Values of academic integrity in higher medical education.

OBJECTIVE: Aim: The aim is to identify features of theoretical and empirical research of academic integrity as characteristics of the educational environment of medical higher education institution (hereinafter - HEI). PATIENTS AND METHODS: Materials and Methods: A complex of general scientific methods: logical-analytical, dialectical, theoretical-logical, comparative analysis, formalization and generalization, as well as quantitative sociological methods for collecting, processing and analyzing information. The object of the pilot empirical study were domestic medical students of full-time education at the Bogomolets NMU (N=472) and scientific and pedagogical staff who provide teaching of fundamental, specialized and socio-humanitarian disciplines at the university (N=153). RESULTS: Results: The values of academic integrity are the moral guideline that reveals the latest ethical demands of society and regulates the educational and scientific activities of all participants in the educational process. Opinions on the primary responsibility for compliance with the rules of academic integrity of a student differ between the surveyed scientific and pedagogical staff and students (p=0.000): the vast majority of the surveyed scientific and pedagogical staff tend to evenly divide the responsibility between a teacher and a student, and the majority of students-respondents noted that the student bears the primary responsibility. CONCLUSION: Conclusions: Commitment to the principles of integrity motivates both students and teaching staff to act in an academic manner. Therefore, the creation of a methodology for studying the phenomenon of academic integrity in medical higher education institution through the study of attitude of the subjects of educational process to basic values is promising.

The application of biosecurity practices for preventing avian influenza in North-Eastern Italy turkey farms: An analysis of the point of view and perception of farmers.

INTRODUCTION: Italian and international outbreaks of highly pathogenic avian influenza (HPAI), particularly in densely populated poultry areas (DPPAs), have increased over the past few decades. These emerging risks, which endanger both human and animal health and the entire poultry industry, can be effectively limited by biosecurity measures implemented at human-animal food chain interfaces. Some problems, however, persist in the application of these measures on the part of poultry farmers, prompting the need to explore those aspects and causes that limit their implementation. MATERIAL AND METHODS: A qualitative approach was selected for the study and a semi-structured interview technique was applied to collect data among turkey farmers (n = 29) working in the north-east of Italy. The aim of this technique was to gather data on farms in order to understand the biosecurity practices adopted and the reasons for and impediments to farmer implementation, or lack thereof. This article presents and discusses the main data collected. RESULTS: The study revealed that farmers were familiar with the biosecurity measures necessary to contain avian influenza (AI) and other poultry diseases; personal disinfection and animal isolation practices were particularly prominent. Based on the reported procedures, managerial, economic, and psychosocial factors were among the barriers behind the failure to implement biosecurity measures. These obstacles were variously intertwined and associated with the different action settings. In particular management factors, such as lack of time to apply the rules and difficulties contingent on the farm's structural characteristics, mediate the application of biosecurity measures. In terms of communication channels, the company, particularly its technicians, proved to be the primary source of information for farmers in case of emergencies, as well as the primary source of information on the application of biosecurity measures. However, other sources of information were indicated, such as word of mouth among farmers or other non-institutional figures (relatives and acquaintances). CONCLUSIONS: What emerged, was the need to improve not only the biosecurity management skills, but also to implement forms of cooperation among the various key stakeholders in the poultry sector. The information presented in this pilot study needs to be discussed among competent authorities, public and company veterinarians, company technicians, and farmers. Furthermore, this information will help in participatory co-planning of risk prevention and communication strategies to implement a long-term, sustainable, effective approach to address future epidemic emergencies.

["That you try to keep it amicable" - Situational Emergence of Closeness from the Perspective of Addressees in Residential Childcare Facilities]. / "Dass man versucht, das freundschaftlich zu halten" ­ Situatives Entstehen von Nähe aus der Sicht von Adressat/ innen in Einrichtungen der stationären Erziehungshilfe.

The antinomy of closeness and distance is inherent in all pedagogical fields and particularly characterises everyday life in residential childcare facilities. In order to shed light on how young recipients of inpatient educational support perceive closeness and distance in different situations with professionals, group discussions were conducted with young people from inpatient educational support facilities and analysed using the documentary method.The analysis shows that the young people perceive different situations as characterised by closeness insofar as the role-specific asymmetrical character of the relationship with the caregivers becomes blurred and the roles diffuse. Taking the perspective of the addressees into account is part of the development of an adequate relation between closeness and distance and thus a prerequisite for dealing adequately with dilemmatic pedagogical situations.

Development of a Training Strategy Aimed at Increasing Veterinarians' Awareness of the Proper Use of Antibiotics on Rabbit Farms.

The rabbit sector faces significant challenges with antimicrobial usage (AMU) and antimicrobial resistance (AMR). A focus group involving nine rabbit sector stakeholders identified key issues contributing to high AMU and the need for veterinarians' training. Participants emphasized the lack of clear legislation, biosecurity standards, and the importance of training on best practices to reduce AMU. To address these concerns, a blended learning course for rabbit veterinarians was organized, focusing on responsible drug use to lower AMU. The course design promoted participant interaction using group exercises and online discussions. The output was an operational tool, encompassing crucial elements to reduce drug dependence, covering housing, environmental conditions, feed, reproduction, disease prevention, diagnosis, and treatments. Validated in veterinarians' daily practices, the tool proved valuable. The tool, presented as a checklist, assists veterinarians in supporting field activities regarding proper drug use and AMR issues. It also helps farmers address knowledge gaps in breeding management and adopt biosecurity practices for disease prevention. Participants were encouraged to use the tool during farm visits and collaborate with farmers. The project presented in the manuscript is a crucial step towards the development of effective strategies for responsible AMU and AMR mitigation in the rabbit sector and beyond.

'Good farmers' and 'real vets': social identities, behaviour change and the future of bovine tuberculosis eradication.

This paper considers the role of social research and human behaviour in attempts to eradicate bTB. Future attempts to eradicate bTB are likely to involve an increasing range of sophisticated technologies. However, the acceptance and use of these technologies is likely to depend on a range of behavioural incentives. The use of appropriate behavioural nudges may facilitate bTB eradication, but the paper contends that of more value are socio-cultural approaches to understanding behaviour. Specifically, the concepts of the 'good farmer' and 'real vets' are discussed to show how bTB eradication is dependent on social identities. In conclusion, the paper outlines four key roles for social research in assisting with future bTB eradication policies.

Contributions of digital social research to develop Telemedicine in Calabria (Southern Italy): identification of inequalities in post-COVID-19.

The paper discusses the role that sociology and digital social research methods could play in developing E-health and Telemedicine, specifically after the COVID-19 pandemic, and the possibility of dealing with new pandemics. In this article, we will reflect on an interdisciplinary research pilot project carried out by a team of sociologists, medical doctors, and software engineers at The University of Calabria (Italy), to give a proof of concept of the importance to develop Telemedicine through the contribution of digital social research. We apply a web and app survey to administrate a structured questionnaire to a self-selected sample of the University Community. Digital social research has highlighted socioeconomic and cultural gaps that affect the perception of Telemedicine in the University Community. In particular, gender, age, educational, and professional levels influence medical choices and behaviors during Covid-19. There is often an unconscious involvement in Telemedicine (people use it but don't know it is Telemedicine), and an optimistic perception grows with age, education, professional, and income levels; equally important are the comprehension of digital texts and the effective use of Telemedicine. Limited penetration of technological advances must be addressed primarily by overcoming sociocultural and economic barriers and developing knowledge and understanding of digital environments. The key findings of this study could help direct public and educational policies to reduce existing gaps and promote Telemedicine in Calabria.

Exploring the use of WeChat for qualitative social research: The case of Italian digital diaspora in Shanghai.

The widespread use of digital communication technologies has created new opportunities for social research. In this paper, we explore the limits and potentials of using messaging and social media apps as tools for qualitative research. Building upon our research on Italian migration to Shanghai, we discuss in detail the methodological choice of using WeChat for teamwork, remote sampling strategies, and conducting interviews. The paper highlights the benefits that researchers may have from employing the same technology that the studied community uses in their daily life as a research tool, and advocates for a flexible approach to research that adapts its tools and methods to the specific requirements and characteristics of the fieldwork. In our case, this strategy allowed us to emphasize that WeChat represents a digital migratory space which played a crucial role in understanding and making of the Italian digital diaspora in China.

Attitudes to COVID-19 Vaccines Among Australians During the Delta Variant Wave: A Qualitative Interview Study.

Since the outbreak of COVID-19 globally, a range of vaccines has been developed and delivered to reduce viral transmission and prevent COVID cases. This article reports findings from a qualitative research project involving telephone interviews with a diverse group of 40 adult Australians about their experiences of the COVID crisis. Interviews were conducted in late 2021 when Australians were dealing with the Delta variant outbreak and following a major effort on the part of government authorities to improve COVID-19 vaccination supplies and take-up. Responses to a question about COVID vaccines revealed that attitudes to and acceptance of COVID vaccines among this group were overwhelmingly positive. All participants had received at least one vaccine dose and the majority expressed views in support of mass vaccination against COVID. People who were hesitant or cautious about accepting COVID vaccination referred to the vaccines' novelty and potential side effects. While many people were aware of debates about vaccine safety in the news media, trust in science and medical advice about COVID vaccines was strong. Participants wanted to protect themselves and others by accepting the recommended doses. Participants' locale was a major factor in shaping experiences and stances on vaccines. The setting of government targets and mandates for vaccination was a key motivating factor. The goal of 'getting back to normal' was expressed as another reason for accepting vaccination, particularly for those living in areas that had been badly affected by high COVID cases and prolonged lockdowns.

Attitudes to COVID-19 vaccines have changed over time, as different variants have emerged, and new vaccines have become available. Identification of the geographical, socioeconomic and political contextual aspects of why people may accept, reject or feel hesitant about COVID vaccines is important. This Australian-based study shows that government road maps and targets can play a key role in encouraging people to accept COVID vaccines. Trust in science and medical advice is an important factor in accepting COVID vaccines in the context in which they have been fast-tracked and side effects have been publicized. Socio-spatial dimensions play a major role in shaping experiences and attitudes towards COVID vaccines.

Sociology between big data and research frontiers, a challenge for educational policies and skills.

The paper focuses on the challenges posed within sociology and social research by the transformations created by the "data society". To this end, the paper outlines some of the most significant elements for new frontier research which sociology is forced to confront also in relation to the challenges for educational policies and skills. While leading literature decries the need to promote alphabetising data, otherwise defined as data literacy, the idea proposed here is that it is necessary to work towards understanding data. An understanding that highlights the role sociology has firmly set itself since its foundation, that of studying and explaining the complexity of the relationships that characterize social life in every context and period.

Privacidad de la información en la investigación social de naturaleza cualitativa: la transición hacia el mundo digital / Privacy of information in qualitative social research: the transition to the digital world / Privacidade da informação na pesquisa social qualitativa: a transição para o mundo digital

Resumen: Este texto aborda el problema de la privacidad de la información en la investigación social de tipo cualitativa que se desarrolla en el contexto del mundo digital. Para ello, se revisa el concepto de privacidad desde una mirada analógica hacia su incorporación en el plano digital con la figura de la privacidad de la información y algunos elementos de la hermenéutica de Gadamer. Primero, se revisa el plano analógico y ético de la privacidad. Luego, se revisa el potencial de la información, la distinción entre información privada y sensible y su aplicabilidad a la investigación social mediante los conceptos de confianza y seguridad. Finalmente se esboza una propuesta para una privacidad renovada que propone rescatar la intersubjetividad que se construye en la relación del participante de la investigación con el investigador.

Abstract: This text addresses the problem of information privacy in qualitative social research developed in the context of the digital world. For this purpose, the concept of privacy is reviewed from an analogical view towards its incorporation in the digital plane with the figure of information privacy and some elements of Gadamer's hermeneutics. First, the analogical and ethical plane of privacy is reviewed. Then, the potential of information, the distinction between private and sensitive information and its applicability to social research through the concepts of trust and security are reviewed. Finally, we outline a proposal for a renewed privacy that proposes to rescue the intersubjectivity that is built in the relationship between the research participant and the researcher.

Resumo: Este texto aborda o problema da privacidade da informação na investigação social qualitativa no contexto do mundo digital. Para o fazer, revê o conceito de privacidade de um ponto de vista analógico para a sua incorporação no plano digital com a figura da privacidade da informação e alguns elementos da hermenêutica de Gadamer. Primeiro, o plano analógico e ético da privacidade é revisto. Em seguida, o potencial da informação, a distinção entre informação privada e informação sensível e a sua aplicabilidade à investigação social através dos conceitos de confiança e segurança são revistos. Finalmente, esboça uma proposta para uma privacidade renovada que se propõe resgatar a intersubjetividade que é construída na relação entre o participante da pesquisa e o pesquisador.

The Critical Role of Consumers in the Prevention of Foodborne Diseases: An Ethnographic Study of Italian Families.

A high incidence of foodborne diseases occurs in the home setting because consumers adopt inappropriate preparation, consumption, and storage procedures. The present study applies an ethnographic approach to identify inadequate practices that could increase the incidence of foodborne diseases. Techniques related to the ethnographic approach were used: participant observation, kitchens mapping, collection of photographic material, and informal interviews in natural settings. A sample of 14 families was involved through the snowball sampling technique. This study identifies habitual practices and routine behaviour as the main risk factors. The inadequacies most frequently encountered related to the microbiological risks are incorrect handwashing, the presence in the kitchen spaces of objects unrelated to food preparation, the improper use of dishcloths and sponges, the inappropriate washing of utensils and food, the incorrect storage of food in the fridge, and the presence of children and pets without an adequate administration of the spaces. The practices that can expose consumers to chemical risk include food preservation through unsuitable containers/materials, food overcooking, and detergents contamination. The data underline the need to implement communicative and training interventions that give precise and targeted indications about correct safety practices in the home setting.

Inclusion of people living with Alzheimer's disease or related dementias who lack a study partner in social research: Ethical considerations from a qualitative evidence synthesis.

BACKGROUND: Because use of a study partner (proxy decision-maker) to give informed consent on behalf of someone living with Alzheimer's disease or related dementias (ADRD) is common in nearly all clinical research, people living with ADRD who lack a study partner are regularly excluded from participation. Social research presents different opportunities and risks than clinical research. We argue that guidelines developed for the latter may be unduly restrictive for social research and, further, that the automatic exclusion of people living with ADRD presents separate ethical challenges by failing to support extant decision-making capacity and by contributing to underrepresentation in research. PURPOSE: The study objective was to identify key components related to including cognitively vulnerable participants who lack a study partner in social research. RESEARCH DESIGN/STUDY SAMPLE: We conducted an adaptive qualitative evidence synthesis (QES) and subsequent content analysis on 49 articles addressing capacity and research consent for potentially cognitively compromised individuals, to include people living with ADRD, who lack a study partner. RESULTS: We identified four major topic areas: defining competency, capacity, and consent; aspects of informed consent; strategies to assess comprehension of risks associated with social research; and risks versus benefits. CONCLUSIONS: Based on findings, we suggest new and ethically appropriate ways to determine capacity to consent to social research, make consent processes accessible to a population experiencing cognitive challenges, and consider the risks of excluding a growing population from research that could benefit millions.

"Sharing Is Caring:" Australian Self-Trackers' Concepts and Practices of Personal Data Sharing and Privacy.

Self-tracking technologies and practices offer ways of generating vast reams of personal details, raising questions about how these data are revealed or exposed to others. In this article, I report on findings from an interview-based study of long-term Australian self-trackers who were collecting and reviewing personal information about their bodies and other aspects of their everyday lives. The discussion focuses on the participants' understandings and practices related to sharing their personal data and to data privacy. The contextual elements of self-tracked sharing and privacy concerns were evident in the participants' accounts and were strongly related to ideas about why and how these details should be accessed by others. Sharing personal information from self-tracking was largely viewed as an intimate social experience. The value of self-tracked data to contribute to close face-to-face relationships was recognized and related aspects of social privacy were identified. However, most participants did not consider the possibilities that their personal information could be distributed well-beyond these relationships by third parties for commercial purposes (or what has been termed "institutional privacy"). These findings contribute to a more-than-digital approach to personal data sharing and privacy practices that recognizes the interplay between digital and non-digital practices and contexts. They also highlight the relational and social dimensions of self-tracking and concepts of data privacy.

A user-centered approach to developing a new tool measuring the behavioural and social drivers of vaccination.

BACKGROUND: Children around the world remain under-vaccinated for many reasons. To develop effective vaccine delivery programmes and monitor intervention impact, vaccine programme implementers need to understand reasons for under-vaccination within their local context. The World Health Organization (WHO) Working Group on the Behavioural and Social Drivers of Vaccination (BeSD) is developing standardised tools for assessing childhood vaccine acceptance and uptake that can be used across regions and countries. The tools will include: (1) a validated survey; (2) qualitative interview guides; and (3) corresponding user guidance. We report a user-centred needs assessment of key end-users of the BeSD tools. METHODS: Twenty qualitative interviews (Apr-Aug 2019) with purposively sampled vaccine programme managers, partners and stakeholders from UNICEF and WHO country and regional offices. The interviews assessed current systems, practices and challenges in data utilisation and reflections on how the BeSD tools might be optimised. Framework analysis was used to code the interviews. RESULTS: Regarding current practices, participants described a variety of settings, data systems, and frequencies of vaccination attitude measurement. They reported that the majority of data used is quantitative, and there is appetite for increased use of qualitative data. Capacity for conducting studies on social/behavioural drivers of vaccination was high in some jurisdictions and needed in others. Issues include barriers to collecting such data and variability in sources. Reflecting on the tools, participants described the need to explore the attitudes and practices of healthcare workers in addition to parents and caregivers. Participants were supportive of the proposed mixed-methods structure of the tools and training in their usage, and highlighted the need for balance between tool standardisation and flexibility to adapt locally. CONCLUSIONS: A user-centred approach in developing the BeSD tools has given valuable direction to their design, bringing the use of behavioural and social data to the heart of programme planning.

A pesquisa crítica na trama de narrativas: desenredando histórias de assédio sexual nas redes sociais / Critical research in a plot of narratives: untangling stories of sexual harassment on social media

Os sites de redes sociais vêm impulsionando protestos antissexistas, nos quais mulheres narram suas experiências de violência sexual e também apoiam outras mulheres com histórias semelhantes. No protesto #PrimeiroAssédio, milhares de mulheres aceitaram o convite para contar suas primeiras histórias de assédio sexual. Este artigo reflete sobre os desafios da pesquisa social crítica e ética com vítimas de assédio sexual que narram suas experiências em plataformas digitais. Tal pesquisa implica desenlear uma trama que envolve as narrativas dominantes acerca dos corpos, papéis, direitos e deveres das mulheres; as contranarrativas das mulheres que contestam as narrativas dominantes; e as narrativas construídas pelas pesquisadoras sobre as histórias contadas. O artigo discute o que está em jogo ao se escolher como narrar, incluindo a narração acadêmico-científica que se debruça sobre essas histórias. Em conclusão, as autoras entendem sua escrita como um ato político voltado para a transformação social e contra a condição subalterna feminina. As pesquisadoras trabalham para fortalecer as vozes das mulheres que denunciam a violência sexual, operando em aliança com elas, enquanto também contestam as narrativas hegemônicas de base patriarcal.

This article reflects on the challenges of critical social research with victims of sexual harassment who narrate their experiences on digital platforms. It draws from a selection of stories told by women in the #FirstHarassment protest (2015) in which they recount, in a tone of denunciation, these first experiences. Inspired by critical discourse analysis and culturally oriented narrative analysis, in dialogue with feminist theorizing, the study distinguishes a plot that involves dominant narratives about women's bodies, roles, rights, and duties; women's counter-narratives that contest dominant narratives; and the narratives constructed by women researchers about the stories told. It discusses how the participants' testimonies undertake efforts to denaturalize sexual harassment and deconstruct the logic of female culpability for sexual violence suffered. The stories create alliances and convey new narratives for gender relations and women's rights advocacy. The article also discusses how the academic-scientific narration that addresses these stories constitutes an ethical-political positioning. The authors conclude that their writing is a political act aimed at social transformation and against the subaltern condition of women. The researchers work to strengthen the voices of women who report sexual violence, operating in alliance with them, while also contesting patriarchally-based hegemonic narratives.

Internal coherence matters: Lessons for nutrition and dietetics research.

AIM: Internal coherence in research refers to the alignment between ontology (nature of reality), epistemology (nature of knowledge), axiology (values), methodology and methods and is an important but often overlooked element of research quality. We therefore aimed to illustrate the concept of internal coherence in nutrition and dietetics research, and its importance beyond individual elements of study quality. METHOD: A targeted literature search in Nutrition and Dietetics was used to identify research illustrating one example of three main approaches to research (scientific, interpretive and critical inquiry) published between November 2017 and November 2020. Studies were included if they related to education research based on the expertise of the authors, and illustrated diverse points about internal coherence. The authors independently critiqued included studies for internal coherence and synthesised their findings. RESULTS: From 76 manuscripts, 14 were identified as describing education research. Of the three selected studies that were critiqued, all had elements of internal coherence, in particular alignment between epistemology and methodology. However, each had elements of misalignment too, specifically between epistemology, axiology and method. The results point to the profession's historical groundings privileging the scientific approach, showing how this can yield misalignments, particularly when describing the limitations of interpretive and critical inquiry approaches. CONCLUSION: This review demonstrates the importance of internal coherence as a marker of quality, over and above existing quality assessment checklists for qualitative and quantitative methodologies. As such, it can help authors, reviewers and editors to improve the quality of nutrition and dietetics research and its reporting.

Testosterone and cortisol are more predictive of choice behavior than a social nudge in adult males on a simple gift give-get task.

Reproducibility of social research is ambitious, and evidence supporting this argument is increasing in psychology and social science research. This may be attributed to, in part, the high volume of qualitative research methodology used in social research along with difficulties in the reliability of measurement techniques. Therefore, use of more and better objective measures to complement existing techniques in social research are necessitated. To highlight this point we explored the success of give-get nudge in adults. Nudge being a subtle intervention to influence choice, without restricting choice. We also wanted to explore whether testosterone and cortisol, as objective psychophysiological markers, could explain nudge outcome. Participants were asked what they would like to get for Christmas, or what they would like to give. They were then presented with two chocolates, one big and one small, and instructed to take as a "reward" for their participation with the knowledge there was one other participant to take chocolate after them. It was hypothesized that those asked to give something for Christmas would take the smaller reward and vice versa. Salivary testosterone and cortisol were measured prior to, and 10 min after completing the exercise. The nature of the nudge itself did not predict behavior, but the hormone measures did. We speculate that testosterone may focus an individual on the nature of the question (nudge), while cortisol encourages self-focus. These results support the need to combine existing social research techniques with more objective markers.

Young People's Use of Digital Health Technologies in the Global North: Narrative Review.

BACKGROUND: A diverse array of digital technologies are available to children and young people living in the Global North to monitor, manage, and promote their health and well-being. OBJECTIVE: This article provides a narrative literature review of the growing number of social research studies published over the past decade that investigate the types of digital technologies used by children and young people in the Global North, in addition to investigating which of these technologies they find most useful or not useful. Key findings as well as major gaps and directions for future research are identified and discussed. METHODS: A comprehensive search of relevant publications listed in Google Scholar was conducted, supported by following citation trails of these publications. The findings are listed under type of digital technology used for health: cross-media, internet, social media, apps and wearable devices, sexual health support and information, and mental health support and information. RESULTS: Many young people in the Global North are active users of digital health technologies. However, it is notable that they still rely on older technologies, such as websites and search engines, to find information. Apps and platforms that may not have been specifically developed for young people as digital health resources often better suit their needs. Young people appreciate the ready availability of information online, the opportunities to learn more about their bodies and health states, and the opportunities to learn how to improve their health and physical fitness. They enjoy being able to connect with peers, and they find emotional support and relief from distress by using social media platforms, YouTube, and online forums. Young people can find the vast reams of information available to them difficult to navigate. They often look to trusted adults to help them make sense of the information they find online and to provide alternative sources of information and support. Face-to-face interactions with these trusted providers remain important to young people. Risks and harms that young people report from digital health use include becoming overly obsessed with their bodies' shape and size when using self-tracking technologies and comparing their bodies with the social media influencers they follow. CONCLUSIONS: Further details on how young people are using social media platforms and YouTube as health support resources and for peer-to-peer sharing of information, including attention paid to the content of these resources and the role played by young social media influencers and microcelebrities, would contribute important insights to this body of literature. The role played by visual media, such as GIFs (Graphics Interchange Format) and memes, and social media platforms that have recently become very popular with young people (eg, Snapchat and TikTok) in health-related content creation and sharing requires more attention by social researchers seeking to better understand young people's use of digital devices and software for health and fitness.

The World Is Not Mine - Barriers to Healthcare Access for Bangladeshi Rural Elderly Women.

Social determinants of health is a core cross-cutting approach of the World Health Organization to reduce health inequalities, and places an emphasis on aged care planning in rural areas of low- and lower-middle income countries including Bangladesh. The complex correlated health and social factors in Bangladesh interplay to shape the healthcare access of rural people. This impact is significant for rural elderly women in particular who have been shown to access healthcare in ways that are described as 'socially determined'. This study aimed to explore how this cohort related their healthcare access to their living circumstances and provided insight into how their healthcare access needs can be addressed. This study was a critical social theoretical exploration from conversational interviews held over three months with 25 elderly women in rural Bangladesh. Two critical social constructs, 'emancipation' of Habermas and 'recognition' of Honneth, were used in the exploration and explanation of the influence of personal circumstances, society and system on rural elderly women's healthcare access. The concept of 'social determinants of healthcare access' is defined from the physical, emotive, symbolic and imaginative experiences of these women. Interviewing the women provided information for exploration of the determinants that characterized their experiences into an overall construct of 'The World is Not Mine'. This construct represented four themes focusing on the exclusion from healthcare, oppressive socioeconomic condition, marginalization in social relationships and personal characteristics that led the women to avoid or delay access to modern healthcare. This study confirms that the rural elderly women require adequate policy responses from the government, and also need multiple support systems to secure adequate access to healthcare. As healthcare services are often a reflection of community values and human rights concerns for the elderly, there is a need of recognition and respect of their voice by the family members, society and the healthcare system in planning and implementation of a prudent aged care policy for rural elderly women in Bangladesh.