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".

Thomas Sackville's Hall of Fame: displaced, reinvented and preserved at Knole.

Between 1605 and 1608 Knole was transformed into a dazzling Renaissance palace by Thomas Sackville, 1st Earl of Dorset. All around its largest Gallery ran a frieze of nearly fifty oval portraits, of which thirty-eight survive on their original rectangular framed oak panels. In 1702 the paintings were prised from their walls and moved elsewhere in the house. The surviving panels had deteriorated, mostly owing to movement in their wood being restrained by their original engaged batten frames. Sources state that in 1793 the paintings restorer Francis Parsons was responsible for significant interventions that effectively changed the set from fragments of a fitted Jacobean decorative interior into a hang of individual paintings in a more contemporary neoclassical livery. Aesthetic changes made by Parsons reflect a change in taste during this era whilst simultaneously addressing the paintings' physical deterioration-principally interventions to the back of the panels in an attempt to keep the portraits flat. Additionally, the set was augmented with six portraits, possibly older than Sackville's original set. These treatments carried out during the eighteenth century to stabilize, restore, augment and update this important Jacobean portrait set demonstrate careful manipulation of their condition and significance.

The End of the Profession as a Sociological Category? Systems-theoretical Remarks on the Relationship between Profession and Society.

Following reflections by Talcott Parsons and Niklas Luhmann, this paper is concerned with the changing meaning of the profession as a sociological category for analyzing modern society. Professions are practical academic occupational groups oriented to certain social values, to which a special significance for society was attributed in the social sciences for a long time, thus marking a connection between professions' research and theory of society. This paper now describes that the causal relationship between profession and society is limited to a historically relatively early period. In the transition to modern society, this close network of relationships begins to dissolve, and now professions operate in the context of some function systems of society whose task is the professional assistance of single clients, such as in the fields of health, law, and pastoral care. However, the professions' highlighted position in the knowledge and action structure of single function systems seems to dissolve more and more today so that one can ask whether we can speak here already of an end of the social form profession. This would correspond with the observation that actually the professions no longer appear at all in the newer theories of society and therefore their function as an important mechanism of social structure formation is no longer attributed to them.

The tired hero and her (il)legitimation: Reworking Parsons to analyse experiences of burnout within the Dutch employment system and lifeworld.

Burnout is an illness label, and in some healthcare systems a diagnostic category, which has received growing attention and usage. Despite its ubiquity and widespread media coverage, the medical sociological literature on the condition remains small and the wider sociological literature tends to treat the rise of burnout as a straightforward reflection of changing working environments. Very few studies have critically reflected on the nature of burnout, its diagnosis and lived experiences of the condition. This neglect is surprising given the relative legitimacy of burnout as an illness category in several national healthcare contexts, not least in the Netherlands. Drawing on in-depth qualitative interviews with a range of burnout sufferers (n = 18) and diagnosing professionals (n = 12) in the Netherlands, we explore participants' narrated understandings of the condition in light of a reworked Parsonian framework. Narratives suggested sufferers of burnout generally received legitimation, often being understood as hardworking, diligent and altruistic. Experiences of (partial) acceptance through a medical label, and the relative lack of stigma were important to sense-making and coping. This recognition of burnout was particularly striking, given several features burnout shares with conditions commonly associated with ontological doubt, moral suspicion and stigma. Yet recognition of commitment and strength sat in tension with psychological assistance, which sought to correct tendencies for working too hard for too long. Drawing on insights from Habermas's extensive reformulation of Parsons's work, we understand the legitimation and tensions around burnout care in light of meanings, metaphors and manipulation which, in turn, we locate in relation to the functioning of wider socio-cultural lifeworlds and political-economic systems, including the sediments of earlier political-economic and cultural structures.

A Parsonian Approach to Patient Safety: Transformational Leadership and Social Capital as Preconditions for Clinical Risk Management-the GI Factor.

The purpose of this study is to investigate the role of the combination of transformational leadership and social capital in safety capacity building. Drawing on the A-G-I-L concept of Talcott Parsons, we test a model for patient safety. The hypothesis is, that good safety management needs a combination of goal attainment (G) and integration (I), here called the GI factor. We tested this hypothesis by using transformational leadership as a surrogate for goal attainment and social capital as a surrogate for integration in a study of the perceptions of chief medical officers in 551 German hospitals. We conducted a cross-sectional hospital survey combined with secondary data analysis in all German hospitals with at least one internal medicine unit and one surgery unit (N = 1224 hospitals) in the year 2008 with a response rate of 45% (N = 551). The regression model explained 17.9% of the variance in perceived clinical risk management. We found that if both requirements for goal-oriented collective action-transformational leadership and social capital-are met, good safety management is more likely. The tentative conclusion is that it takes transformative leaders and cohesive followers together as a social basis to improve safety in hospitals.

Fabulous Dentist Photograph of Yesteryear.

William Henry Parsons (1849-1928), Dentist, Clifton, Kansas is posed in a photograph by Henry Luther Wolf of Eskridge, Kansas. Mr. Wolf was a well-known photographer who did some of his most notable work while living in Southwest Kansas. His best-known photo was said to be a picture of a pioneer woman pushing a wheelbarrow of cow manure, entitled "Independence on the Plains #18 Gathering Chips" (Fig. 1).

O estudo de práticas médicas: o cenário da sociologia das profissões / L'étude des pratiques médicales: l'écran de la sociologie des professions / Study of medical practices: the framework of the sociology of professions

Résumé La sociologie de la médecine s'est constituée à partir du modèle de la sociologie américaine des professions qui a émergé au cours des années 1930 (modèle qui a aussi marqué les historiens de la médecine). Cet article retrace le contexte dans lequel a émergé puis s'est institutionnalisé la sociologie des professions aux États-Unis à partir notamment des travaux des Talcott Parsons, Everett Hughes et Eliot Freidson. Aujourd'hui encore les questionnements portés sur les pratiques médicales en subissent fortement l'empreinte alors même que la sociologie des professions comporte des postulats discutés et discutables et des points aveugles importants, tel le lien entre l'État et la médecine.

Abstract The sociology of medicine is constituted from the model of the American sociology of professions, which has emerged in the 1930s (a model that has also marked the historians of medicine). This article traces the context in which the sociology of professions emerged and later became institutionalized in the United States, notably from the works by Talcott Parsons, Everett Hughes and Eliot Freidson. Even now, questionings about medical practices are strongly influenced by these authors, while the sociology of professions include debated and debatable postulates and important blind spots, such as the link between State and medicine.

Resumo A sociologia da medicina é feita a partir do modelo da sociologia americana das profissões que surgiu no decorrer da década de 1930 (modelo que também marcou os historiadores da medicina). O artigo traz de volta o contexto em que a sociologia das profissões surgiu e, em seguida, quando foi institucionalizada nos Estados Unidos, sobretudo a partir dos trabalhos de Talcott Parsons, Everett Hughes e Eliot Freidson. Ainda hoje os questionamentos realizados em práticas médicas são fortemente influenciados por essa empreitada, enquanto a sociologia das profissões comporta suposições discutidas e discutíveis e pontos cegos importantes, tais como a ligação entre o Estado e a medicina.

From sick role to narrative subject: An analytic memoir.

Questions of illness experience and identity are discussed, based on the analysis of a story told by the breast-cancer activist Audre Lorde. Displacing Parsons' conceptualization of illness as a sick role, I understand the ill person as a narrative subject, defined by discursive possibilities. Three discourses of illness are proposed: the medical institutional discourse, the discourse of illness experience, and the pink-ribbon discourse. Each has its preferred narratives. These discourses overlap and mutually affect each other. Problems with the Foucauldian conceptualization of the subject are considered, and a dialogical imagination of relations of governmentality is proposed.

Samuel Holden Parsons Lee (1772-1863): American physician, entrepreneur and selfless fighter of the 1798 Yellow Fever epidemic of New London, Connecticut.

Samuel Holden Parsons Lee practised medicine at a time when the germ theory of disease had not yet been proposed and antibiotics remained undiscovered. In 1798 he served selflessly as the only physician in town who was willing to battle the Yellow Fever outbreak of New London, Connecticut. Because he practised at the dawn of the age of patent medicine, unfortunately his name also came to be associated with medical quackery. We argue that his contributions have been grossly underestimated. He compounded and vended medications - including bilious pills and bitters - that were gold standards of the day. Moreover, one preparation for treatment of kidney stones led to his sub-specialization in this field and was met with such success that its sale continued for nearly 100 years after his death. While a talented medical man, Lee also had a knack for business, finding success in trading, whaling and real estate.

The use of Mo Kα radiation in the assignment of the absolute configuration of light-atom molecules; the importance of high-resolution data.

Recent studies have confirmed the usefulness of the Hooft and Parsons methodologies for determination of the absolute crystal structures of enantiopure light-atom compounds using Cu Kα radiation. While many single-crystal diffractometers used for small-molecule structure determination are equipped with molybdenum anodes, use of data from such instruments for the absolute structure determination of light-atom crystal structures is rarely documented and has often been found to be unsuccessful. The Hooft and Parsons methodologies have been applied to 44 data sets obtained from single crystals containing light-atom molecules of known chirality using Mo Kα radiation. Several factors influencing the calculation of accurate and precise values for the Hooft and Parsons parameters obtained from these data sets have been identified, the inclusion of high-resolution diffraction data being particularly important. The correct absolute structure was obtained in all cases, with the standard uncertainties of the final absolute structure parameters below 0.1 for the great majority.

General practitioners' management of the long-term sick role.

In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees/patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons's model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence.

Absolute structure of R-(-)-2-methylpiperazine and S-(+)-2-methylpiperazine.

The absolute structures of R-(-)-2-methylpiperazine (rmpip), S-(+)-2-methylpiperazine (smpip), R-(-)-2-methylpiperazinediium dibromide (rmpipBr) and S-(+)-2-methylpiperazinediium dibromide (smpipBr) have been determined by anomalous dispersion employing the Parsons' Q and Hooft methods. The studies were undertaken to determine the limitations of the absolute structure determination of light element structures (C, H, N) employing routine single-crystal X-ray diffraction laboratory conditions. The structures of the neutral methylpiperazines were known from a priori non-crystallographic methods and were confirmed by the absolute structure determination of their dibromide salts. By employing the full data collection of Bijvoet pairs and minimizing systematic errors, the absolute structure parameters 0.09 (8) (Hooft) for R-(-)-2-methylpiperazine and 0.05 (8) (Hooft) for S-(+)-2-methylpiperazine were determined.