Objective To elicit patientsÕ views on whether they could contribute to improvements in their care by carrying their own health information to clinician encounters; and to consider the implications for the development of a patient-held health file (PHF).Background Increasing rates of chronic disease lead to health care being delivered by multiple care providers often at distributed geographic locations. As a way of increasing the availability of patient information to care providers our project will trial a PHF. Patients carry these files to doctorsÕ appointments where clinicians record data for other doctors or the patient. Increasing the availability of patient information is anticipated to enhance the safety and quality of care delivery and improve health outcomes.
Abstract. This article applies a cultural political economy lens within a sustainable livelihood framework and examines how cultural norms and values as well as social protection amplify or attenuate livelihood shocks leading to care-home entry. We used framework analysis and higher-level interpretive analysis of data from interviews with 30 older care-home residents from three districts in Tamil Nadu, India, to understand the practices that allow the social welfare system to function alongside the beliefs and values legitimizing these practices. Results reveal a divergence between the value orientation of social-protection policy and cultural practices which constrains the choices available for care in later life and reinforces culturally constructed inequalities rather than protecting or remediating livelihood shocks and loss of assets.
This paper presents an analysis of contemporary neuropsychiatric meaning-making regarding dementia, encompassing distinct beliefs, practices and objects, and the peculiarities of its fragmented public manifestations. First, some core neuropsychiatric beliefs are discussed, arguing that the designation of those beliefs as exceptional truths engenders an imperialist ethic whereby the beliefs must be spread into other populations. Second, the enactment of this spread through dementia awareness is considered, whereby people are presented as having wrong beliefs to justify the promotion of alternative correct knowledge. Third, some emerging contradictions within neuropsychiatric dementia are outlined, as moves toward early diagnosis and “living well” sit uneasily beside notions of dementia as a frightening epidemic. The paper concludes that this produces dissonant dementia wherein contradictory meanings are held together. Finally, it is suggested that this dissonance will likely continue, underpinned by specific interests.
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