A sociology of public responses to hospital change and closure

The "problem" of public resistance to hospital closure is a recurring trope in health policy debates around the world. Recent papers have argued that when it comes to major change to hospitals, "the public" cannot be persuaded by clinical evidence, and that mechanisms of public involvement are ill-equipped to reconcile opposition with management desire for radical change. This paper presents data from in-depth qualitative case studies of three hospital change processes in Scotland's National Health Service, including interviews with 44 members of the public. Informed by sociological accounts of both hospitals and publics as heterogeneous, shifting entities, I explore how hospitals play meaningful roles within their communities. I identify community responses to change proposals which go beyond simple opposition, including evading, engaging with and acquiescing to changes. Explicating both hospitals and the publics they serve as complex social phenomena strengthens the case for policy and practice to prioritise dialogic processes of engagement. It also demonstrates the continuing value of careful, empirical research into public perspectives on contentious healthcare issues in the context of everyday life

A Case Study in Resiliency: How a University Survived a Pandemic

This case study was conducted to investigate how the COVID-19 pandemic affected the campus of a small private university in central Mississippi, where traditionally, relational community and interaction were key contributors to campus culture. Through document analysis, individual interviews with campus leaders, and focus groups consisting of members of key departments, the role of resiliency was examined during the early days of the COVID-19 pandemic. Emerging from the data were the four thematic categories of leadership, campus culture, engagement and interaction, and challenges. Key components in each category revealed the significance of resiliency of university leaders, faculty, and staff as they met the challenge of continued academic progress and normal collegiate activity in the midst of an unprecedented challenges

The uneven impacts of research impact: adjustments needed to address the imbalance of the current impact framework

The current approach to measuring and assessing research impact favours certain kinds of academics and research topics over others. Kat Smith and Ellen Stewart outline three areas that require further consideration. Academics who are negatively impacted by the current framework might look to suggest adjustments which limit or ameliorate these effects

Legitimating complementary therapies in the NHS:campaigning, care and epistemic labour

Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM's growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM's 'publics', however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public's effort to legitimate CAM within the UK's National Health Service: the campaign to 'save' Glasgow’s Centre for Integrative Care (CIC). Campaigners skilfully intertwined 'experiential' knowledge of the value of CIC care with 'credentialed' knowledge (Rabeharisoa et al., 2014) regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance

We need to talk about impact:Why social policy academics need to engage with the UK's research impact agenda

Of all the social sciences, social policy is one of the most obviously policy-orientated. One might, therefore, expect a research and funding agenda which prioritises and rewards policy relevance to garner an enthusiastic response among social policy scholars. Yet, the social policy response to the way in which major funders and the Research Excellence Framework (REF) are now prioritising ‘impact’ has been remarkably muted. Elsewhere in the social sciences, ‘research impact’ is being widely debated and a wealth of concerns about the way in which this agenda is being pursued are being articulated. Here, we argue there is an urgent need for social policy academics to join this debate. First, we employ interviews with academics involved in health inequalities research, undertaken between 2004-2015, to explore perceptions, and experiences, of the ‘impact agenda’ (an analysis which is informed by a review of guidelines for assessing ‘impact’ and relevant academic literature). Next, we analyse high and low scoring REF2014 impact case studies to assess whether these concerns appear justified. We conclude by outlining how social policy expertise might usefully contribute to efforts to encourage, measure and reward research ‘impact’

‘The biggest charity you’ve never heard of’:Institutional logics of charity and the state in public fundraising in Scotland’s NHS.

The boundaries between state and charitable activities within the NHS are set out in regulations but are also enacted, blurred, and contested through local practices. This article reports research on NHS Charities– charitable funds set up within NHS organizations to enhance statutory provision – in Scotland. We analysed financial accounts and conducted qualitative interviews with staff in 12 of the 14 NHS Charities in Scotland, where they are generally known as endowments. Our findings suggest that Scotland’s endowments are relatively wealthy in charitable terms, but that this wealth is unevenly distributed when population size and socio-economic deprivation are considered. We also identify two diverging organisational approaches to decisions, including those about appropriate and inappropriate fundraising. We argue that these approaches cohere with contrasting ‘state’ and ‘charitable’ institutional logics, which in turn imply different attitudes to potential inequalities, and to relationships with local publics

Health Effects of Indoor-Air Benzene in Anchorage Residences: A Study of Indoor-Air Quality in Houses with Attached Garages

Benzene is a known carcinogen. It affects white blood cells; it causes leukemia and aplastic anemia. It may also affect the immune system which is dependent on white blood cells.1 It has been removed from all household products, but it is still present in gasoline. Alaskan gasoline is particularly high in benzene (>5%). Gasoline refined in Alaska has high concentrations of benzene and other the aromatic compounds as much as 50% aromatics by volume. Leaving the aromatics in the gasoline helps cars start in the cold, but it also puts high concentrations of benzene in both the ambient and indoor air. We already knew from previous work done in Alaska by Bernard Goldstein in Valdez2 and the Anchorage Department of Health and Human Services in Anchorage3 that people were exposed to high ambient levels of benzene in the winter, and that there were high indoor benzene concentrations in homes with attached garages if the garage was used to store gasoline or gasoline powered engines. Benzene does not bioaccumulate in the body as dioxin or some pesticides do. But are its effects cumulative? Does a little dose of benzene everyday have the same effect as a large dose over less time? Benzene reduces CD4 cells in a dose-response manner at workplace concentrations less than 1 ppm (OSHA 8-hour exposure limit) in workers.4 People who live in homes with high benzene concentrations may be exposed 24 hours a day, seven days a week. There have been no studies of health effects of such environmental exposure to benzene. This study was done to determine three things: 1. What percentage of Anchorage homes with attached garages had high levels of indoor benzene? 2. Were the high levels of indoor benzene affecting the health of the residents? 3. Were residents more likely to develop asthma in homes with high levels of indoor benzene?Municipality of AnchorageIntroduction / Methods / Recruitment / Results / Laboratory Results / Smoking / Health Results / Demographics / Determining Risk Levels / Asthma Outcomes / Children / Work and Hobby Exposure / General Health / Conclusions / Bibliography / Appendice

A mutual NHS? The development of distinctive public involvement policy in a devolved Scotland

Academic research on health policy divergence across the United Kingdom since devolution has characterised Scotland's approach as ‘professionalistic’ or ‘collaborative’. This article argues that more nuanced studies of particular policy areas are needed, and offers an exploration of the Scottish approach to public involvement as an example. An analysis of policy documents since devolution reveals the shifting significance of public involvement, and the introduction of new instruments for its accomplishment. The Scottish National Party’s vision of ‘a mutual National Health Service’ is presented as a complex, even contradictory, project, which warrants further empirical attention both within and beyond the context of four-system comparisons.</jats:p