Mikhail Bakhtin’s philosophical thought is largely focused on the interconnectivity of human discourse, privileging literary genres (i.e. the novel). Language comprises of both the structural components of linguistics and a non-verbal component that corresponds to the context of the enunciation. Therefore, the social situation that creates an utterance cannot be diminished. This thesis examines the social history of John Steinbeck’s The Grapes of Wrath (1939) and Boris Pasternak’s Doctor Zhivago (1958), both realist novels that have faced censorship, using Bakhtin’s theories of dialogics and centripetal and centrifugal forces. The Grapes of Wrath and Doctor Zhivago came out in different epochs and were products of the two conflicting ideologies of the 20th century – liberal capitalism and communism. These distinctions provide an interesting forum for comparing the legitimacy of Bakhtin’s theories with regard to censorship across societies.

Focusing on the A-text (1604) version of Marlowe's Doctor Faustus , this study further assesses biographical information on the poet and intellectual currents of the Counter Reformation, so as to investigate the play's relation to emergent trends of individualism in the Renaissance, recovery of the pagan past, and intellectual aspirations that could readily collide with orthodoxy. Clearly reflecting anxieties of the period about individual deviance from social norms through intellectual overreaching, Doctor Faustus powerfully testifies to the potential dangers of human aspiration and the scholarly spirit of unbounded learning. While thus exploring the exotic temptations of forbidden knowledge, the play resurrects and interrogates traditional taboos which related intellectual appetite to wrongful lust. Marlowe stages an explosive conflict between the conservative tradition of intellectual inquiry, which distrusted the unorthodox scholarship and Neoplatonic magic that some widely influential thinkers promoted in the Italian Renaissance, and Faustus's own creative desires, ambitions, and imagination. The tension between proscribed and prescribed knowledge climaxes in the invocation of Helen of Troy. While Helen's significance is complex, we find that, in relation to the play's concern with dissent from orthodoxy, she focuses the power of intellectual longing to seduce and ravish the mind. Apart from being a superior play, Doctor Faustus encapsulates Marlowe's awareness of his period's uneasy perception of unconventional thinking, and urges the importance of challenging restrictions on how much one is permitted to know.

This study investigates doctors’ and patients’ usage of three speech functions; namely statements, questions and commands in the American medical drama series House M.D. Furthermore, the study investigates interruptions between doctors and patients. The aim of the study was to ascertain whether the claim that doctors practice power over patients can be verified. The data comprises transcripts of 16 video recorded sessions of doctors and patient interacting where the material was personally collected and analyzed. In their interactions, doctors were found to dominate in making statements, asking questions and uttering commands. In addition, it was detected that the doctors’ and patients’ way to communicate differed given the fact that doctors are trained in their roles as doctors while patients are not. However, both interactants were found to perform the different speech functions similarly. The study also revealed that doctors interrupted more as compared to patients. Furthermore, gendered interruptions were found in the data, all of which came from male participants and it was concluded that the findings could be linked to the social and cultural roles of the participants. Overall, it was concluded that there exists a power relationship between doctors and patients.

As a therapist within the multi-disciplinary setting, one is confronted with a wide array of pathology and diagnoses. Care is taken to optimize treatment outcomes and overall return of function to every patient admitted to the various rehabilitation facilities. Treatment is often standardized to ensure quality care benchmarked against outcome parameters. The aforementioned is also true for medical practitioners, pharmacists and other auxiliary service providers. Research is aimed at improving quality of care, finding and establishing the best practises through all hospitals and care facilities. Medical care has undergone a transformation over the past few decades with a strong emphasis being placed on protocols and procedures. Through applying standardized care, protocols and procedures, the researcher have come to realize that certain denominators within patient care have no prediction or outcome control. After more than a decade of treating patients in various rehabilitation settings the researcher have come to realize that one complaint exists with each and every patient under my care – pain. This was even more evident within the group of joint replacement patients. No two patients presented with the exact same pain profile or pain reports despite various commonalities such as anthropometric data (age, gender, length, mass), surgical procedure, attending physician, care facility, pathway exposure, diagnosis, radiographic findings and pharmaceutical intervention. If all the obvious factors were identical – what accounted for the different pain reports? This question is at the heart of the study – why do pain reports differ in the presence of so many similarities between patients? It soon became apparent that pain is recognized in the organic form. Organic pain can be measured and is expected with injury, illness or surgical intervention. The entire multi-disciplinary team is aware of organic pain and ready to intervene with medication, surgery and a pathway of care. All vigorously record organic pain and adapt treatment according to the pain levels as organic pain is real pain: real pain existing through exposure to real surgical intervention. Still the question remained: if all the factors prior to surgery, during surgery and after surgery were the same, why are patients experiencing and reporting very different pain levels? This question was the catalyst for the research and lead to keen focus during patient interviews. Every patient receiving an educational session prior to surgery had very vivid ideas about the pain they will experience post-operatively. The majority of patients formed pre-conceived notions about pain prior to undergoing surgery. They presented with a clear pain rating of what they expected to feel post-operatively. The pre-conceived pain rating was constructed in almost all the cases after some form of information obtained during consultation with their surgeon or a member of the multidisciplinary team. This pain notion existed as a tangible and measurable rating in the client’s mind prior to undergoing the knee replacement surgery. In select cases perceived pain was constructed as a result of information obtained from family or friends that underwent the same procedure while other clients constructed perceived pain due to a lack of information on the proposed surgery. It became evident that education or lack thereof on surgical interventions played a primary role in the construct of perceived pain. Patients were entering theatres for procedures and already experienced a form of perceived pain. If pain could be constructed prior to experiencing surgical intervention – can perceived pain then translate into actual organic pain and account for the variable pain reports post surgery? Against this backdrop, research was directed at understanding perceived pain and the factors that aid the construction of perceived pain. As education was found to be at the heart of every pain construct, the doctor-patient consultation was evaluated as a core component to ascertain the impact this relationship has on perceived pain. Measurement of perceived pain was also performed to conclude on the impact of this pain form on organic pain. The study is aimed at addressing the variant pain reports that no pathway or procedure can predict and provide for. It is an attempt to validate pain as constructed by the patient that impacts on their post-surgical pain ratings and behaviour. This research might contribute towards existing knowledge and understanding of the influence of doctor-patient interaction as well as the significance of this interaction on pain. As only scant research on perception of pain has been undertaken this research can prove insightful for further studies or as supplement to existing views and opinions. It can also serve as a foundation in developing practices that will manage pain by enhancing doctor-patient interaction in the health setting. / MA, Medical Sociology, North-West University, Vaal Triangle Campus, 2012

Tyrimo tikslas – ištirti gydytojų ir slaugytojų paslaugų kokybės vertinimą pirminės sveikatos priežiūros centruose. Tyrimo uždaviniai: 1. Įvertinti sveikatos priežiūros paslaugų techninę ir funkcinę kokybę pirminės sveikatos priežiūros centruose gydytojų ir slaugytojų požiūriu. 2. Išanalizuoti gydytojų ir slaugytojų išorinio teikiamų paslaugų efektyvumo vertinimą. 3. Ištirti, koks yra gydytojų ir slaugytojų požiūris į pacientų pasitenkinimą pirminės sveikatos priežiūros paslaugų kokybe. 4. Palyginti gydytojų ir slaugytojų pirminės sveikatos priežiūros darbuotojų kompetencijos vertinimą. Tyrimo metodika. Tyrimas buvo atliktas 5 Kauno PSPC 2012 metų gruodžio-2013 metų vasario mėn. Tyrime dalyvavo 113 gydytojų ir 137 slaugytojos. Klausimynas sudarytas remiantis Ferguson ir kt. Gautas bioetikos leidimas vykdyti tyrimą. Rezultatai. Gydytojai ir slaugytojai visus techninės ir funkcinės paslaugų kokybės aspektus įvertino teigiamai, t.y. palankiai. Techninės ir funkcinės kokybės vertinimas priklausomai nuo gydytojų bei slaugytojų darbo stažo taip pat buvo teigiamas. Vertinant techninę paslaugų kokybę dėl dviejų teiginių buvo suabejota – 35,4 proc. gydytojų ir 31,4 proc. slaugytojų teigė, kad nei sutinka, nei nesutinka su teiginiu, kad patalpos, skirtos gydymui, yra aukščiausio lygio ir 36,3 proc. gydytojų bei 39,2 proc. slaugytojų teigė, kad nei sutinka, nei nesutinka su teiginiu, kad įranga, reikalinga tyrimams ir gydymui, yra aukščiausio lygio. Vertinant funkcinę paslaugų kokybę... [toliau žr. visą tekstą] / The aim of this study – to investigate of doctors and nurses services quality evaluation in primary health care system centers. Objectives: 1. To evaluate technical and functional quality of services by attitude of primary health care system centers doctors and nurses. 2. To analyze evaluation of doctors and nurses external services effectiveness evaluation. 3. To investigate doctors and nurses attitude to quality of patients satisfaction primary health care. 4. To compare doctors and nurses primary health care employer’s competition evaluation. Method’s. Research was held in five Kaunas primary health centers in Dec 2012 - February 2013. Questionnaire was made according to Ferguson etc. (1999) questionnaire about primary health care quality evaluation. Results. There were participating 113 doctors and 137 nurses in this research. Doctors and nurses all the technical and functional aspects of service quality review were assessed as positive, both by doctors and nurses. Technical and functional assessment of the quality depends on the doctors and nurses work experience has also been positive. The technical quality of the two statements has been questioned - 35.4 percent. physicians and 31.4 percent nurses said that neither agree nor disagree with the statement that the premises for treatment, is the highest level and 36.3 percent doctors and 39.2 percent nurses said that neither agree nor disagree with the statement that the equipment is necessary for research and treatment of... [to full text]

The paper examines ??red packets?? ?? a form of informal payment ?? in the Chinese health-care system from the perspectives of power and ??inxit?? theories. Drawing on qualitative data collected from focus groups, interviews and documentary sources, the research investigates, from doctors?? perspective, the giving, taking, declining and disciplining of and solutions for red packets. Findings testify to four hypotheses developed from the theoretical perspectives, leading to the conclusion that red packets emerged from and can exert an influence on the power relationships between doctors, the Party-state and patients, and are a response to distrust and quality shortage in the health-care system.

This thesis is a qualitative study investigating the communication about sexual health between HIV-positive gay men and their doctors and other health care providers. The study was conducted in 2007 and 2008 in Sydney, Australia. Data was collected through in-depth interviews with eleven HIV-positive gay men, and analysed according to a modified grounded theory approach. The study aims to explore the men??s needs, expectations and experiences in relation to how sexual health is addressed in clinical consultations. While previous research has documented that HIV/AIDS is a diagnosis that poses significant physical, emotional and social challenges for People Living With HIV/AIDS (PLWHA) which may impact on their sexual health and well-being, this thesis examines whether, and to what extent this is communicated between HIV-positive gay men and their doctors. In doing so the study identifies and describes the ways in which HIV-positive gay men understand sexual health, how they currently talk to their clinicians about sexual health issues, the priority that such issues have for these men, and barriers and ??incentives?? to sexual health being discussed within HIV treatment settings. The study reveals that the men??s communication about sexual health with their doctors is essentially limited to discussions about sexually transmissible infections (STIs), which represent a common understanding of what constitutes sexual health. The emotional and social aspects of sexual health and well-being are rarely discussed in doctor-patient communication. Instead, the men rely on sources outside the health system, such as friends, peers, partners, gay and HIV community organizations and the gay and HIV media for sexual health information, advice and support. This indicates that broad, holistic sexual health has a low priority in discussions between patients and their doctors, and that social networks therefore play an important role in how HIV-positive gay men take care of their sexual health.

This thesis is a qualitative study investigating the communication about sexual health between HIV-positive gay men and their doctors and other health care providers. The study was conducted in 2007 and 2008 in Sydney, Australia. Data was collected through in-depth interviews with eleven HIV-positive gay men, and analysed according to a modified grounded theory approach. The study aims to explore the men??s needs, expectations and experiences in relation to how sexual health is addressed in clinical consultations. While previous research has documented that HIV/AIDS is a diagnosis that poses significant physical, emotional and social challenges for People Living With HIV/AIDS (PLWHA) which may impact on their sexual health and well-being, this thesis examines whether, and to what extent this is communicated between HIV-positive gay men and their doctors. In doing so the study identifies and describes the ways in which HIV-positive gay men understand sexual health, how they currently talk to their clinicians about sexual health issues, the priority that such issues have for these men, and barriers and ??incentives?? to sexual health being discussed within HIV treatment settings. The study reveals that the men??s communication about sexual health with their doctors is essentially limited to discussions about sexually transmissible infections (STIs), which represent a common understanding of what constitutes sexual health. The emotional and social aspects of sexual health and well-being are rarely discussed in doctor-patient communication. Instead, the men rely on sources outside the health system, such as friends, peers, partners, gay and HIV community organizations and the gay and HIV media for sexual health information, advice and support. This indicates that broad, holistic sexual health has a low priority in discussions between patients and their doctors, and that social networks therefore play an important role in how HIV-positive gay men take care of their sexual health.

Thesis (Ph. D.)--University of Washington, 1988. / Vita. Bibliography: leaves [179]-187.

Thesis (M.A.)--Auburn University, 2008. / Abstract. Vita. Includes bibliographical references (p. 121-129).