Applying Social Practice Theory to Explore Australian Preschool Children's Oral Health

INTRODUCTION

Despite substantial research and provision of dental care, significant morbidity remains for children's oral health. Guided by social practice theory (SPT), this research moves away from the often-ineffective focus on changing individual behavior to rethinking the centrality of the social world in promoting or undermining oral health outcomes. We define social practice as a routinized relational activity linking and integrating certain elements (competence, materials, and meanings) into the performance of a practice that is reproduced across time and space.

OBJECTIVE

To investigate oral health in preschool children in Perth, Western Australia, using social practice theory.

METHODS

With no definitive methodology for investigating SPT, we chose focused ethnography as a problem-focused, context-specific approach using mainly interviews to investigate participants' experience caring for their children's oral health. The focus of analysis was the practice of oral health care, not individual behavior, where themes identified from participants' transcripts were organized into categories of elements and performance.

RESULTS

Eleven parents, all of whom were married or partnered, were interviewed in 2021. Findings identified social practices relevant to oral health within parenting and family relations linked to routine daily activities, including shopping, consumption of food and beverages, and toothbrushing. Oral health literacy was reflected in integrating competence, materials, and meanings into performing oral health care, notably preferences for children to drink water over sugary beverages and information often being sourced from social media and mothers' groups rather than health providers.

CONCLUSION

Focusing on social practices as the unit of analysis offers a more layered understanding of elements in young children's oral health care that can indicate where the problem may lie. Findings provide an opportunity to consider future research and policy directions in children's oral health.

KNOWLEDGE TRANSFER STATEMENT

Examining social practices related to young children's oral health care identifies parents/carers' knowledge about, for example, toothbrushing, the resources required, and why toothbrushing is important. Analyzing these separate elements can reveal both enablers and barriers to oral health care. This provides researchers, clinicians and policymakers an opportunity to focus on not changing individual behavior but understanding how social context impacts parents/carers' capacity to make optimum decisions around young children's oral health.

Countering 'the moral science of biopolitics': Understanding hepatitis C treatment 'non-compliance' in the antiviral era

Although new hepatitis C treatments are a vast improvement on older, interferon-based regimens, there are those who have not taken up treatment, as well as those who have begun but not completed treatment. In this article, we analyse 50 interviews conducted for an Australian research project on treatment uptake. We draw on Berlant's (2007, Critical Inquiry, 33) work on 'slow death' to analyse so-called 'non-compliant' cases, that is, those who begin but do not complete treatment or who do not take antiviral treatment as directed. Approached from a biomedical perspective, such activity does not align with the neoliberal values of progress, self-improvement and rational accumulation that pervade health discourses. However, we argue that it is more illuminating to understand them as cases in which sovereignty and agency are neither simplistically individualised nor denied, and where 'modes of incoherence, distractedness, and habituation' are understood to co-exist alongside 'deliberate and deliberative activity […] in the reproduction of predictable life' (Berlant, 2007, p. 754). The analysed accounts highlight multiple direct and indirect forces of attrition and powerfully demonstrate the socially produced character of agency, a capacity that takes shape through the constraining and exhausting dynamics of life in conditions of significant disadvantage.

Conversation Analysis and genre theory

Since its genesis in the 1960s, Conversation Analysis (CA) has noticeably developed further in terms of its subjects and methods. Its analyses, today, not only focus on conversations in the original sense, but also on visual elements such as gazes in interactions and the role of bodies. However, it also analyzes especially larger communicative units, e.g., in institutionalized settings and it addresses larger sequences of action. One of these approaches is the theory and analysis of communicative genres. Communicative genres are to be understood as consolidated forms of communication. The theory of communicative genres understands these forms as solutions to communicative problems. Genre analysis is methodologically grounded in CA; however, it exceeds it conceptually and theoretically, thus anchoring its questions clearly within sociology. The paper starts out by outlining the concepts and theory of communicative genres. The article discusses the empirical contribution of genre analysis using the example of three so-called "families of genres" families. The examples discussed are reconstructive genres (speaking about the past), genres of moral communication (speaking about other people's behavior), and projective genres (speaking about the future). Using examples from empirical research, it is shown which communicative problems these genres solve. The paper finally considers the insights to be gained from genre analysis for sociology and CA.

Health policy counterpublics: Enacting collective resistances to US molecular HIV surveillance and cluster detection and response programs

Health policies and the problems they constitute are deeply shaped by multiple publics. In this article we conceptualize health policy counterpublics: temporally bounded socio-political forms that aim to cultivate particular modes of conduct, generally to resist trajectories set by arms of the state. These counterpublics often emerge from existing social movements and involve varied forms of activism and advocacy. We examine a health policy counterpublic that has arisen in response to new forms of HIV public health surveillance by drawing on public documents and interview data from 2021 with 26 stakeholders who were critical of key policy developments. Since 2018, the national rollout of molecular HIV surveillance (MHS) and cluster detection and response (CDR) programs in the United States has produced sustained controversies among HIV stakeholders, including among organized networks of people living with HIV. This article focuses on how a health policy counterpublic formed around MHS/CDR and how constituents problematized the policy agenda set in motion by federal health agencies, including in relation to data ethics, the meaningful involvement of affected communities, informed consent, the digitization of health systems, and HIV criminalization. Although familiar problems in HIV policymaking, concerns about these issues have been reconfigured in response to the new sociotechnical milieu proffered by MHS/CDR, generating new critical positions aiming to remake public health. Critical attention to the scenes within which health policy controversies play out ought to consider how (counter)publics are made, how problems are constituted, and the broader social movement dynamics and activist resources drawn upon to contest and reimagine policymaking in public life.

The idea of society: the Spoken World Theory and the ontological conceptualization of society

This article presents a new conceptualization of society with the ambition to sharpen thinking about social reality and to better understand how society relates to personhood. This exercise is framed in an attempt to develop the Spoken World Theory, inspired by the thinking of Rom Harré. It involves a radical rethink of the social ontology and is to be seen as an alternative to the traditional conceptualization of society as a social structure that is opposed to individual agency. The proposed alternative is based upon the disentanglement of four aspects of society along the Vygotskian public/private and individual/collective axes. As such, society can be said to manifest itself in four realms: (i) the world as we hear it: a worldwide and history-long ongoing web of conversations; (ii) the world as we see it: a set of materialized social artifacts, including a set of institutional facts; (iii) the world as we imagine it: individual umwelts or worldviews for each person based on appropriated knowledge and moral frameworks; and (iv) the world as we shape it: persons have the power to formulate intentions that they can bring to the conversational space or the space of artifacts. A major consequence of this conceptualization is that it no longer puts society outside human beings, nor that personality is only to be located inside persons. The proposed ontological framework allows us to speak in much clearer terms about how persons and society are entangled with each other in the sense that without the personhood of people, there can be no society, and that without society, people cannot have personhood. Both personhood and society are to be seen as two intertwined mechanisms that allow the individuals of the human species to complement the genetic basis of survival with a system of cultural resources that can be used for coping with everyday life. The article ends with a discussion of the practical implications of social theorizing.

Theories of disorder and order, energy and information, in sociological thought

There has always been a close relation between thermodynamic theory and sociological theory, although they repeatedly part company and later rejoin. I discuss some of the most important ways in which the two have been in contact, focusing on the potential passage from theories of energy to theories of information and vice versa. I close by discussing how a closer engagement with classic thermodynamics may continue to be fruitful for sociological theorizing. This article is part of the theme issue 'Thermodynamics 2.0: Bridging the natural and social sciences (Part 2)'.

Critical physiotherapy: a ten-year retrospective

Critical physiotherapy has been a rapidly expanding field over the last decade and could now justifiably be called a professional sub-discipline. In this paper we define three different but somewhat interconnected critical positions that have emerged over the last decade that share a critique of physiotherapy's historical approach to health and illness, while also diverging in the possibilities for new forms of practice and thinking. These three positions broadly align with three distinctive philosophies: approaches that emphasize lived experience, social theory, and a range of philosophies increasingly referred to as the "posts". In this paper we discuss the origins of these approaches, exploring the ways they critique contemporary physiotherapy thinking and practice. We offer an overview of the key principles of each approach and, for each in turn, suggest readings from key authors. We conclude each section by discussing the limits of these various approaches, but also indicate ways in which they might inform future thinking and practice. We end the paper by arguing that the various approaches that now fall under the rubric of critical physiotherapy represent some of the most exciting and opportune ways we might (re)think the future for the physiotherapy profession and the physical therapies more generally.

Dwelling in epistemic disobedience: A reply to Go

In Thinking Against Empire: Anticolonial Thought as Social Theory, Julian Go continues his vital work on rethinking and redirecting the discipline of sociology. Go's piece relates to his wider oeuvre of postcolonial sociology - found in works such as his Postcolonial Thought and Social Theory (2016) as well as multiple journal articles on epistemic exclusion (Go 2020), Southern theory (Go 2016), metrocentrism (Go 2014), and the history of sociology (Go 2009). In this response article, my aim is to think alongside some of the central themes outlined in Go's paper rather than offering a rebuttal of any sorts. In particular, I want to think through how the recent work on 'decoloniality' may play more of a central role in Go's vision of sociology and social theory than he acknowledges. In doing so, I hope to engage in Go's prodigious scholarship through centering discussions of the geopolitics of knowledge, double translation, and border thinking. Before proceeding to this discussion, I will offer a brief review of my reading of Go's paper.

Towards a historical sociology of associations and dissociations between food, food events and alcoholic drinks: A reply to Warde et al

This commentary reflects on the strengths of the paper by Warde et al. entitled "Situated drinking: the association between eating and alcohol consumption in Great Britain". It suggests that practice-theoretical approaches towards studying contemporary connections between foods, food events and alcoholic drinks provides an excellent basis for overcoming the analytical limits of fields such as food studies, drinks studies, alcohol studies and related areas. This is especially so if Warde et al.'s quantitative methodology were to be yoked to two further sources of inspiration, namely Mary Douglas's structuralist analysis of food combinations within food events and Stephen Mennell's utilisation of the concepts and concerns of Norbert Elias to produce a systematic historical sociology of food. An extended inter-paradigmatic approach to the study of how alcoholic drinks relate to foods and eating practices emerges as a result.

The (postcolonial) return of grand theory in American sociology: Julian Go on postcolonial thought and social theory

Julian Go's BJS annual lecture is discussed in reference to his landmark OUP text Postcolonial Thought and Social Theory (2016). Go is one of the most prominent names in a "third wave" of post-colonial thought, now spearheading a post- (or de-) colonial turn in sociological theory, something that has professionally revived the sub-field of "grand" social theory in mainstream US sociology. While endorsing the aims and substantive themes of this turn, the review raises questions about the delayed timing of this post-colonial wave in the discipline, both relative to the humanities more generally, and to the impact of post-colonialism in other national contexts. Go's challenge is, in effect, something quite particular to teaching social theory in the US sociology context. The review goes on to question how effectively the critique speaks to mainstream empirical practitioners, given its lack of focus on transforming technical methods. It concludes by raising concerns about the relationship of Go and other "third wave" decolonial theorists to Marxism and Marxist politics.

Thinking against empire: Anticolonial thought as social theory

Sociology was born in the late 19th and early 20th centuries as a project in, of, and for empire. This essay excavates a tradition of social thought that grew alongside metropolitan sociology but has been marginalized by it: anticolonial thought. Emerging from anticolonial movements, writers and thinkers, anticolonial thought in 19th and 20th centuries emerged from a variety of thinkers (from indigenous activists in the Americas to educated elites in the American, Francophone and British colonies). I argue that this body of thought offers distinct visions of society, social relations, and social structure, along with generative analytic approaches to the social self, social solidarity and global relations-among other themes. Anticolonial thought offers the basis for an alternative canon and corpus of sociological thinking to which we might turn as we seek to revitalize and decolonize sociology.

Anticolonial thought, the sociological imagination, and social science: A reply to critics

This essay responds to commentaries (this issue) on Go's "Thinking Against Empire: Anticolonial Thought as Social Theory" (this issue). The essay addressed shared concerns and underlying themes of the commentaries, most of which pivot around the problem of the anticolonial and the status of disciplinary sociology as a knowledge project. Is there a need for sociology to incorporate anticolonial thought? How does anticolonial thought as social theory differ from other epistemic projects? Is the distinction between sociology's imperial episteme and anticolonial thought fruitful or obfuscating? And what are the possibilities and limits of a social science informed by anticolonial thought? Ultimately, the essay maintains that anticolonial thought offers a powerful sociological imagination that can be fruitfully tethered to a project of realist social science. It also maintains that realist social science can be emancipatory; provided that it is reoriented by anticolonial thought.

Personal recovery and socio-structural disadvantage: A critical conceptual review

Despite its seeming breadth and diversity, the bulk of the personal (mental health) recovery literature has remained strangely 'silent' about the impact of various socio-structural inequalities on the recovery process. Such an inadequacy of the empirical literature is not without consequences since the systematic omission or downplaying, at best, of the socio-structural conditions of living for persons with lived experience of mental health difficulties may inadvertently reinforce a reductionist view of recovery as an atomised, individualised phenomenon. Motivated by those limitations in extant scholarship, a critical literature review was conducted to identify and critique relevant research to problematise the notion of personal recovery in the context of socio-structural disadvantage such as poverty, homelessness, discrimination and inequalities. The review illuminates the scarcity of empirical research and the paucity of sociologically-informed theorisation regarding how recovery is shaped by the socio-structural conditions of living. Those inadequacies are especially pertinent to homelessness research, whereby empirical investigations of personal recovery have remained few and undertheorised. The gaps in the research and theorising about the relational, contextual and socio-structural embeddedness of recovery are distilled. The critical review concludes that personal recovery has remained underresearched, underproblematised and undertheorised, especially in the context of homelessness and other forms of socio-structural disadvantage. Understanding how exclusionary social arrangements affect individuals' recovery, and the coping strategies that they deploy to negotiate those, is likely to inform anti-oppressive interventions that could eventually remove the structural constraints to human emancipation and flourishing.

Paradoxes, contradictions, and dilemmas: Reflections on the contours of a pandemic and its implications for social work education

Summary

This is a reflective and theoretical article that discusses the impact of COVID-19 on social work practice. The pandemic, which made its presence felt globally from early 2020, continues to have ongoing and significant consequences for lives, livelihoods, public health, and personal freedoms. We argue that, while its specific contours are yet to be comprehensively researched, let alone the final outcomes understood, the pandemic has presented opportunities to develop new ways of thinking about social work and social work education.

Findings

Through a discussion of relevant literature, including a recent work of fiction, we contend that social workers have been able to adapt, to some extent, to the pandemic but in reactive rather than proactive ways. The biopsychosocial and person-in-environment perspectives that characterize social work education, theory, and practice might be greatly enhanced by the introduction of complexity theory in terms of developing new thinking about the theoretical basis of social work, enabling new questions and new strategies to emerge to strengthen social work responses to the challenges posed by COVID-19.

Applications

Arising from this theoretical article, there are many implications for introducing complexity theory within social work education programs. Complexity theory can provide a conceptual frame fit-for-purpose for social work pandemic and post-pandemic theory and practice.

Communication with mechanically ventilated patients in intensive care units: A concept analysis

AIMS

The aim of this study was to perform a concept analysis of communication with mechanically ventilated patients in intensive care units and present a preliminary model for communication practice with these patients.

DESIGN

The Im & Meleis approach for concept analysis guided the study.

SEARCH METHODS

A literature search was performed in January 2022 in MEDLINE, Embase, CINAHL, psycINFO and Scopus, limited to 1998-2022. The main medical subject headings search terms used were artificial respiration, communication and critical care. The search resulted in 10,698 unique references.

REVIEW METHODS

After a blinded review by two authors, 108 references were included. Core concepts and terminology related to communication with mechanically ventilated patients were defined by content analytic methods. The concepts were then grouped into main categories after proposing relationships between them. As a final step, a preliminary model for communication with mechanically ventilated patients was developed.

RESULTS

We identified 39 different phrases to describe the mechanically ventilated patient. A total of 60 relevant concepts describing the communication with mechanically ventilated patients in intensive care were identified. The concepts were categorized into five main categories in a conceptual map. The preliminary model encompasses the unique communication practice when interacting with mechanically ventilated patients in intensive care units.

CONCLUSION

Highlighting different perspectives of the communication between mechanically ventilated patients and providers through concept analysis has contributed to a deeper understanding of the phenomena and the complexity of communication when the patients have limited possibilities to express themselves.

IMPACT

A clear definition of concepts is needed in the further development of guidelines and recommendations for patient care in intensive care, as well as in future research. The preliminary model will be tested further.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution, as this is a concept analysis of previous research.

Making morbidity multiple: History, legacies, and possibilities for global health

Multimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest that the significance of multimorbidity lies not only in challenging divisions between disease categories but also in what it reveals about the culture and history of transnational biomedicine. Drawing on social research from sub-Saharan Africa to ground our arguments, we begin by describing the historical processes through which morbidity was made divisible in biomedicine and how the single disease became integral not only to disease control but to the extension of biopolitical power. Multimorbidity, we observe, is hoped to challenge single disease approaches but is assembled from the same problematic, historically-loaded categories that it exposes as breaking down. Next, we highlight the consequences of such classificatory legacies in everyday lives and suggest why frameworks and interventions to integrate care have tended to have limited traction in practice. Finally, we argue that efforts to align priorities and disciplines around a standardised biomedical definition of multimorbidity risks retracing the same steps. We call for transdisciplinary work across the field of global health around a more holistic, reflexive understanding of multimorbidity that foregrounds the culture and history of translocated biomedicine, the intractability of single disease thinking, and its often-adverse consequences in local worlds. We outline key domains within the architecture of global health where transformation is needed, including care delivery, medical training, the organisation of knowledge and expertise, global governance, and financing.

Situating stigma: Accounting for deviancy, difference and categorial relations

This article returns to Goffman's early formulations of 'stigma' in outlining a critique of contemporary social scientific uses and abuses of the concept. We argue that whilst Goffman's discussion of stigma is not without its troubles, it has mostly been approached in a manner that treats the concept outside of an appreciation of stigma as a phenomenon of interaction order. More specifically, we discuss and demonstrate how stigma serves an analytic gloss for social relations observable in social settings and in accounts of difference, deviance and degradation. We analyse both social scientific and lay uses of the stigma concept in relation to care-experienced young children and self-harm to demonstrate the shared categorisational practices and logics that are often obscured through theoretical treatments of stigma. The recommendation is, then, that an attention to 'stigma' in care settings must begin with the conditions in and from which stigma might come to feature as a sense-making device for all parties.

Thinking with and Against the Social Determinants of Health: The Latin American Social Medicine (Collective Health) Critique from Jaime Breilh

The concept of the social determinants of health has become increasingly accepted and mainstream in anglophone public health over the past three decades. Moreover, it has been widely adopted into diverse geographic, sociocultural, and linguistic contexts. By recognizing the role of social conditions in influencing health inequalities, the concept challenges narrow behavioral and reductive biological understandings of health. Despite this, scholars and activists have critiqued the concept of the social determinants of health for being incomplete and even misrepresenting the true nature of health inequities. Arguably, these critiques have been most thoroughly developed among those working in the Latin American social medicine and collective health traditions who formulated the "social determination of health" paradigm and the concept of interculturality decades prior to the advent of the social determinants of health. We draw on Jaime Breilh's main works, with a focus on the recently published book, Critical Epidemiology and the People's Health, to (1) provide a broad overview of the social determination of health paradigm and its approach to interculturality and (2) clarify how these ideas and the broader collective health movement challenge assumptions within the social determinants of health concept.

Critical health literacy: reflection and action for health

Health literacy research is growing rapidly and broadly; however, conceptual advances in critical health literacy (CHL) seem hampered by a lack of a clear definition. In this paper, we refer to key features of the concept as identified in earlier works, offer a new definition of CHL and briefly discuss its theoretical roots. Reflection and action are suggested as the two constituent components of CHL. Consequences for future research are also discussed.

Using COMPASS (Context Optimisation Model for Person-Centred Analysis and Systematic Solutions) Theory to Augment Implementation of Digital Health Solutions

Digital health research is an emerging discipline that requires easy-to-understand theoretical frameworks and implementation models for digital health providers in health and social care settings. The COVID-19 pandemic has heightened the demand for digital health discipline-specific instruction on how to manage evidence-based digital health transformation. Access to the use of these models guarantees that digital health providers can investigate phenomena using safe and suitable approaches and methods to conduct research and identify answers to challenges and problems that arise in health and social care settings. The COMPASS theory is designed to aid transformation of health and social care environments. A navigational rose of primary quadrants is divided by four main compass points, with person-centred care being central to the philosophy. Two axes produce Cartesian planes that intersect to form a box plot, which can be used to discover human and physical resource weightings to augment digital health research design and implementation. A third continuum highlights stakeholders’ capabilities, which are critical for any multidisciplinary study. The COMPASS mnemonic guides end users through the process of design, development, implementation, evaluation, and communication of digital health transformations. The theory’s foundations are presented and explained in context of the ‘new normal’ of health and social care delivery.

Critique of everyday narco-capitalism

Capitalism is not only an economic mode of production; it is also a form of life. This also applies to a historical type of capitalism, which is the capitalism founded on (illicit) drugs - in other words: narco-capitalism. The article discusses how capitalism alters life at the nexus of drug production, trade and consumption through a study of drug heartlands in Colombia, Afghanistan and Myanmar. What forms of life emerge under narco-capitalism? And how do people seek change and express agency in the exploitative conditions governed by narco-capital? To do so, the article proceeds through the following sections: first, it elucidates its definition of the 'everyday' as a conceptual and methodological scheme to understand capitalist forms of life. Then it uses material collected from people's everyday encounter with narco-capitalism in Afghanistan, Myanmar and Colombia to discuss mystification, predation and alienation. The article explores how capitalism produces forms of life that make use of drugs and narco-capital to dispossess and alienate collectivities. Finally, the article argues that to move beyond this alienating condition, drug wars and/or development are not a solution, because drugs are not the problem. Instead, it is people's organisation and world-building in dialectical mode to capitalist forms of life that can transform everyday life beyond predation and alienation.

A qualitative study applying Bourdieu's concept of field to uncover social mechanisms underlying major curriculum reform

PURPOSE

Planning committees play a key role in blueprinting major curriculum reform. In this qualitative study, we apply Bourdieu's sociological concept of field to the perceptions of committee members to identify the social mechanisms operating in major curriculum reform.

METHOD

A planning committee with 18 members developed a blueprint for major curriculum reform at the Charité Berlin in its transition from a discipline-based programme to a fully integrated undergraduate medical programme. Interviews with 13 members about their experiences were subjected to inductive-deductive content analysis.

RESULTS

Viewed through a Bourdieuan lens, the curriculum committee represents a social field of intense competition and conflicts. Groups of committee members struggled for and with different forms of economic, cultural and social capital to maintain and increase their power and social position in the medical programme. In our case, the major reform was accompanied by loss of power within the teaching department group, while the student group gained power.

CONCLUSION

Bourdieu's concept of field reveals that a major curriculum reform is substantially shaped by power struggles over various forms of capital and social positions related to the future curriculum. The findings may serve as a complementary guide for those navigating the complexity of major curriculum reform.

Breaking out of the citadel: social theory and psychiatry

British psychiatry has tended to hold itself aloof from social theory. Nonetheless, these ideas have influenced the development of mental health services. Alongside this, the biopsychosocial model cannot reconcile contradictions in the scientific evidence regarding mental illness. We need to develop a more constructive understanding of the implications of social theory.

Family and school-based educational intervention on fruits and vegetable consumption of female students: Application of social cognitive theory

BACKGROUND

Fruits and vegetable (F.V) consumption is the most pivotal strategy of preventing cardiovascular diseases, obesity, diabetes, and cancers. The present study aims to evaluate the effect of educational intervention based on social cognitive theory (SCT) on consumption of F.Vs among female high schools' students in Rafsanjan (South of Iran).

SUBJECTS AND METHODS

This quasi-experimental study was carried out among 272 students (intervention = 134 and control group = 138) using a multistage sampling method. The instrument used in this study included demographic characteristics, the students' F.V consumption during the past 7 days and its determinants based on the theory. Educational interventions were made in three sessions for students and two sessions for parents, teachers, and school officials. The data were analyzed by SPSS version 18 using the statistical tests of Chi-square, independent samples t-test, paired-samples t-test, and univariate model at a significant level of 0.05.

RESULTS

Three months after the educational program, mean scores and standard deviation of F.V consumption and constructs in the intervention group increased significantly (P < 0.001). Respectively, 22.2% and 36.1% of the changes in the average unit of F.V consumption were the result of the present educational intervention.

CONCLUSION

The intervention based on SCT with an emphasis on the interaction between student, family, and school has had an effect on F.V consumption behavior. Therefore, in forming behavior, attention is paid to the interaction of individual and interpersonal factors.

The COVID-19 pandemic: Analysing nursing risk, care and careerscapes

This qualitative study explores how junior nurses, and some who were still in training, navigated the complexities and uncertainties engendered by the COVID-19 pandemic. Data are drawn from in-depth interviews with 18 students/nurses in Christchurch, New Zealand. Managing intertwining risk, care and careerscapes takes an intensified form as existing infection control rules, established norms of care, boundaries between home and work and expected career trajectories roil. 'Safe' and 'risky' spaces are porous but maintained using contextual, critical, clinical judgement. Carescapes are stretched, both within and beyond the walls of healthcare settings. Within the COVID-19 riskscape, careerscapes are open to both threat and opportunity. Countries demand much of their healthcare staff in times of heath crises, but have a limited appreciation of what it takes to translate seemingly tightly bounded protocols into effective practice. The labour required in this work of translation is navigated moment by moment. To surface some of this invisible work, those implementing pandemic plans may need to more carefully consider how to incorporate attention to the work/home/public boundary as well as overtly acknowledging the invisible emotional, physical and intellectual labour carried out in crisis risk, care and careerscapes.

Exploring the professionalization of respiratory therapy in Canada

Introduction

A recurrent challenge facing respiratory therapists (RTs) is their legitimacy as professionals. RTs are often referred to as technologists, vocationalists, or technicians and must often justify their status as full professionals rather than "professional technicians". There is currently little exploration of what it means to be a profession and the process of professionalization in respiratory therapy.

Approach

Drawing from sociological theory, the purpose of this paper is to discuss the professionalization of respiratory therapy in Canada using Andrew Abbott's theory, the "system of professions". We will use this theory as a lens to propose areas of consideration for professional development regarding two pervasive themes in the respiratory therapy community, RTs' specialized body of knowledge and professional autonomy.

Findings

Abstract knowledge is believed to be essential in the evolution from occupation to profession and is valuable to a profession in three ways: it can influence the profession's legitimacy, it can be used for conducting research, and it promotes higher education. RTs possess jurisdictional professional autonomy within Canada. The privilege of self-regulation allows RTs to act according to their knowledge and judgement without direct oversight from other professions.

Conclusion

Based on Abbott's theoretical position, RTs can rightly justify their position as professionals. However, RTs need to acknowledge that professionalization is a dynamic and continuous process that requires creative changes to innovate within the profession and support future efforts to reinforce their position as professionals. Throughout this paper, we offer suggestions for how RTs can contribute to the ongoing professionalization of respiratory therapy.

Stigmatization in nursing: Theoretical pathways and implications

Stigmatization of patients exists in nursing and results in less than optimal nursing care and poor patient outcomes. It is also a violation of our code of ethics. In order to eliminate stigmatization from nursing practice, it is necessary to understand how it develops. Two possible theoretical pathways are proposed to explain the development of stigmatization in nursing. These pathways are informed by a conceptual understanding of stigma and theories of professional socialization, professional formation, symbolic interactionism, and social cognitive theory. Re-labeling and role-taking and moral disengagement are proposed as two possible processes that may lead to stigmatization of patients. Both proposed pathways have implications on professional socialization, formation, and the development of professional identity. Devoting attention to and reframing normative behavioral expectations, eliminating labeling, developing empathy, focusing on relationships, and cultivating ethical comportment and moral maturity during nursing formation may reduce the stigmatization of patients by nurses.

Obese societies: Reconceptualising the challenge for public health

The prevalence of obesity and related health problems has increased sharply in recent decades. Dominant medical, economic, psychological, and especially epidemiological accounts conceptualise these trends as outcomes of individuals' lifestyles - whether freely chosen or determined by an array of obesogenic factors. As such, they rest on forms of methodological individualism, causal narratives, and a logic of substitution in which people are encouraged to set currently unhealthy ways of life aside. This article takes a different approach, viewing trends in obesity as consequences of the dynamic organisation of social practices across space and time. By combining theories of practice with emerging accounts of epigenetics, we explain how changing constellations of practices leave their marks on the body. We extend the concept of biohabitus to show how differences in health, well-being, and body shape are passed on as relations between practices are reproduced and transformed over time. In the final section, we take stock of the practical implications of these ideas and conclude by making the case for extended forms of enquiry and policy intervention that put the organisation of practices front and centre.

Algorithmic Accountability in Context. Socio-Technical Perspectives on Structural Causal Models

The increasing use of automated decision making (ADM) and machine learning sparked an ongoing discussion about algorithmic accountability. Within computer science, a new form of producing accountability has been discussed recently: causality as an expression of algorithmic accountability, formalized using structural causal models (SCMs). However, causality itself is a concept that needs further exploration. Therefore, in this contribution we confront ideas of SCMs with insights from social theory, more explicitly pragmatism, and argue that formal expressions of causality must always be seen in the context of the social system in which they are applied. This results in the formulation of further research questions and directions.

Exploring disconnected discourses about Patient and Public Involvement and Volunteer Involvement in English health and social care

BACKGROUND

Patient and public involvement (PPI) in health and social care policy, service decision-making and research are presented as good practice in England. Yet the explicit rationale for PPI and how it is positioned within the literature, policy and practice remain confused, in particular, in relation to Volunteer Involvement (VI). In health and social care, PPI and VI are managed and valued as conceptually distinct, yet the discourses in their policy and practice documents treat them as closely related in fundamental ways.

OBJECTIVE

Compare and critically evaluate discourses framing PPI and VI within English health and social care.

DESIGN

A critical discourse approach was used to explore the accounts of PPI and VI in policy. These accounts were then compared and contrasted with personal accounts of volunteering in health and social care settings.

RESULTS

Twenty documents from key national health and social care bodies were discursively examined in terms of their framing PPI and VI. A narrative disconnect between the two was repeatedly confirmed. This finding contrasted with an analysis of personal accounts of VI which displayed VI as a form of PPI.

CONCLUSION

There is a disconnect between language, narratives and practice in PPI and in VI which may have direct consequences for policy and practice. Recognising and managing it can offer innovative ways of enabling volunteers to be involved across health and social care settings, ensuring the experiential value added by volunteers' service contributions, to be recognised so that their democratic participation may be seen to shape services.

COVID-19 shifts mortality salience, activities, and values in the United States: Big data analysis of online adaptation

What is the effect of a life-threatening pandemic at the societal level? An expanded Theory of Social Change, Cultural Evolution, and Human Development predicts that, during a period of increasing survival threat and decreasing prosperity, humans will shift toward the psychology and behavior typical of the small-scale, collectivistic, and rural subsistence ecologies in which we evolved. In particular, subjective mortality salience, engagement in subsistence activities, and collectivism will all increase, while the aspiration to be wealthy will decrease. Because coronavirus has forced unprecedented proportions of human activity online, we tested hypotheses derived from the theory by analyzing big data samples for 70 days before and 70 days after the coronavirus pandemic stimulated President Trump to declare a national emergency. Google searches were used for an exploratory study; the exploratory study was followed by three independent replications on Twitter, internet forums, and blogs. Across all four internet platforms, terms related to subjective mortality salience, engagement in subsistence activities, and collectivism showed massive increases. These findings, coupled with prior research testing this theory, indicate that humans may have an evolutionarily conditioned response to the level of death and availability of material resources in society. More specifically, humans may shift their behavior and psychology toward that found in subsistence ecologies under conditions of high mortality and low prosperity or, conversely, toward behavior and psychology found in modern commercial ecologies under conditions of low mortality and high prosperity.

Dealing with dysnomia: Strategies for the cultivation of used concepts in social research

This article follows recent calls to turn social theory away from its fixations on intellectual history and toward the mechanics and craft of creating social theories in the research process. The subject of this article is a dilemma common to theorizing in social science: dysnomia, or the phenomenon in which some object is poorly named. Specifically, this article focuses on how social scientists distinguish original concepts from their equivalents in everyday speech. Three tactics for dealing with dysnomia are named-academic arcana, classification and sociologism-and considered in order to ascertain the strengths and weaknesses of each.

Unintended consequences in traffic-light food labeling: A call for mixed methods in public health research

Nudge theory describes how indirect suggestions and positive reinforcement can influence decision-making. We used nudge theory to implement a traffic-light labeling and choice architecture (modifying product placement) intervention at Harvard University cafeterias, but found no significant change in sales. Survey and focus group data showed that some students thought the labeling may exacerbate eating disorders, however, there is extremely limited research on potential negative consequences of labeling. One way to describe these findings is through 20th century philosopher Michel Foucault's concept of biopower. Biopower manipulates cultural norms and nudges individuals to engage in self-surveillance and self-discipline, de facto subjugating themselves to certain ways of being. Biopower may lead to the creation of an in-group and an out-group based on who can adopt the new behaviors, such as healthy eating. Those in the out-group may face additional unintended consequences, highlighting the need for mixed-methods research to better evaluate public health interventions.

On the legacy of normalization

In 1998 Howard Parker, Judith Aldridge & Fiona Measham published Illegal Leisure, a ground-breaking study of profound changes in British youth cultures in the 1990s, and the place of drugs and drug use in these upheavals. This work introduced the 'normalization thesis' to the social sciences, offering a novel vocabulary for re-imagining the normative character of young people's attitudes towards and experiences of illicit drug use. Arriving at the dawn of the new century, the book offered a thoroughgoing re-thinking of the character of youth cultures at a time of great social, cultural, economic and technological disruption. In so doing, the book deftly anticipated many of the most interesting currents of critical drug studies that followed.

Impact of a work-based feedback intervention on student performance during clinical placements in acute-care healthcare settings: a quasi-experimental protocol for the REMARK programme

INTRODUCTION

Current perspectives present feedback as a dynamic, dialogic process. It is widely accepted that feedback can have an impact on workplace performance, however, how dialogic feedback is enacted with the learner in authentic healthcare settings is less apparent. This paper seeks to describe the design and development of an implementation study to promote the learner voice in the feedback process and improve feedback encounters between learners and learning partners in healthcare settings.

METHODS AND ANALYSIS

A quasi-experimental study design will be used to evaluate whether implementation of a work-based intervention to improve feedback impacts student performance during clinical placements in healthcare settings. Student performance will be measured at three time points: baseline (pre), mid-placement (post-test 1) and end-placement (post-test 2) in keeping with standard assessment processes of the participating university. The intervention is underpinned by Normalisation Process Theory and involves a layered design that targets learners and learning partners using best-practice education strategies. Data regarding participants' engagement with feedback during clinical placements and participants' level of adoption of the intervention will be collected at the completion of the clinical placement period.

ETHICS AND DISSEMINATION

This study has ethics approval from both Griffith University and Metro South Health Human Research and Ethics committees. Dissemination of results will be local, national and international through forums, seminars, conferences and publications.

The dialectics of universality: The heterodox critical social theory of Robert Fine

Robert Fine was among the most original social theorists in Britain of the past 30 years, and the aim of this paper is to offer a first systematic assessment of his intellectual contribution. There are sound intellectual reasons to explore Fine's scholarship. He maintained a problematic relation with mainstream sociology and, against the reduction of sociology to questions of method, culture, or class, he argued that sociologists must continue to ask difficult normative questions as part of the social world they ought to explain. And there are also pressing political concerns that justify a reconsideration of his writings. Global politics is currently marked by a populist wave that decries the very ideas and values that were central to Fine's social theory: the need to uphold the rule of law at home and abroad, the politics of cosmopolitan solidarity, and the significance of antisemitism and its relationships with different forms of authoritarian politics. My main argument is that there is a dialectics of universality that drives forward Fine's intellectual project. By this, I mean that a universalistic idea of humanity-an all-inclusive conception of all human beings-is the most important normative intuition of modern times. This idea of humanity moves forward in history through a dual process of emancipation and domination: successful forms of social, legal, and political inclusion help make visible previous dynamics of exclusion but may also create or recreate discriminatory practices. Building on the work of French historian Michael Löwy on heterodox Jewish thinkers, I explain the three main tenets of Fine's work: (a) his reconstruction of critical social theory; (b) the notion of cosmopolitan solidarity; and (c) the significance and main features of modern antisemitism.

Finding "What's Wrong With Us": Antibiotic Prescribing Practice Among Physicians in the United States

Antibiotic stewardship-or the responsible use of antibiotics-has been touted as a solution to the problem of antibiotic resistance. Antibiotic stewardship in medical institutions attempts to change the antibiotic prescribing "behaviors" and "habits" of physicians. Interventions abound targeting "problem prescribers," or those physicians whose practice is out of line with physician peers. Thus, the locus of decision-making in antibiotic prescribing is thought to be the found with the individual physician. Based on 18 months of participant observation and in-depth interviewing of antibiotic-prescribing physicians at two medical institutions in the United States, this paper will question notions of antibiotic stewardship that center on individual "behaviors" and "habits." Many physicians have taken to heart a reductionist approach in studies of antibiotic prescribing, including several physicians I encountered during research who enthusiastically located the benefit of my research in the ability to identify "what's wrong with us." In this paper, I use two representative ethnographic case studies to argue that antibiotic stewardship interventions aimed at identifying and correcting "bad" physician practice limit the possibilities of understanding the social dynamics of the institution. Through an analysis of everyday encounters in the hospital setting, I show how decision-making in antibiotic prescribing can more productively be located between and among institutions, physicians, patient charts, and other hospital-based staff members (e.g., pharmacists, nurses). By demonstrating that antibiotic prescribing is a collective practice occurring through engagement with social and material surroundings, I argue that we can better account for the weighted ways in which social action and relations unfold over time.

Religion in the Age of Social Distancing: How COVID-19 Presents New Directions for Research

In this brief note written during a global pandemic, we consider some of the important ways this historical moment is altering the religious landscape, aiming our investigative lens at how religious institutions, congregations, and individuals are affected by the social changes produced by COVID-19. This unprecedented time prompts scholars of religion to reflect on how to strategically approach the study of religion in the time of "social distancing," as well as moving forward. Particularly important considerations include developing heuristic, innovative approaches for revealing ongoing changes to religion, as well as how religion continues to structure social life across a wide range of contexts, from the most intimate and personal to the most public and global. Although our note can only be indicative rather than exhaustive, we do suggest that the initial groundwork for reconsiderations might productively focus on several key analytical themes, including: Epidemiology, Ideology, Religious Practice, Religious Organizations and Institutions, as well as Epistemology and Methodology. In offering these considerations as a starting point, we remain aware (and hopeful) that inventive and unanticipated approaches will also emerge.

Predictors of Patients' Loyalty Toward Doctors on Web-Based Health Communities: Cross-Sectional Study

Background

Web-based health communities provide means for patients to not only seek care but also to promote their relationship with doctors. However, little is known about the predictors of patients’ loyalty toward doctors in Web-based health communities.

Objective

This study aimed to investigate the predictors of patients’ loyalty toward doctors in Web-based health communities.

Methods

On the basis of sociotechnical systems theory and attachment theory, we propose that social factors including emotional interaction, perceived expertise, and social norm influence patients’ loyalty through their emotional attachment, whereas technical factors including sociability, personalization, and perceived security affect patients’ loyalty through functional dependence. To validate our proposed research model, we used the survey method and collected 373 valid answers. Partial least square was used to analyze the data.

Results

Our empirical analysis results showed that all the social factors including emotional interaction (beta=.257, t₃₅₀=2.571; P=.01), perceived expertise (beta=.288, t₃₅₀=3.412; P=.001), and social norm (beta=.210, t₃₅₀=2.017; P=.04) affect patients’ emotional attachment toward doctors significantly, whereas except sociability (beta=.110, t₃₅₀=1.152; P=.25), technical factors such as personalization (beta=.242, t₃₅₀=2.228; P=.03) and perceived security (beta=.328, t₃₅₀=3.438; P=.001) impact functional dependence significantly. Considering the effect of working mechanisms, both emotional attachment (beta=.443, t₃₅₀=4.518; P<.001) and functional dependence (beta=.303, t₃₅₀=2.672; P=.008) influence patients’ loyalty toward doctors in Web-based health communities significantly.

Conclusions

Patients’ loyalty toward doctors in Web-based health communities is important for the effectiveness of doctors’ advice or service in Web-based health communities. The research results not only fill the gaps in the literature of the patient-doctor relationship and Web-based health communities but also has many implications for establishing patients’ loyalty on Web-based health communities and in physical context.

Social Cognitive Theories and Electronic Health Design: Scoping Review

Background

There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change.

Objective

This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications.

Methods

The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed.

Results

Expressive interaction tools were found in 48.6% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8%). The vast majority of studies (100%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9%).

Conclusions

This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution.

Towards ending the US HIV epidemic by 2030: Understanding social determinants of health and HIV in Mississippi

The disproportionate burden of HIV-related inequities borne by African Americans in the US South amplifies the role of social determinants of health (SDH) in shaping social patterning of illness. Despite some attention, SDH remain overlooked in a biomedically oriented, federal HIV policy. Mississippi is the poorest state with the worst HIV outcomes, nationally. Using qualitative methods, we investigated how primarily African American, HIV-positive Mississippians experienced SDH and health inequities in their daily lives. Employing grounded theory and in-depth interviews (n = 25) in an urban and rural site in 2015 yielded these findings: (1) absence of an enabling structural environment; (a) HIV-stigma constructed via social discourse; (b) lack of psycho-social support and HIV education; (c) insufficient economic and social support resources; and (2) presence of family support for coping. Due to stigma, being HIV-positive seemed to lead to further status loss; diminished social position; reduced life chances; and contractions in particular freedoms. Stigma further compounded existing inequalities - contributing to the moral, social experience of those living with HIV. Trump's plan to end HIV by 2030 creates the opportunity to rethink the biomedical-paradigm and fully engage SDH - using social science theory and methods that address multi-level social determinants in ways that are also policy-responsive.

Predictors of Patients' Intention to Interact With Doctors in Web-Based Health Communities in China: Cross-Sectional Study

BACKGROUND

Web-based health communities provide opportunities for doctors and patients to interact with each other and change the traditional communication mode between doctors and patients. However, little is known about the predictors of patients' intention to interact with doctors in Web-based health communities in China.

OBJECTIVE

The purpose of this study was to investigate what are the predictors of patients' intention to interact with doctors in Web-based health communities in China.

METHODS

On the basis of two-factor theory and service convenience theory, we propose that the attributes of Web-based health communities including ease of use and perceived synchronicity influence patients' intention to interact through convenience of Web-based health communities, whereas the attributes of physical health facilities such as inaccessibility and discontinuity affect patients' intention to interact through inconvenience of physical health facilities. We employed the survey method to validate our hypothesized relationships. Through developing the measurement instruments, we collected 334 valid answers from Web health community users and utilized partial least square to analyze the data.

RESULTS

Ease of use (t₃₁₁=2.924, P=.004) and perceived synchronicity (t₃₁₁=2.353, P=.019) were found to influence convenience of Web-based health communities significantly, whereas inaccessibility (t₃₁₁=3.189, P=.002) and discontinuity (t₃₁₁=3.149, P=.002) were found to impact inconvenience of physical health facilities significantly. Meanwhile, both convenience of Web-based health communities (t₃₁₁=2.353, P=.019) and inconvenience of physical health facilities (t₃₁₁=2.787, P=.006) were found to affect patients' intention to interact with doctors in Web-based health communities significantly. Therefore, all the proposed hypotheses were supported.

CONCLUSIONS

Through including factors from both Web-based health communities and physical health facilities, we can understand patients' intention to interact comprehensively. This study not only contributes to literature of doctor-patient interaction and Web-based health platforms but also provides implications to promote doctor-patient interaction online and offline.

Theory-Based Predictors of Mindfulness Meditation Mobile App Usage: A Survey and Cohort Study

Background

Mindfulness meditation has become increasingly popular over the last few years, due in part to the increase in mobile apps incorporating the practice. Although studies have demonstrated the potential of mindfulness meditation to positively impact health, little has been uncovered about what predicts engagement in mindfulness meditation. Understanding the predictors of mindfulness meditation may help practitioners and phone app developers improve intervention strategies and app experience.

Objective

The purpose of this study was to use the Theory of Planned Behavior and Temporal Self-Regulation Theory to determine factors predicting mindfulness meditation mobile app use.

Methods

The sample consisted of 85 undergraduate students with no prior mindfulness meditation experience. During their first laboratory visit, participants completed tasks to measure their executive functioning and a survey to measure Theory of Planned Behavior constructs about mindfulness meditation. Over the following 2 weeks, participants logged the days and minutes that they practiced mindfulness meditation using a phone app. Hierarchical regression modeling was used to analyze the data.

Results

After controlling for demographic factors, participant subjective norms (beta=14.51, P=.001) and intentions (beta=36.12, P=.001) were predictive of the number of minutes practicing mindfulness. Participant executive functioning did not predict mindfulness meditation practice, nor did it moderate the link between intentions and mindfulness meditation practice. Participant attitudes (beta=0.44, P<.001) and perceived control (beta=0.42, P=.002) were positively associated with intentions to practice mindfulness.

Conclusions

These results suggest that among college student populations, the Theory of Planned Behavior may be useful in predicting the use of mindfulness meditation phone apps. However, participant executive functioning was not a predictor or moderator of mindfulness practice, and Temporal Self-Regulation Theory may be less useful for explaining mindfulness meditation behaviors using phone apps over a short period of time among college students. The results have implications for public health professionals, suggesting that a focus on subjective norms and intentions may promote mindfulness meditation practice using phone apps.

[From words to action: measuring health inequalities to "leave no one behind"Da retórica à ação: mensurar as desigualdades em saúde para não deixar ninguém atrás]

Health equity is a guiding principle for public health action. Its noble purpose is to build healthier, sustainable societies that are also more just and inclusive. This is reflected in the global commitment to "leave no one behind", expressed in the 2030 Agenda for Sustainable Development, although none of the Agenda's 169 targets focuses on reducing health inequalities, either conceptually or quantitatively. Recognizing the urgency to go beyond words and move forward decidedly in the design and implementation of pro-equity social and health policies at both the local and global levels, this special report reviews the conceptual and methodological framework for tackling health equity. Concepts and methodology are explicitly linked in a practical proposal that promotes the analytical use of subnationally disaggregated administrative data to inform decision-making in that area. This report concludes by proposing the need to institutionalize the measurement, analysis, and monitoring of social disparities in health to create effective national capacity to act on the social and environmental determinants of health and ensure accountability in the commitment to "leave no one behind" on the road to sustainable development, universal health, and social justice.

The Crush the Crave Quit Smoking App and Young Adult Smokers: Qualitative Case Study of Affordances

Background

Mobile phone apps have emerged as a promising way to reach young adult smokers, given their high mobile phone ownership rates and openness to receiving cessation support via digital technologies. Although emerging evidence indicates that quit smoking apps are an effective way to reduce smoking among young adults, lacking is formative evaluative research that captures the perspectives of end-users.

Objective

The objective of this study was to contribute insights toward understanding how young adults interact with the Crush the Crave (CTC) app, and how this interaction shapes young adults’ smoking cessation experiences and practices, with consideration of the influence of gender.

Methods

Semistructured interviews were conducted with 31 young adult CTC end-users. Guided by sociomateriality theory and an affordances approach, data were inductively analyzed to derive thematic findings in relation to the impacts of CTC on quit efforts, and to expose the underlying affordances (mechanisms) that lend to these outcomes. Findings were grouped according to the 4 design components of CTC: credibility, social support, task support, and dialogue support.

Results

The credibility component of CTC played an important role in harnessing the trust of young adults because it afforded them promise in relation to its potential effectiveness in assisting them with quitting smoking. The social support component lent to various end-user practices and experiences that rendered this aspect as the weakest component in supporting quit efforts. Although most functions situated in the task and dialogue support components were found to be helpful, there were a few affordances in CTC that resulted in negative experiences, notably weaning from smoking. Gender-related influences were also evident. For example, young men preferred to control and self-manage their quitting and, therefore, did not engage with functions that afforded journaling or reminding to stay on track. Women, in contrast, were more likely to benefit from these affordances.

Conclusions

An affordances approach is productive for gaining an in-depth understanding of how mobile apps interact with end-users to lend to particular outcomes. The study findings have implications for developing and improving apps for helping young adults quit smoking, as well as apps that target other health behaviors. Productive affordances may also serve as a framework for leveraging apps for smoking cessation.

Back to Hegel? On Gillian Rose's critique of sociological reason

Thirty-five years ago, Gillian Rose articulated a significant critique of classical sociological reason, emphasizing its relationship to its philosophical forebears. In a series of works, but most significantly in her Hegel contra Sociology, Rose worked to specify the implications of sociology's failure, both in its critical Marxist and its 'scientific' forms, to move beyond Kant and to fully come to terms with the thought of Hegel. In this article, I unpack and explain the substance of her criticisms, developing the necessary Hegelian philosophical background on which she founded them. I argue that Rose's attempted recuperation of 'speculative reason' for social theory remains little understood, despite its continued relevance to contemporary debates concerning the nature and scope of sociological reason. As an illustration, I employ Rose to critique Chernilo's recent call for a more philosophically sophisticated sociology. From the vantage point of Rose, this particular account of a 'philosophical sociology' remains abstract and rooted in the neo-Kantian contradictions that continue to characterize sociology.

'You're there because you are unprofessional': patient and public involvement as liminal knowledge spaces

Patient and public involvement in health research and care has been repeatedly theorised using the metaphor of spaces, knowledge spaces and participatory citizenship spaces. Drawing on data from a three year qualitative study of people involved in health research with organisations across England, this article explores where these spaces fit in a wider social, political and historical landscape. It outlines a theme recurring frequently in the study data: a unified public/patient/service-user perspective in opposition to a professional/clinical/academic view. This is discussed in relation to Habermas's division between the lifeworld and system. Patient and public involvement is mapped as spaces between these spheres, therefore between the social norms pertaining to them. In this way, involvement spaces are seen as liminal, in-between or threshold spaces; this concept provides us with new insights on both the opportunities and the conflicts that are integral in the ambiguous, complex interactions which take place in these spaces.