The Social Construction of Aging Among a Clinic-Based Population and Their Healthcare Workers in Zambia.

Objectives: We sought to understand the social construction of aging in a clinic-based population, with and without HIV, to address gaps in care for older individuals living with HIV in Zambia. Methods: Our exploratory qualitative study included 36 in-depth interviews with clinic clients and four focus group discussions with 36 professional and lay healthcare workers providing services to the clients. We identified themes based on social construction theory. Results: At the individual level, aging was multidimensional, perceived both as an achievement in the HIV era and as a period of cognitive, physical, and economic decline. In social interactions, older individuals were often stereotyped and treated as helpless, poor, and "witches." Those living with HIV faced the additional stigma of being labeled as promiscuous. Some of the participants living without HIV refused to take daily medication for non-communicable diseases to avoid being mistaken for taking antiretroviral therapy for HIV. Older individuals wanted quality healthcare and family support to address the intersectional stigma of aging, poverty, and chronic illness. Conclusion: Multifaceted interventions are required to combat age-related prejudice, intersectional stigma, and discriminatory practices, particularly for people living with HIV.

Invited Commentary: Race, Ethnicity, and Racism in Epidemiologic Research-Perspectives from Public Health Critical Race Praxis (PHCRP).

In 2023, Martinez et al. examined trends in the inclusion, conceptualization, operationalization and analysis of race and ethnicity among studies published in US epidemiology journals. Based on a random sample of papers (N=1,050) published from 1995-2018, the authors describe the treatment of race, ethnicity, and ethnorace in the analytic sample (N=414, 39% of baseline sample) over time. Between 32% and 19% of studies in each time stratum lacked race data; 61% to 34% lacked ethnicity data. The review supplies stark evidence of the routine omission and variability of measures of race and ethnicity in epidemiologic research. Informed by public health critical race praxis (PHCRP), this commentary discusses the implications of four problems the findings suggest pervade epidemiology: 1) a general lack of clarity about what race and ethnicity are; 2) the limited use of critical race or other theory; 3) an ironic lack of rigor in measuring race and ethnicity; and, 4) the ordinariness of racism and white supremacy in epidemiology. The identified practices reflect neither current publication guidelines nor the state of the knowledge on race, ethnicity and racism; therefore, we conclude by offering recommendations to move epidemiology toward more rigorous research in an increasingly diverse society.

Cultural sips: Exploring sociodemographic and dominance factors in French wine appraisal.

This study investigates the intricate relationship between sociodemographic factors, social dominance orientation (SDO), and perceptions of wine in France. Emphasizing the symbolic role of wine in French culture, and employing a survey-based approach, the research explores how societal hierarchies and individual positioning within these structures influence the appraisal of rosé wine. The findings revealed that sociodemographic factors, particularly education level, significantly influence wine appraisal, while social dominance orientation serves as a mediating factor. This research contributes to the understanding of the cultural and social dynamics shaping wine consumption in France, highlighting the fact that wine appraisal is deeply embedded in societal structures.

Psychopathology and Metaphysics: Can One Be a Realist About Mental Disorder?

Metaphysical realism about mental disorder is the thesis that mental disorder exists mind-independently. There are two ways to challenge metaphysical realism about mental disorder. The first is by denying that mental disorder exists. The second is by denying that mental disorder exists mind-independently. Or, differently put, by arguing that mental disorder is mind-dependent. The aim of this paper is three-fold: (a) to examine three ways in which mental disorder can be said to be mind-dependent (namely, by being causally dependent on the human mind, by being weakly dependent on human attitudes, and by being strongly dependent on human attitudes), (b) to clarify their differences, and (c) to discuss their implications regarding metaphysical realism about mental disorder. I argue that mental disorder being mind-dependent in the first two senses is compatible with metaphysical realism about mental disorder, whereas mental disorder being mind-dependent in the third sense is not.

The important issue of awareness of disaster response to the COVID-19.

This study aimed to analyze the community's disaster response awareness during the Covid-19 pandemic during the implementation of The Large-Scale Social Restrictions (LSSR) in Gresik. Self-awareness was observed using Peter L. Berger and Thomas Luck man's Social Construction Theory through a dialectical process of internalization, objectification, and externalization. The results showed that there had been no good awareness in efforts to prevent the spread of Covid-19 in Gresik. Socially, the community had not taken the dangers of Covid-19 seriously. There was also an inconsistency between knowledge and reality related to disaster response. In coping with the dialectical process, the community had not implemented a disaster-aware culture by obeying the existing regulations. At least, the sociocultural environment determined a person's construction for self-identification, interaction, and adjustment to the social changes that occurred. Hence, the sociocultural construction of the community had never made the disease outbreak a serious problem and considered it as well as God's reminder even though infected cases continued to increase. A situation was indeed difficult for the Task Force to succeed in the Large-Scale Social Restrictions (LSSR) to Community Activities Restrictions Enforcement (CARE) suppressed the increase of Covid-19 positive cases in Gresik, Indonesia. This research sees that the government's policies in handling Covid- 19 are not enough, it needs more optimal involvement of community and religious leaders, to provide education on the importance of maintaining health protocols and building self-awareness of the dangers of Covid.

Encircling discourses-A guide to critical discourse analysis in caring science.

AIM: The aim of this article was to introduce Fairclough's critical discourse analysis (CDA) in caring and nursing science, to provide a guide on how to perform such an analysis, and to describe the wider context of discourse epistemology. DESIGN: The article is designed as a methodological paper, including (a) epistemological roots of discourse analysis, (b) an overview of discourse analytical research within caring and nursing science which points out an increased trend, and (c) a guide to conducting a CDA. ANALYSIS: It is important that discourse analysis is available and accessible to nursing and caring researchers. Through the process of encircling discourses, valuable insight is given into fields that otherwise would be lost or would not be available. CONCLUSION: Our summary stance is that discourse analysis as it is presented in this article is strongly advisable for use in nursing and caring sciences.

Stemming the "ageism pandemic": A qualitative inquiry with older adults in residential care facilities during the Covid-19 outbreak.

The Covid-19 pandemic added to collective concerns, making health risks salient especially for the older population. The health emergency exacerbated an already widespread negative representation of aging, and phenomena such as ageism. With the present qualitative inquiry, 21 episodic interviews were collected with the aim of understanding the experience of older adults in residential care facilities, exploring their ideas of aging and the viewpoints that helped them to respond to the pandemic successfully. A thematic analysis was conducted using NudIst software. The results show that participants described multiple personal and relational resources they used to cope with the pandemic, and they were able to express counter-narratives to the ideas of aging as coinciding with decline, and of lockdown as a source of distress alone. The paper concludes with reflections on the relevance of research capable of challenging unhelpful dominant discourses and averting the risk of them turning into negative prophecies.

A Discourse of Deviance: Blame, Shame, Stigma and the Social Construction of Head and Neck Cancer.

Cancer of the head and neck is a confronting condition, as the disease and its treatments alter the appearance and function of body organs associated with physical appearance and identity. Many of the risk factors for head and neck cancers, including tobacco, alcohol, and human papilloma virus, can also have significant negative social and moral permutations. Language and action (discourse) plays an important role in constructing disease and illness and shape the way it is managed, both institutionally and socially. This research used a critical constructionist lens to investigate how the common discourses surrounding head and neck cancer are constructed within the healthcare context and how this influences patients and healthcare professionals' responses to the illness. Data were collected through semi-structured interviews, field noting, journaling and literature reviews. Analysis was guided by a three-dimensional approach to critical discourse analysis that investigated text, discursive practices, and social context. The overarching finding was that deviance dominates the common discourse and shapes head and neck cancer and responses to it. Deviance is channelled through metaphors, adjectives, descriptors, and collective nouns and is made overt through labelling, avoidance, blaming, shame, and categorization. Discourse is contextualized by a sociocultural understanding that when someone deviates from what is perceived as normal, they are devalued. Open dialogue and reflection on head and neck cancer discourse could enable better understanding of how people experience their condition and inform more supportive responses.

Who has mental health problems? Comparing individual, social and psychiatric constructions of mental health.

PURPOSE: The persistent gap between population indicators of poor mental health and the uptake of services raises questions about similarities and differences between social and medical/psychiatric constructions. Rarely do studies have assessments from different perspectives to examine whether and how lay individuals and professionals diverge. METHODS: Data from the Person-to-Person Health Interview Study (P2P), a representative U.S. state sample (N ~ 2700) are used to examine the overlap and correlates of three diverse perspectives-self-reported mental health, a self/other problem recognition, and the CAT-MH™ a validated, computer adaptive test for psychopathology screening. Descriptive and multinominal logit analyses compare the presence of mental health problems across stakeholders and their association with respondents' sociodemographic characteristics. RESULTS: Analyses reveal a set of socially constructed patterns. Two convergent patterns indicate whether there is (6.9%, The "Sick") or is not (64.6%, The "Well") a problem. The "Unmet Needers" (8.7%) indicates that neither respondents nor those around them recognize a problem identified by the screener. Two patterns indicate clinical need where either respondents (The "Self Deniers", 2.9%) or others (The "Network Deniers", 6.0%) do not. Patterns where the diagnostic indicator does not suggest a problem include The "Worried Well" (4.9%) where only the respondent does, The "Network Coerced" (4.6%) where only others do, and The "Prodromal" (1.4%) where both self and others do. Education, gender, race, and age are associated with social constructions of mental health problems. CONCLUSIONS: The implications of these results hold the potential to improve our understanding of unmet need, mental health literacy, stigma, and treatment resistance.

Construcción de las identidades de género y las implicaciones en la violencia en adolescentes indígenas / Construction of gender identities and the implications for violence in indigenous adolescents

Objetivo: Comprender las reflexiones sobre la construcción de las identidades de género y las implicaciones en la violencia expuestas por adolescentes indígenas en el noreste de Oaxaca. Metodología: Estudio cualitativo con referencial filosófico del interaccionismo simbólico. Participantes: 45 adolescentes entre 12 y 16 años de edad de comunidades indígenas chinantecas. Se conformaron cinco grupos focales respetando el criterio de homogeneidad en relación con la edad. El análisis se realizó con base en la Teoría Fundamentada en los Datos. Resultados principales: Emergieron dos temas centrales: “Construcción social de ser hombre o mujer en la comunidad chinanteca” y “Las nuevas generaciones y las percepciones sobre género”. Conclusión principal: Los usos y costumbres propios de la cultura chinanteca se conjugan con el género para internalizar los roles asignados a hombres y mujeres. Son las mujeres quienes empiezan a cuestionar los privilegios de los hombres en una cultura anclada en los usos y costumbres.(AU)

Objective: To understand the reflections about the construction of gender identities and the implications for violence in indigenous adolescents in north-east Oaxaca. Methods: Qualitative study with philosophical reference of symbolic interactionism. Participants: 45 teenagers between 12 and 16 years of age from Chinantec indigenous communities. Five focus groups were formed adhering to the criteria of homogeneity in relation to age. The analysis was based on the Grounded Theory in the data. Results: Two central themes emerged: "Social construction of being a man or woman in the Chinantec community" and "The new generations and the perceptions of gender." Conclusions: The uses and customs of the Chinantec culture are combined with the gender to internalize the roles assigned to men and women. Women are the ones who begin to question the privileges of men in a culture anchored in uses and customs.(AU)

Aproximaciones a la sexualidad en la niñez desde terapia ocupacional / Aproximações à sexualidade na infância a partir da terapia ocupacional / Approaches to sexuality in childhood from occupational therapy

Resumen El presente artículo consta de una revisión bibliográfica que tiene por objetivo describir los distintos factores que influyen en el desarrollo de la sexualidad infantil para comprenderla desde la terapia ocupacional. La problemática planteada aborda la invisibilidad de los componentes naturales y normativos de la sexualidad en la primera y segunda infancia y cómo la terapia ocupacional se aproxima a estos factores en su intervención. Para llevar a cabo esta búsqueda bibliográfica, se utilizaron variadas bases de datos y revistas de terapia ocupacional, con el fin de encontrar textos que tuvieran relación con el objetivo y problemática propuesta, los cuales fueron filtrados de acuerdo a criterios de exclusión e inclusión. De los resultados se obtiene que existe escasa información académica respecto a cómo se relacionan directamente los componentes de la sexualidad infantil con las áreas de trabajo de la terapia ocupacional. Por lo anterior se concluye que la disciplina está recientemente en la incorporación del abordaje de esta temática y se plantea la necesidad urgente de reconstruir la conceptualización de la sexualidad infantil, desde una base de derechos de la niñez y alejándose de la hegemonía de una cultura heteronormada y adultocéntrica. Se consideran los distintos factores que influyen al desarrollo de la sexualidad infantil y entendiéndola no solo como ocupación sino como parte fundamental de la identidad ocupacional, que tiene como componentes la autonomía corporal, el desarrollo socio afectivo, el placer y el disfrute, el género y las elecciones ocupacionales, los cuales guiarían el abordaje de terapia ocupacional.

Resumo O presente artigo consiste em uma revisão bibliográfica que tem como objetivo descrever os diferentes fatores que influenciam o desenvolvimento da sexualidade infantil para compreendê-la a partir da terapia ocupacional. A problemática levantada aborda a invisibilidade dos componentes naturais e normativos da sexualidade na primeira e segunda infâncias e como o terapeuta ocupacional aborda esses fatores em sua intervenção. Para realizar esta busca bibliográfica, foram utilizadas diversas bases de dados e periódicos da área de terapia ocupacional, a fim de encontrar textos que estivessem relacionados ao objetivo e problemática propostos, os quais foram filtrados segundo critérios de exclusão e inclusão. Dos resultados obtém-se que há escassa informação acadêmica a respeito de como os componentes da sexualidade infantil estão diretamente relacionados às áreas de atuação do terapeuta ocupacional. Portanto, conclui-se que a disciplina está incorporando recentemente a abordagem dessa temática e se levanta a urgente necessidade de reconstruir a conceituação da sexualidade infantil, a partir de uma base de direitos da criança e afastando-se da hegemonia de uma cultura heteronormativa adultocêntrica. São considerados os diferentes fatores que influenciam o desenvolvimento da sexualidade infantil, entendendo-a não apenas como uma ocupação, mas também como parte fundamental da identidade ocupacional, cujos componentes são autonomia corporal, desenvolvimento socioafetivo, prazer e gozo, gênero e escolhas ocupacionais, os quais orientariam a abordagem da terapia ocupacional.

Abstract This article consists of a bibliographical review that aims to describe the different factors that influence the development of child sexuality to understand it from Occupational Therapy (OT). The problem raised addresses the invisibility of the natural and normative components of sexuality in early and second childhood and how OT approaches these factors in its intervention. To carry out this bibliographic search, various databases and journals of Occupational Therapy were used, in order to find texts that were related to the objective and proposed problem, which were filtered according to exclusion and inclusion criteria. From the results it is obtained that there is limited academic information regarding how the components of child sexuality are directly related to the areas of work of the OT. From the foregoing, it is concluded that the discipline is recently incorporating the approach to this issue and the urgent need to reconstruct the conceptualization of child sexuality is raised, from a base of children's rights, moving away from the hegemony of a heteronormative culture, and adult centric. The different factors that influence the development of child sexuality are considered, understanding it not only as an occupation but also as a fundamental part of occupational identity, whose components are bodily autonomy, socio-affective development, pleasure and enjoyment, gender and occupational choices, which would guide the occupational therapy approach.

Long COVID - Can we deny a diagnosis without denying a person's reality?

OBJECTIVE: The aim is to consider Long COVID not as a new clinical entity but as another example of a disabling, historical phenomenon. CONCLUSIONS: A triad of polymorphic symptomatology, an elusive pathophysiological explanation and a hostile defensiveness has appeared throughout history. The reluctance to consider these contextually may delay early intervention and appropriate patient care.

Forensic investigations of disasters: Past achievements and new directions.

In the 2020s, understanding disaster risk requires a strong and clear recognition of values and goals that influence the use of political and economic power and social authority to guide growth and development. This configuration of values, goals, power and authority may also lead to concrete drivers of risk at any one time. Building on previous disaster risk frameworks and experiences from practice, since 2010, the 'Forensic Investigations of Disasters (FORIN)' approach has been developed to support transdisciplinary research on the transformational pathways societies may follow to recognise and address root causes and drivers of disaster risk. This article explores and assesses the achievements and failures of the FORIN approach. It also focuses on shedding light upon key requirements for new approaches and understandings of disaster risk research. The new requirements stem not only from the uncompleted ambitions of FORIN and the forensic approach but also from dramatic and ongoing transformational changes characterised by climate change, the coronavirus disease 2019 (COVID-19) pandemic and the threat of global international confrontation, among other potential crises, both those that can be identified and those not yet identified or unknown. Contribution: Disasters associated with extreme natural events cannot be treated in isolation. A comprehensive "all risks" or "all disasters" approach is essential for a global transformation, which could lead to a better world order. To achieve this, an Intergovernmental Panel for Disaster Risk is suggested to assess risk science periodically and work towards sustainability, human rights, and accountability, within a development and human security frame and on a systemic basis and integrated perspective.

Historia cultural sobre el conocimiento de higiene y lavado de manos en las mujeres nahuas del México Antiguo / História cultural sobre os conhecimentos de higiene e lavagem das mãos das mulheres Nahua no México Antigo / Cultural history on the knowledge of hygiene and hand washing in the Nahua women of Ancient Mexico

Introducción. El trabajo de cuidados ha sido el núcleo fundamental de análisis y objeto de estudio tradicional de la Enfermería. Las investigaciones que durante mucho tiempo se han realizado se han centrado mayoritariamente en la producción de cuidados desde la mirada cientificista y hegemónica de la ciencia una ciencia de la enfermería llena de conocimientos técnicos y mecánicos desde una visión parcial de estos, una visión eurocentrista y anglosajona con "valor" académico, dejando al margen los trabajos que se realizan fuera de estos ámbitos y que no están plagados de números y cosas "tangibles". Metodología. Se trata de una investigación histórico cultural, que pretende deconstruir y cristalizar el conocimiento femenino en torno a la higiene y al lavado de manos, por medio de la transdisciplinariedad, haciendo uso de la heurística y la hermenéutica analógica. Hallazgos. Las mujeres nahuas del México Antiguo, dice Clementina Battcock en el Seminario de Historia de las Mujeres en el México Antiguo (Battcock, 2018, 2021), que la historia de las mujeres en el México Antiguo es una historia acallada, "bajita", por lo cual las historiadoras e historiadores han ido construyendo un debate profundo sobre las aportaciones de las mujeres. A través de la heurística seguida se logró encontrar la valiosa recopilación de libros, hecha por Andrés de Olmos denominada "Huehuetlatolli", también denominados la "antigua palabra", gracias a estos escritos se sabe la forma de educación que brindaban mujeres y hombres sabios (tlamatini, mujeres u hombres que saben algo, que conocen las cosas) Discusión. La higiene en la sociedad náhuatl era un método de cuidado para la salud individual y colectiva. Estudiar estos fenómenos como sustento de la la historia del cuidado en la sociedad mexicana gracias al pueblo nahua, es una fuente de información que robustece el cuerpo histórico académico de la profesión de enfermería en México y Latinoamérica Conclusiones. La participación de las mujeres en la educación y en otros ámbitos ha tenido un realce inconmensurable, equiparable con el conocimiento hegemónico proveniente de Europa, las mujeres histórica y universalmente son quienes se han encargado de ilustrar y enseñar desde el seno del hogar las normas básicas de convivencia y civilidad, y aunque ha sido un papel de cierta forma impuesto, no se debe dejar de lado que el conocimiento empírico de todas estas mujeres es valioso y digno de darse a conocer

Introduction. The work of care has been the fundamental nucleus of analysis and traditional object of study of nursing. The research that has been carried out for a long time has focused mainly on the production of care from the scientificist and hegemonic viewpoint of science, a nursing science full of technical and mechanical knowledge from a partial view of this, a Eurocentric and Anglo-Saxon view with academic "value", leaving aside the work that is carried out outside these fields and which is not full of numbers and "tangible" things. Methodology. This is cultural-historical research, which aims to deconstruct and crystallize feminine knowledge around hygiene and hand washing, by means of transdisciplinarity, making use of heuristics and analogical hermeneutics. Findings. Nahua women in Ancient Mexico, says Clementina Battcock in the Seminar on the History of Women in Ancient Mexico (Battcock, 2018, 2021), that the history of women in Ancient Mexico is a silenced history, "bajita", for which historians and historians have been building a deep debate on the contributions of women. Through the heuristics followed, it was possible to find the valuable compilation of books, made by Andrés de Olmos called "Huehuetlatolli", also called the "ancient word", thanks to these writings we know the form of education provided by wise women and men (tlamatini, women or men who know something, who know things). Discussion. Hygiene in the Nahuatl society was a method of care for individual and collective health. Studying these phenomena as a support for the history of care in Mexican society thanks to the Nahua people, is a source of information that strengthens the academic historical body of the nursing profession in Mexico and Latin America. Conclusions. The participation of women in education and in other fields has had an immeasurable enhancement, comparable to the hegemonic knowledge coming from Europe, women historically and universally have been in charge of illustrating and teaching from the bosom of the home the basic rules of coexistence and civility, and although it has been a role somewhat imposed, it should not be left aside that the empirical knowledge of all these women is valuable and worthy of being made known

Introdução. O trabalho de cuidar tem sido o núcleo fundamental de análise e o objeto tradicional de estudo da enfermagem. A investigação que se realizou durante muito tempo centrou-se principalmente na produção de cuidados a partir da visão cientificista e hegemónica da ciência, uma ciência de enfermagem cheia de conhecimentos técnicos e mecânicos a partir de uma visão parcial desta, uma visão eurocêntrica e anglo-saxónica com "valor" académico, deixando de lado o trabalho que se realiza fora destes campos e que não está cheio de números e coisas "tangíveis". Metodologia. Trata-se de uma investigação histórico-cultural, que tem como objetivo desconstruir e cristalizar o conhecimento feminino sobre higiene e lavagem das mãos através da transdisciplinaridade, utilizando a heurística e a hermenêutica analógica. Conclusões. No Seminário de Clementina Battcock sobre a História das Mulheres no México Antigo (Battcock, 2018, 2021), Clementina Battcock afirma que a história das mulheres no México Antigo é uma história silenciada, "baixa", razão pela qual os historiadores têm vindo a construir um debate aprofundado sobre os contributos das mulheres. Através da heurística seguida, foi possível encontrar a valiosa compilação de livros escritos por Andrés de Olmos chamada "Huehuetlatolli", também chamada de "palavra antiga", graças a estes escritos conhecemos a forma de educação fornecida por mulheres e homens sábios (tlamatini, mulheres ou homens que sabem algo, que sabem coisas). Discussão. A higiene na sociedade Nahuatl era um método de cuidado da saúde individual e colectiva. O estudo destes fenómenos como base para a história dos cuidados na sociedade mexicana graças ao povo Nahua é uma fonte de informação que reforça o corpo académico histórico da profissão de enfermeiro no México e na América Latina. Conclusões. A participação das mulheres na educação e em outros campos teve uma importância incomensurável, comparável ao conhecimento hegemónico proveniente da Europa. Histórica e universalmente, as mulheres foram encarregadas de ilustrar e ensinar as regras básicas de convivência e civilidade a partir do seio do lar, e embora tenha sido um papel um tanto imposto, não se deve esquecer que o conhecimento empírico de todas essas mulheres é valioso e digno de ser divulgado

Victims or perpetrators, agency, and politics of intimate partner violence in the social construction of health and wellbeing: a qualitative study from Kenya.

Deeply rooted cultural beliefs and norms relating to the position and the responsibilities assigned to men and women play a significant role in propagating intimate partner violence (IPV). It is yet to be understood in what ways experiences of IPV contribute to how people socially construct their health and wellbeing as they navigate the tensions created by the prevailing sociocultural systems. To address this knowledge gap, we employed a social constructionist perspective and the eco-social model to explore how Kenyans aged 25-49 years socially construct their health and wellbeing in relation to their experiences of IPV. We conducted nine in-depth interviews and ten focus group discussions in four counties in Kenya between January and April of 2017. Textual analysis of the narratives reveals that although men are usually framed as perpetrators of violence, they may also be victims of reciprocal aggression by women, as recently witnessed in cases where women retaliate through gang attacks, chopping of male genitalia, and scalding with water. However, women are still disproportionately affected by gender-based violence because of the deeply rooted gender imbalances in patriarchal societies. Women experience social stigma associated with such violence and when separated or divorced in situations of unsafe relationships, they are viewed as social misfits. As such, most women opt to stay in unhealthy relationships to avoid social isolation. These experiences are not only unhealthy for their psychological wellbeing but also for their physical health and socioeconomic status and that of their offspring.

"Somewhere Between an Actual Disease and a Disease": A Grounded Theory Study on Diagnosing Functional Neurological Disorders From a Multi-Informant Perspective.

Functional Neurological Disorders are characterized by sensory-motor or cognitive symptoms. Recent research has revealed their complex nature involving biological, psychological, and social factors. Care requires a multidisciplinary approach, which, to date, has yet to be considered. A Constructivist Grounded Theory study was conducted to understand the reasons behind this, exploring Functional Neurological Disorders diagnosis, communication, and understanding from multiple perspectives (patients and healthcare professionals). The core category was "negotiating Functional Neurological Disorders meanings and care amid a dissatisfying dichotomy," with sub-categories: i) seeking to "word" the disease, ii) exposing reductionism, and iii) a pluralist vision emerging. Diagnosing and communicating Functional Neurological Disorders is a process of negotiating meanings and care that hinges on participants' diverse ontological perspectives regarding the condition. Results highlight the difficulty in finding common ground and achieving mutual understanding among the various viewpoints, creating a challenge in establishing a unified approach to Functional Neurological Disorders care. In this context, only a few healthcare professionals emphasized the potential benefits of increased integration. A shift is required from a reductionist to an integrated biopsychosocial perspective to develop a more cohesive approach. Defining a medical paradigm through dialogue with teams and patients is essential in addressing Functional Neurological Disorders effectively. Furthermore, the required interdisciplinary approach holds the potential to mitigate the dissatisfaction arising from fragmented and compartmentalized care (the "dissatisfying dichotomy") experienced by our participants. It signifies a comprehensive strategy that could address the concerns of all involved parties and enhance the overall quality of care provided.

Historia cultural sobre el conocimiento de higiene y lavado de manos en las mujeres nahuas del México Antiguo / História cultural sobre os conhecimentos de higiene e lavagem das mãos das mulheres Nahua no México Antigo / Cultural history on the knowledge of hygiene and hand washing in the Nahua women of Ancient Mexico

Introducción. El trabajo de cuidados ha sido el núcleo fundamental de análisis y objeto de estudio tradicional de la Enfermería. Las investigaciones que durante mucho tiempo se han realizado se han centrado mayoritariamente en la producción de cuidados desde la mirada cientificista y hegemónica de la ciencia una ciencia de la enfermería llena de conocimientos técnicos y mecánicos desde una visión parcial de estos, una visión eurocentrista y anglosajona con "valor" académico, dejando al margen los trabajos que se realizan fuera de estos ámbitos y que no están plagados de números y cosas "tangibles". Metodología. Se trata de una investigación histórico cultural, que pretende deconstruir y cristalizar el conocimiento femenino en torno a la higiene y al lavado de manos, por medio de la transdisciplinariedad, haciendo uso de la heurística y la hermenéutica analógica. Hallazgos. Las mujeres nahuas del México Antiguo, dice Clementina Battcock en el Seminario de Historia de las Mujeres en el México Antiguo (Battcock, 2018, 2021), que la historia de las mujeres en el México Antiguo es una historia acallada, "bajita", por lo cual las historiadoras e historiadores han ido construyendo un debate profundo sobre las aportaciones de las mujeres. A través de la heurística seguida se logró encontrar la valiosa recopilación de libros, hecha por Andrés de Olmos denominada "Huehuetlatolli", también denominados la "antigua palabra", gracias a estos escritos se sabe la forma de educación que brindaban mujeres y hombres sabios (tlamatini, mujeres u hombres que saben algo, que conocen las cosas) Discusión. La higiene en la sociedad náhuatl era un método de cuidado para la salud individual y colectiva. Estudiar estos fenómenos como sustento de la la historia del cuidado en la sociedad mexicana gracias al pueblo nahua, es una fuente de información que robustece el cuerpo histórico académico de la profesión de enfermería en México y Latinoamérica Conclusiones. La participación de las mujeres en la educación y en otros ámbitos ha tenido un realce inconmensurable, equiparable con el conocimiento hegemónico proveniente de Europa, las mujeres histórica y universalmente son quienes se han encargado de ilustrar y enseñar desde el seno del hogar las normas básicas de convivencia y civilidad, y aunque ha sido un papel de cierta forma impuesto, no se debe dejar de lado que el conocimiento empírico de todas estas mujeres es valioso y digno de darse a conocer.

Introduction. The work of care has been the fundamental nucleus of analysis and traditional object of study of nursing. The research that has been carried out for a long time has focused mainly on the production of care from the scientificist and hegemonic viewpoint of science, a nursing science full of technical and mechanical knowledge from a partial view of this, a Eurocentric and Anglo-Saxon view with academic "value", leaving aside the work that is carried out outside these fields and which is not full of numbers and "tangible" things. Methodology. This is cultural-historical research, which aims to deconstruct and crystallize feminine knowledge around hygiene and hand washing, by means of transdisciplinarity, making use of heuristics and analogical hermeneutics. Findings. Nahua women in Ancient Mexico, says Clementina Battcock in the Seminar on the History of Women in Ancient Mexico (Battcock, 2018, 2021), that the history of women in Ancient Mexico is a silenced history, "bajita", for which historians and historians have been building a deep debate on the contributions of women. Through the heuristics followed, it was possible to find the valuable compilation of books, made by Andrés de Olmos called "Huehuetlatolli", also called the "ancient word", thanks to these writings we know the form of education provided by wise women and men (tlamatini, women or men who know something, who know things). Discussion. Hygiene in the Nahuatl society was a method of care for individual and collective health. Studying these phenomena as a support for the history of care in Mexican society thanks to the Nahua people, is a source of information that strengthens the academic historical body of the nursing profession in Mexico and Latin America. Conclusions. The participation of women in education and in other fields has had an immeasurable enhancement, comparable to the hegemonic knowledge coming from Europe, women historically and universally have been in charge of illustrating and teaching from the bosom of the home the basic rules of coexistence and civility, and although it has been a role somewhat imposed, it should not be left aside that the empirical knowledge of all these women is valuable and worthy of being made known.

Introdução. O trabalho de cuidar tem sido o núcleo fundamental de análise e o objeto tradicional de estudo da enfermagem. A investigação que se realizou durante muito tempo centrou-se principalmente na produção de cuidados a partir da visão cientificista e hegemónica da ciência, uma ciência de enfermagem cheia de conhecimentos técnicos e mecânicos a partir de uma visão parcial desta, uma visão eurocêntrica e anglo-saxónica com "valor" académico, deixando de lado o trabalho que se realiza fora destes campos e que não está cheio de números e coisas "tangíveis". Metodologia. Trata-se de uma investigação histórico-cultural, que tem como objetivo desconstruir e cristalizar o conhecimento feminino sobre higiene e lavagem das mãos através da transdisciplinaridade, utilizando a heurística e a hermenêutica analógica. Conclusões. No Seminário de Clementina Battcock sobre a História das Mulheres no México Antigo (Battcock, 2018, 2021), Clementina Battcock afirma que a história das mulheres no México Antigo é uma história silenciada, "baixa", razão pela qual os historiadores têm vindo a construir um debate aprofundado sobre os contributos das mulheres. Através da heurística seguida, foi possível encontrar a valiosa compilação de livros escritos por Andrés de Olmos chamada "Huehuetlatolli", também chamada de "palavra antiga", graças a estes escritos conhecemos a forma de educação fornecida por mulheres e homens sábios (tlamatini, mulheres ou homens que sabem algo, que sabem coisas). Discussão. A higiene na sociedade Nahuatl era um método de cuidado da saúde individual e colectiva. O estudo destes fenómenos como base para a história dos cuidados na sociedade mexicana graças ao povo Nahua é uma fonte de informação que reforça o corpo académico histórico da profissão de enfermeiro no México e na América Latina. Conclusões. A participação das mulheres na educação e em outros campos teve uma importância incomensurável, comparável ao conhecimento hegemónico proveniente da Europa. Histórica e universalmente, as mulheres foram encarregadas de ilustrar e ensinar as regras básicas de convivência e civilidade a partir do seio do lar, e embora tenha sido um papel um tanto imposto, não se deve esquecer que o conhecimento empírico de todas essas mulheres é valioso e digno de ser divulgado.

Is scientific knowledge socially constructed? A Bayesian account of Laboratory Life.

In the book Laboratory Life Latour and Woolgar present an account of how scientific "facts" are formed through a process of microsocial interactions among individuals and "inscription devices" in the lab initially described as social construction. The process moves through a series of steps during which the details and nature of the object become more and more certain until all qualifications are dropped, and the "fact" emerges as secure scientific knowledge. An alternative to this account is described based on a Bayesian probabilistic framework which arrives at the same end point. The motive force for the constructivist approach appears to involve social processes of convincing colleagues while the Bayesian approach relies on the consistency of theory and evidence as judged by the participants. The role of social processes is discussed in Bayesian terms, the acquisition and asymmetry of information, and its analogy to puzzle solving. Some parallels between the Bayesian and constructivist accounts are noted especially in relation to information theory.

The use of 'sex' and 'gender' in medical research.

There is a widespread practice of using 'sex' and 'gender' interchangeably. The World Health Organization considers that they are not. It defines sex as a set of chromosome-dependent biological variables that show unique hormone profiles and anatomy. Conversely, gender refers to socially constructed sex attributions with differential roles, behavioral expressions, identity, etc. Researchers and institutions have proposed guidelines to ensure that good science is not compromised by ideologies, media or social pressures, morality, religion or economic interests. Sex differences are immune to any ideology or socio-cultural interest, because they are governed by biologically determined genetic parameters. Considering men and women to be alike is very valuable from a moral or social perspective, but ignoring differences could be wrong and unacceptable from a biomedical perspective. The organization of health and/or research systems that does not consider the different morbidity, evolution or treatment response depending on sex would generate biases and mistakes. To work on medical innovation with a gender perspective should need to take sex differences into account and integrate them properly, recognizing diversity. The controversy is not just about sex or gender, but about sex and gender and how they may influence each other. Maintaining a scientific and academic approach will help both to advance science and enrich laws and/or ideologies.

Interrogating the pill: Rising distrust and the reshaping of health risk perceptions in the social media age.

Since its introduction in 1960, the combined oral contraceptive pill has become the dominant reversible contraceptive technology for controlling female fertility in spite of early and ongoing ethical, critical medical, and societal disapproval. Over the last decade, prescription rates among young women in Western Europe have declined alongside the rise of social media use. This article investigates the mechanisms underlying this change in contraceptive choices and the role played by social media in this trend. Via exploratory online observation and an in-depth interview study with 19 informants in Germany and Denmark, we find social media consolidates the social construction of hazards associated with the contraceptive pill by reshaping young women's risk perception from questions around drug reliability and safety to those of individual physical, mental, and social well-being. We shed light on how social media contributes to the delegitimation of health professionals such as gynaecologists and general practitioners and adds to wider debates on the erosion of medical authority and the attendant rise of peer influencers. We condense our findings into a framework for health-related attitude formation and decision-making in the social media age, which elucidates how social media amplifies and reshapes societal discourses regarding health-related technologies, choices, and risks.