After illness, under diagnosis

A vast portion of the world’s population live with ill health following acute infection or disease and its emergency management. This reflects the increased capacity of technological innovations and pharmaceuticals to interrupt decline or complications, even when cure is unlikely. The authors in this Special Section illustrate how, in different localities, people live with risk for themselves or their offspring; with non-communicable, degenerative, autoimmune, and congenital conditions; with the after-effects of diagnostic procedures and surgical interventions; and with continued treatment and surveillance. We attend to the value of conceptualising this as ‘living under’ diagnosis or description. We illustrate how diagnostic labels overdetermine subsequent embodied states of being, structuring interactions and social relations with family, friends, and health professionals. Living under diagnosis, we argue, impacts on self-care, care for and by others, everyday lives, and anticipations of the future

The Racism, Acceptance, and Cultural-Ethnocentrism Scale (RACES): Measuring Racism in Australia

No existing scale has been designed for, and validated in, the Australian context which can objectively evaluate the levels of general racist attitudes in Australian individuals or groups. Existing Australian measures of racist attitudes focus on single groups or have not been validated across the lifespan. Without suitable instruments, racism reduction programs implemented in Australia cannot be appropriately evaluated and so cannot be judged to be making a meaningful difference to the attitudes of the participants. To address the need for a general measure of racial, ethnic, cultural, and religious acceptance, an Australian scale was developed and validated for use with children, adolescents, and adults. The Racism, Acceptance, and Cultural-Ethnocentrism Scale (RACES) is a 34-item self-report instrument measuring explicit racist attitudes, consisting of three interdependent subscales (Accepting Attitudes – 12 items; Racist Attitudes – 8 items; Ethnocentric Attitudes – 4 items) and a 10-item measure of social desirability. The current chapter summarises the mixed methods approach to the development and evaluation of the novel scale, and reports on the reliability and validity data for children, adolescents, and adults from diverse racial, ethnic, cultural, and religious backgrounds around Australia. The results of examinations of psychometric properties, including latent structure, internal consistency, test-retest reliability, convergent validity, discriminant validity, and predictive validity, are discussed. Utilised analytical techniques include qualitative thematic analysis of interviews and focus groups, unidimensional and multidimensional Rasch (Item Response Theory) analyses, and various Classical Test Theory analyses

The development of the Pergerakan Kaum Ibu UMNO, 1945-1972

Within traditional Malay society, its religion and its custom, women were clearly subordinate to men, their prime function the fulfilment of their roles as wives and mothers, as supporters and nurturers. Despite this prescription, they played a vital and essential role in subsistence agriculture and small commerce. Their participation in economic life provided them with avenues of influence in decision-making, but, with the exception of a few aristocratic women, this influence was generally indirect and informal. The reinstatement of British rule in Malaya following World War Two, and the subsequent involvement of Malay women as well as men in national political life, suggests a dramatic change in the role of women. They attended rallies and demonstrations; they made speeches; they joined political organisations; later they voted and sought election to public office. Concurrently, women in increasing numbers enjoyed the availability of formal schooling; a growing number moved from unpaid rural work to paid employment in the secondary and tertiary sectors of the economy. But these changes - political, educational and economic - were changes which affected most Malay men as they did women; they did not necessarily demand a change in the role of women vis-a-vis men. To what extent did change in fact occur in the role of women involved particularly in political life? Had traditional attitudes towards the role of women been replaced by new values? Or was tradition, instead, sufficiently flexible to accommodate the participation of women in a non-traditional setting, without necessitating essential changes in their role? To examine these questions, this thesis focuses on the Pergerakan Kaum Ibu UMNO, the largest women's political organisation in Malaya. The Kaum Ibu began as a number of small independent women's associations in 1945. They confederated as state organisations affiliated with the United Malays National Organisation in 1947; in 1949, they reconstituted as the women's section of the party. From 1949, this section expanded and consolidated, to become a mass women's organisation of significant political importance to the party. The section and its members appeared far removed from the women of traditional Malay society a quarter of a century earlier. However, by examining the status of the section, its interests, its activities and its attitudes to the role of women within the party and within society, the thesis argues that in fact essential change had not occurred, and that the Kaum Ibu provided a continuum from traditional life to involvement in contemporary political processes

Orchestrating home

The private space of the home is an important site of health care in most industrialised countries, and rehabilitation following intensive in-hospital treatment largely takes place in domestic settings. Home in this context is implicitly understood by individuals affected by illness (people with illness, family members, friends, carers), health care providers, and policy makers as an a priori entity that naturally provides continuity and stability. This takes for granted that family carers will maintain both therapeutic activities and the sense of ‘being at home’ – and all of the accompanying emotional dimensions – within the home environment. Drawing on ethnographic research with relatively young spousal carers in Victoria, Australia, we explore how the reconstruction of home as a site for post-stroke recovery changed the experiences and meanings given to the idea of home. Home as a therapeutic place depended on constant orchestrating work that reconfigured the physical, symbolic, and practical elements of home. This was not a straightforward or singular process, as tensions arose in trying to integrate the new, post-stroke therapeutic landscape and pre-stroke conceptualisations and lived realities of home life

Managing depression in primary health care centers: The highlights of the program and further improvements

Many people with probable depression present at primary health care centers (PHC) with physical complaints. Clinical psychologists (CPs) in Sleman district and Yogyakarta city, Special Province of Yogyakarta, Indonesia, have been integrated into PHC to provide psychological services. The study on which we draw aimed to explore how depression is managed in PHC. Thirty four CPs and twenty people diagnosed with mild to moderate depression participated in semi-structured interviews. Based on the thematic analysis of their transcribed interviews, seven themes emerged: community education and support, referral pathways, assessing depression, diagnosis, communicating a diagnosis, accepting diagnosis, and treatment of depression. The co-location of CPs with other medical services at the PHC level supports community understandings of mental health problems. It also encourages community members to use PHC services and to have access to various behavioral interventions for people with depression. Recommendations and directions for further research are discussed

Measuring the impact of health problems among adults with limited mobility in Thailand: further validation of the Perceived Impact of Problem Profile

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Understanding media publics and the antimicrobial resistance crisis

Antimicrobial resistance (AMR) imperils health for people across the world. This enormous challenge is being met with the rationalisation of prescription, dispensing and consumption of antimicrobials in clinical settings and in the everyday lives of members of the general population. Individuals need to be reached outside clinical settings to prepare them for the necessary changes to the pharmaceutical management of infections; efforts that depend on media and communications and, therefore, how the AMR message is mediated, received and applied. In 2016, the UK Review on Antimicrobial Resistance called on governments to support intense, worldwide media activity to promote public awareness and to further efforts to rationalise the use of antimicrobial pharmaceuticals. In this article, we consider this communications challenge in light of contemporary currents of thought on media publics, including: the tendency of health communications to cast experts and lay individuals in opposition; the blaming of individuals who appear to ‘resist’ expert advice; the challenges presented by negative stories of AMR and their circulation in public life, and; the problems of public trust tied to the construction and mediation of expert knowledge on the effective management of AMR

The application of social innovation in healthcare: a scoping review.

BACKGROUND: Social innovation has been applied increasingly to achieve social goals, including improved healthcare delivery, despite a lack of conceptual clarity and consensus on its definition. Beyond its tangible artefacts to address societal and structural needs, social innovation can best be understood as innovation in social relations, in power dynamics and in governance transformations, and may include institutional and systems transformations. METHODS: A scoping review was conducted of empirical studies published in the past 10 years, to identify how social innovation in healthcare has been applied, the enablers and barriers affecting its operation, and gaps in the current literature. A number of disciplinary databases were searched between April and June 2020, including Academic Source Complete, CIHAHL, Business Source Complete Psych INFO, PubMed and Global Health. A 10-year publication time frame was selected and articles limited to English text. Studies for final inclusion was based on a pre-defined criteria. RESULTS: Of the 27 studies included in this review, the majority adopted a case research methodology. Half of these were from authors outside the health sector working in high-income countries (HIC). Social innovation was seen to provide creative solutions to address barriers associated with access and cost of care in both low- and middle-income countries and HIC settings in a variety of disease focus areas. Compared to studies in other disciplines, health researchers applied social innovation mainly from an instrumental and technocratic standpoint to foster greater patient and beneficiary participation in health programmes. No empirical evidence was presented on whether this process leads to empowerment, and social innovation was not presented as transformative. The studies provided practical insights on how implementing social innovation in health systems and practice can be enhanced. CONCLUSIONS: Based on theoretical literature, social innovation has the potential to mobilise institutional and systems change, yet research in health has not yet fully explored this dimension. Thus far, social innovation has been applied to extend population and financial coverage, principles inherent in universal health coverage and central to SDG 3.8. However, limitations exist in conceptualising social innovation and applying its theoretical and multidisciplinary underpinnings in health research