The Academy of Nutrition and Dietetics is the leading professional organization for registered dietitians (RDs)--globally--with over 75,000 members. Professional organizations are often overlooked in communication scholarship. However, the Academy offers a rich setting for researching occupational identities, health activism, and neoliberalism. I used semi-structured interviews to explore how taken-for-granted discourses, power relationships, and unquestioned norms are challenged, reinforced, and (re)constructed within the Academy. Specifically, this study analyzed two challenges to the Academy and the dietetics profession: claims to professional expertise and a debate surrounding the Academy's corporate sponsorship. My findings suggest that the profession, which happens to be predominantly female, is struggling with issues of marginalization. RDs described their expertise through a rhetorical turf war--in which they defined themselves against nutritionists--to help elevate their profession. Further, I found that the Academy has a sub-group of health activists that are unified through their holistic approach to nutrition. These health activists attempted to address complaints about the Academy's corporate sponsorship program but lacked a unified vision for their efforts. By researching the Academy, I hope to contribute new understandings about how professional organizations, discourses of expertise, and corporate sponsorship contribute and influence the public's understandings of health and nutrition. While my results have practical and theoretical implications for RDs and the Academy, they also have broader implications for understanding power relationships and hidden discourses within our complex, dynamic food system.

An estimated 300,000 people contract Lyme disease in the USA every year, 10-20% of whom will experience long-term symptoms even after antibiotic treatment. These patients are said to have Chronic Lyme Disease (CLD). However, diagnostic guidelines, treatment protocols, and the etiological existence of CLD have been the subject of much controversy in the biomedical field, leading to negative mental and physical health outcomes for of patients with CLD. Patient support networks focused on illness experience, known as biosocialities, have formed in response to this controversy. CLD biosocialities create opportunities for patients to participate in biomedical activism and the scientific research process. A historical precedent for biosocial impact on biomedical knowledge and improved health outcomes has been established from patient activists with HIV/AIDS, breast cancer, and PTSD. The impact of CLD patients’ biosocial activism on a scientific and sociological level is evaluated through an examination of the publications of CLD support networks and biomedical research publications. CLD biosocial activism has resulted in more patient-centered research endeavours, etiological proof of CLD, improved diagnostic technologies, and new treatment protocols. These biomedical results have implications for improved CLD patient health outcomes and credibility for CLD as a legitimate disease on a biological and sociological level.

With more than 33 million people living with HIV/AIDS, and an infection rate that is increasing rather than falling among high-risk groups, the 30-year history of the AIDS epidemic has been characterised as ‘islands of success in a sea of failure.’ Given the lack of a medical cure for the disease, the world has looked to social marketing campaigns to promote behaviour change that would decrease infection rates. Under the best of circumstances, change is difficult, and health behaviour change, especially when it relates to sex and politics, is even more challenging, so social marketers have a difficult task that calls on every technique at their disposal. There is an increasing expectation that HIV/AIDS social marketing interventions will yield measurable results, and that involves fully understanding the AIDS landscape, marketing theory and practice, and the evolving medical picture relating to the pandemic. This research explores links between social marketing and HIV/AIDS while mapping their marketing connections to both the conventional and alternative medical communities. To better understand the HIV/AIDS landscape, early research focused on three diverse countries— Mexico, Uganda, and the United States—selected for their significant cultural, economic, and political differences. Given the multiple social perspectives and fields of knowledge involved in this project, a transdisciplinary approach using mixed research methods was selected. Mixed methods for collecting and presenting data included case studies, content analysis, semistructured interviews, a quantitative survey, and in-depth reaction interviews. Through analysis of 18 social marketing campaigns in the three countries selected for study, the content, focus, purpose, and implications of the controlled public dissemination of HIV/AIDS information were examined. Key informants with professional and academic credentials in the areas of marketing, advocacy, and HIV/AIDS medicine were interviewed to learn rationales behind the campaigns and to explore political and economic factors that affect HIV/AIDS health activism. The last major phase of information gathering surveyed more than 340 patients at a clinic in Houston, Texas, to ascertain their knowledge and perceptions about HIV/AIDS treatment and prevention information. After the survey data was compiled, reaction interviews from key informants provided additional input. Informed by this wealth of secondary and primary research, an Integrated Social Marketing Conversation (Marcon) Model was created to demonstrate that social marketing campaigns should be localised and customer centred, with participants engaging in an ongoing conversation at every stage. The communication model offers valuable guidelines for more effective dissemination of HIV/AIDS prevention and treatment information to high-risk, high-interest target audiences such as HIV-positive people and the organisations that work with that subculture. Because this research crosses so many boundaries and addresses an actual need, it should be of interest to a wide variety of individuals and organisations in both academic and professional fields. From marketers to medical practitioners to activists associated with HIV/AIDS issues, this project’s findings will apply to their concerns. Also, HIV/AIDS organisations — both government agencies as well as private groups — should find information in this work that addresses their ongoing efforts. While investigating existing models for HIV/AIDS communication, it became evident that most research and communication models have focused on how HIV/AIDS prevention programmes are working and what is effective, but little has been done in regards to treatment options and information. For that reason, the integrated social marcon model presented in this thesis is an important addition to the body of practical literature on this topic. Finally, the volatility of the issues examined here and the contacts made during five years of work offer multiple possibilities for follow-up research and fieldwork with opportunities to make a positive contribution in the battle against the HIV/AIDS pandemic.

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / O processo de construção de diagnósticos na contemporaneidade vem sofrendo modificações, constituindo novo foco de trabalho no campo da sociologia médica. O surgimento de grupos de reivindicação de direitos de pacientes e familiares, no final do século XX, determina um novo elemento na criação de categorias diagnósticas. Ao divulgar conhecimento sobre a experiência do doente, e reivindicar tratamentos, esses grupos desafiam a noção de exclusividade do conhecimento médico sobre os diagnósticos. Nesse sentido, a Internet se mostra um terreno fértil de propagação de conhecimento e de mobilização social, tanto de contestação quanto de afirmação do saber médico. Este trabalho faz uma análise do conteúdo de seis comunidades brasileiras de autismo da rede de relacionamentos do Orkut. Alguns resultados são apresentados em relação à divulgação de modelos teóricos, conhecimento baseado no cotidiano de pacientes e formas de ativismo em saúde nessas comunidades virtuais. / The contemporary process of construction of diagnostics has undergone changes, constituting a new focus of research in the field of medical sociology. The emergence of advocacy-groups of patients rights and their families, in the late twentieth century, provides a new element in the creation of diagnostics categories. By spreading knowledge about patient experience and claiming treatments, these groups challenge the notion of exclusivity of medical knowledge about diagnostics. In this sense, Internet proves a fertile terrain of knowledge dissemination and social mobilization of contestation but also affirmation of medical knowledge. This research analyzes the content of discussion from six autism brazilian communities of the Orkut social network. Some results are presented in relation to the dissemination of theoretical models, knowledge based on patients everyday life and forms of health activism in these virtuals communities.

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / O processo de construção de diagnósticos na contemporaneidade vem sofrendo modificações, constituindo novo foco de trabalho no campo da sociologia médica. O surgimento de grupos de reivindicação de direitos de pacientes e familiares, no final do século XX, determina um novo elemento na criação de categorias diagnósticas. Ao divulgar conhecimento sobre a experiência do doente, e reivindicar tratamentos, esses grupos desafiam a noção de exclusividade do conhecimento médico sobre os diagnósticos. Nesse sentido, a Internet se mostra um terreno fértil de propagação de conhecimento e de mobilização social, tanto de contestação quanto de afirmação do saber médico. Este trabalho faz uma análise do conteúdo de seis comunidades brasileiras de autismo da rede de relacionamentos do Orkut. Alguns resultados são apresentados em relação à divulgação de modelos teóricos, conhecimento baseado no cotidiano de pacientes e formas de ativismo em saúde nessas comunidades virtuais. / The contemporary process of construction of diagnostics has undergone changes, constituting a new focus of research in the field of medical sociology. The emergence of advocacy-groups of patients rights and their families, in the late twentieth century, provides a new element in the creation of diagnostics categories. By spreading knowledge about patient experience and claiming treatments, these groups challenge the notion of exclusivity of medical knowledge about diagnostics. In this sense, Internet proves a fertile terrain of knowledge dissemination and social mobilization of contestation but also affirmation of medical knowledge. This research analyzes the content of discussion from six autism brazilian communities of the Orkut social network. Some results are presented in relation to the dissemination of theoretical models, knowledge based on patients everyday life and forms of health activism in these virtuals communities.