An Adverse Drug Reaction (ADR) is defined by the World Health Organization as “a noxious response to a medication that is unintended at doses usually administered for diagnosis, prophylaxis, or treatment.” Estimates suggest that such episodes – in which prescription drugs cause negative health consequences – account for more than 2 million hospitalizations and more than 100,000 deaths per year in the United States alone, making ADRs one of the leading causes of death. To put these numbers into perspective: death from treatment with prescription drugs is about 10 times as common as death from suicide. This dissertation aims to understand why these numbers are so high. Prior work has focused mainly on the politics of drug approval to show that factors such as deadlines, status of pharmaceutical firms, and foreign approval can account for variation in regulatory decision making by the Food and Drug Administration. I take another route and focus on the production of evidence about the safety of prescription drugs. The way in which medical scientists have typically used evidence is by extracting meaning through aggregation or classification of pieces of evidence. The argument that I am making in this dissertation is that rather than aggregating or classifying evidence, one needs to account for the relationships between pieces of evidence. In particular, the dissertation shows how social theories about the structures of evidence production can be used to better understand the harm that drugs can do and, as a result, allow us to identify unsafe drugs more rapidly. The dissertation presents analyses based on data from the two main sources of evidence that the Food and Drug Administration has at its disposal to identify unsafe drugs. The first is the Adverse Event Reporting System (AERS). AERS is an FDA maintained system through which patients and physicians can voluntarily report ADRs to the FDA. The FDA uses this system by monitoring disproportional increases in the number of ADRs reported for a given drug. The second source of evidence is the scientific literature about prescription drugs. The FDA uses this literature to inform regulatory action. The first set of findings in this dissertation demonstrate that ADR reports for a specific drug are more likely to be submitted if a drug has been publicly scrutinized or when a drug treats the same health condition as a drug that was publicly scrutinized. Patients and physicians differ in the ways in which their reporting behavior changes in response to increased scrutiny. Preliminary findings suggest that these episodes of changes in reporting behavior are associated with delays in regulatory action compared to drugs in which reporting behavior did not change. These findings are consistent with the hypothesis that the detection of signals in massive yet sparse data benefits from social theories of evidence production. The second set of findings show that the social structure in which scientific evidence about the safety and efficacy of prescription drugs is not uniformly cumulative. In particular, in some cases the scientific debate about the safety and efficacy of prescription drugs is characterized by a disconnect between the claims made before a drug is approved for marketing and the claims made after approval. Moreover, the results from the study demonstrate that debates characterized by a strong disconnect are more likely to be the target of regulatory action. This suggests that a discontinuity in scientific closure is consistent with the idea that the quality of pre-approval scientific evidence predicts post-approval regulatory action. In sum, this dissertation identifies salient structures in collective production processes and it demonstrates that the structure of collective production reveals meaning that could reduce ambiguity in interpretation.

The concept of conflict theory is applied to the dynamics of everyday interaction among British Sign Language (BSL) users in the workplace in this study. This research aims to explore Deaf and hearing BSL users’ experiences of working together, and to consider the causes of conflict among this group. The research identifies BSL users’ experiences in relation to interaction in the workplace and the causes of conflict are explored through Mayer’s (2000) ‘wheel of conflict’. The study is carried out in line with the sociocultural model of Deafhood (Ladd, 2003). This theoretical backdrop provides an opportunity to view and understand Deaf BSL users as a cultural and linguistic minority, a perspective that stands in contrast to the persistent medical view of sign language users. This perspective aims at redefining approaches to Deaf people from a dominated, pathological position to an alternative visuality paradigm (Kannapell, 1993). This includes paying attention to the shared experiences surrounding Deaf people’s lives and attempting to understand the control and inequalities, and the language and cultural differences at play, that is, a sociocultural approach. The research comprises a small-scale study of qualitative group discussion and individual self-testimony activities. These research activities enable the study to explore the circumstances that underlie workplace conflicts, leading to identification of the various experiences. The participants in the study were BSL users who work in predominantly deaf workplaces. A thematic analysis identifies recurring experiences that demonstrate power and control, and instance of inequality, examined through a hermeneutic phenomenological methodology (Gadamer, 2004) that provides a basis for qualitative research. The analysis reveals six nomothetic themes (Atkinson, 2007) of audism, attitude, paternalism, transition, resolution and empathy, which expose previous and current experiences related to aspects of employment among Deaf and hearing BSL users. Discussion of the likely causes of workplace conflict and the potential for resolution brings the research findings to a conclusion, before noting that future research into the experiences of a mixed Deaf and hearing working environment is required in order to expand the findings of this phenomenological study. It is important for us to understand Deaf people’s work experiences; it is also important that we understand hearing people’s experiences. The author of this study acknowledges that, as Gournaris and Aubrecht (2013: 70) advise, “this process of self-examination may be uncomfortable for the reader”.

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As a multicultural cosmopolitan, transnational migration has an inseparable relationship with the socio-economic development of Hong Kong, the phenomenon of transnational marriage between Hong Kong men and Southeast Asian women has become one of the influential factors impacting the family and social structure in this city. This research aimed to investigate the complicated identities of Thai female migrants within this specific socio-demographic group in Hong Kong. This study, guided by identity, gender, and narrative perspectives, examines the subjective experiences of Thai female migrants through their journey of transnational migration to Hong Kong from an intersectionality perspective. Therefore, the central focus of my research question is 1). How do Thai female migrants living in Hong Kong perceive their identity? 2). How does the Hong Kong context shape Thai female migrants’ identity negotiation? Using qualitative research methodology with an ethnographic approach, in-depth interviews with fourteen Thai female migrants from diverse backgrounds and participant observations were conducted at two field sites in Hong Kong. A thematic analysis was then used to analyse the narratives to examine how these migrants negotiate their national, ethnic and gender identities in the new socio-cultural environment. Based on my in-depth interviews and ethnographic work with Thai migrant communities in Hong Kong, this thesis argues on two grounds. First, the stories shared in the interviews resonated common themes that had impacted on participants’ lives and shaped their identity; being a belief in Buddhism which has a close relationship with Thai nation-state building and identity. Buddhism has become a symbol of the Thai people to articulate their identity and become the connection between Thai migrants and Thailand. Respondents used various strategies to maintain Thainess1 and perceive their identity. Second, I argue when Thai female migrants arrived in Hong Kong, their experiences on the autonomy and freedom for women in Hong Kong society empower them to challenge and question the gender inequality and the definition of woman. Under these circumstances, the subtle idea changes set the way for the negotiation of gender role expectations and reinvent their womanhood in Hong Kong. This study enriches understanding of the dynamic nature of identity negotiation and in-between identity. These findings lend an understanding to illustrate the influence of multiculturalism on female migrants’ meaning making and accentuate the importance to pay attention to diversity within a migrant population; in particular, the presence of various groups of migrants at the same point of time, and to maintain a multicultural orientation to understand transnational migration in the current time.

This study examines the question of how persisting economic and social inequalities between perpetrators and victims affect victims’ perceptions of justice and forgiveness in cross-cultural settings by applying the theory of relative deprivation. The hypothesis of this study is that inequalities trigger relative deprivation in victims, which in turn has a direct negative effect on forgiveness as well as an indirect effect via justice perceptions. Relative deprivation is defined as a consequence of a disadvantageous comparison with an outgroup. It includes the cognitive elements of comparing and perceiving the own outcome as less than deserved, as well as the affective components of anger and resentment. The comparison conditions applied in this study are economic status and social acknowledgement. In order to test the direct effect of relative deprivation on forgiveness, as well as the indirect effect via justice perceptions, vignette experiments were employed. The same causal relationships were tested with a survey to complement the experiment with a real-life setting. The studies were conducted in two culturally and historically diverse post-conflict settings, namely Poland and northern Uganda. To achieve a fuller picture of the similarities and differences between those settings this study made use of qualitative methods, such as open-ended questions and interviews. The regression analysis revealed consistent negative effects of relative deprivation on justice perceptions. The direct negative effects of relative deprivation on forgiveness are mostly significant but vary across both countries with regard to its different dimensions. As expected, a perception of justice contributes to forgiveness. Contrary to the theoretical predictions, victims experience varying degrees of relative deprivation in all experimental conditions except the one, where they are better off than the perpetrator. The qualitative findings revealed that an improvement of economic conditions is of utmost importance for the justice perceptions of most victims in both countries, as are apologies and remorse for forgiveness.