• Complementary and alternative medicine’s attempts at occupational closure: a thematic analysis driven by grounded theory

      Almeida, Joana; University of Bedfordshire (SAGE, 2017-03-03)
      When I embarked on my PhD in 2007, I embraced two research areas which became my main areas of sociological interest: health and the professions. I had decided to explore the topic of complementary and alternative medicine practitioners in Portugal. My decision was influenced by the fact that very little sociological analysis had been done on the dynamics of complementary and alternative medicine in Portugal, particularly from the perspective of the sociology of professions, an area within sociology which analyzes the role and status of professionals in society. In some countries, the “revival” of complementary and alternative medicine and the professionalization of complementary and alternative medicine practitioners were being increasingly discussed and analyzed. I decided to contribute to closing this knowledge gap by exploring these topics in Portugal. I analyzed complementary and alternative medicine practitioners’, medical doctors’, and institutional actors’ perspectives on complementary and alternative medicine regulation and adopted a sociological lens based on a neo-Weberian theory of the professions, a theory centered on the strategies used by occupational groups to gain and/or maintain professional standing in the marketplace. In this case study, I provide an account of how dominant strategies used by complementary and alternative medicine practitioners to gain professional status within health care in Portugal can be derived from a thematic analysis of 20 semi-structured interviews with traditional acupuncturists and traditional homeopaths. With this case, I illustrate (a) how thematic analysis embraces chaos and uncertainty but ends in a rewarding systematization of the data and engagement with theory, and (b) how I combined thematic analysis with grounded theory to simultaneously verify, validate, and generate theory.
    • Complementary and alternative medicine’s occupational closure in Portuguese healthcare: contradictions and challenges

      Almeida, Joana; University of Bedfordshire (SAGE, 2016-08-29)
      This article analyses strategies of closure recently enacted by complementary and alternative medicine practitioners in order to achieve occupational control over work domains in healthcare, taking Portugal as an example. A combination of the neo-Weberian occupational closure theory of the professions and Abbott’s jurisdictional vacancy theory is proposed as the framework for analysis. Acupuncture and homeopathy will be presented as case studies. Data are derived from in-depth interviews with 10 traditional acupuncturists and 10 traditional homeopaths. Data analysis suggests that (1) professionalisation, (2) alignment with biomedical science and (3) expressing ‘legitimating values’ of a countervailing nature have been three significant strategies complementary and alternative medicine practitioners have used in an attempt to achieve market closure. It is argued that these strategies are contradictory: some involve allegiances, while others involve demarcation from biomedical science. A further outcome of these strategies is the promotion of complementary and alternative medicine treatments and solutions in everyday life. The success of these strategies therefore, although helping to reinforce the biomedical model, may simultaneously help complementary and alternative medicine to demarcate from it, posing thus challenges to mainstream healthcare.
    • Diagnosis and decision-making in telemedicine

      Pappas, Yannis; Vseteckova, Jitka; Mastellos, Nikolas; Greenfield, Geva; Randhawa, Gurch; University of Bedfordshire; Open University; Imperial College London (SAGE, 2018-10-08)
      This article provides an analysis of the skills that health professionals and patients employ in reaching diagnosis and decision-making in telemedicine consultations. As governmental priorities continue to emphasize patient involvement in the management of their disease, there is an increasing need to accurately capture the provider-patient interactions in clinical encounters. Drawing on conversation analysis of 10 video-mediated consultations in 3 National Health Service settings in England, this study examines the interaction between patients, General Practitioner (GPs), nurses, and consultants during diagnosis and decision-making, with the aim to identify the range of skills that participants use in the process and capture the interprofessional communication and patient involvement in the diagnosis and decision-making phases of telemedicine consultations. The analysis shows that teleconsultations enhance collaborative working among professionals and enable GPs and nurses to develop their skills and actively participate in diagnosis and decision-making by contributing primary care-specific knowledge to the consultation. However, interprofessional interaction may result in limited patient involvement in decision-making. The findings of this study can be used to inform training programs in telemedicine that focus on the development of effective skills for professionals and the provision of information to patients.
    • The HOTSHOT taxonomy and a signature pedagogy framework for operating department practice: the juxtaposition to the academic apartheid surrounding higher order thinking

      Beckwith, Philip (SAGE, 2019-01-02)
      Bloom’s insistence on using verbs and Anderson and Karthwohl’s juxtaposition with nouns creates an academic apartheid, where there is only black and white with no grey when addressing the parts of speech used to define Higher Order Thinking. This paper embraces the grey and by draining the conceptual swamp surrounding traditional perceptions of Higher Order Thinking, creates fertile new ground which in turn feeds emergent notions, and allows pioneering characterisation of Higher Order Thinking to propagate.
    • Longitudinal evaluation of balance quality using a modified bathroom scale: usability and acceptability

      Duchêne, Jacques; Hewson, David (SAGE, 2011-12-31)
      We adapted a commercial bathroom scale in order to acquire the raw data from the weight sensors and then to send them to a server via a mobile phone. We investigated the usability and acceptability of the device in a long-term experiment with 22 elderly users that produced more than 5000 weight recordings. Four basic variables were extracted from the vertical force measurements and the stabilogram. The technology was accepted unreservedly, presumably because it did not differ from devices usually encountered in the home. The quantitative results showed a high variability of day-to-day measurement, which was countered by taking a moving average. A balance index was able to identify changes in balance over time. The preliminary results appear promising.
    • Mapping transitional care pathways among young people discharged from adolescent forensic medium secure units in England

      Livanou, Maria; Singh, Swaran P.; Liapi, Fani; Furtado, Vivek; ; Kingston University; University of Warwick; Birmingham and Solihull Mental Health NHS Foundation Trust; Birmingham and Solihull Mental Health NHS Foundation Trust; University of Bedfordshire (SAGE, 2019-11-10)
      This study tracked young offenders transitioning from national adolescent forensic medium secure units to adult services in the UK within a six-month period. We used a mapping exercise to identify eligible participants moving during the study period from all national adolescent forensic medium secure units in England. Young people older than 17.5 years or those who had turned 18 years (transition boundary) and had been referred to adult and community services were included. Of the 34 patients identified, 53% moved to forensic adult inpatient services. Psychosis was the most prevalent symptom among males (29%), and emerging personality disorder symptomatology was commonly reported among females (18%) followed by learning disability (24%). The mean time for transition to adult mental-health services and community settings was eight months. There were no shared transition or discharge policies, and only two hospitals had discharge guidelines. The findings highlight the need for consistency between policy and practice among services along with the development of individualised care pathways. Future qualitative research is needed to understand and reflect on young people's and carers' experiences to improve transition service delivery.
    • The mental health of sexually trafficked survivors in Nepal

      Rimal, Retina; Papadopoulos, Chris (SAGE, 2016-06-03)
      Background: Despite further recent research into the consequences associated with human sex trafficking, scant evidence associated with the mental health outcomes among victims of sex trafficking remains, including within Nepal where trafficking continues to be a growing problem. Aim: To investigate the prevalence and explanatory factors of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms among female survivors being housed and supported by two non-governmental organisations (NGOs) in Nepal. Methods: A total of 66 female sex trafficking survivors being housed by two NGOs were purposively sampled. Anxiety and depression symptomatology were measured using the Hopkins Symptoms Checklist–25 instrument and PTSD symptomatology was measured using the PTSD Checklist–Civilian Version. Results: In all, 87%, 85.5% and 29.7% of the sample scored above anxiety, depression and PTSD thresholds, respectively. HIV-positive status and length of workday during trafficking period significantly associated with at least one outcome measure. Conclusion: The results contribute further evidence of how damaging sex trafficking can be to victims, particularly in terms of being at risk of clinical depression and/or anxiety. Continued efforts to prevent trafficking from occurring as well as effective, timely intervention for survivors are needed.
    • People living with facial disfigurement after having had noma disease: a systematic review of the literature

      Wali, Imamatu Muhammad; Regmi, Krishna; Noma Children Hospital Nigeria; University of Bedfordshire (SAGE, 2016-02-01)
      Noma disease often results in impairment, morbidity and severe facial disfigurement. This article reports a systematic review of literatures published between 2006 and 2015 to establish existing knowledge about social stigma associated with facial disfigurements. Five databases were searched and 114 citations were screened, of which only 15 met the relevant criteria. Titles and abstracts of the retrieved articles were independently reviewed. The research was heterogeneous; therefore, overall synthesis using meta-analysis was inappropriate. It can be seen that the review demonstrates that facial disfigurements are far more complex than was previously thought.
    • The prevalence of domestic violence among pregnant women in Nigeria: a systematic review.

      Orpin, Joy; Papadopoulos, Chris; Puthussery, Shuby; University of Bedfordshire (SAGE, 2017-09-22)
      To identify, appraise, and synthesize research evidence on the prevalence of domestic violence (DV) among pregnant women in Nigeria. We conducted a systematic review of all published studies between April 2004 and June 2016. Comprehensive searches were conducted on electronic databases such as PubMed, CINAHL, Global Health, MEDLINE, PsycINFO, Directory of Open Access Journals, Google Scholar, and electronic libraries of the authors' institution. Identified articles were screened in two stages against the inclusion criteria with titles and abstract screened first followed by full-text screening. Selected articles were assessed using the "guidelines for evaluating prevalence studies," and findings were synthesized narratively. Among 19 studies that met the inclusion criteria, two articles were excluded due to low methodological quality and 17 articles were included in the review. The prevalence of DV during pregnancy in Nigeria ranged between 2.3% and 44.6% with lifetime prevalence rates ranging between 33.1% and 63.2%. Physical, sexual, psychological, and verbal abuses were the most frequent types of DV reported in this review. The most common perpetrators were husbands, as reported in 11 of the 17 studies. Pregnant women between the ages of 20 and 30 years were the most common victims of DV. Our review suggests high prevalence of DV in pregnancy among women in Nigeria and higher lifetime prevalence. However, determining an overall, synthesized accurate prevalence rate of DV within this population based on existing evidence presents a challenge. The findings have important implications for stakeholders such as planners, policy makers, maternity care providers, and researchers in public health and social policy at national, regional, and international levels toward combating the issue. OBJECTIVE METHOD RESULTS CONCLUSION
    • Systematic review of the prevalence of mental illness stigma within the Greek culture

      Tzouvara, Vasiliki; Papadopoulos, Chris; Randhawa, Gurch; King’s College London; University of Bedfordshire (SAGE, 2016-02-17)
      BACKGROUND: A number of primary studies have now assessed mental illness stigma within the Greek culture. A synthesis and appraisal of all available evidence is now required and will contribute to our growing understanding of the relationship between the cultural context and the formation of stigmatising attitudes. AIM: To systematically review the prevalence of mental illness public stigma within the Greek and Greek Cypriot culture. METHOD: Empirical articles with primary data pertaining to the prevalence of mental illness public stigma among Greek and/or Greek Cypriot populations were retrieved. Included studies were assessed for quality and extracted data were narratively synthesised. RESULTS: A total of 18 studies met the inclusion criteria. Methodological quality was highly variable; only 1 study was adequately statistically powered, 10 studies employed at least some element of probability sampling and obtained response rates of at least 70%, while 10 and 13 studies employed reliable and validated prevalence tools, respectively. Studies sampled the general population (n = 11), students (n = 4), healthcare professionals (n = 2), police officers, employers and family members (all n = 1). Stigma was consistently identified in moderate and high proportions across all of these groups, particularly in terms of social discrimination and restrictiveness, social distance and authoritarianism. However, some evidence of benevolence and positivity towards high-quality social care was also identified. CONCLUSION: The review highlights the wide-scale prevalence of mental illness stigma within the Greek culture and the need for further rigorous research including culturally tailored stigma interventions.