological approaches and their respective stances or takes on the (biological) body. The subsequent section considers where we might profitably be going in the future in terms of bringing the biological body (back) in, and the broader issues this raises for the sociological enterprise as a whole. Various problems associated with this evolving project and merits of other recent approaches, such as the sociology of translation, are considered. The article concludes with some further thoughts and reflections on these matters, including a revisiting of relations between the sociology of the body and medical sociology in the light of these debates

Parsons revisited: from the sick role to...?

This article revisits Parsons’ insights on medicine, health and illness in the light of contemporary debates in medical sociology and beyond. A preliminary balance sheet of the Parsonian legacy is first provided, taking on board standard accounts and criticisms of Parsons’ work within medical sociology to date. The remainder of the article, in contrast, involves a close re-reading of Parsons in the light of contemporary sociological debates on the body, emotion, trust, uncertainty and health, including late modern and postmodern interpretations of his work. Parsons, it is concluded, despite his (many) critics and detractors, has much to contribute here, not simply in terms of past insights, but also with regard to the present and futur

The Impact of European Integration on the Development of Modern Citizenship.

Interlinking vital aspects of the legal, economic, political and social competencies of its participating member states the European Union as it is presently constituted represents a unique experiment in the development of a new type of supranational political system. Driven by the accelerating processes of globalisation and actioned through a variety of formal and informal mechanisms European integration is slowly shifting the centre of political authority to a new supranational European level. The challenge for the European Union is to reconcile these developments and create an institutional framework that provides democratic legitimacy promotes equality, social inclusion and social justice and creates a political system that can recognise and accommodate the differences inherent in an increasingly multi-cultural society. Recognising the close inter-relationship between the effects of integration and the exercise of meaningful political participation, the European Commission has explicitly identified European citizenship as the mechanism to legitimise continued integration. The purpose of this research is to analyse the implications of this decision and to explore whether over time European citizenship has the potential to create and foster a distinct European identity which can promote a genuine and meaningful form of participatory post-national citizenship based outside the nation state. Drawing together both integration and citizenship theory into a new synthesis, the research is seeking to develop a new syncretic model of integration that can satisfactorily explain both the complexity and sophistication of the European Union and explain the forces which are currently driving forward the momentum of integration towards an "ever closer" political Union

Multiband processing of multimode light: combining 3D photonic lanterns with waveguide Bragg gratings

The first demonstration of narrowband spectral filtering of multimode light on a 3D integrated photonic chip using photonic lanterns and waveguide Bragg gratings is reported. The photonic lanterns with multi-notch waveguide Bragg gratings were fabricated using the femtosecond direct-write technique in boro-aluminosilicate glass (Corning, Eagle 2000). Transmission dips of up to 5 dB were measured in both photonic lanterns and reference single-mode waveguides with 10.4-mm-long gratings. The result demonstrates efficient and symmetrical performance of each of the gratings in the photonic lantern. Such devices will be beneficial to space-division multiplexed communication systems as well as for units for astronomical instrumentation for suppression of the atmospheric telluric emission from OH lines.Comment: 5 pages, 4 figures, accepted to Laser & Photonics Review

A Semiconductor Under Insulator Technology in Indium Phosphide

This Letter introduces a Semiconductor-Under-Insulator (SUI) technology in InP for designing strip waveguides that interface InP photonic crystal membrane structures. Strip waveguides in InP-SUI are supported under an atomic layer deposited insulator layer in contrast to strip waveguides in silicon supported on insulator. We show a substantial improvement in optical transmission when using InP-SUI strip waveguides interfaced with localized photonic crystal membrane structures when compared with extended photonic crystal waveguide membranes. Furthermore, SUI makes available various fiber-coupling techniques used in SOI, such as sub-micron coupling, for planar membrane III-V systems

Enhancement imaginaries : exploring public understandings of pharmaceutical cognitive enhancing drugs

The growing use of psychoactive substances in everyday life, the increasing experimentation among users and the potential of poly drug use for non-medical, lifestyle or enhancement purposes presents an evolving policy challenge. The paper aims to build on previous research to gain a more in-depth qualitative understanding of the imaginaries around pharmaceutical cognitive enhancement (PCE). It focuses in particular on how the so-called pharmaceutical cognitive enhancing drugs (PCEDs) might be used and the social acceptability of these uses across multiple social contexts and groups. Data come from 23 focus groups (99 participants), representing a wide range of social groups, recruited in the UK. We discuss four distinct ‘enhancement practices’ where PCE use was conceptualised as a way to (1) become the best version of oneself; (2) gain a competitive edge over others; (3) for personal achievement or well-being; and (4) promote personal/public safety. The findings problematise the term ‘enhancement’ by showing the different ways in which the use of pharmaceutical ‘enhancement’ drugs can be imagined and understood. We argue for the value of policy responses that acknowledge and respond to a wider range of enhancement practices including those of prospective user groups

The concept of medicalisation reassessed : a response to Busfield

Joan Busfield’s (2017) reassessment of the concept of medicalisation is a welcome and timely contribution to a key issue within medical sociology, past and present. Not simply medical sociology however. Medicalisation indeed, as Conrad (2015) himself notes, now carries ‘analytical weight’ in a range of disciplines beyond sociology including history, anthropology, bioethics, economics, media studies and feminism. To this of course we may add engagements within medicine itself as well as the wider circulation of ‘medicalisation’ within popular culture if not public consciousness today as a commonly used if not abused term of reference, thereby rending medicalisation a victim of its own success perhaps. Hence debates in recent years as to whether or not medicalisation has outlived its usefulness as a concept, including its relationship to other newly developed concepts and ways of theorising these matters, in sociology and beyond (Bell & Figert, 2015a,b, 2014; Rose, 2007)

Is resilience a normative concept?

In this paper, we engage with the question of the normative content of the resilience concept. The issues are approached in two consecutive steps. First, we proceed from a narrow construal of the resilience concept – as the ability of a system to absorb a disturbance – and show that under an analysis of normative concepts as evaluative concepts resilience comes out as descriptive. In the second part of the paper, we argue that (1) for systems of interest (primarily social systems or system with a social component) we seem to have options with respect to how they are described and (2) that this matters for what is to be taken as a sign of resilience as opposed to a sign of the lack of resilience for such systems. We discuss the implications of this for how the concept should be applied in practice and suggest that users of the resilience concept face a choice between versions of the concept that are either ontologically or normatively charged