Social Factors Influencing Utilization of Old Age Homes by Elderly in Urban Area of South Chennai, Tamil Nadu.

Background: Currently, most old age homes in India are completely occupied. Nowadays, nuclear families are more than joint families, and due to various factors such as urbanization, the elderly are deprived of essential care at home and are moved from their own homes to old-age homes. With the increasing geriatric population, this study explored the various social factors influencing the elderly to reside in old age homes. Material and Methods: The study was conducted among 330 elderly in old age homes using simple random sampling. The study population included elderly above the age of 60 years and residing in old age homes, who were willing to participate. A pretested structured questionnaire with data on sociodemographic characteristics, family, financial support, and various other social factors was collected. Data were analyzed using SPSS. Results: Among the respondents, 20.6% were supported by children financially and 18.5% had a pension. Almost 70% of the elderly were left unattended by friends and family. Care and support through means of calls, letters, and visits when analyzed showed that 27.3% were provided care and support through children and 33.6% were left unattended. Conclusion: Family members, friends, and relatives should be encouraged to give regular visits and spend time with the elderly so that the bonding will have a positive effect on their mental health. Aging and geriatric health should be considered sensitively and should be made mandatory for schools and colleges to arrange visits to old age homes, thereby keeping the younger generation aware of the issues.

Hospital Environment and Medical Sociology: User-Centered Environmental Sociology Model Based on a Systematic Review.

PURPOSE: This study investigates the relationship between environmental quality and medical sociology in hospitals and suggests a conceptual framework for understanding their interrelation. BACKGROUND: Despite the importance of environmental properties in the sociological approach to users' health and the role of medical sociology research in the design of hospital environments, few studies have been conducted in the field of hospital environments and medical sociology interrelation. Therefore, this article attempts to fill this gap in our knowledge. METHODS: A systematic review was carried out in five databases (Scopus, Web of Science, Google Scholar, MEDLINE, and ScienceDirect) based on PRISMA guidelines to survey how environmental quality and medical sociology factors are related in the medical/environmental sociology research and the hospital design. RESULTS: The search yielded the final 17 potentially relevant articles after finding 3,840 records, screening 1,295 nonduplicate articles, and reviewing 158 full-text articles. The findings revealed that four main aspects of medical sociology (physical-biological, psychological, social, and economic) and hospital environmental quality (physical, social, and psychological dimensions) influence users' health and disease status. The hospital environment includes various social issues in medical sociology (like interactions, behavior patterns, lifestyle, work motivation, and culture). The physical and psychosocial factors of the hospital environment (such as spatial configuration, aesthetics, scale, privacy, and collective spaces) are associated with psychosocial aspects of medical sociology (like social class, behavior patterns, culture, and lifestyle). CONCLUSION: Environmental features and psychosocial issues should be considered to improve users' health and experience in hospitals and to create a user-centered health-promoting environment.

Os movimentos sociais e a gênese de propostas para a saúde da população LGBT na Bahia, Brasil (1979-2014): disputas iniciais e alternativas possíveis / Social movements and the genesis of LGBT health policy in Bahia, Brazil (1979-2014): initial disputes and possible alternatives

Resumo Com o objetivo de descrever a gênese de propostas para a saúde da população de LGBT na Bahia, foi realizado um estudo sócio histórico entre 1979 e 2014. Adotou-se as proposições de Patrice Pinell para a análise sociológica de políticas públicas. A análise do espaço social compreendeu a identificação das trajetórias dos agentes envolvidos com as propostas no estado da Bahia e as relações entre esses agentes e o espaço social nacional, assim como, o campo do poder do Estado. Na Bahia, destacaram-se agentes com trajetórias vinculadas ao campo científico, dos direitos humanos, dos direitos sexuais, do feminismo e do espaço AIDS, com alto capital burocrático e militante, que propiciou aproximação às questões relacionadas a saúde LGBT local. As condições de possibilidade que permitiram a formulação de propostas políticas baseadas na integralidade e na universalidade da atenção à saúde foram a formalização do Comitê Técnico Estadual de Saúde Integral LGBT da Bahia, em 2014, onde buscou-se ampliar a Atenção Integral à Saúde voltada às populações de maior vulnerabilidade; e o Plano Bahia sem homofobia, que permitiu ampliar o diálogo com a sociedade civil e os movimentos sociais e abarcar as principais críticas para a formulação de propostas políticas.

Abstract We conducted a socio-historical study covering the period 1979-2014 to explore the genesis of LGBT health policy in Bahia, Brazil, drawing on Pinell's theoretical framework for the sociological analysis of public policy. To analyze the social space, we investigated the trajectories of the agents involved in policy formulation and the relations between these agents and the national social space and field of State power. The agents were predominantly from the scientific, human rights, sexual rights, feminism and AIDS fields, and had a high level of bureaucratic and militant capital, meaning they were well-versed in LGBT health issues. The historical conditions of possibility underlying the formulation of LGBT health policy included the formalization of the State Technical Committee on LGBT Health in 2014, in an effort to improve access to comprehensive health care for vulnerable groups; and the Bahia without Homophobia plan, which helped expand dialogue around with civil society and social movements and address the main criticisms of policy making.

Social representations of cancer in patients from Medellín, Colombia: a qualitative study.

Background: Cancer has different explanatory theories that address its etiology and treatment. It is usually associated with pain and suffering. Recently, new technologies, knowledge, and therapies have been developed, which may have transformed the classic social representations of the disease. This study aimed to understand the social representations (SRs) of cancer in patients from Medellín, Colombia. Methods: This study used a grounded theory in 16 patients with cancer. The information was collected between June 2020 and May 2021. Information was analyzed following the open, axial, and selective coding stages. Results: SRs of cancer at the time of diagnosis evoke negative connotations. However, cancer is redefined as a positive event as the clinical course of the disease progresses, and patients interact with health professionals and respond to treatment. The resignification of the disease depends on the etiological models of the patients, which include genetic, socio-anthropological, psychosocial, and psychogenic factors. In line with the SRs of etiology, patients seek out treatments complementary to the biomedical ones that can be socio-anthropological and psychogenic. Conclusion: In this group negative representations about cancer persist, this way of understanding the disease is determined by the convergence of cultural meanings and personal experiences. The causal representation is connected to the actions and willingness of the patients to face their diagnosis. In this sense, two categories stand out: the first expresses that cancer is the consequence of a body subjected to excessive productivity; the second subsumes a psychogenic predisposition caused by the context where the ideology of happiness appears to be a social norm. This double saturation in which an individual is immersed results in new burdens that are not visible to caregivers and healthcare workers.

Trajectories of hospitalizations after age-based statutory retirement.

Retirement years are ideally spent in good health. We aimed to produce new information using person-oriented methods by identifying groups of statutory retirees who did or did not achieve this objective and the factors that distinguish these groups from each other. Our particular focus was on the years directly after the transition into retirement, and the pre-retirement factors that explained the development of health, using a more severe health-related outcome-hospitalization. We studied the retirement, hospitalizations, education, and work characteristics of former employees of the City of Helsinki, Finland (N = 6569), from complete registers. We used group-based trajectory models and identified groups of constant low, constant high, decreasing, and temporarily occurring hospitalizations, and one group of increasing hospitalizations among women and two groups of earlier and later increasing hospitalizations among men. Multinomial regression models showed that among women, belonging to groups with less favourable health was associated with secondary education, older age at retirement, and reduced working hours. Education and work characteristics before retirement both contribute to the development of health, as indicated by hospitalizations directly after retirement. Our findings show that socioeconomic inequalities in health are persistent and should also be addressed after transition into retirement.

Explaining the health system in a practical way - the use of a simulation game in medical sociology teaching.

Objective: A simulation game is a valuable method for conveying teaching content in a practical way. The aim was to design a teaching module for medical sociology on the subject of "The German health care system" which would convey the contents and connections to the students in a practical way using a simulation game. Project description: In addition to the development of scenarios for the simulation game, role cards for various institutions of the health care system were also produced as a result. The students were given the opportunity beforehand to work on theoretical content regarding the German health care system online (the "flipped classroom method"). In the 90-minute face-to-face event the simulation game was played, followed by a feedback session. The initial impressions of the students were collected. Results: In the 2022 summer semester, a total of 185 students from the 4th pre-clinical semester took part in the seminar. The students were divided into twelve seminars. One scenario was worked on per seminar. The simulation game contributed to a better understanding of the health care system. The students were generally very satisfied with this type of knowledge transfer and thought that this method might well be integrated into teaching in the future. Conclusion: Communicating the health care system through a simulation game is evidently suitable for explaining clearly complex issues and presenting the various interests of the individual institutions. In addition, a simulation game stimulates critical debate and can contribute to imparting theoretical content in teaching medical sociology in a practical way.

Making the visible seen: The interactional competence of a person in a disordered state of consciousness.

We examine a 12-min video-recorded interaction among a patient (KN) in a disordered state of consciousness (DOC) and a speech language pathologist clinician (CL) that takes place in a medical rehabilitation setting. The video is a demonstration of how caregivers could use a clinical assessment to observe their loved one's behavior to communicate potential behavioral changes to healthcare professionals. The purpose of this paper is to make visible the communication practices used by participants that may not be obvious to researchers, medical rehabilitation practitioners, and clinical assessment developers. We use phenomenological, linguistic and conversation analytic approaches to analyze the interaction. We found that KN demonstrates multiple conversational competencies, some (but not all) of which are acknowledged by CL, and most of which are not directly addressed by the assessment scoring criteria. For example, KN demonstrates conversational competency by responding non-verbally to CL's prompts from the assessment protocol and following along with the unspoken rules of discourse. He does this primarily through gaze, which broadcasts the focus of his attention and actively signals his participation in the conversation. Though KN does not always respond correctly to CL's questions, he nevertheless demonstrates implicit conversational competencies during turns of talk such as returning to 'neutral' position which signals the completion of a turn of talk. KN's conversational competencies may be missed by CL and the assessment protocol but we argue that they are important in understanding KN's capacity. Our analyses show that competency is not simply a performance by one person who appropriately and correctly responds to a series of questions in a prescribed time frame. Competence is a collaborative achievement among participants, co-produced in situ, and influenced by linguistic and cultural habits of talk and epistemic norms that privilege clinical knowledge and expertise.

Incongruous identities: Mental distress and burnout disparities in LGBTQ+ health care professional populations.

Health care professionals are chronically overworked due to structural workplace demands and institutional challenges [1]. During the COVID-19 pandemic, US biomedical health care professionals experienced additional environmental strain [2]. Health care professionals who occupy socio-politically minoritized identities are more likely to report symptoms of distress and workplace overburden than their counterparts [2]. While minority stress and identity formation theories explain the relationship between socially constructed identity and environmental strain, these theories remain largely unexplored in LGBTQ+ health care professional populations. Furthermore, contemporary investigations into health care professional burnout and mental distress fail to include differential impacts of identity-based stress, particularly within LGBTQ+ groups. This paper proposes a theoretical explanation for differential stress experiences by health care professionals and calls for research to investigate identity congruence as a key aspect of professionalization in medical schools. Health professions researchers need to attend to identity-based stress models to address discriminatory experiences with burnout and mental distress.

Can a disability studies-medical sociology rapprochement help re-value the work disabled people do within their rehabilitation?

This paper draws attention to the health-related work that disabled people do when engaging with rehabilitation services. Medical sociology has a rich history of looking at the 'illness work' that patients do, while disability studies scholars have explored the cultural value placed upon paid work and the effects on social status of being unable to work. Yet, a longstanding froideur between these two disciplines, which have fundamentally opposed ontologies of illness and disability, means that neither discipline has attended closely to the rehabilitation-related work that disabled people do. The concept of 'adjusting' to illness highlights seemingly irreconcilable disciplinary differences. Yet this article argues that the notion of 'adjustment work' can elucidate the socio-political character of the work disabled people do in their rehabilitation, which could create a more substantial and sustainable dialogue on this subject between disability studies and medical sociology. To make this case, we discuss interview data from the Rights-based Rehabilitation project, which sought to explore disabled people's lived experiences of rehabilitation.

Reconfiguring the social organization of work in the intensive care unit: Changed relationships and new roles during COVID-19.

The COVID-19 pandemic caused hospitals to make changes to workflow that exacerbated emotional exhaustion and burnout among health care workers. This article examines one of those changes, restricted visitation, showing how it changed the social organization of work by upending established interactional patterns and relationships between health care workers, patients, and patients' families. Based on 40 interviews with intensive care unit (ICU) workers in units that were full of COVID-19 patients and had fully restricted visitation, study findings show that staff took on emotional support roles with patients that had typically been done by families at the bedside. They also faced increased anger, distrust, and misunderstandings from families who were not allowed to see their dying loved one. With each other, staff bonded together with dark humor and candid talk about the scale of deaths, constructing a shared understanding and solidarity amidst the tragedy of the pandemic.

The Skagit County choir COVID-19 outbreak - have we got it wrong?

OBJECTIVES: Over time, papers or reports may come to be taken for granted as evidence for some phenomenon. Researchers cite them without critically re-examining findings in the light of subsequent work. This can give rise to misleading or erroneous results and conclusions. We explore whether this has occurred in the widely reported outbreak of SARS-CoV-2 at a rehearsal of the Skagit Valley Chorale in March 2020, where it was assumed, and subsequently asserted uncritically, that the outbreak was due to a single infected person. STUDY DESIGN: Review of original report and subsequent modelling and interpretations. METHODS: We reviewed and analysed original outbreak data in relation to published data on incubation period, subsequent modelling drawing on the data, and interpretations of transmission characteristics of this incident. RESULTS: We show it is vanishingly unlikely that this was a single point source outbreak as has been widely claimed and on which modelling has been based. CONCLUSION: An unexamined assumption has led to erroneous policy conclusions about the risks of singing, and indoor spaces more generally, and the benefits of increased levels of ventilation. Although never publicly identified, one individual bears the moral burden of knowing what health outcomes have been attributed to their actions. We call for these claims to be re-examined and for greater ethical responsibility in the assumption of a point source in outbreak investigations.

Expressivist objections to prenatal screening and testing: Perceptions of people living with disability.

The 'expressivist objection' (EO) refers to the notion that using reproductive (genetic) technologies to prevent the birth of future would-be disabled people contain, and express, a negative valuation of life with disability. Whilst the EO has received increased attention in recent years in line with rapid technological and genomic developments, there remains scant research on how EO concerns are experienced and expressed by disabled people and their families, especially within and between impairment groups. Bringing together two studies-one with adults and family members living with genetic conditions (n = 62) and one with parents of children with Down's syndrome (n = 22)-we argue that disabled people and their families variously embrace, reject or rework the EO across contexts, and yet also frequently situate it within broad support for reproductive technologies. We present three key factors that mediate responses to the EO: (1) the nature of impairment and its integration within identity; (2) social and cultural contexts relating to disability and (3) the (individual and collective) imagined futures of disabled people. In so doing, we blend the conceptual architecture of medical sociology and disability studies, arguing that this allows us to accurately illuminate the nuanced responses of disabled people and their families.

The Ongoing Process of HIV-Stigma (Re)Production.

HIV stigma negatively affects the social experiences of people living with HIV (PLWH) and remains a challenge to HIV prevention, treatment, and care. Research has overwhelmingly focused on individual cognitive measures of HIV stigma (e.g., internalized, anticipated, and experienced). However, little research explores the interactions and societal structures through which HIV stigma is produced. Data from qualitative interviews with 30 black gay and bisexual men living with HIV in the U.S. Deep South revealed an interconnected and interdependent set of processes that produce and reproduce HIV stigma. These included social interactions (silence, euphemism, and gossip), witnessed acts of marginalization, word-of-mouth transmission of HIV misinformation, and laws and policies carried out within the education and criminal justice systems. Efforts to reduce stigma that focus on individual beliefs and attitudes are critical to improving the well-being of PLWH. However, reducing HIV stigma requires intervening on the social interactions and structures through which HIV stigma is produced and reproduced.

The social construction of the PrEP1519 study: conditions of possibility for advances in HIV/AIDS prevention / A construção social do estudo PrEP1519: possíveis condições para os avanços na prevenção do HIV/aids / La construcción social del estudio PrEP1519: posibles condiciones para avances en la prevención del VIH/sida

This paper analyzed the genesis of the PrEP1519 study and feasibility conditions for its construction. A qualitative-approach study was conducted using the Bourdieusian sociology framework to reconstruct the dynamics of the social environment where PrEP1519 emerged during 2015-2018. A document analysis and ten in-depth interviews were carried out to analyze the trajectory of the project. Pre-exposure prophylaxis (PrEP) was introduced in Brazil as a public policy in 2017. The lack of scientific evidence available among the adolescent population led to the development of a demonstrative cohort study, associated with an intervention, aimed at combining the prevention and treatment of sexually transmitted infections at three sites in Brazil. PrEP1519 sought to generate evidence for global use and to help the Brazilian Ministry of Health apply PrEP among adolescents. The articulation of bureaucratic, scientific, and activist stakeholders enabled this study. The feasibility conditions for developing PrEP1519 included a favorable relationship of national organizations with international organizations, the favorable approach that public administrators had at the time towards new technologies and prevention strategies, the researchers' previous experience in studies with the target population or with PrEP, articulation efforts with social movements, civil society organizations, and other public agencies, and the integration between scientific institutions, which allowed using international resources and developing a response to the problem. Completing this study at a moment when conservatism advances in Brazil demands that the scientific community and activists closely monitor and take stances on PrEP to ensure its availability for adolescents as a public policy.

Este trabalho analisou a gênese do estudo PrEP1519 e as condições de possibilidade para sua construção. Um estudo qualitativo foi realizado, utilizando a estrutura sociológica de Bourdieu para reconstruir a dinâmica do ambiente social onde surgiu o estudo PrEP1519, de 2015 a 2018. Foram realizadas uma análise documental e 10 entrevistas aprofundadas, com análise de suas trajetórias. A pofilaxia pré-exposição (PrEP) foi introduzida no Brasil como política pública em 2017. A escassez de evidências científicas disponíveis entre a população adolescente levou ao desenvolvimento de um estudo de coorte demonstrativo, associado a uma intervenção, visando combinar a prevenção e o tratamento de infeccções sexualmente transmissíveis em três localidades no Brasil. O objetivo era gerar evidências para uso global, e apoiar o Ministério da Saúde com a incorporação da PrEP entre adolescentes. Este trabalho resultou da articulação de atores burocráticos, científicos e ativistas. As possibilidades de desenvolvimento deste estudo permearam uma relação favorável com organizações internacionais, a abordagem favorável dos administradores públicos da época para com as novas tecnologias e estratégias de prevenção, a experiência anterior dos pesquisadores em estudos com a população-alvo ou com a PrEP, os esforços de articulação com movimentos sociais, organizações da sociedade civil e outros órgãos públicos, e a integração entre instituições científicas que possibilitaram recursos internacionais e uma resposta ao problema. A conclusão deste estudo em cenário no qual o conservadorismo avança no país, exige que os campos científico e ativista acompanhem de perto e tomem posições, para garantir a disponibilidade da PrEP para adolescentes como política pública.

Este trabajo analizó la génesis del estudio PrEP1519 y las posibles condiciones para su desarrollo. Se realizó un estudio cualitativo a partir del marco sociológico de Bourdieu para reconstruir la dinámica del entorno social donde surgió el estudio PrEP1519, de 2015 a 2018. Se llevó a cabo un análisis documental y 10 entrevistas en profundidad, con análisis de sus trayectorias. La profilaxis pre-exposición (PrEP) se introdujo en Brasil como política pública en 2017. La escasez de evidencia científica disponible entre la población adolescente llevó al desarrollo de un estudio de cohorte demostrativo, asociado a una intervención, con el objetivo de combinar la prevención y el tratamiento de las enfermedades de transmisión sexual en tres localidades de Brasil. El objetivo fue generar evidencia de uso global y apoyar al Ministerio de Salud con la incorporación de la PrEP entre los adolescentes. Este trabajo resultó de la articulación de actores burocráticos, científicos y activistas. Las posibilidades para desarrollar este estudio permearon una relación favorable con organismos internacionales, el enfoque favorable de los administradores públicos hacia las nuevas tecnologías y estrategias de prevención, la experiencia previa de los investigadores en estudios con la población objetivo o con PrEP, los esfuerzos de articulación con movimientos sociales, organizaciones de la sociedad civil y otros organismos públicos, y la integración entre instituciones científicas que posibilitaron recursos internacionales y una respuesta al problema. La conclusión de este estudio en un escenario en el que avanza el conservadurismo en el país requiere que los campos científicos y activistas vigilen y tomen posiciones para asegurar la disponibilidad de la PrEP para adolescentes como política pública.

The social construction of the PrEP1519 study: conditions of possibility for advances in HIV/AIDS prevention / A construção social do estudo PrEP1519: possíveis condições para os avanços na prevenção do HIV/aids / La construcción social del estudio PrEP1519: posibles condiciones para avances en la prevención del VIH/sida

This paper analyzed the genesis of the PrEP1519 study and feasibility conditions for its construction. A qualitative-approach study was conducted using the Bourdieusian sociology framework to reconstruct the dynamics of the social environment where PrEP1519 emerged during 2015-2018. A document analysis and ten in-depth interviews were carried out to analyze the trajectory of the project. Pre-exposure prophylaxis (PrEP) was introduced in Brazil as a public policy in 2017. The lack of scientific evidence available among the adolescent population led to the development of a demonstrative cohort study, associated with an intervention, aimed at combining the prevention and treatment of sexually transmitted infections at three sites in Brazil. PrEP1519 sought to generate evidence for global use and to help the Brazilian Ministry of Health apply PrEP among adolescents. The articulation of bureaucratic, scientific, and activist stakeholders enabled this study. The feasibility conditions for developing PrEP1519 included a favorable relationship of national organizations with international organizations, the favorable approach that public administrators had at the time towards new technologies and prevention strategies, the researchers' previous experience in studies with the target population or with PrEP, articulation efforts with social movements, civil society organizations, and other public agencies, and the integration between scientific institutions, which allowed using international resources and developing a response to the problem. Completing this study at a moment when conservatism advances in Brazil demands that the scientific community and activists closely monitor and take stances on PrEP to ensure its availability for adolescents as a public policy.

Este trabalho analisou a gênese do estudo PrEP1519 e as condições de possibilidade para sua construção. Um estudo qualitativo foi realizado, utilizando a estrutura sociológica de Bourdieu para reconstruir a dinâmica do ambiente social onde surgiu o estudo PrEP1519, de 2015 a 2018. Foram realizadas uma análise documental e 10 entrevistas aprofundadas, com análise de suas trajetórias. A pofilaxia pré-exposição (PrEP) foi introduzida no Brasil como política pública em 2017. A escassez de evidências científicas disponíveis entre a população adolescente levou ao desenvolvimento de um estudo de coorte demonstrativo, associado a uma intervenção, visando combinar a prevenção e o tratamento de infeccções sexualmente transmissíveis em três localidades no Brasil. O objetivo era gerar evidências para uso global, e apoiar o Ministério da Saúde com a incorporação da PrEP entre adolescentes. Este trabalho resultou da articulação de atores burocráticos, científicos e ativistas. As possibilidades de desenvolvimento deste estudo permearam uma relação favorável com organizações internacionais, a abordagem favorável dos administradores públicos da época para com as novas tecnologias e estratégias de prevenção, a experiência anterior dos pesquisadores em estudos com a população-alvo ou com a PrEP, os esforços de articulação com movimentos sociais, organizações da sociedade civil e outros órgãos públicos, e a integração entre instituições científicas que possibilitaram recursos internacionais e uma resposta ao problema. A conclusão deste estudo em cenário no qual o conservadorismo avança no país, exige que os campos científico e ativista acompanhem de perto e tomem posições, para garantir a disponibilidade da PrEP para adolescentes como política pública.

Este trabajo analizó la génesis del estudio PrEP1519 y las posibles condiciones para su desarrollo. Se realizó un estudio cualitativo a partir del marco sociológico de Bourdieu para reconstruir la dinámica del entorno social donde surgió el estudio PrEP1519, de 2015 a 2018. Se llevó a cabo un análisis documental y 10 entrevistas en profundidad, con análisis de sus trayectorias. La profilaxis pre-exposición (PrEP) se introdujo en Brasil como política pública en 2017. La escasez de evidencia científica disponible entre la población adolescente llevó al desarrollo de un estudio de cohorte demostrativo, asociado a una intervención, con el objetivo de combinar la prevención y el tratamiento de las enfermedades de transmisión sexual en tres localidades de Brasil. El objetivo fue generar evidencia de uso global y apoyar al Ministerio de Salud con la incorporación de la PrEP entre los adolescentes. Este trabajo resultó de la articulación de actores burocráticos, científicos y activistas. Las posibilidades para desarrollar este estudio permearon una relación favorable con organismos internacionales, el enfoque favorable de los administradores públicos hacia las nuevas tecnologías y estrategias de prevención, la experiencia previa de los investigadores en estudios con la población objetivo o con PrEP, los esfuerzos de articulación con movimientos sociales, organizaciones de la sociedad civil y otros organismos públicos, y la integración entre instituciones científicas que posibilitaron recursos internacionales y una respuesta al problema. La conclusión de este estudio en un escenario en el que avanza el conservadurismo en el país requiere que los campos científicos y activistas vigilen y tomen posiciones para asegurar la disponibilidad de la PrEP para adolescentes como política pública.

Processo de trabalho em Clínicas Populares de Saúde na perspectiva de médicos / El proceso de trabajo en Clínicas Populares de Salud bajo la perspectiva de médicos / Work process in Low-Cost Health Clinics from the perspective of physicians

O objetivo deste estudo foi compreender a perspectiva de médicos acerca do processo de trabalho em Clínicas Populares de Saúde. Para isso, realizamos uma pesquisa qualitativa na qual foram entrevistados oito jovens médicos especialistas que atuam nessas empresas em São Luís, Maranhão. Identificamos condições precarizadas de trabalho, mas com pouca resistência por parte dos médicos, considerando que essas empresas são encaradas como espaços de projeção no mercado de trabalho local. Devido às limitações do modelo assistencial do tipo queixa-conduta, os entrevistados acionam uma rede informal e os usuários das Clínicas Populares de Saúde são encaminhados para o Sistema Único de Saúde (SUS). Assim, o processo de trabalho do médico é desafiado por esse modelo assistencial fragmentado, o que faz borrar os limites nas interfaces público-privado na medida em que uma dupla porta de entrada para o SUS é naturalizada.(AU)

El objetivo de este estudio fue comprender la perspectiva de médicos sobre el proceso de trabajo en Clínicas Populares de Salud. Para ello, realizamos una investigación cualitativa en la que fueron entrevistados ocho jóvenes médicos especialistas que actúan en esas empresas en São Luís, Maranhão. Identificamos condiciones precarias de trabajo, pero con poca resistencia por parte de los médicos, considerando que esas empresas son consideradas como espacios de proyección en el mercado de trabajo local. Debido a las limitaciones del modelo asistencial del tipo queja-conducta, los entrevistados ponen en acción una red informal y los usuarios de las Clínicas Populares de Salud son derivados para el Sistema Brasileño de Salud (SUS). De tal forma, el proceso de trabajo del médico es desafiado por ese modelo asistencial fragmentado, lo que borra los límites de las interfaces público-privado a medida que se naturaliza una doble puerta de entrada al SUS.(AU)

The objective of the study was to understand the perspective of doctors regarding the work process in Low-cost Health Clinics. To this end, we conducted qualitative research interviewing 8 young specialist doctors who work in these business firms in São Luís, Maranhão. We identified precarious working conditions, although presenting little resistance from the doctors, considering that these businesses are seen as spaces of projection in the local job market. Due to the limitations of the complaint-driven model of care, the interviewees activate an informal network, and the users of the Low-Cost Health Clinics are referred to the Brazilian National Health System (SUS). Thus, the physician's work process is challenged by this fragmented care model, which blurs the boundaries in the public-private interfaces leading to a naturalized double gateway to the SUS.(AU)

Analysis on Pediatric Sick Role and Doctor-patient Relationship Based on Parsons’ Theory of "Sick Role" / 中国医学伦理学

With the development of medicine technology and the increasing of people’s demand for quality of life, the complexity of doctor-patient relationships is also increasing. Pediatrics is one of the departments with the most concentrated and complex doctor-patient conflicts, therefore, it is necessary to analyze the sick roles and doctor-patient relationships in pediatrics. This paper explained the connotation of the sick role and the doctor-patient social interaction pattern based on Parsons’ theory of "sick role", and analyzed the particularity of the pediatric sick roles in China according to China’s national conditions. Meanwhile, combining the group characteristics and social background of pediatric sick role, this paper elaborated the sociological crux of pediatric doctor-patient relationship in China, and conducted a critical analysis on Parsons’ theory of "sick role".

Does the Chronic Stress of Everyday Discrimination or Race Itself Better Predict AD Onset Risk?

Using evidence from the Health and Retirement Study, we explore racial disparities in Alzheimer's Disease (AD) onset risk. From a stress process perspective, there is substantial evidence in the literature that everyday discrimination is a chronic strain for Black individuals that acts as a social determinant of illness. However, few studies have examined specific relationships between this social stressor, race, and AD onset risk. Using Cox Proportional Hazard Models, we examined racial differences in exposure and vulnerability to everyday discrimination. Findings suggest that everyday discrimination predicts AD onset risk, and Black individuals experience more frequent exposure to everyday discrimination as a chronic strain. However, contrary to the stress process model, Black respondents were not more vulnerable to the effect of everyday discrimination on AD onset risk. Racial bias from medical professionals during the diagnostic process and mortality selection bias may explain this effect. Overall, the results of this study provide further evidence that discrimination is a key factor in predicting AD while also considering that many racial minorities with high rates of this type of social stress may not receive an unbiased diagnosis and/or survive to late life to develop AD.

Mapping the Intellectual Structure of Medical Sociology: A Co-Word Analysis.

Background: Medical sociology is concerned with the relationship between social factors and health, and with the application of sociological theory and research techniques to questions related to health and the health care system. Considering the wide range of studies in the field that each examined different aspects, to promote health in community, bibliometrics analysis in this area is felt. Methods: In this descriptive-analytical study with a scientometric approach, the data about "medical sociology" were retrieved from PubMed in MEDINE format, including 1226 records over the period 1945-2018. By using Co-word analysis, clustering methods, and strategic diagram with the help of SPSS, UcInet 6 software the data were analyzed. Results: The keyword "Attitude to Health" and two pairs of frequently used keywords, namely "Power (Psychology)*Professional Autonomy" were the most frequent in medical sociology. The results shaped the concepts of medical sociology in 7 clusters. The clusters "Attitude of health personnel", "Health Policy" and "Sociology of Medical Education" are topics that may be emerging or disappearing. The "Physicians", "Models of Social Determinants of Health" and "medical philosophy" are immature clusters. Conclusion: This research used co-word networks that indicate the important links between keywords of research areas. Considering the frequency of keywords along with the clusters obtained, it seems that the most research approach was seen on the medical aspect rather than the sociological aspect. Despite the importance of sociological aspects such as social rooting of disease, sociability, medicine as a social institution and etiological studies, these subjects have not been sufficiently considered.