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Social Science & Medicine

Alice Reid, Eilidh Garrett
This paper examines the effect of variable reporting and coding practices on the measurement of maternal mortality in urban and rural Scotland, 1861-1901, using recorded causes of death and women who died within six weeks of childbirth. This setting provides data (n = 604 maternal deaths) to compare maternal mortality identified by cause of death with maternal mortality identified by record linkage and to contrast urban and rural settings with different certification practices. We find that underreporting was most significant for indirect causes, and that indirect causes accounted for a high proportion of maternal mortality where the infectious disease load was high...
February 8, 2018: Social Science & Medicine
Lars E F Johannessen
In theorising 'the system of professions', Andrew Abbott emphasised how jurisdictional boundaries in the workplace are far fuzzier than those specified in law. A key reason for this fuzziness is the process he characterised as 'workplace assimilation', involving on the job learning of a craft version of another profession's knowledge system. However, despite its centrality, workplace assimilation remains poorly elaborated in the scholarly literature. To address this shortcoming, this study explores the workplace assimilation of nurses in a Norwegian emergency primary care clinic...
February 7, 2018: Social Science & Medicine
Roger A Atinga, Irene Akua Agyepong, Reuben K Esena
Policy analysis on why women and children in low- and middle-income settings are still disadvantaged by access to appropriate care despite Primary Health Care (PHC) programmes implementation is limited. Drawing on the street-level bureaucracy theory, we explored how and why frontline providers (FLP) actions on their own and in interaction with health system factors shape Ghana's community-based PHC implementation to the disadvantage of women and children accessing and using health services. This was a qualitative study conducted in 4 communities drawn from rural and urban districts of the Upper West region...
February 5, 2018: Social Science & Medicine
Bethan Benwell, Catrin S Rhys
Preoperative assessments provide an essential clinical risk assessment aimed at identifying patient risks and requirements prior to surgery. As such they require effective and sensitive information-gathering skills. In addition to physical examination, the preoperative assessment includes a series of routine questions assessing a patient's fitness for surgery. These questions are typically designed to elicit minimal, 'no problem' responses, but patients sometimes produce expanded responses that extend beyond the projected information...
February 5, 2018: Social Science & Medicine
Patricia N E Roberson, Rebecca L Shorter, Sarah Woods, Jacob Priest
RATIONALE: There has been substantial research linking marital quality to physical health outcomes; however, the mechanisms linking marital quality and physical health have been studied less extensively, especially with longitudinal data. Of the hypothesized mechanisms, only psychological distress (anxiety/depression) and physiological mechanisms (inflammation) have been tested and confirmed. Health behaviors such as diet, exercise, smoking, drinking, and sleeping have not previously been examined as mechanisms linking marital quality and physical health...
February 3, 2018: Social Science & Medicine
Margaret H Cadden, Peter A Arnett, Tuula M Tyry, Jonathan E Cook
RATIONALE: People living with MS often report feeling stigmatized, but little research has examined the psychological impact of this, which is important considering the high prevalence of depression in this population. OBJECTIVES: The aim of this study was to assess, concurrently and prospectively, the association between stigma and depression in people living with MS. METHODS: Data were available from 5369 participants enrolled in the semi-annual survey conducted by the North American Research Committee on Multiple Sclerosis (NARCOMS)...
February 2, 2018: Social Science & Medicine
Katrina Kimport
In developed countries, women bear the primary, and sometimes exclusive, responsibility for preventing pregnancy in heterosexual sexual relations. This unequal burden is not an intrinsic fact; it is the consequence of broad social narratives and interpersonal negotiations. The contraceptive counseling visit is increasingly recognized as a site of the discursive production of normative ideas about reproduction, suggesting that clinicians themselves may contribute to the assignment of responsibility for contraceptive labor to women (i...
February 2, 2018: Social Science & Medicine
Joshua Garoon
This paper analyzes the effects of antiretroviral therapy (ART) on the social worlds of people living with HIV and ART (PLHA) in rural northern Zambia. Studies have demonstrated high rates of ART adherence over a range of sites in southern Africa. Drawing on a year of ethnographic research conducted in Zambia's Mukungule chiefdom between 2006 and 2008, this study investigates expectations of this exemplary adherence, and experiences of treatment failure. Motivated by the life and AIDS-related death of a Mukungule resident, Grace, it moves beyond asking "what made initial cohorts of African PLHA exceptionally adherent?" to raise the pressing question of "what happens next?" Previous scholarship addressing this question has analyzed how PLHA navigate the competing moral and political economies of local kinship and social networks and global HIV/AIDS initiatives...
February 2, 2018: Social Science & Medicine
Bobby Macaulay, Micaela Mazzei, Michael J Roy, Simon Teasdale, Cam Donaldson
An emerging stream of literature has focused on the ways in which social enterprises might act on the social determinants of health. However, this previous work has not taken a sufficiently broad account of the wide range of stakeholders involved in social enterprises and has also tended to reduce and simplify a complex and heterogeneous set of organisations to a relatively homogenous social enterprise concept. In an attempt to address these gaps, we conducted an empirical investigation between August 2014 and October 2015 consisting of qualitative case studies involving in-depth semi-structured interviews and a focus group with a wide variety of stakeholders from three social enterprises in different regions of Scotland...
February 2, 2018: Social Science & Medicine
Jason Fletcher
This paper explores the consequences of hopefulness when the environment changes. Much literature has documented the importance of a positive outlook in pursuing investments in health and education that pay off in the future. A question that has received less attention is whether a positive outlook creates resilience in the face of setbacks or whether a positive outlook may be a disadvantage in extreme circumstances, especially when there is a large mismatch between expectations and reality. This paper uses the coincidental interview schedule of the Add Health data (N = 15,024) around the terrorist attack of September 11, 2001 to examine interactions with this environmental shock and previously elicited measures of hopefulness...
January 31, 2018: Social Science & Medicine
Xavier Chojnicki, Yasser Moullan
Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004...
January 31, 2018: Social Science & Medicine
Ernestina Coast, Alison H Norris, Ann M Moore, Emily Freeman
We present a new conceptual framework for studying trajectories to obtaining abortion-related care. It assembles for the first time all of the known factors influencing a trajectory and encourages readers to consider the ways these macro- and micro-level factors operate in multiple and sometimes conflicting ways. Based on presentation to and feedback from abortion experts (researchers, providers, funders, policymakers and advisors, advocates) (n = 325) between 03/06/2014 and 22/08/2015, and a systematic mapping of peer-reviewed literature (n = 424) published between 01/01/2011 and 30/10/2017, our framework synthesises the factors shaping abortion trajectories, grouped into three domains: abortion-specific experiences, individual contexts, and (inter)national and sub-national contexts...
January 31, 2018: Social Science & Medicine
Maureen Mackintosh, Paula Tibandebage, Mercy Karimi Njeru, Joan Kariuki Kungu, Caroline Israel, Phares G M Mujinja
Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy...
January 31, 2018: Social Science & Medicine
Mengcen Qian, Shin-Yi Chou, Mary E Deily, Jin-Tan Liu
We estimate a gender differential in the intergenerational transmission of adverse birth outcomes. We link Taiwan birth certificates from 1978 to 2006 to create a sample of children born in the period 1999-2006 that includes information about their parents and their maternal grandmothers. We use maternal-sibling fixed effects to control for unobserved family-linked factors that may be correlated with birth outcomes across generations, and define adverse birth outcomes as small for gestational age. We find that when a mother is in the 5th percentile of birth weight for her gestational age, then her female children are 49-53% more likely to experience the same adverse birth outcome compared to other female children, while her male children are 27-32% more likely to experience this relative to other male children...
January 31, 2018: Social Science & Medicine
Jesse Bonwitt, Michael Dawson, Martin Kandeh, Rashid Ansumana, Foday Sahr, Hannah Brown, Ann H Kelly
Following the 2013-2016 outbreak of Ebola virus disease (EVD) in West Africa, governments across the region imposed a ban on the hunting and consumption of meat from wild animals. This injunction was accompanied by public health messages emphasising the infectious potential of wild meat, or 'bushmeat.' Using qualitative methods, we examine the local reception and impact of these interventions. Fieldwork was focused in 9 villages in the Eastern and Southern provinces of Sierra Leone between August and December 2015...
January 31, 2018: Social Science & Medicine
Sarah Alami, Jonathan Stieglitz, Hillard Kaplan, Michael Gurven
Indigenous people worldwide suffer from higher rates of morbidity and mortality than neighboring populations. In addition to having limited access to public health infrastructure, indigenous people may also have priorities and health perceptions that deter them from seeking adequate modern healthcare. Here we propose that living in a harsh and unpredictable environment reduces motivation to pursue deliberate, costly action to improve health outcomes. We assess whether variation in Health Locus of Control (HLC), a psychological construct designed to capture self-efficacy with respect to health, explains variation in treatment uptake behavior among Tsimane Amerindians (N = 690; age range: 40-89 years; 55...
January 31, 2018: Social Science & Medicine
M Biggeri, M Nannini, G Putoto
Community health insurance (CHI) aims to provide financial protection and facilitate health care access among poor rural populations. Given common operational challenges that hamper the full development of the scheme, there is need to undertake systematic feasibility studies. These are scarce in the literature and usually they do not provide a comprehensive analysis of the local context. The present research intends to adopt a mixed-methods approach to assess ex-ante the feasibility of CHI. In particular, eight preconditions are proposed to inform the viability of introducing the micro insurance...
January 31, 2018: Social Science & Medicine
Barbara Ribeiro, Sarah Hartley, Brigitte Nerlich, Rusi Jaspal
Between 2015 and 2016, Zika became an epidemic of global concern and the focus of intense media coverage. Using a hybrid model of frame and social representations theory, we examine how the Zika outbreak was reported in two major newspapers in Brazil: O Globo and Folha de São Paulo. The analysis of 186 articles published between December 2015 and May 2016 reveals a dominant 'war' frame supported by two sub-frames: one focused on eradicating the vector (mosquito) and another on controlling microcephaly, placing the burden of prevention on women...
January 31, 2018: Social Science & Medicine
Eleanor Holmes, Jennifer L Black, Amber Heckelman, Scott A Lear, Darlene Seto, Adeleke Fowokan, Hannah Wittman
North American food bank use has risen dramatically since the 1980s, and over 850,000 Canadians were estimated to have visited a food bank monthly in 2015. Food banks serve multiple roles in communities, ranging from 'emergency responses' to individualized and short-term experiences of hunger, to 'chronic' supports as part of long-term subsistence strategies. This study used a mixed-methods design to examine the spectrum of food bank user experiences in a large urban context, as part of a community-based project aiming to envision a redesign of the food bank to contribute to broader community food security outcomes...
January 31, 2018: Social Science & Medicine
Lars Fynbo, Carsten Strøby Jensen
According to the World Health Organization, antimicrobial resistance is one of the most severe threats to public health. Since the 1950's contemporary farming of pigs has been heavily dependent on the use of antibiotics. Recently, concerned experts of public health have become more outspoken, often, criticizing pig farmers for social irresponsibility and gambling with public health. Danish pig farmers are internationally renewed for their relatively low use of antibiotics. Nevertheless, the public criticism aimed at farmers is relatively strong in Denmark...
January 31, 2018: Social Science & Medicine
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