Social, Political and Cultural Dimensions of Health

Dew, Kevin; Scott, Anne Firor; Kirkman, Allison

doi:10.1007/978-3-319-31508-9

Cited by 11 publications

(6 citation statements)

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“…Since its definition as a disease, several etiologies have been proposed for FM, including autoimmunity, infection, and psychosomatic manifestations, making the syndrome a conflicting and challenging condition for physicians to diagnose (18,19). Although the primary etiology of FM syndrome is still unknown, and predisposing factors are a topic of debate, the disease has been generally diagnosed, treated, and cared for by rheumatologists (20,21).…”

Section: Discussionmentioning

confidence: 99%

Fibromyalgia among patients presenting to a rheumatology clinic: prevalence and diagnosis

et al. 2023

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Introduction: Fibromyalgia (FM) syndrome is a chronic musculoskeletal disorder with extensive symptoms. Its most characteristic manifestation is the presence of persistent and diffuse chronic pain. The prevalence of this disease is 1% to 6% in different studies. Its exact nature and manifestations are not fully known; hence the empirical diagnosis of doctors and the proposed diagnostic criteria may differ in diagnosis. Objectives: This study aims to investigate the prevalence of FM symptoms among rheumatology patients, identify components of symptom and laboratory markers, and determine the interrater agreement between clinician judgment and diagnostic criteria. Patients and Methods: During one year, all patients referred to the rheumatology clinic were selected by simple sampling and underwent medical history collecting and physical examination by a single experienced rheumatologist, and the clinician’s judgment on the diagnosis of FM in the patients was recorded. Also, the American College of Rheumatology (ACR) standard questionnaire was used to evaluate the diagnosis of FM. Results: Between May 2018 and May 2019, 1762 patients were recruited, of whom 1428 (81%) were female, and 334 (19%) were male, with a mean age of 48.4±13.4 years. According to the rheumatologist and ACR criteria, 620 (35.1%) and 491 (27.8%) were diagnosed with FM respectively. Analysis indicated a lower agreement between the two in patients with underlying rheumatologic conditions of a mechanical origin. Younger age in patients with FM (P<0.001). A higher prevalence of FM was found among women (P<0.001). There was a significant correlation between concomitant rheumatologic conditions and FM occurrence (P=0.0004). Symptoms were clustered into 10 components with the component including fatigue explaining 22.18% of the variance in the results. Laboratory markers were clustered into 5 components. Conclusion: Fibromyalgia is a widespread disease among women that is frequently comorbid with other rheumatologic conditions. Agreement between ACR criteria and rheumatologist judgment is acceptable but can be improved by examining the symptoms in clusters rather than individually.

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Section: Discussionmentioning

confidence: 99%

Fibromyalgia among patients presenting to a rheumatology clinic: prevalence and diagnosis

et al. 2023

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“…Māori suffered a significant loss of land and economic base, autonomy, te reo and culture, as well as their way of life and wellbeing. Māori, like many Indigenous peoples, have suffered significant ill health as a result of colonisation, urbanisation and globalisation (20).…”

Section: Poor Māori or Pomare? Responses To Colonisationmentioning

confidence: 99%

A tangata whenua (people of the land) approach to conceptualising Māori health and wellbeing

2022

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From a Māori (Indigenous to New Zealand) perspective, health is not confined to the treatment of illness but also includes the philosophical concepts, structures and cultural practices which reinforce health and wellbeing. The ill-health of Māori is often the focus of health initiatives, particularly if there is an equity approach that centres on disparities between ethnic groups. However, an Indigenous approach prioritises health and wellbeing aspirations through strengthening self-determination, identity and connection with the environment. This article synthesises knowledge from Indigenous and Māori rights, mātauranga (Māori ways of knowing) expressed in pūrākau (epistemological narratives), tikanga (Māori principles), te reo (Māori language) and lived experience to reflect a shared understanding of Māori health and wellbeing. Consideration is given to the status of Māori pre-colonisation, the ongoing impacts of colonisation, and Māori led responses to contemporary health issues. It is proposed that health for Māori, like many Indigenous peoples, should be informed by an enhanced understanding of Indigenous rights, an Indigenous worldview and notions of wellbeing. We argue that a tangata whenua (people of the land) approach is integral to the effectiveness of health policies and initiatives aimed at improving Māori outcomes sustainably. We propose that the current reorganisation of Aotearoa New Zealand’s health system, as well as the COVID-19 pandemic response, provide opportunities to emphasise and embed Māori health leadership and knowledge, as well as a tangata whenua conceptualisation of health and wellbeing.

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“…Market forces have been shaped by, and have capitalized on this popular and professional health consciousness [5,18,19]. Corporations influence the trend of overuse of diagnostic tests through the identification and creation of a need and subsequent marketing of a new drug or technology to meet that need [20][21][22]. The abundant supply of biomedical technologies to evaluate and manage risk engages individuals with technological choices and options, which are publicized through the media.…”

Section: Corporations Media and The Construction Of Riskmentioning

confidence: 99%

Overuse of Diagnostic Tests in Canada: A Critical Perspective

et al. 2019

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In this commentary we describe the interplay between 1) contemporary popular and professional understandings of “risk” and “normality” in health and healthcare, and 2) the promotion by state and market forces of individual self-regulation of health. We draw upon the work of critical theorists who have described the relationship between risk, fear, and the notion of “normal” in health discourse to argue that these factors act, primarily via the popular media, to shape the discourse on, and overuse of, diagnostic tests in Canada.

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Social, Political and Cultural Dimensions of Health

Cited by 11 publications

References 0 publications

Fibromyalgia among patients presenting to a rheumatology clinic: prevalence and diagnosis

Fibromyalgia among patients presenting to a rheumatology clinic: prevalence and diagnosis

A tangata whenua (people of the land) approach to conceptualising Māori health and wellbeing

Overuse of Diagnostic Tests in Canada: A Critical Perspective

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