Progressive muscle relaxation in pandemic times: bolstering medical student resilience through IPRMP and Gagne's model.

Background: Medical education, already demanding, has been further strained by the COVID-19 pandemic's challenges and the shift to distance learning. This context underscores the need for effective stress reduction techniques in competency-based medical curricula (CBMC). Objective: We assessed the feasibility and benefits of integrating a Progressive Muscle Relaxation (PMR) module-a known effective stress-reducing technique-into a time-restricted CBMC, particularly given such modules often find placement as elective rather than mandatory. Methods: Adapting Gagne's nine events of instruction, a 2-h PMR program was designed and implemented during the pandemic. Twenty participants were engaged on a first-come, first-served basis, ensuring adherence to social distancing measures. Feedback was continuously gathered, leading to two post-program focus group sessions. Qualitative data underwent thematic analysis following Braun and Clarke's approach, with study quality maintained by the Standards for Reporting Qualitative Research (SRQR). To gauge adaptability, we aligned the program with various learning outcomes frameworks and explored its fit within CBMC using Bourdieu's Theory of Practice. Results: The pilot PMR program was well-received and effectively incorporated into our CBMC. Our analysis revealed five central themes tied to PMR's impact: Self-control, Self-realization, Liberation, Awareness, and Interpersonal relationships. Feedback indicated the program's capacity to mitigate stress during the pandemic. The SRQR confirmed the study's alignment with qualitative research standards. Further, the PMR program's contents resonated with principal domains of learning outcomes, and its integration into CBMC was supported by Bourdieu's Theory. These observations led us to propose the Integrative Psychological Resilience Model in Medical Practice (IPRMP), a model that captures the intricate interplay between the identified psychological constructs. Conclusion: This research showcases an innovative, theory-guided approach to embed a wellbeing program within CBMC, accentuating PMR's role in fostering resilience among medical students. Our PMR model offers a feasible, cost-effective strategy suitable for global adoption in medical institutions. By instilling resilience and advanced stress-management techniques, PMR ensures that upcoming healthcare professionals are better equipped to manage crises like pandemics efficiently.

When the Penny Drops: Understanding how social class influences speciality careers in the UK medical profession.

In the UK, the medical profession is socially exclusive and socially stratified as doctors from more advantaged backgrounds are more likely to train for specialities with more competitive entry. However, in research to date the causes and consequences of social stratification have been overlooked. We explore this subject here, drawing on a qualitative study comprising in-depth interviews with 30 medical students and doctors from less advantaged socio-economic backgrounds negotiating medical school and early careers. Using Bourdieu's 'theory of practice' we show how socialisation in the family and at school influences how aspirant medics from less advantaged backgrounds view the world, suggesting some inclination towards more community orientated careers, which may be less competitive. However, these tendencies are encouraged as they lack stocks of social, economic and cultural capital, which are convertible to power and position in the field. While allowing for both choice and constraint our core argument is that speciality outcomes are sometimes inequitable and potentially inefficient, as doctors from more advantaged backgrounds have privileged access to more competitive careers for reasons not solely related to ability or skill. Our main theoretical contribution is to literature in the sociology of medical education where ours is the first study to open-up the 'black box' of causal factors connecting medical students' resources on entering the field of education and training with speciality outcomes, though our findings also have important implications for practitioners, the profession and for patients. We discuss the implications for safe and effective healthcare and how this informs directions for future research.

Capital sharing and socialization in an interprofessional student-led clinic: a Bourdieuan analysis.

BACKGROUND: Interprofessional student-led clinics offer authentic clinical experiences of collaborative patient care. However, theoretical research on the sustainability of these clinics, considering forms of capital beyond the economic, remains limited. This study addresses this gap by employing Bourdieu's theoretical framework to explore how alternative conceptions of capital; both social and cultural might sustain conditions for interprofessional working in a student-led clinic serving patients living with a chronic neurological impairment. METHODS: The teaching and learning focussed clinic was established in 2018 to mirror a clinical service. Semi-structured focus groups with participants involving 20 students from 5 professions and 11 patients gathered in-depth insights into their experiences within the clinic. A thematic analysis was guided by Bourdieu's concepts of field, habitus, and capital. RESULTS: In the complex landscape of the student-led clinic, at the intersection of a patient support group, a hospital-based aged care facility, and university-based healthcare professions, three pivotal mechanisms emerged underpinning its sustainability: Fostering students' disposition to interprofessional care, Capitalizing on collaboration and patient empowerment, and a Culture of mutual exchange of capital. These themes illustrate how students and patients specific dispositions towards interprofessional healthcare enriched their habitus by focusing on shared patient well-being goals. Diverse forms of capital exchanged by students and patients fostered trust, respect, and mutual empowerment, enhancing the clinic experience. CONCLUSION: This study bridges an important gap in theoretically informed explorations of the conditions for sustaining student-led clinics, drawing on Bourdieu's theory. It accentuates the significance of investment of diverse forms of capital in such clinics beyond the economic, whilst emphasizing a primary commitment to advancing interprofessional healthcare expertise. Recognizing patients as equal partners shapes clinic dynamics. In order for student clinics to thrive in a sustainable fashion, educators must shift their focus beyond solely maximizing financial resources. Instead, they should champion investments in a wider range of capital forms. This requires active participation from all stakeholders; faculties, patient partners, service providers, and students. These findings underscore the importance of investing in interprofessional learning by optimizing various forms of capital, and embracing patients as dynamic contributors to the clinic's sustainability.

How Person-Centred Is Cardiac Rehabilitation in England? Using Bourdieu to Explore Socio-Cultural Influences and Personalisation.

The National Health Service (NHS) cardiac rehabilitation patient care pathway has remained largely unchanged for many years despite, on average, half of all eligible patients declining to engage. To investigate reasons for non-engagement, we explored the experiences of ten cardiac patients who participated in cardiac rehabilitation, dropped out, or declined, as well as experiences of seven people deemed significant others by participants. Our ethnographic study involved participant observations, repeat in-depth semi-structured interviews, and reflexive journaling. Reflexive thematic analysis was conducted, focusing on participants' lived experiences. Utilising Bourdieusian concepts of habitus, capital, and field, this article highlights how personal biography, material conditions, and dispositional inclinations combine to make cardiac health care decision-making individual and complex. Despite this, health professionals were not always attuned to specific circumstances arising from differences in patients' experiences and lifeworlds. By considering service improvement recommendations that acknowledge socio-cultural influences, cardiac rehabilitation can work towards providing patients and their significant others with more appropriate, personalised, and person-centred support.

A Bourdieusian Latent Class Analysis of Cultural, Arts, Heritage and Sports Activities in the UK Representative Understanding Society Dataset.

To Bourdieu, interaction with culture has symbolic power and drives the manifestation of social stratification. Many have adapted his theory and methodology, developing new models of cultural engagement. Here, to further integrate these theoretical and methodological approaches, Bourdieu's tools were used to operationalise and interpret a Latent Class Analysis of cultural engagement in the Understanding Society dataset. Six classes of increasing engagement were established, and were increasingly correlated with youth, capital and social advantage. However, some qualitative differences in engagement were also seen. The classes also varied by which characteristics correlated with membership. For example, economic capital was associated with sports engagement, while advantaged social position was associated with broad-scale engagement. Overall, this analysis combined Bourdieusian theory with contemporary methodology in the largest representative UK dataset and highlights the broader relevance of cultural engagement patterns in indicating (and possibly generating) status, identity, capital and social position.

Changing mobility practices. Can meta-ethnography inform transferable and policy-relevant theory?

Social practice theories have attracted attention for their potential insights into how to change transport systems towards "healthier" states. However, most evidence is from small-scale qualitative case studies. We explored whether a synthesis of qualitative evidence on mobility practices in one country, informed by meta-ethnography and a Bourdieusian approach to practice, could produce theory that is of sufficient abstraction to be transferable, yet also capable of informing intervention planning. The synthesis identified three third order constructs: mobility practices result from habitus plus capital in fields; specific configurations of local mobility practices are shaped, but not determined, by material infrastructures and social structures; and changes in practice happen across a number of scales and temporalities. This body of evidence as a whole was then interpreted as an integrative "storyline": Mobility systems are complex, in that outcomes from interventions are neither unilinear nor necessarily predictable from aggregations of individual practice changes. Infrastructure changes may be a necessary, but not sufficient, condition for change. Moving systems towards "healthier" states requires changing habitus such that "healthier" practices align with fields, and that interventions take sufficient account of the power relations that materially and symbolically constrain or enable attachments to and changes in mobility practices. Meta-ethnography is a useful approach for integrating qualitative evidence for informing policy.

Schools as Drivers of Capitalist Accumulation Conditional Socialized Reproduction in Shenzhen.

Based on fieldwork in an urbanized village of Shenzhen, this paper analyzes the place of schools in the reproduction of Chinese state capitalism. It retraces the circuit of socialized capital that allows for the social reproduction of the native elite and the exclusion of many migrant workers in the context of Shenzhen's development as a special economic zone and its efforts to upgrade the economy. The native villagers, now forming an urban upper-class of rentiers, have capitalized on their overseas connections and capital accumulation to finance their school, allowing for their elite's upward social mobility after, but also already under Mao. After China's transition to capitalism, this school has served as an asset in generating value in the context of redevelopment and the real estate-driven upgrading of Shenzhen's economy. Property ownership is now a major criterion in points-based systems for accessing school places. I make two interrelated arguments. First, there is a closer relationship between the secondary circuit of socialized capital and the larger circuit of capital than what the literature on social reproduction implies. Second, the conditionality of quality education upon value generation amounts to separating the population deemed worthy of socialized reproduction and the surplus population that is left out. The paper connects diverse strands of social reproduction theory, Althusser's interpellation and ideological state apparatuses, feminist agentive social reproduction theories, and Bourdieu's capital conversion recuperated within a Marxian framework, to provide an integrated approach to social reproduction within capitalism.

Mapping the Language of Male Partner Violence: An Historical Examination of Power, Meaning, and Ambivalence.

This article questions why violence carried out by men toward their female romantic partners remains so prevalent today by examining how it has been understood and talked about over time. The aim here is twofold: the first is to historically map the changes in how male partner violence has been addressed in society-and to what effect. The second is to examine subtle dynamics within this historical map in order to suggest how language could be used to destabilize its fixture in society.

The social grounds of self-tracking in insurance: A mixed-method approach to adoption and use.

Scholars have explored the role of self-tracking in mediating people's values, perceptions, and practices. But little is known about its institutionalised forms, although it is becoming a routine component of health policies and insurance programs. Furthermore, the role of structural elements such as sociodemographic variables, socialisations, and trajectories has been neglected. Using both quantitative (n = 818) and qualitative (n = 44) data gathered from users and non-users of an insurance program's self-tracking intervention, and drawing from Bourdieu's theoretical framework, we highlight the impact of users' social background on the adoption and use of the technology. We show that older, poorer, and less educated individual are less likely to adopt the technology, and describe four prototypical categories of users, the meritocrats, the litigants, the scrutinisers and the good-intentioned. Each category displays different reasons and ways to use the technology that are grounded in users' socialisations and life trajectories. Results suggest that too much emphasis may have been put on self-tracking's transformative powers and not enough on its reproductive inertia, with important consequences for both scholars, designers, and public health stakeholders.

[The ritual challenge-Corona and the Holy Spoon]. / Die rituelle Herausforderung ­ Corona und der Kampf um den Heiligen Löffel.

The corona pandemic also triggered crises, even fights, in the religious fields that went beyond the usual disputes about the legitimate definition of religion. Last but not least, they concerned the ritual dimension, as is shown by an example of the liturgy of the Christian Orthodox Churches. A fierce conflict arose within them over the meaning of a ritual artefact, the 'Holy Spoon'. Its use is said to bring salvation, but it can also cause harm. The discourses about the 'Holy Spoon' triggered by the Corona crisis turn out to be discourses about the identity of the Orthodox Church and about its typical 'energetic' definition of reality of transcendence, which had to be secured in the 'field of power' (Bourdieu).

Trump divide among American conservative professors.

There has been an outpouring of research on right-wing populist conservatism since the advent of the Trump presidency and right-wing movements in Europe. Yet, little research has been devoted to divisions among conservatives themselves, especially among conservative academics. Although Trump has maintained remarkable unity within the Republican Party for electoral reasons, he has fostered sharp divisions among conservative intellectuals and academicians. This article compares 102 politically conservative professors who are Trumpists and 80 conservative professors who are anti-Trumpists. All 182 function as public intellectuals who advocate their views in print and digital media. Drawing on recent research in the sociology of intellectuals and particularly Pierre Bourdieu's analytical field perspective, this article proposes a fielding political identities and practices framework to show how these two groups of professors (Trumpists and anti-Trumpists) differ in where they teach, their intellectual orientations, their scholarly productivity, where they network with think tanks, scholarly professional associations, and government agencies, and their stances on key issues surrounding the Trump presidency. The academic Trumpists embrace the right-wing populist wave mobilized by Trump and the conservative academic critics resist this move. This polarization of views between these two groups of conservative professors is enduring and rooted in two distinct social networks that connect positions in the academic field to affiliations with think tanks, government agencies, and professional associations in the field of power that reinforce their respective political identities. This research contributes to political sociology, the sociology of intellectuals, and the sociology of conservative politics in American higher education.

Inclusion and Participation in a Support Programme for Bereaved Adolescents - Relational Perspectives From an Ethnographic Field Study in a Swedish Context.

The death of a parent is a life-changing event, and different programmes are developed to support children. This study explored how parental bereaved adolescents were included and (inter)acted in a Swedish support programme. The conducted ethnographic field study included six adolescents, their parents, and eight volunteers. The empirical material was thematically analysed through a theoretical lens inspired by Bourdieu. Three themes emerged: 'Different strategies for adolescents' inclusion in the programme,' 'Medico-psychological understanding of grief and suffering,' and 'Reproduction of the logic of the school.' Adolescents were included in the programme through different strategies, where adults functioned as gatekeepers. The programme reproduced the school logic and was based on a medico-psychological grief/bereavement understanding. Volunteers had pedagogic authority and concomitant symbolic power, ruling adolescents to do what they must do in the meetings, silently socialising them into the medical logic. The adolescents only interacted and communicated with each other during breaks.

The same everywhere? Exploring structural homologies of national social fields using the case of journalism.

Pierre Bourdieu argued for the existence of general properties and even laws of social fields. In contrast to spaces of class relations and patterns of cultural lifestyles, however, almost no systematic comparative research exists on the homologies of national social fields of a more specialised nature. Also, the large majority of research is done on Western countries, raising concerns about the relevance of the concept for less differentiated societies. Using the field of journalism as a case, typical structures of 67 national fields (n = 27,567) are in this article investigated using a reverse approach: First, the subjective spaces of journalists' experienced constraints and imperatives in their jobs are sketched as a proxy for field structure using variants of multiple correspondence analysis, and second, the distribution of the social and professional properties of journalists are used to suggest capital structures. The results suggest great stability in the fundamental organising principles of fields of journalism around the world, although with considerable variation in their autonomy.

Disrupting Patriarchal Illusio to Reduce Violence Against Women and Girls.

We apply a Bourdieusian lens to understand the reproduction of a patriarchal illusio that works to maintain violence-supportive attitudes and concurrent low levels of support for gender equality among young people. We analyze interview and focus group data collected with young women and men and conclude that we must disrupt the reproduction of patriarchal norms by: recognizing the intentional operation of backlash by men's rights activist groups that undermine attempts to transform society; ensuring girls' and women's safety on new technologies to reduce their exposure to sexism and violence; and introducing prevention early to disrupt misogynist social norms being internalized.

Microenterprise and home care for older adults in England and Wales: A partial revolution?

Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self-employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi-structured interviews with stakeholders working in home care, the paper describes how the interaction of changes to field structures, and altered practices of care have challenged the taken-for-granted acceptance of traditional, transactional forms of care provision. This process has been highly dependent on local state actors, their ability to mobilise relevant forms of capital and the factors which shaped their habitus. It should be seen within the context of changes to local field structures and the hierarchical classification processes which underpin them. These changes threaten the distribution of capital in the home care field in ways that are beneficial to microentrepreneurs. Bourdieu might categorise these developments as 'partial revolutions', which do not challenge the fundamental axioms of the field. However, for care entrepreneurs, formerly employed as low-paid home-care workers, a revolution that is only partial may be better than none at all.

Refined Analysis of Older eHealth Users From an Agency Perspective: Quantitative Telephone Interview Study.

BACKGROUND: Most studies on the eHealth divide among older people have compared users to nonusers and found that age, gender, and education were associated with eHealth misuse. They assumed that these characteristics were structural barriers to eHealth adoption. Furthermore, eHealth practices have been examined in a narrow and incomplete way, and the studies disagree about the association between health conditions and eHealth use. Using a more dynamic theoretical lens, we investigated the potential motivations driving older adults' agential adoption of eHealth practices despite their advanced age. OBJECTIVE: This study aimed to obtain a complete and detailed description of eHealth uses among older adults; examine whether demographic characteristics such as age, gender, and education (previously related to eHealth misuse) are still associated with the various eHealth clusters; and determine whether contextual factors such as changes in the health condition of older eHealth users or their loved ones are associated with older adult eHealth use. METHODS: We conducted a 30-minute telephone interview with a representative sample of 442 Israeli adults (aged ≥50 years) with a sampling error of 2.04%. The interviews were conducted in Hebrew, Arabic, and Russian. Using factor analysis with 21 eHealth use questions, we identified 4 eHealth clusters: instrumental and administrative information seeking, information sharing, seeking information from peers, and web-based self-tracking. In addition to age, gender, education, internet experience, frequency of internet use, perceived eHealth literacy, and self-rated health, we asked respondents to indicate how much they had used offline health services because of a health crisis in the past year. RESULTS: We found differences in the number of older eHealth users in the various clusters. They used instrumental and administrative information (420/442, 95%) and obtained information from peers (348/442, 78.7%) the most; followed by web-based self-tracking related to health issues (305/442, 69%), and only a few (52/442, 11.3%) uploaded and shared health information on the web. When controlling for personal attributes, age, gender, and education were no longer predictors of eHealth use, nor was a chronic ailment. Instead, internet experience, frequency of internet use, and perceived eHealth literacy were associated with 3 eHealth clusters. Looking for health information for family and friends predicted all 4 eHealth clusters. CONCLUSIONS: Many older adults can overcome structural barriers such as age, gender, and education. The change in their or their loved ones' circumstances encouraged them to make deliberate efforts to embrace the new practices expected from today's patients. Seeking health information for family and friends and dealing with unexpected health crises motivates them to use eHealth. We suggest that health professionals ignore their tendency to label older people as nonusers and encourage them to benefit from using eHealth and overcome stereotypical ways of perceiving these patients.

Mapping an online production network: The field of 'actual play' media.

This article maps out and analyzes relationships shaping production in a growing cultural field of online gaming media production called 'Actual Play' (AP). AP occupies an ambiguous economic space between fan production and professional media and is marked by widespread monetization. Drawing on qualitative semi-structured interviews with 24 AP producers, this article uses actor-network theory and the concept of cultural fields to understand that space through an account of the actors constituting it. This maps the how AP producers develop their practices through complex relational networks. The analysis identifies 'key actor types' - the varieties of technological, human and corporate actors whose activities give shape to producers' practices. The article concludes that despite pervasive pressures to professionalize, the field offers limited pathways to vocational sustainability.

What cultural hierarchy? Cultural tastes, status and inequality.

Research on cultural stratification often draws on Bourdieu's misrecognition model to interpret socioeconomic gradients in cultural tastes and participation. In this model, an assumed cultural hierarchy leads individuals to adopt cultural tastes and behaviours whose status is congruent with that of their socioeconomic position (SEP). Yet, this assumed cultural hierarchy remains opaque. In this paper, we derive and test three empirical implications of the cultural hierarchy: (1) cultural activities have different status (recognition); (2) individuals in high and low SEPs have similar perceptions of the status of cultural activities (necessary condition for misrecognition); and (3) individuals prefer and engage in cultural activities whose status matches that of their SEP (status congruence). We collected survey data in Denmark and find that cultural activities differ in terms of perceived status (e.g., opera has higher perceived status than flea market), status perceptions are similar in high- and low-SEP groups and individuals prefer activities whose status matches that of their SEP. These results are consistent with the idea that a cultural hierarchy exists that sustains SEP gradients in cultural tastes and participation.

Respected physician in Syria, unemployed refugee in the Netherlands: An analysis of the integration of Syrian refugees with a medical degree in the Dutch medical field.

Refugees in the Netherlands are expected to integrate in society and find employment. Despite years of education, Syrian refugees who graduated in medicine (SRGMs') struggle to enter the Dutch medical field. To ensure patient safety, physicians with a medical degree obtained outside Europe are obliged to finish an 'assessment procedure' (AP) and might be forced to redo clinical internships, before being allowed to practice medicine. In this research, SRGMs' experiences were analysed using Bourdieu's capital theory. Semi-structured interviews were conducted with 17 SRGMs. In Syria, they acquired much capital as physicians, in the shape of financial means (economic capital), connections (social capital), medical degrees and skills (cultural capital), and status (symbolic capital). Their medical skills often provide the only capital that remains when arriving in the Netherlands, but it loses value as they have to prove their competence first in the AP. This is a long and arduous process. The mean duration, for those who had yet finished the AP, from arrival to employment was 4.5 years (n = 5, range 2.7-5.8 years). SRGMs experience difficulties in these AP years because they are forced to study from home and feel excluded from medical practice. They are unable to regain their economic, social and symbolic capital, whilst struggling to get their cultural capital acknowledged. Mentally this is challenging and when they do finish, this capital gap leaves them at a disadvantage when applying for competitive job applications. Once employed, SRGMs need time to adjust but are finally rebuilding their capital and integrating in Dutch society. Both SRGMs and Dutch society benefit when SRGMs' integration in the Dutch medical field improves. Although certain challenges for SRGMs seem inevitable, by offering a clinical internship before the assessment of SRGMs' skills, their capital acquisition might improve which would facilitate their integration.

The culture of official statistics. Symbolic domination and "bourgeois" assimilation in quantitative measurements of immigrant integration in Germany.

While cultural sociology has recently made a comeback in research on social inequality both in the context of poverty studies and studies of immigrant integration, it has rarely investigated how particular constructions of the problem of socioeconomic mobility are themselves culturally situated. The article addresses this neglect by investigating the problematization of disadvantaged lives within the relational framework of Bourdieu's cultural theory of the state. Here, the state exercises symbolic violence by transforming one arbitrary cultural standpoint in social space into a universal standard, or a taken-for-granted "doxa," against which other cultural positions can only come off as deficient. The article extends this perspective by addressing the role of official statistics in this process. Taking Germany's official monitoring of the socioeconomic integration of immigrants as its case and drawing from document analysis, interviews, ethnographic observation, and data from the German General Social Survey, the article shows how such statistical instruments of the welfare state in fact tacitly universalize a model of the good life particular to civil servants, the very constructors of the monitors, as a benchmark for immigrant integration.