Ps Cook

Constructions and experiences of authenticity in medical tourism: the performances of places, spaces, practices, objects and bodies.

Using the concepts of constructivist authenticity and existential authenticity, I will analyse how claims to, and experiences and understandings of authenticity, are central to medical tourism. This is achieved by examining the interplay of places, spaces, objects, practices and bodies that create this cultural phenomenon. This includes a concern with how medical tourism is constructed around and performed through the perceptions of bodies, and the experiences of being a body. It is these complexities and their interdependencies that provide medical tourism its dynamism. This theorizing of medical tourism goes beyond existing studies that primarily seek to define it or restrict it to typologies, by analysing the practices and experiences that actually constitute this significant social phenomenon.

The conditions of exposure and immediacy: Internet surveillance and Generation Y

Surveillance through information and communication technologies is an integral part of modernity. However, there has been little research into how surveillance is experienced, with much research focusing on the structural aspects of surveillance. We conducted focus groups with Generation Y internet users to investigate their experiences of internet surveillance. They demonstrate an awareness of and ambivalence about surveillance online, negotiating their digital visibility and exposure against the risks and benefits of using the internet. However, their overwhelming interest and concern is that their online access to desired content is immediate and unfettered. We argue that immediacy has come to dominate how Generation Y understand and negotiate their internet experience, and describe how immediacy outweighs any concerns participants have. This study highlights the need to further explore the experience of surveillance, and the importance of immediacy in understanding sociotechnical systems and experiences.

‘To actually be sociological’: Autoethnography as an assessment and learning tool

As a qualitative and experiential research method, autoethnography enables students to explore the relationship between their personal, lived experiences with wider social structures and forces, thus actively developing and engaging their sociological imagination. However, while various studies advocate the use of autoethnography as a learning and assessment tool, no study explores the acquisition of knowledge and learning from the student’s perspective. This is the first study that explores student reactions to and experiences of autoethnography as an assessment and learning tool in sociology. Through the feedback of 15 undergraduate students on qualitative open-ended surveys, this article shows that autoethnography actively engaged the students and enhanced their sociological learning by stimulating their critical thinking on the relationship between their lived experiences and the social. While there are some ethical issues that need to be considered when assigning an autoethnography as an assessment item, the potential benefits for students, as identified by them, far outweigh the possible negatives.

The textures of globalization: biopolitics and the closure of xenotourism

In this paper, we explore the tensions around a recent controversial development in medical tourism: xenotourism in Mexico. We take this bioendeavor – now ceased – to be emblematic of the global character of contemporary biomedicine, providing insights into the production and operation of scientific knowledge. We explore this through what we call the “textures of globalization”: the anxiety regarding the extent to which Mexico was understood as an (in)appropriate venue for the generation of novel knowledge on xenotransplantation, and as a location for xenotourism. These tensions, which oscillated between calls for individual freedom (choice) and global regulation (standardization), ultimately led to the closure of xenotourism in Mexico.

Engineering the fitness of older patients for chemotherapy: an exploration of Comprehensive Geriatric Assessment in practice.

Clinicians often report that currently available methods to assess older patients, including standard clinical consultations, do not elicit the information necessary to make an appropriate cancer treatment recommendation for older cancer patients. An increasingly popular way of assessing the potential of older patients to cope with chemotherapy is a Comprehensive Geriatric Assessment. What constitutes Comprehensive Geriatric Assessment, however, is open to interpretation and varies from one setting to another. Furthermore, Comprehensive Geriatric Assessment’s usefulness as a predictor of fitness for chemotherapy and as a determinant of actual treatment is not well understood. In this article, we analyse how Comprehensive Geriatric Assessment was developed for use in a large cancer service in an Australian capital city. Drawing upon Actor–Network Theory, our findings reveal how, during its development, Comprehensive Geriatric Assessment was made both a tool and a science. Furthermore, we briefly explore the tensions that we experienced as scholars who analyse medico-scientific practices and as practitioner–designers charged with improving the very tools we critique. Our study contributes towards geriatric oncology by scrutinising the medicalisation of ageing, unravelling the practices of standardisation and illuminating the multiplicity of ‘fitness for chemotherapy’.

Cancer treatment decision-making with/ for older adults with dementia: the intersections of autonomy, capital, and power

ABSTRACT In healthcare, health risk assessments are influenced by technical ‘objective’ measurements of the physical body and disease; the values that underlie professional practices (such as beneficence, non-maleficence, and autonomy); the organisations healthcare professionals work for; and subjective belief systems of individual healthcare professionals. As a result, cancer treatments prescribed for older adults can be tempered by personal views about a patient’s age, and other age-associated health conditions or comorbidities that they may have. Drawing from interviews undertaken with nine key staff members in a large cancer service, we examine how treatment recommendations and decisions are determined when older adults with cancer also have dementia; two health conditions more common in older age. Our analysis reveals two themes that underlie the complicated processes of risk-benefit assessment in treatment decision-making: the unequal distribution of capital and power between health workers; and whether older adults with cancer and dementia are assessed as solely individuals or embedded in supportive social networks (individual versus relational autonomy). This analysis exposes capital and personal beliefs about dementia are implicit in health risk assessments for older adults who have cancer and dementia which, in conjunction with organisational constraints, significantly influence how treatment recommendations and decisions are reached.

“It's a risk that requires evaluation and rational appraisal”: emotion and infectious risk in xenotransplantation

Xenotransplantation (XTP) is a potential solution to a variety of human health problems. While immunological disparities between source animals and humans remain significant hurdles to successful XTP, serious concerns have been raised with regard to cross-species viral transfer (zoonosis). This article explores how six male Australian scientists and clinicians working, or with collaborative roles, in the field of XTP construct infectious risk. These negotiations reveal that they primarily focus on known, measured risks, namely that of porcine endogenous retroviruses. This is used to prove zoonotic safety, which marginalizes broader zoonotic concerns. Such assessments heavily rely upon technical, cultural and emotional evaluations to provide an impression of certainty when faced with the potential problematic and uncertain outcomes. The combination of the technical and emotional, or what I call techniemotion, exposes the emotion that is invested in science and integral to science, and operates as part of XTP science.

Continuity, change and possibility in older age: identity and ageing-asdiscovery

Traditionally, sociology has framed older age as a time of disengagement, withdrawal and reduced social integration. While now largely dismissed in contemporary sociological understandings of ageing, narratives of decline still feature heavily across social, media, and medical discourses. This negativity towards ageing could be at odds with how older people experience their age and identity. In this article, I will explore how 16 older people construct their self-identity. Drawing on participant-generated imagery and interview data, this article exposes that they experience older age as a time of continuity, discovery, possibility and change, where identity is multiple and fluid, and emerges through the links they make between the past, present and future. Thus, while ageing is not without its difficulties, the research participants challenge the social myths that reductively and negatively frame older age by constructing an identity that builds on their past through an active exploration of new possibilities and experiences.

Book Review: Kate O’Loughlin, Collette Browning and Hal Kendig (eds), Ageing in Australia: Challenges and OpportunitiesAgeing in Australia: Challenges and OpportunitiesO’LoughlinKateBrowningColletteKendigHal (eds) New York: Springer, 2017.

Ageing in Australia: Challenges and Opportunities Kate O’Loughlin,Collette Browning & Hal Kendig (eds) New York: Springer, 2017.

Confronting ageism: The potential of intergenerational contemporary art events to increase understandings of older adults and ageing

To explore the impact of an innovative intergenerational art event showcasing retirement village life on attendees’ understandings of older adults and ageing.