Dissertations / Theses on the topic 'Medicalisation'
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Dura, Vila G. "Medicalisation of sadness, depression and spiritual distress." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1461034/.
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A qualitative study was conducted amongst 57 practising Catholics in Spain: students, priests, and contemplative monks and nuns. Through semi-structured interviews, participant observation and ethnography their understanding of severe sadness and the difference with pathological sadness, coping mechanisms and help-seeking behaviour were explored. The participants clearly differentiated between sadness in response to a cause, sadness that “made sense”, and cases where sadness was not explained by the context, sadness that “did not make sense”. The former was seen as a normal reaction to adversity which should be resolved by the individuals’ social, cultural and religious resources, while the latter was likely to be conceptualised as pathological, along the lines of depression, warranting psychiatric consultation. It was also found that religion played a crucial role in the way sadness was understood and resolved: symptoms that otherwise might have been described as evidence of a depressive episode were often understood in those more religiously committed within the framework of the “Dark Night of the Soul” narrative, an active transformation of emotional distress into a process of self-reflection, attribution of religious meaning and spiritual growth. A complex portrayal of the role of the spiritual director and the parish priest in helping those undergoing sadness and depression emerged, containing positive aspects and criticisms of some priests’ lack of commitment and mental health training. This study emphasises the importance of taking into account the context of depressive symptoms, as the absence of an appropriate context is seemingly what made participants conceptualise them as abnormal. It also warns about the risks of medicalising normal episodes of sadness and raises questions about the lack of face validity of the current diagnostic classification for depressive disorder, which exclusively uses descriptive criteria. The thesis concludes by making some suggestions regarding differentiating normal from pathological sadness and how to incorporate existential issues into clinical practice.
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OLIVIER, DONADIEU SYLVIE. "Medicalisation du secours en milieu vertical urbain et industriel." Aix-Marseille 2, 1992. http://www.theses.fr/1992AIX20020.
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BARDIN, ERIC. "Interet de la medicalisation precoce des traumatises craniens graves." Reims, 1989. http://www.theses.fr/1989REIMM004.
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Arribas-Ayllon, Michael. "On the medicalisation of welfare : towards a genealogy of dependency." Thesis, Cardiff University, 2005. http://orca.cf.ac.uk/54255/.
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The thesis combines genealogical investigation with an 'analytics of government' to diagnose present reforms of Australian Social Security. The Australian example poses a new diagram of knowledge/power relations linked to early nineteenth century debates on pauperism and poor policy. Characteristic of 'advanced' liberal government, social welfare is transformed from an income redistribution scheme to a behaviour modification regime. This raises serious implications for contemporary citizenship, subjectification and the apparent flexibility of wage-labour. By re-tracing modern welfare's conditions of possibility, the present is reconstructed to breach the naturalness and self-evidence with which we accept the current crisis of welfare as problems of 'community', 'dependency' and 'participation'. The case is made that present control strategies rapidly recycle clients into flexible wage-labour via human technologies that seek the ethical and moral reconstruction of the poor. But diagnosis is a limited enterprise if it fails to consult the experiences of those to which these reforms are applied. A discursive analysis of 12 interview participants deemed 'at risk' of welfare dependency explores themes of labour market activity, welfare regulation and practices of freedom to understand how welfare subjects manage and transform their lives. Interviews confirm the existence of discourses that reinscribe distinctions between the deserving and undeserving poor, intensify stigma of welfare receipt, and increase ambivalence about labour market security. Furthermore, a psychological subject emerges as one of two positions: it reactivates the pathologies of abject sectors of the population, while shoring-up capacities for rational self- management. Arguably, psychology has become a key technology for the ethical reconstruction of conduct and the calculated management of risk. Discourses of poverty are now recast as problems of 'the excluded' as welfare rationalities monitor and prevent behaviours that lead to market passivity. Like early nineteenth century statements on poverty, citizenship is now conditional upon moral improvement. And while neo-classical solutions have succeeded in moving the welfare debate away from contradictions of political economy, welfare reform risks producing a sector of the population that is low paid, casualised, under-protected from risk, insecure and desocialised.
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Songhurst, Leah. "The medicalisation of happiness : a history of St. John's wort." Thesis, University of Exeter, 2010. http://hdl.handle.net/10036/3060.
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This thesis explores the histories of mild to moderate depression and the use of over the counter (OTC) St. John’s wort (St. John’s wort) during the 1990s. In doing so it not only investigates the diagnosis and definition of mental illnesses, it also raises questions about the interface between conventional and alternative medicine. Using a variety of printed sources, including popular media articles, scientific and medical journal publications, and St. John’s wort self-help books, a number of historical themes are explored. This thesis takes issue with existing medical historical studies of depression. Firstly it is argued that they have presented progressive depression histories. Secondly, it is suggested that they have retrospectively diagnosed depression on the basis of similar symptoms. It is therefore argued that illness is specific to the time in which it exists and should be understood within its own historical timeframe. During the 1990s standardised St. John’s wort was promoted as a natural and safe remedy. Adverts and media reports also highlighted the fact that it had a long medical history. Although this thesis establishes that the plant has been traditionally used to treat physical illnesses, it seems that a growing distrust of conventional antidepressants, combined with an established interest in alternative medicine, encouraged some lay people to use the remedy to treat mild mood disorders. It is further argued that lay people have a history of self-treating minor mental illnesses using preparatory and OTC remedies such as preparatory nerve tonics. Not only did lay people desire autonomous treatments, it also seems that standardised St. John’s wort provided a functional role as an OTC remedy. By the 1990s the concepts of responsible self-care and self-treatment were being actively encouraged by medical authorities. Therefore this thesis reclassifies the passive mild to moderately depressed patient as an active consumer. Following an analysis of the popular media it is suggested that the 1990s coverage of depression and its treatments was confusing. Indeed, depression and its treatment with conventional medicines and St. John’s wort were sometimes presented as part of a wider life style choice. Finally, it is argued that by the 1990s standardised St. John’s wort received the same scientific and medical scrutiny as conventional medicines. It is therefore suggested that the remedy represents a situation in which the boundaries between conventional and alternative medicines have become increasingly indistinguishable.
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Iles, S. C. "Patriarchal therapeutism : The medicalisation of deviance, with particular reference to women." Thesis, University of Kent, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.371144.
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TEILLOL, DOMINIQUE. "Medicalisation des epreuves sportives : etude prospective et experience du s.a.m.u. 42." Saint-Etienne, 1991. http://www.theses.fr/1991STET6228.
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OHAYON, ALAIN. "Le programme de medicalisation du systeme d'information hospitalier : description et analyse." Aix-Marseille 2, 1988. http://www.theses.fr/1988AIX20199.
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ERBETTA, BRUNO. "Les secours souterrains en midi-pyrenees : proposition d'une strategie de medicalisation." Toulouse 3, 1993. http://www.theses.fr/1993TOU31032.
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You, Su-Fen. "Health, policy and medicalisation : a case study of Taiwan's health care reforms." Thesis, University of Warwick, 2003. http://wrap.warwick.ac.uk/55733/.
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This thesis charts the rising importance of the state in extending the influence of modern medicine, contexualised within the history and political-economic dynamics of the health care reforms in Taiwan, a leading Newly Industrialised Country (NIC) which has a distinguished record of health improvement. It highlights the processes by which health care reforms represented a shift towards medicalisation, particularly as consolidated by the creation of a universal National Health Insurance (NHI) system in 1995. The thesis seeks to analyse these processes by bridging the gap between medical sociology and health policy evaluation. It deploys a range of methods: historical analysis of secondary sources and multiple methods of data collection. These include qualitative in-depth interviews with key actors, a questionnaire survey and relevant policy documents. This thesis employs an overarching framework for analysis, which embraces both the 'political economy' and the 'cultural critique' approaches to health, in ways which seek to integrate discussion of policy issues and developments at the macro, meso, and micro-levels. It starts by locating the NHI reform against longer-term historical processes of modernisation, often as a result of outside influences, and the associated transformation of medical paradigms that occurred in different periods. It charts how particular structural factors have impinged on medicine to enable it to become dominant collegiate profession, with special reference to the role of the state promoting the legitimation of particular modes of medical intervention. The thesis highlights the fact that the NHI has extended the influence of doctors, paradoxically also provides the basis by which medical autonomy has been undermined. On the other hand, it charts the social impacts of modern medical care, and argues that the NHI has played an important role in stimulating the process medicalisation and consequently fostered a culture of dependency and passivity contained in medical technology and in the healing relationship. This thesis is a reminder that the contemporary Taiwanese health care state is arriving at a moment of crisis, and that deep reflection on the strengths and weaknesses of the NHI reform is necessary in order to deal with problems associated with growing medicalisation, public demands for greater social equity, and new threats to health, the latest being SARS.
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Duchemin-Pelletier, Maelle Jessica. "Stillbirth : medicalisation and social change, 1901-1992, with special reference to Scotland." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8976/.
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In Scotland, medical understanding of, medical practice in relation to, and medical attitudes towards stillbirth, its prevention and management underwent significant changes throughout the twentieth century. This thesis argues that these changes were shaped by technological and scientific advances in medicine, greater specialisation, and changes in public health practices. It also argues, however, that medical developments were closely linked to broader social, legal and religious concerns around the meanings given to stillbirth. This thesis focuses particularly on the ways in which these developments were evident in Glasgow, and locates change more broadly within Scotland, and indeed, Britain as a whole. This thesis underlines the reasons behind the medical attention towards stillbirths and the prevention of stillbirths from the early twentieth century onwards. It also shows how the legislations in regards to stillbirths as well as the societal perspective on stillbirth influenced and were influenced by the changing medical attention. Medical articles and reports on stillbirths in Glasgow, Scotland and the rest of Britain were analysed to investigate the progress and increase knowledge in understanding the causes of stillbirths and how to prevent those stillbirths. It is highlighted how the medical community focused first on purely obstetric causes of stillbirths to then extend their gaze towards broader causes such as social class and nutrition. The thesis also emphasises how the attention towards stillbirth by the medical profession encouraged always greater medicalisation and hospitalisation of childbearing and childbirth, and this trend was accelerated after the establishment of the National Health Service. The welfare system was a promise of a healthy population, in regards to pregnancy and childbirth, of live births. This meant a medical responsibility was felt to offer the best care, skills and technologies available in order to deliver healthy live babies, hence averting any preventable stillbirths. A lower fertility rate, the promise of live birth through highly skilled medical care and the increased use of obstetric ultrasound changed the societal view of fetuses towards them being regarded as babies even during pregnancy, and thus changed societal perceptions of stillbirth. From the late 1970s, the evolution in society’s views towards stillbirth influenced the medical perspective by demanding a change in the management of stillbirth alongside the provision of support to mothers and, where applicable, their families. Medical professionals, for example, stopped telling women to just start planning for a new pregnancy, but emphasis on the loss that was a stillbirth and the need to grieve became central. This is one of the numerous transformations around the management and support to mothers/families that will be highlighted. This thesis also argues that the evolution in the understanding and prevention of stillbirths by the medical profession as well as the changes of the societal view on stillbirth resulted in developments towards the religious perspective on stillbirth in the late twentieth century, with regards to theology and pastoral care. The changes in medical perspectives towards stillbirths are highlighted, and also how they influenced legalisations, and societal and religious views. The evolution throughout the twentieth century, and especially in the late twentieth century, of those different perspectives are the reasons behind our current understanding of stillbirths and the way we respond to stillbirth. This thesis contributes to increase our understanding of the medical developments around stillbirth as well as the inter-relationship between these different aspects influencing stillbirths in twentieth century Scotland and Britain. An example of this would be that the medical advances helped prevent stillbirth as well as increase the fetal viability earlier in pregnancy, explaining the change of the legal definition of stillbirth in 1992 in Scotland, England and Wales.
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Middleton, Raymond P. "Narratives of Troubled Journeys: Personality disorder and the medicalisation of moral dilemmas." Thesis, University of Bradford, 2017. http://hdl.handle.net/10454/17388.
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This thesis examines the interaction of the medical and moral in the historical evolution of “personality disorder” starting with the relationship between Prichard’s (1835) diagnosis of “Moral Insanity” and an anti-modern religious text (Hancock, 1824) describing disorder of the moral faculty. Moral insanity is traced through to Psychopathic Personalities and the military’s Medical 203 to Personality Disorder in DSM I (1952) through to DSM 5 (2013). The extent to which DSM medicalises everyday moral categories is examined by building on the works of writers theorising moral orders and moral selves, such as Harré (1993), Bakhtin (1981, 1984, 1986) and Taylor (1989). This thesis moves from macro-level concerns to the micro-level using dialogical narrative methodology (Sullivan, 2012) alongside Bakhtin’s conceptual tools to examine how medical and personal narratives of "Personality Disorder" interact in lived experience by analysing a triangulation of my psychiatric clinical notes, contemporary diary entries and an autobiographical account. An analysis is undertaken of several diverse autobiographical accounts of ‘successful’ recovery from mental health crisis already available in the public sphere. Consideration was given to how concepts developed throughout this study might be used in future work, concepts such as “dialogical search for a new narrative”, the dialogical ethics of “habitual excess and insufficiency” and “authoritative narrators”. This thesis’s originality is in linking DSM 5’s diagnosis of personality disorder to anti-modern moral discourses on disorder of the moral faculty, and in revealing complex genre relationships between literal/medical and literary/moral understandings of emotional and mental crisis and recovery.
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Vialette, Jean-Paul. "Application du programme de medicalisation des systemes informatiques au traitement du pneumothorax." Aix-Marseille 2, 1990. http://www.theses.fr/1990AIX20829.
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Hunt, Daniel. "Anorexia nervosa, depression and medicalisation : a corpus-based study of patients and professionals." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/28065/.
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This study reports on the analysis of the Mental Health Discourse Corpus. This dataset is comprised of four sub-corpora that contain patients' online discussions of anorexia nervosa, patients' online discussions of depression, general practitioners' discussions of anorexia, and general practitioners' discussions of depression, respectively. The methodology integrates quantitative corpus linguistic approaches with qualitative analysis drawing on Hallidayan functional grammar, discourse analysis and discursive psychology. By interrogating corpora of health communication across communicative modes and participants, the study offers novel insights into the verbal presentation of anorexia and depression by patients and professionals, and examines their respective uptake of medical explanations of mental illness. Common patterns in the online patient interactions are linguistic choices which realise the externalisation and personification of anorexia and depression, the discursive construction of individual helplessness, and the representation of psychological distress in terms of medical pathology. The uptake and proliferation of biomedical explanatory models of anorexia and depression serves to reduce illness stigma for individuals and, notably, is also used to perform local interactional tasks. In the practitioners' talk, participants draw on medical and social explanations of depression and anorexia. Doctors construct depression as a categorical medical diagnosis while also expressing doubt towards its medical treatment and advocating non-medical interventions. When discussing anorexia, clinicians emphasise the bureaucratic role which body mass index scores occupy in managing anorexia and repeatedly highlight the difficulty of overcoming patients' resistance. In both cases, participants highlight the bureaucratic and communicative challenges of working with anorexic and depressed patients and construct a range of unfavourable moral identities for the chronically ill. The practical implications of the research for users of online support groups and general practitioners working with depressed and anorexic patients are identified. In particular, I emphasise the centrality of communication to primary mental health care and the utility of studying online support groups to illuminate the experiences and beliefs of patients. A critical evaluation of the study's methodology is offered, along with recommendations for future research.
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Harper, Ian David. "Mission, magic and medicalisation : an anthropological study into public health in contemporary Nepal." Thesis, SOAS, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407935.
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This thesis examines the medicalisation of health and suffering in the district of Palpa in west central Nepal. The product of twenty months of ethnographic fieldwork, it explores issues around the introduction and institutionalisation of a number of public health programmes as well as the impact of the presence of a large mission hospital in the area. Specifically, the following areas and programmes are examined in detail: 1. The relationship between the introduction of a biomedical order of knowledge / practice and mission discourse. In what ways are mission ideology and medicine linked? What are some of the local perceptions about the presence of the mission hospital and the wider availability of medical services for the populace? 2. The introduction of the tuberculosis control strategy, Directly Observed Therapy Short-course (DOTS), and its institutionalisation through the public primary health care services, as part of a large research trial. As part of the globalised mandate to eliminate the disease, how has this policy been taken up in the district? 3. As an epistemological form, the one that impinges most on the practice of a range of so-called "traditional" healers is that of the emerging mental health services. The uptake of the diagnosis of "depression" is explored as it is used both by the staff in the mission hospital and more widely through the primary health care system. 4. The current commodification of disease is seen particularly through the national vitamin A capsule distribution programme. In what ways are both the representations of this problem, and the programme itself, complicit with the overwhelming commodification of health related issues in Nepal? 5. How have traditional healers been constituted in relation to the health of Nepal and its people? Aware that they are frequently placed under negative description, traditional healers adapt their practice accordingly. It is those people who are ill, and receive conflicting diagnoses, who have to negotiate this rapidly changing epistemological terrain.
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MEASSON, DIDIER. "Budget global et p. M. S. I. (programme de medicalisation du systeme d'information)." Lyon 1, 1989. http://www.theses.fr/1989LYO1M475.
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Martin, Eric. "Bilan du programme de medicalisation du systeme d'information (pmsi) en 1989 au chru de nancy." Nancy 1, 1990. http://www.theses.fr/1990NAN11286.
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JOFFRE, CESBRON CATHERINE. "Les sections de cure medicale : - le regroupement ou non des lits medicalises - la medicalisation." Angers, 1993. http://www.theses.fr/1993ANGE1119.
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LANG, OLIVIER. "Medicalisation des courses camarguaises : problemes des soins d'urgence aux blesses par corne de taureaux." Aix-Marseille 2, 1994. http://www.theses.fr/1994AIX20024.
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MARTIN, DUPE FRANCOISE. "Projet de medicalisation du systeme d'information : etude experimentale dans un service de medecine interne." Angers, 1988. http://www.theses.fr/1988ANGE1027.
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Ellins, Jo. "Beyond medicalisation : a sociology of the growth in medicines prescribing in the UK and US." Thesis, University of Sussex, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413868.
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BELIN, PATRICK. "Diagnostic d'urgence et p. M. S. I. : analyse du rapport d'activite medicale 1993 du s.m.u.r. du c.h. de saint-dizier ; constats, discussion et propositions." Reims, 1994. http://www.theses.fr/1994REIMM014.
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Thirion, Xavier. "Analyse comparative et evolutive de l'activite hospitaliere : a propos des methodes et des outils." Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX20657.
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Das, Arpita. "Postcoloniality and the Biopolitical State: Gender Assignment Decisions on Intersex Bodies in India." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29197.
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Intersex bodies confound stereotypical notions of sex and gender and are often subjected to medical management processes. Focusing on intersex bodies in India, I study how medical and health professionals make meaning of intersex bodies and the factors that guide their decisions on gender assignment of intersex people. I examine these gender assignment practices through the use of semi-structured, qualitative, in-depth interviews with twenty-two medical and health professionals from both public and private health set-ups, six families of intersex people and three intersex adults, across eight cities in India. While focusing on medical management of intersex bodies, I am also invested in the socio-cultural, political, and economic contexts within which gender assignment decisions take shape in India. Intersex bodies, globally, are commonly subjected to early medicalisation and assigned a binary gender. In Western contexts, specifically the USA, gender assignment heavily leans towards female gender assignment partly because of the relative ‘ease’ in the ‘construction’ of female bodies in comparison to male bodies. In contrast, within India, there is a strong preference for male gender assignment. I argue that the preference for male assignment is influenced by conditions of son preference inherent to the Indian sub-continent. I interrogate gender assignment decisions for intersex people within India’s postcolonial context of ‘population control’ as well as sex selection against female foetuses. Through this study, I make a significant contribution to a nascent intersex scholarship in understanding intersex medicalisation and decision-making around gender assignment processes within India.
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Silva, Tais Cerqueira. "The Medicalisation of Domestic Violence; Medical discourses on Violence Against Women and Their Translation into Politics." Thesis, University of Bristol, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.520586.
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MacKay, Michael Hubbard. "The rise of a medical speciality : the medicalisation of elite equine care c.1680-c.1800." Thesis, University of York, 2009. http://etheses.whiterose.ac.uk/14229/.
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There are currently very few historians of veterinary medicine and outside of their scholarship there is almost nothing that has been written about veterinary history in the past thirty years. This is despite the fact that medical historians have created a large body of scholarship since the 1980s, including studies of political movements, social and cultural histories, histories of ideas of the medical profession, histories of specific diseases and histories of science. The lack of veterinary history is also striking because there has been a plethora of research corning from the field of human/animal relations. Furthermore, the history of animal care before formal veterinary education (1790s) is even more neglected and the scholarship that does exist is over forty years old and generally anachronistic-save the work of Louise Curth. This is all despite the outstanding changes that were occurring during the eighteenth century in Britain. Part of the reason that the current interpretations of eighteenth-century animal care are so anachronistic is due to the focus of historians upon the emergence of the London Veterinary College (1792) as an enlightened step toward progression. This is far from correct because a new medical specialty emerged in animal care over a century before the College. This thesis shows that those involved in the gentlemanly practice of farriery created a new specialised field of farriery that was much more medical. Like midwifery, oculism and dentistry, equine medicine became a new medical specialism. This is demonstrated by analysing elite farriery literature published between 1550 and 1800, by reconstructing the identity of eighteenth century farriery practitioners (especially those that claimed to be gentlemen), by uncovering the practice of these elite practitioners in horse hospitals and anatomy lectures. These findings suggest a new narrative of the history of animal care, showing that veterinary medicine was a product of the larger changes in equine medicine occurring well before the 1790s.
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PROTHERY, ERIC. "Presentation et bilan d'activite de l'annee 1991 de la medicalisation prehospitaliere de la ville de marignane." Aix-Marseille 2, 1992. http://www.theses.fr/1992AIX20116.
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Carryer, Jennifer B. "A feminist appraisal of the experience of embodied largeness : a challenge for nursing : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, New Zealand." Massey University. School of Health Sciences, 1997. http://hdl.handle.net/10179/264.
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To be a fat woman is to experience a prolonged, personal battle with the body. The battle is enacted in a social context which is the site of remarkable consensus about the personal culpability of fat people for their bodily largeness; for women in particular the sanctions are especially powerful. In this research nine large women have engaged in a prolonged dialogue about the experience of being 'obese'. In the course of a feminist research endeavour, with a researcher who is similarly positioned, they have both contributed to and gained from a project which illuminates the experience of largeness alongside a critical examination of the discourses which shape body size.This dissertation critiques a dominant medical discourse which ignores conflicting research and supports a narrow view of health by simplistically linking increased body weight with poor health outcomes. Such is the hegemonic power of medicine that an examination of both nursing and popular literature in the area of study, reveals wide-spread acceptance of the notion that to be thin is to be healthy and virtuous, and to be fat is to be unhealthy and morally deficient. For nursing, the unquestioning obedience to medical teaching, raises serious questions about nursing's autonomy and separateness from medicine. Nurses have perpetuated an unhelpful and reductionist approach to their care of large women, in direct contradiction to nursing's supposed allegiance to a holistic approach to health care. Current strictures on women's body size and continued support for reduction dieting leave large women with the choice between two binary opposites; to diet or not to diet. Either choice has consequences which are traumatic and not health promoting. The experience of largeness emerges as a socially constructed disability in which many women are denied the opportunity to be fully healthy.
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Hayes, Sarah. "The Medicalisation of Maladjustment : The Conceptualisation and Management of Child Behavioural problems in Britain, ca. 1890-1955." Thesis, University of Exeter, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499623.
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This study examines the medicalisation of maladjustment in Britain, from the last years of the nineteenth century to the middle decades of the twentieth century. The study focuses on the conceptualisation and application of the tenn 'maladjusted', and the ways in which this reflected changing professional and lay perspectives of child behavioural problems throughout the early twentieth century. Examination of the process by which maladjustment was established as a medical category highlights the complex interplay between psychiatric, psychological, psycho-analytical, sociological, educational, and judicial theories and practices relating to child development. This study will show how a shifting emphasis on moral, intellectual and emotional development was reflected in the changing nature of theories relating to the behaviour of children. This process is explored from the introduction of psychological notions of mental and emotional adjustment in the 1890s, through the establishment of management strategies, including child guidance, in Britain in the inter-war period, the recognition of maladjustment as a statutory handicap under the 1944 Education Act, and, finally, to the publication of the Report of the (Underwood) Committee on Maladjusted Children in 1955. Focus on models of maladjustment illustrates the processes by which social factors, such as individual behaviour and parenting, became the subject of medical attention, highlighting issues surrounding increased intervention by the state and medical profession into the private domestic sphere. Examination of a range of primary and archival sources reveals how interest in the mental and emotional wellbeing of children came to dominate many key areas of policy-making throughout this period. This study challenges existing analyses which present the medicalisation process as one of harmonious teamwork, framed around shared agendas of child welfare and well-being. Despite the development of increasingly sophisticated medical and psychological theories of maladjustment, and greater understanding of child behaviour, professional focus on maladjusted children resulted in increased marginalisation of maladjusted children by the post-war period.
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BOTTON, JEAN-FRANCOIS. "Du projet au programme. . . : la medicalisation du systeme d'information hospitalier ; l'experience du c.h.g. de villefranche-sur-saone." Lyon 1, 1992. http://www.theses.fr/1992LYO1M038.
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Guerin, Olivier. "Mise en place et premiers resultats du programme de medicalisation des systemes d'information au centre regional de lutte contre le cancer paul papin d'angers." Angers, 1992. http://www.theses.fr/1992ANGE1018.
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Nuttall, Alison M. "The Edinburgh Royal Maternity Hospital and the medicalisation of childbirth in Edinburgh, 1844-1914 : a casebook-centred perspective." Thesis, University of Edinburgh, 2003. http://hdl.handle.net/1842/4055.
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This thesis examines the development of the Edinburgh Royal Maternity Hospital in the context of medical care in Edinburgh during the period 1844-1914. It is based primarily on casebooks of the hospital and, in particular, on in-depth micro-studies of all of the hospital's Indoor and Outdoor cases in four discrete years, at approximately 20-year intervals. The central argument of the thesis is that Over the period 1844- 1914, professionals and patients at the hospital came to understand birth as a medical rather than a social event, and that this had repercussions for both groups as well as the institution itself. Chapter 1 places the thesis in the context of other secondary uork on the development of maternity hospitals and care, and examines the use of casebooks as primary sources. Chapter 2 considers the hospital and its staff in relation to the city and the Edinburgh medical community in particular. Chapter 3 examines the patients who attended. It argues that, in the nineteenth century, their perception of the hospital was as a place of social shelter. However, by 1912 a greater number attended for otherwise unaffordable medical care at birth. Chapter 4 examines the medical treatment given to patients. It argues that there was increasing acceptance of medicalisation by patients in the period studied, and increasing confidence in giving such treatment by the professionals involved. Chapter 5 discusses the staff and male and female trainees at the hospital. It suggests that, prior to the introduction of national requirements, the provision of training was driven by commercial concerns, and therefore varied throughout the period studied, particularly in the amount of practical experience offered. The relationship between the different grades of staff and the treatment they offered, described in the chapter, suggests increasing stratification in the roles of doctors and nurses at delivery and during the puerperium. The increase in nursing care following the birth indicates the creation of a professional role that among the poor had previously been undertaken by family members. The role played by increasing anxiety over infection following the introduction of strict antiseptic measures is discussed. The thesis concludes that in Edinburgh the medicalisation of childbirth among the poor was well-advanced by 1912, and suggests that this was a result of increasing patient acceptance combined with the increasing professionalisation of care.
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Upmark, Marianne. "Alcohol, sickness absence and disability pension : a study in the field of disease, ill health, psychosocial factors, and medicalisation /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3696-X/.
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LAPIERRE, OLIVIER. "Un exemple de collaboration entre l'hopital et les sapeurs-pompiers : medicalisation pre-hospitaliere dans la region du comtat-venaissin." Aix-Marseille 2, 1992. http://www.theses.fr/1992AIX20140.
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FICHEUX, THIERRY. "Gestion hospitaliere : tendances et orientations actuelles." Toulouse 3, 1991. http://www.theses.fr/1991TOU31112.
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Hamilton, Mindy. "A Critical Discourse Analysis of Cognitive Enhancement Advertising: The Contemporary Mind as a Commodity." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535468783036117.
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Nordin, Emma. "Abort, fosterdiagnostik och människosyn : En politisk utredning i jakt på etiska ställningstaganden kring ny medicinteknik i 1980-talets Sverige." Thesis, Umeå universitet, Institutionen för idé- och samhällsstudier, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-123283.
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This thesis explores the political and ethical response to the development of new medical technology in the 1980s through the governmental commission Utredningen om det ofödda barnet [the commission regarding the unborn child] and its final report Den gravida kvinnan och fostret – två individer: om fosterdiagnostik, om sena aborter: slutbetänkande av Utredningen om det ofödda barnet [The Pregnant Woman and the Foetus – two individuals. On prenatal diagnosis. On late abortions: final report on the commission on the unborn child]. This governmental commission, alongside the late 1980s more broadly, have been described as a conservative backlash and reaction to the feminist movement and the fight for women’s right to their bodies. However, a close reading of the report shows that though it draws controversial connections between abortion, prenatal diagnosis and ability variations, the governmental commission advocated an extension of the law, not a limitation of rights. Through a biopolitical perspective this thesis shows how power was distributed between the state, the society and the individual. Unlike previous research’s polarisation, this thesis’s take on medicalisation shows that medicalisation is not something that necessarily opposes moralisation, but that they can be used to legitimate each other. Finally it discusses what this means for our understanding of the political climate in Sweden during the 1980s and how this changes our perception of what makes a human being.
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Laloum, Valérie. "Orientation des élèves en ULIS école et processus de médicalisation des difficultés d'apprentissage : de l'échec scolaire au handicap." Thesis, Toulouse 2, 2017. http://www.theses.fr/2017TOU20062/document.
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La loi du 11 février 2005 « pour l’égalité des droits et des chances, la participation et la citoyenneté des personnes handicapées » a provoqué une profonde mutation du système éducatif et entrainé un nouveau partage entre le monde médico-social et l’Éducation nationale avec la mise en place d’un travail de partenariat. Un changement paradigmatique majeur s’est opéré avec l’émergence du concept d’inclusion. L’école devenue « inclusive » s’efforce désormais de répondre aux besoins éducatifs particuliers de chaque élève en adaptant la norme scolaire. Les dispositifs collectifs d’inclusion sont des leviers privilégiés de la scolarisation d’élèves en situation de handicap qu’ils accompagnent suite à une notification de la Maison Départementale des Personnes Handicapées.L’objectif central de cette thèse consiste à interroger, plus de 10 ans après la loi, les processus à l’œuvre lors de l’orientation d’élèves vers des ULIS école. Certains élèves sont orientés en ULIS école sans pour autant présenter de handicap avéré. Ils sont, pour la plupart, issus d’un environnement marqué par une précarité sociale assorti d’une problématique familiale. Ces orientations qui inscrivent l’enfant sur le registre du handicap se font sous couvert d’un étiquetage médico-psychologique, les difficultés scolaires étant assimilées à de la déficience légère. Elles sont rendues possibles par un élargissement de la catégorie du handicap, par des critères d’orientation de plus en plus larges et par l’accroissement actuel des réponses médico-psychologiques face à l’échec scolaire. Il semblerait que les dispositifs ULIS continuent à assurer une fonction de régulation sociale, le recours à l’enseignement spécialisé restant socialement différencié. Dans le contexte actuel de médicalisation des difficultés scolaires, sont orientés en ULIS école des élèves qui mettent le système ordinaire en difficulté et pour lesquels, il ne semble avoir d’autre réponse que l’inscription dans le champ du handicapThe 11th of February 2005 law « for disabled persons rights and opportunities equality, participation and civic rights » brought about a deep educational system change and provoked a new sharing between the medico-social system and the Éducation Nationale with the positioning of a partnership. A main changing paradigm has occured with the inclusion concept emergence. Schooling today inclusive is trying to answer pupils’ special educational needs by adjusting school standards. Group inclusion systems are privileged levers to help disabled pupils at school following the Maison Départementale des Personnes Handicapées notifications.This thesis main goal, more than ten years after the law for the disabled persons, consists in examining the process at work when pupils are guided towards a primary school ULIS (Unité Localisée d’Inclusion Scolaire). A certain number of pupils have received educational counselling towards primary school ULIS without any proven disability. They have, mostly, originated from environments with social and family problems. These notifications labelling children as disabled have been done on a medico-psychological basis, the children’s schooling difficulties labelled as mild disability. Those have occured because of a widening of the disability category, wider and vaguer educational counselling criterions and today’s increasing medico-psychological solutions to school underperforming. ULIS systems would seem to carry on ensuring a social regulating function, the recourse to special needs education being socially differentiated. Today’s context of medicalizing school underperformance is leading to guide towards primary school ULIS pupils, putting the common system in a difficult position, and, for whom there seems to be no other solution than labelling them as disabled
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Mérida, Cristiane Brandão Augusto. "O cérebro criminógeno na antropologia criminal do século XIX: um estudo sobre a etiologia do crime a partir da medicalização da sociedade." Universidade do Estado do Rio de Janeiro, 2009. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=5226.
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O presente trabalho se dedica a realizar uma incursão na história do pensamento criminológico a fim de contribuir para um mapeamento das justificativas do surgimento de certas normas penais, algumas ainda em vigor, e o mapeamento das razões da edificação de muitas instituições jurídicas e administrativas, algumas ainda em funcionamento. A análise tradicional da biografia da Criminologia costuma, todavia, omitir certas ideias que deveriam ser integradas ao percurso da sua vertente científica. Vários são os autores que apontam para a origem da trajetória cientificista criminológica na Europa do fim do século XIX. No entanto, quando se aprofunda na identificação das raízes das referências positivistas na implicação Medicina-Pessoa-Sociedade da era moderna e sua influência na seara criminológica, percebesse que uma tímida Criminologia já estava nascendo no início do século XIX com os estudos sobre a fisiologia cerebral. Em meio a um processo político amplo de fortalecimento do Estado e da burguesia, dá-se a formação de um aparato médico-jurídico, pelo qual se demonstra a tentativa de reconhecimento da autoridade médica para além dos limites
legítimos da atividade. Preocupa-se, portanto, em chamar a atenção para o movimento de medicalização do criminoso por uma leitura histórica do impacto do cientificismo cerebral na esfera criminal. O material desenvolvido pela Frenologia e, depois, pela Antropologia Criminal, é emblemático dessa onda cientificista do século XIX, na qual as pesquisas cerebrais imprimem a visão sobre a etiologia do crime a partir de seus marcadores biológicos. Mais particularmente, atenta-se para a recepção das teorias de Franz Joseph Gall e de Cesare Lombroso sobre o cérebro (do) criminoso na criminologia do século XIX, através da discussão da noção de livre arbítrio, do debate sobre retribuição versus tratamento, bem como das propostas de medidas preventivas em caso de tendências à violência e das políticas públicas voltadas para o cerceamento de direitos em nome de uma suposta defesa social.The current work aims at performing an analysis of the history of criminological reasoning in order to contribute to an overview that justifies the appearance of certain criminal rules, some of them still ongoing, together with the mapping of the reasons for the building of many juridical and administrative institutions, some of which are still functioning. Traditional analysis of the genesis of Criminology is accustomed to, nevertheless, omitting certain ideas, which ought to be integrated into the current scientific scope. There are several authors who point to the origin of the scientificist trajectory in Europe, at the end of the 19th- century. However, when we go deeper into the identification as to the roots of the positivist references in the implication Medicine-Person-Society of modern times and its influence on the criminological domain, we realize that a timid Criminology was about to be born at the beginning of the 19th -century, following the studies on brain physiology. Amidst the vast political process of the strengthening of the State and the bourgeoisie, a medical-juridical apparatus is originated, through which the attempt of recognition of the medical authority is demonstrated, beyond the legitimate limits of the activity. It is concerned, therefore, in drawing attention to the criminals medicalisation movement by means of a historical reading of the impact of brain scientificism in the criminal sphere. The material developed by Phrenology and, afterwards, by Criminal Anthropology, is a significant sign of such a scientificist trend in the 19th-century, in which brain researchers put forward their vision on the etiology of the crime from its biologic markers. More particularly, there is an emphasis on the reception of the theories of Franz Joseph Gall and Cesare Lombroso about the criminal brain in 19th-century Criminology, through discussion of the notion of free will, the debate on retribution versus treatment, as well as the proposition of preventive measures in cases of tendencies to violence and public policies towards controlling rights in the name of a socalled social defense.
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JOUANOLOU, CHRISTIAN. "R. E. A. G. I. R. Dans les hautes-pyrenees : interet de la regulation des appels d'urgences par le 15 et de la medicalisation des secours." Toulouse 3, 1989. http://www.theses.fr/1989TOU31051.
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Faure, Martine. "Problemes juridiques et statutaires poses par l'assistance medicale de grandes manifestations sportives : a propos de la medicalisation des grands prix sur le circuit de nevers magny-cours." Clermont-Ferrand 1, 1992. http://www.theses.fr/1992CLF13018.
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Gidlööf, Catharina. "Riskerar mediciner att bli substitut för det behandlande samtalet? : en kvalitativ studie kring fyra psykoterapeuter och en läkares erfarenhet av psykoterapi och psykofarmaka." Thesis, Ersta Sköndal högskola, S:t Lukas utbildningsinstitut, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-2074.
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Syftet med föreliggande uppsatsarbete är att beskriva erfarenheter av psykofarmaka och psykoterapi. Studien är kvalitativ till sin karaktär och utgår från intervjuer med fyra psykoterapeuter och en läkare. Uppsatsen tar utgångspunkt i ett fenomenologiskt perspektiv. Intervjuerna har analyserats så förutsättningslöst som möjligt utifrån EPP-metoden. Arbetet har haft sin grund utifrån fem övergripande frågeställningar; Hur uppfattar vi lidandets mening i relation till psykofarmaka? Påverkas en individs möjlighet att känna och tänka om denne regelbundet brukar psykofarmaka? Kan den som lider förvänta sig vägledning i de olika enskilda, respektive kombinationsbehandlingar som finns? Minskar det egna lidandet genom att sätta ord på sin ångest i psykoterapi? Hur resonerar läkemedelsindustrin i frågan kring individens psykiska lidande? Dessa frågeställningar har vilat mot en filosofisk fond som ställer frågan: Är medikaliseringen ett sätt att medicinera mot livet självt, att göra samhällets tillkorta-kommanden till ett individuellt problem? Resultaten presenteras i fem synopsis som visar på att; lidande kan ses som kraft till förändring. Antidepressiva läkemedel har en tendens att döva tankar och känslor. Patientens egen vilja är viktig. Mediciner tenderar att bli till substitut för mötet med människor och att relationen till läkemedelföretagen är problematiskt för behandlare då den också är en vinstmaskin.The purpose of the study is to describe experiences gained from the use of psychotropic drugs and/or psychotherapy. The study is qualitative in nature and based on interviews with four psychotherapists and physicians. The study takes as its basis a phenomenological perspective. The interviews were analyzed as unprejudiced as possible using the EPP method. The work was based on five overreaching issues; How do we perceive suffering, meaning in relation to psychotropic drugs? Is an individual's ability to feel and think affected by regular use of psychotropic drugs? Can an individual who suffers expect guidance via individual treatment or via available combined treatments? Is an individuals suffering reduced by setting words to the anxiety in psychotherapy? How does the pharmaceutical industry discuss the issue of individual mental suffering? These issues have been tested against a philosophical background that asks the question: Is medicalisation a way of medicating against life itself, a way of making society's shortcomings the individual`s problem? The results are presented in five synopsis which say that suffering can be seen as force for change. Antidepressants have a tendency to numb thoughts and feelings. The patient's own will is important. Medication tends to be a substitute for meeting people and the relationship to pharmaceutical companies problematic for therapists as the industry is also a profit machine.
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Buhaj, Véronique. "Bilan de la mise en place de l'informatisation de l'hôpital général de Périgueux dans le cadre d'un démarche régionale : exemple d'un service de médecine." Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M102.
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Lehmann, Michel. "Programme de médicalisation des systèmes d'information : historique, développements, applications médicales et financières à un service de pneumologie." Montpellier 1, 1991. http://www.theses.fr/1991MON11152.
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Urbain, Pascal Daniel. "Particularités de la médicalisation au froid en montagne : étude dans le massif du Mont-Blanc." Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M105.
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Lavis, Victoria J., Christine Horrocks, Nancy Kelly, and V. Barker. "Domestic Violence and Health Care: Opening Pandora¿s Box ¿ Challenges and Dilemmas." Sage, 2005. http://hdl.handle.net/10454/2551.
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In this article we take a critical stance toward the rational progressive narrative
surrounding the integration of domestic violence within health care. Whilst changes in
recent UK policy and practice have resulted in several tangible benefits, it is argued that
there may be hidden dilemmas and challenges. We suggest that the medical model of care
and its discursive practices position women as individually accountable for domestic
violence-related symptoms and injuries. This may not only be ineffective in terms of
service provision but could also have the potential to reduce the political significance of
domestic violence as an issue of concern for all women. Furthermore, it is argued that the
use of specific metaphors enables practitioners to distance themselves from interactions
that may prove to be less comfortable and provide less than certain outcomes. Our analysis
explores the possibilities for change that might currently be available. This would
appear to involve a consideration of alternative discourses and the reformulation of power
relations and subject positions in health care.
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Laloum, Valérie. "Orientation des élèves en ULIS école et processus de médicalisation des difficultés d'apprentissage : de l'échec scolaire au handicap." Electronic Thesis or Diss., Toulouse 2, 2017. http://www.theses.fr/2017TOU20062.
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La loi du 11 février 2005 « pour l’égalité des droits et des chances, la participation et la citoyenneté des personnes handicapées » a provoqué une profonde mutation du système éducatif et entrainé un nouveau partage entre le monde médico-social et l’Éducation nationale avec la mise en place d’un travail de partenariat. Un changement paradigmatique majeur s’est opéré avec l’émergence du concept d’inclusion. L’école devenue « inclusive » s’efforce désormais de répondre aux besoins éducatifs particuliers de chaque élève en adaptant la norme scolaire. Les dispositifs collectifs d’inclusion sont des leviers privilégiés de la scolarisation d’élèves en situation de handicap qu’ils accompagnent suite à une notification de la Maison Départementale des Personnes Handicapées.L’objectif central de cette thèse consiste à interroger, plus de 10 ans après la loi, les processus à l’œuvre lors de l’orientation d’élèves vers des ULIS école. Certains élèves sont orientés en ULIS école sans pour autant présenter de handicap avéré. Ils sont, pour la plupart, issus d’un environnement marqué par une précarité sociale assorti d’une problématique familiale. Ces orientations qui inscrivent l’enfant sur le registre du handicap se font sous couvert d’un étiquetage médico-psychologique, les difficultés scolaires étant assimilées à de la déficience légère. Elles sont rendues possibles par un élargissement de la catégorie du handicap, par des critères d’orientation de plus en plus larges et par l’accroissement actuel des réponses médico-psychologiques face à l’échec scolaire. Il semblerait que les dispositifs ULIS continuent à assurer une fonction de régulation sociale, le recours à l’enseignement spécialisé restant socialement différencié. Dans le contexte actuel de médicalisation des difficultés scolaires, sont orientés en ULIS école des élèves qui mettent le système ordinaire en difficulté et pour lesquels, il ne semble avoir d’autre réponse que l’inscription dans le champ du handicapThe 11th of February 2005 law « for disabled persons rights and opportunities equality, participation and civic rights » brought about a deep educational system change and provoked a new sharing between the medico-social system and the Éducation Nationale with the positioning of a partnership. A main changing paradigm has occured with the inclusion concept emergence. Schooling today inclusive is trying to answer pupils’ special educational needs by adjusting school standards. Group inclusion systems are privileged levers to help disabled pupils at school following the Maison Départementale des Personnes Handicapées notifications.This thesis main goal, more than ten years after the law for the disabled persons, consists in examining the process at work when pupils are guided towards a primary school ULIS (Unité Localisée d’Inclusion Scolaire). A certain number of pupils have received educational counselling towards primary school ULIS without any proven disability. They have, mostly, originated from environments with social and family problems. These notifications labelling children as disabled have been done on a medico-psychological basis, the children’s schooling difficulties labelled as mild disability. Those have occured because of a widening of the disability category, wider and vaguer educational counselling criterions and today’s increasing medico-psychological solutions to school underperforming. ULIS systems would seem to carry on ensuring a social regulating function, the recourse to special needs education being socially differentiated. Today’s context of medicalizing school underperformance is leading to guide towards primary school ULIS pupils, putting the common system in a difficult position, and, for whom there seems to be no other solution than labelling them as disabled
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Neophytou, Koula, and res cand@acu edu au. "ADHD, a Social Construct? The Experience of families who have a child diagnosed with Attention Deficit Hyperactivity Disorder." Australian Catholic University. School of Arts and Sciences, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp52.29082005.
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The diagnosis of children with Attention Deficit Hyperactivity Disorder (ADHD) has increased over the last few years in Australia. ADHD is currently understood largely through a medical perspective, and in that context, the treatment recommended is stimulant medication. ADHD is a mental health label given to children who exhibit challenging behaviour. These children are diagnosed according to the categories stated in the Diagnostic Statistical Manual (DSM) – IV. To date, there is no medical test children can undertake to show that they ‘have’ ADHD. This research focuses on an alternative view of ADHD. Focussing upon families’ experience of ADHD, and the medicalisation of children’s behaviour, it argues that behaviour is socially influenced and constructed. It is because insufficient attention has been given to the family experience and the social implications of ADHD, that the child is often seen as ‘the problem’. The gap in our understanding of ADHD is situated in our understanding of the broader social context. To challenge this I will explore perceptions of the ‘good child’, ‘good mothers’ and the social consequences of inappropriate behaviour. Each family was interviewed five times every three months over a two-year period. Their stories and experiences are presented in this thesis.
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Jautrou, Henri. "Les tests génétiques vendus en libre accès sur l'Internet : une médicalisation sans médecin ?" Thesis, Toulouse 2, 2016. http://www.theses.fr/2016TOU20105/document.
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La thèse porte sur les Tests Génétiques vendus en Accès Libre (TGAL), notamment sur l’Internet, et qui sont dédiés à la santé ou à la physiologie, aux performances ou aux comportements. En pleine expansion depuis la fin des années 1990, ce marché va à l’encontre de certaines législations nationales et génère des controverses. Il se construit en l'absence de prescription médicale lors de la vente, et d'accompagnement par un professionnel de santé lors de l’accès aux résultats. Pour autant, les auto-tests relèvent-ils d’une médicalisation sans médecin ? Pour comprendre la dynamique socio-économique de ce marché sur une dizaine d'années, nous avons répertorié 130 sites web (contre une soixantaine dans la littérature académique existante) et identifié 155 entrepreneurs, pour ensuite étudier l’évolution de leurs caractéristiques. La localisation du marché évolue, les sites web européens étant au final aussi nombreux que leurs homologues nord-américains. Que ce soit en matière de conception comme de distribution des dispositifs techniques, les TGAL marquent une progression de l’autonomie des outsiders du champ médical, voire leur intrusion dans ce champ. La distribution médicale se développe en parallèle des ventes en accès libre, entre autres via le recrutement de médecins en interne aux entreprises (i.e. ventes via une hotline). En outre, certains outsiders sont relativement nouveaux puisqu’il faut noter la présence de fonds d’investissement spécialisés en science, et plus ou moins indépendants des traditionnels groupes industriels. Il faut par ailleurs constater la présence de firmes de l’informatique et de l'Internet qui, jusqu'à présent, ne s'étaient pas vraiment intéressées au champ de la santé. Au final, les TGAL amènent à parler également de biomédicalisation et d’auto-médicalisationThe thesis deals with Direct-To-Consumers Genetic Testing (DTCGTs) sold on the Internet, and more specifically with the ones for health, physiology, performance and behaviour. This market is booming since the end of the 90’s, and is sparking off controversies which are rooted in multiples scientific and medical uncertainties (“missing heritability”, informed consent, third parties, etc.). It doesn’t require for medical prescription, and health professional consultancy for test data and results is not systematically needed, which is not allowed by some national legislations. For all that, is it a medicalisation phenomenon without physician ?To understand the socio-economic dynamic of this market, we had listed 130 websites (for 60 in the academic literature) and identified 155 entrepreneurs, then we studied the evolution of theirs characteristics. The territorial localisation of the market changed, and european websites are finally as numerous as theirs north-american counterparts. Either in technical devices conception, or in commercialisation, DTCGTs are a sign of the autonomy progression of outsiders from the medical field, if not of their intrusion in this field. Medical dispensing systems are growing alongside of DTC selling, notably through the physician hiring by the DTCGT companies (i.e. hotline selling). Furthermore, some outsiders are relatively new, for they are related to investment funds which are specialized in science and more or less independent from industrial groups. Furthermore, one must notice the presence of informatics and Internet companies which, till now, didn’t really explore the health field. Finally, DTCGT relate also to biomedicalisation and automedicalisation
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Lavinas, Ingrid Piassá Malheiros. "A dinâmica da demanda por serviços de saúde no município de Piraí, RJ, do ponto de vista da medicalização." Universidade do Estado do Rio de Janeiro, 2012. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=4460.
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Apesar da definição da Estratégia de Saúde da Família (ESF) como porta de entrada preferencial do sistema de saúde e estratégia de reorganização da assistência, os usuários do
SUS, vêm demonstrando historicamente preferência pelo serviço de urgência/emergência hospitalar. Neste contexto, o campo do presente estudo é a cidade de Piraí e seus habitantes, que desde 2002 contam com 100% de cobertura da ESF, modelo que dá ênfase: à lógica territorial na assistência, no cuidado continuado e transversal, no vínculo e no acesso facilitado pelo acolhimento humanizado e escuta qualificada; ocupando o centro da rede de serviços atuando como ordenador e coordenador do cuidado. Avaliando os dados de produtividade (com foco nas consultas médicas) hospitalar e da ESF notamos que a busca por assistência médica hospitalar, tem aumentado exponencialmente, e pode-se perceber que a grande maioria destes usuários se apresenta ao serviço com demandas de atenção básica, o que é considerado ilógico e contraditório na visão de gestores e profissionais. A prática profissional tem me levado a um processo de reflexão sobre as expectativas dos usuários ao procurarem o sistema de saúde (principalmente a ESF), sobre os caminhos que cada um deles constrói diante de uma questão de saúde e como se dá a tomada de decisão em busca da resolutividade da questão. Dessa forma, o objetivo deste trabalho é compreender como se constrói essa demanda; que critérios estão envolvidos na tomada de decisão desses usuários ao optarem pelo serviço de emergência como porta de entrada preferencial; mesmo em um município que oferece um serviço estruturado, pautado nas diretrizes da ESF e com uma
cobertura que alcança toda a sua população. Acreditamos que o processo conhecido como medicalização da vida, que descreve o processo pelo qual problemas não médicos são
definidos e tratados como problemas médicos, usualmente em termos de doenças e desordens (CONRAD, 2007); influencie na construção dessa demanda. Quanto a metodologia, foram
realizadas entrevistas semiestruturadas, com usuários do SUS, residentes no município e que buscaram espontaneamente o serviço de urgência/emergência hospitalar. Verificou-se que a
imagem que o usuário faz dos serviços de saúde se relaciona principalmente com o tempo de espera pelo atendimento, o acesso (interpretado principalmente como a certeza/incerteza do
atendimento) e a acessibilidade. Os usuários frequentemente se referem à organização das unidades da ESF com o significado de barreiras ao acesso (principalmente pela necessidade de agendamento) e demonstram ter em relação às USF uma imagem de grande limitação de recursos humanos (quase exclusivamente em relação ao médico) e materiais. Por outro lado, prontos-socorros e hospitais se apresentam para eles, por várias razões, como espaços de acesso garantido. É importante ressaltar que o processo de medicalização da vida aparece como parte importante da engrenagem que move a construção dessa demanda.Although the definition of the Family Health Strategy (FHS) as the preferred gateway to the health system and strategy for the reorganization of assistance, users of SUS, demonstrate historically their preference for the hospital emergency service. In this context, the field of this study is the city of Piraí e its habitants, that since 2002 have 100% cover of FHS, model of health care that emphasis: the territorial logics of assistance, the continuing and transverse care, the bond (between user and health professionals) and the access facilitated by humanized host and qualified listening; being the center of the net services acting as the order and coordinator of health care. Evaluating the reports of productivity (focusing on doctors treatment) from the city hospital and the FHSunits we notice that the search for the hospital medical care has greatly increased in the past years, although the most part of this users have primary care demands, which is considered illogical and contradictory by managers and health professionals. The daily practice has led me to a reflexion process over the users expectations on their search for the health system (mostly the FHS), over the routes users bield before a health issue and how is the decision-making process in pursuit of resolvability of the issue. Thus, the purpose of this paper is to understand how this demand is built; which criterions are evolved in the decision-making process of this users when they choose the hospital service as preferred gateway; even in a city that offers a well structured health service, based on FHS guidelines and with a cover that achieve all habitants. We believe that the process known as medicalisation, that describes a process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness and disorders (CONRAD, 2007); influences the decision-making process of users. Concerning to the methodology, semi-structured interviews were conducted with SUSusers, residents in Piraí and that spontaneously searched the hospital emergency service. We verified that users image of health services is related mostly with the waiting time for care, the access (understood mainly as the certainty/uncertainty to receive the care) and the accessibility. Users frequently refers to the FHS organization with the access barriers (mostly for the need of schedule appointments) and shown to have, related to the FHS image, great limitation of human resources (almost exclusively in relation to physicians) and materials. On the other hand, emergency rooms and hospitals present themselves, for so many reasons, as spaces of guaranteed access. It is important to highlight that the process of medicalisation appears as an important part of the gear that moves the construction of this demand for health services.