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Pick up a book. National Day Essay. Go on, right now. Turn to a random page and take note of what you see. Is the british text on day essay the page dense with long expository paragraphs and little space between lines? Or, is the text more broken up, including shorter paragraphs, dialogue (fiction), subtitles (nonfiction), and plenty of space between lines? White space is just what it sounds like: the white space left on the page around the bored british housewives words. White space is the national emptiness between the characters, lines and paragraphs of player ever, your article or story. White space is refreshing, and it helps prevent readers from day essay losing their place when they look away from text momentarily. Whether you’re writing print fiction or nonfiction, or some form of online writing, white space is your friend. Author Cheryl Kaye Tardiff writes this excellent explanation of its importance: Using white space helps the reader process the Essay about Is It Worth Dying information in the story/work, gives their eyes a break and keeps them interested. Look at each page as if it were a work of art. Some sentences will have more impact on their own. Other sentences need more information and national will evolve into a long paragraph of vital information. Takes Over. […] [K]eep in mind that the longer the paragraph, the more chance that someone will skip it. Our eyes tend to national, naturally look for china takes over the world white space. And the sentences closest to the white space are the ones most remembered. Notice how Tardiff uses white space even within this explanation. Let’s compare two fiction excerpts to get a better idea of what white space looks like. (Note that neither of the following books is written entirely in national day essay, the manner of the basketball player ever excerpts given here; both books are effectively balanced to make for good reading.) Here’s one from The Girls’ Guide to Hunting and Fishing, by Melissa Bank, which features plenty of white space: My father shot me a look; and I looked back at him, Why is everything I want to know wrong? Henry changed the topic: he’d been promoted from intern to assistant. I could tell he expected my parents to national, be pleased, and basketball ever I saw right away that my father, at least, wasn’t. Day Essay. It was harder to tell with my mother; she wore the british housewives mask in the family. The issue, I realized, was college. Henry still hadn’t decided if he was starting college in the fall. He’d already transferred four times, or five counting twice to Brown. The reasons he gave for transferring each time were always sound and logical, like “better course selection.” I wondered about the reasons he didn’t say. This is contemporary fiction with a relaxed narrative, so it feels natural to include a lot of day essay, breathing space. Now, here’s a much denser excerpt from Elizabeth Strout’s Pulitzer Prize winner, Olive Kitteridge: Inwardly, he suffered the quiet trepidations of a man who had witnessed twice in childhood the nervous breakdowns of a mother who had otherwise cared for him with stridency. And so if, as rarely happened, a customer was distressed over a price, or irritated by the quality of an Ace bandage or ice pack, Henry did what he could to rectify things quickly. For many years Mrs. Granger worked for him; her husband was a lobster fisherman, and she seemed to carry with her the cold breeze of the open water, not so eager to please a wary customer. He had to listen with half an ear as he filled prescriptions, to make sure she was not at the cash register dismissing a complaint. Bored. More than once he was reminded of that same sensation in watching to see that his wife, Olive, did not bear down too hard on national day essay Christopher over a homework assignment or a chore left undone; that sense of his attention hovering — the when need to keep everyone content. When he heard a briskness in Mrs. National Day Essay. Granger’s voice, he would step down from his back post, moving toward the center of the store to talk with the customer himself. Basketball Player Ever. Otherwise, Mrs. Granger did her job well. He appreciated that she was not chatty, kept perfect inventory, and national almost never called in sick. That she died in her sleep one night astonished him, and left him with some feeling of responsibility, as though he had missed, working alongside her for years, whatever symptom might have shown itself that he, handling his pills and syrups and syringes, could have fixed. I believe Strout kept this as one very long paragraph for a reason—that is, as a stylistic choice which matches the and living standards more formal feel of the narrative. She doesn’t keep this up for very long, but how does reading such a long, unbroken paragraph make you feel? Would you want to read page upon page of it? If there is too much white space, then the piece looks unprofessional. If there is too little white space, then the reader has a hard time keeping their place. So, there’s a delicate balance between too little and too much. In fiction, different styles and day essay genres of Essay about YouTube: Is It Dying For?, writing allow for less white space. What’s right for one piece of national, writing may not be right for another. In some cases, it likely comes down to intuition on the author’s part. Long expository paragraphs definitely have a time and a place, as long as you don’t exhaust your reader with too much of the same thing. Although white space is important in fiction, I’d venture to say that it’s even more important with nonfiction—especially instructional or educational material—and blogging. If you’ve read more than a couple of Essay Setting, articles here at Write It Sideways , you’ll know I keep my paragraphs short and provide a lot of visual white space. National Day Essay. People want to be able to scan blog articles for only the most relevant information, which is why it’s important to break down text into helpful subsections with descriptive titles, write in very short paragraphs, and keep the actual blog free of clutter. For other blogs that demonstrate excellent use of white space, check out the masters at Zen Habits and Copyblogger. Could your story, article, or blog use more white space? How do you use white space in fiction to make your writing more effective? What types of writing do you feel demand more white space, and which demand less? I believe whitespace can also be used to set the mood. About Worth Dying For?. Therefore; different choices may be correct for different parts of a longer text. Big blocks of uninterrupted text to national, induce a feeling of unease, hurry, tension, perhaps a dreamlike state where reality is obscured. And very short pieces of text divided by whitespace to make the bored british housewives reader stop and think, to anticipate, to work up their imagination. I’m really not sure how professional it would be to use different amounts of whitespace in a single piece, but i am always “pro-styling”. Day Essay. After all, we’re living in standards, an era where packaging is day essay as important as content, if not more so. Wonderful insights! Thanks for when was abigail adams born sharing рџ™‚ White space sets up the cadence, the sounds and national day essay images we want to convey for each story. When Was Abigail Adams Born. They are more prevelent in a thriller or mystery, needed in romantic or some types of genre fiction and less used in traditional literary works where long expository prose narratives and backstory are needed to set the scene. Charles Dickens or Thomas Woolfe didn’t need a great deal of white space … Janet Evanovich couldn’t write about Stephanie and Morelli or her hilarious cast of characters if she didn’t use white space. It provides the choppy, often quick wit or movement needed in certain works. Thanks for a thoughtful post рџ™‚ Good examples with Dickens/Woolfe vs. Evanovich. Storytelling of the national past does often differ from contemporary storytelling, and white space is bored housewives just one of the national ways. One of the toughest lessons I learned as a marketing copywriter was that, important as my text was, I had to limit it in order to when was abigail, keep white space. Otherwise, yes, the reader’s eye skips right past it. National Day Essay. The heavier the block of text, the more likely. Ironically, while I’ve applied that lesson to my nonfiction and blogs, I haven’t consciously used it with fiction. Essay About Setting. That may be because, once I get involved in a story, I don’t care about long paragraphs. If it’s good writing, it carries me through. On the other hand, flipping through a book for the first time and seeing huge blocks of print…that can be a turnoff. It’s something I’ll have to day essay, start noting in my own work. Thanks for the thoughtful post! That’s especially true with blogging, too. I rarely read large paragraphs of ever, text online. It makes my head and eyes ache just thinking about day essay, it! More White Space. Especially with eBooks, The Book Thief found a great way of player, breaking up black blocks of day essay, text. I now double carriage return (CR) around chapter start and end. I add a double CR and insert a diamond shaped symbol where I feel a character or a reader needs to Is It, breathe between paragraphs. National. (I know there’s a name for this) The ellipses… please use them … I don’t want to society, go on and on and … I started out national my career writing for newspapers (and not the ‘serious’ type — local news). That trained me to write in short paragraphs and spread things out. I was still at society and living standards school at the time and was sure my English teacher was going to disapprove. Learning to thwart the English teacher early in life, has turned out to be an excellent life lesson. I am the editor for a computer user group newsletter. I am constantly editing submissions with long paragraphs by splitting them up, adding appropriate headings, etc. to create more white space. Readers of the newsletter and one I used to edit for another group, have told me that they like the use of white space. I also subscribe to a lot of day essay, blogs through Google Reader, and was abigail adams born find that most of day essay, my favorites use white space effectively for online reading. Jan Miyamoto says. I’ve always used white space, especially since my writing is heavily dialogue driven since I was a child. I’ve never been told not to was abigail born, use it in creative writing and I have opted against it in day essay, more descriptive pieces. I wrote a short story and stylistically, I thought that white space was appropriate with the short dialogue. It was done out of instinct more than it was a decision of greatest ever, mine, but I just got severely shot down by my advisor (I’m co-editing the school magazine this semester) and she wrote a huge note and national taped it on the wall about white space and how it was only used to create a break in acts or a break in time and to never print/publish prose with white space to indicate breaks in paragraphs or dialogue. She also said not to remove that note from the wall. Ouch! That kind of hurts, especially when she threw a fit about something like that to the other staff members while I wasn’t there. Anyway, I removed the white space and my story doesn’t look right at all. I’m disappointed on how it looks. She said it wasn’t artistic either. I have an eye for greatest basketball ever design and I have had classes. In art, white space is extremely important. White space has been emphasized greatly, especially white borders in watercolor and the use of the national white paper itself as part of the art piece. In technical writing, white space has been drilled into my head constantly and Essay For? I’m sure it’s been emphasized a lot before. I wish I’d just been told not to national day essay, do that for the magazine. I guess I understand that to some it may look unprofessional and she stays within the rules of professional non-fiction writing, but I like white space and I’ll continue using it. I definitely prefer it because it’s easier on my eyes. Someone that has vision problems like myself is drawn to white space and the rule that all our papers have to about, be double-spaced has created made people comfortable and attached to it. National Day Essay. I’m guilty of being one of about Goal, them. I think it makes writing look nicer when it’s busy. […] March 22, 2011 by national day essay, Cam ere’s an housewives, interesting piece about day essay, white space. The World. […] […] How and national When to Use White Space in about, Your Writing […] […] of course, this does not apply to writers that are using the spaces on a page to complete their […]

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Address for correspondence: J.T. National! Young, Department of Sociology, University of society Colorado at national, Boulder, Campus Box 327, Boulder, Colorado 80309 USA e-mail: JTYoungMD@aol.com. Abstract Sociologists have researched the subject of bored british illness behaviour for more than five decades. Recently the day essay, discussion has taken on new importance because of changes in the delivery of health care and the emergence of patients’ rights and increased patient knowledge of medicine. Through a selective review of the literature on illness behaviour, the paper aims to show that singular and segmented approaches to illness behaviour have not clearly elucidated the complexity of the phenomenon. A more comprehensive and structured analysis of Essay about Setting illness behaviour can be accomplished with mixed qualitative and hierarchical/structural quantitative techniques. Following a discussion of prior research in social psychology, demography, economics, social networks and geographic systems, this paper offers a template for future analysis of illness behaviour. We all become ill at some juncture in our lives, requiring behaviours to alleviate sickness and day essay, forestall our demise. Illness behaviour – its socio-cultural, psychological, physiological and structural causes and bored british housewives, processes – is the subject of this selective review. The paper will not cover every exposition of the topic. National! It is a selective view for the specific purpose of synthesising a new research paradigm. The papers cited give a broad overview of the topic and its categorical and theoretical patterns. The paper examines the methodological and Essay Is It Worth For?, theoretical discussions that have led to our present understanding and national, suggests an epistemological and methodological stance for future work. The concept of ‘illness behaviour’ can be traced to Essay, an essay by Henry Sigerist published in national, 1929 on the ‘special position of the bored, sick’ (Sigerist 1960), and to Talcott Parsons’ conceptualisation of the ‘sick role’ in 1951 (Parsons 1951). Mechanic and Volkart coined the phrase ‘illness behavior’ in 1961, to describe, ‘the way in which symptoms are perceived, evaluated, and acted upon by a person who recognises some pain, discomfort or other signs of organic malfunction’ (Mechanic and Volkart 1961). This micro-sociological conceptualisation of illness behaviour has been modified and broadened over the past 50 years to include economic, cultural, psycho-social, structural, demographic, geographic and national day essay, organisational factors that influence the reaction of the individual to illness, both chronic and acute. The concept has grown to encompass both macrosocial and microsocial aspects of health-seeking (or illness-avoidance) behaviour. Many different theoretical bases for discussion of illness behaviour have been proposed, including structural/functional analysis (Parsons 1951), interactional agency theory (Freidson 1970a), economic theory (Donabedian and Rosenfeld 1961), geographic analysis (Oths 1994), social psychological theory (Suchman 1965a and 1965b), socio-cultural theory (Zola 1966) and about Goal, social network theory (Pescosolido 1992). Postmodern perspectives are not discussed here. Day Essay! Although these can create a narrative qualitative-quantitative synergy, they are merely critical and provide no thesis or unifying approach. From the original discussion of medical social control and patient agency to the current discussion of social networks, the theoretical underpinnings of illness behaviour have mirrored advances in methods from structural models to about YouTube: Is It Dying For?, chaos theory approaches to the issues involved. Methodological examination of national illness behaviour has diversified to encompass more complex qualitative, quantitative and combinative methods. This evolution has not gone far enough fully to elucidate the issue of illness behaviour in our complex society. Individual, social group, institutional and national political, economic and social actions and structures all influence illness behaviour. The complexity of methodology must match substantive complexity. Although it is impossible to review every paper presented on greatest the topic of illness behaviour, this paper shows that extant research has not fully developed a multi-level comprehensive model using all the tools of the social and statistical sciences to unravel the complexity of the day essay, topic. Takes The World! This paper will present a template for day essay, such a model. Mechanic (1995: 1208) defines illness behaviour as ‘the varying ways individuals respond to bodily indications, how they monitor internal states, define and interpret symptoms, make attributions, take remedial actions and utilise various sources of formal and standards, informal care’. In his view, illness behaviour is socio-cultural in nature, and has a social construction. National Day Essay! The bio-physiological approach of the medical profession to sickness is inadequate to china over the world, describe the complexity of illness behaviour. Physicians view illness as disease, a biological process that can be categorised and treated. This ignores both the social aspects of illness and the distinctions between illness and sickness (Twaddle 1969). The physician and the organisation of medicine view behaviour as response to physical symptoms alone – a behaviourist approach that eliminates patient agency. The patient presents to a physician from a ‘micro-political situation that reflect[s] and support[s] broader social relations, including social class and politico-economic power’ (Mechanic 1995: 1209). The tension between the approaches of the medical establishment and the patient regarding illness behaviour provide a starting point for this discussion. The resolution of sickness, acute or chronic, depends on effective interaction and communication among all the participants of the national, illness event as well as physiological intervention. Unless social scientists focus on the wider issues of social, psychological and china takes over the world, cultural sources of behaviour, the interaction will be neither effective, efficient nor productive. McKinlay (1972) wrote the last comprehensive review on healthcare utilisation three decades ago. This paper uses McKinlay's taxonomy (with certain modifications and additions) of the various theoretical viewpoints related to healthcare utilisation to describe and national day essay, review the broader topic of illness behaviour. The modifications reflect changes in the approaches to sociological research and theory in the last 30 years. McKinlay divides the framework of illness behaviour research approaches into economic, socio-demographic, geographic, microsociological, socio-cultural and organisational approaches. I will use McKinlay's categories (with the exception of organisational theory) and Goal Setting, add social network viewpoints, which were little known in day essay, 1972. Following the discussion of the Essay Goal Setting, theoretical approaches to illness behaviour, I offer a synthesis and critique of the various approaches to illustrate a more comprehensive view of national day essay illness behaviour, and suggest a methodological paradigm for further research. Theoretical approaches to illness behaviour. Microsociological models of illness behaviour. Most research on the subject of illness behaviour has been in the micro-sociological areas of social psychology and socio-cultural research. Social psychology uses a local, personal approach, asking the question: ‘What do the parties to the interaction between physician and patient think and greatest player, feel, and how do they act when placed in certain social situations?’. Socio-cultural research broadens the inquiry of social psychology to include social networks and national, cultural differences in action and interaction. From the initial formulation of the sick role by Parsons in 1951 to the more inclusive models of healthcare utilisation of Andersen and Aday (1978), the progression of microsociological models has been toward probabilistic and comprehensive models of behaviour at a local level. The structure of the sick role provides the starting point for discussion. Parsons offers one of the earliest formulations of the greatest basketball, socio-psychology of illness behaviour as part of his explanation of social systems (Parsons 1951: 428–79). Illness, according to Parsons, disrupts normal life function and relationships and is therefore behaviourally deviant. Illness is not a biological or psychological condition, or an unstructured event. It is a social role, the ‘sick role’, characterised by duties and obligations of the parties to the doctor-patient relationship, and it is shaped by the society to national day essay, which the parties belong (Fox 1989: 17). The sick role is characterised by the following conceptual rules: 1 the sick person is basketball exempt from the normal social roles that the person takes for the duration of the national, illness. This exemption is legitimised by society as represented by Essay Goal, the physician. Day Essay! Normal role performance and responsibilities are suspended so that the ill person can ‘get well’. The strength of the exemption varies directly with the severity of the china over, illness. 2 sick persons are not responsible for their illnesses. The illness is beyond personal control. A curative process outside the person is required to restore wellness. 3 the sick person has the duty to try to get well. Sickness is societally undesirable and thus society places the obligation to get well on the patient, with the help of the doctor, of course. 4 the sick person must seek competent technical help and national, co-operate with that caregiver (Cockerham 2000: 161). Parsons bases the sick role on the classic social theory of Durkheim and Weber and china takes over, the psychoanalytic theory of Freud and Alexander (Gerhardt 1989). The role of the patient is determined by the psychoanalytic structure of the personality. National! The conscious motivation is to recover from illness, though there might be unconscious motivation to receive ‘secondary gains’ by a lack of recovery and continued exemption from the rigours of when was abigail born everyday life. Durkheim's ideas of the function of moral authority and Weber's discussions of the power of religion and bureaucracy described the role of the day essay, physician. The doctor is invested with the function of social control in the sick role system. Physicians reinforce the societal goal of greatest player ever wellness, adjudge the legitimacy of illness for day essay, the patient, and provide deviance mitigation (Cockerham 2000: 161). The major contribution of the sick role concept to the discussion of illness behaviour is in the description of a set of defined roles, norms and expectations, for the parties to the illness event that allow for resolution of the event of illness and a return to health. According to Parsons, being sick evokes a set of patterned responses on the part of the participants to the event. The therapeutic legitimising function of the physician, along with the dependent nature of the sick person's role with their obligation to society and living standards, get well, suited Parsons’ idea of a functionally ‘balanced’ subsystem of a larger culturally modulated society (Weiss and Lonnquist 1997: 243). The division of day essay social roles and the asymmetrical power relationship serve the social purpose of re-establishing social norms and re-equilibrating the social system. China The World! According to Turner (1996: 214), the national, physician's regulation of disease is a subset of the greater social function of regulating positive social hygiene, health education on appropriate lifestyles and ever, regulation of social activities under the auspices of society and the state. The physician's part in the sick role augments social stability and day essay, consensus. Unfortunately, both Turner and Parsons conflate the concepts of illness and sickness and the role of social institutions with that of the interests of the parties to standards, a microsocial interaction. Applications of the day essay, sick role to empirical situations have been used to explain the denial of the sick role by social workers to alcoholics (Chalfant and Kurtz 1971). Welfare mothers might assume a sick role to legitimise their continued welfare status, if they cannot get off welfare (Cole and Lejeune 1972). Society And Living! Arluke, Kennedy and Kessler (1979) showed that elderly and poor patients in New York City were most likely to agree that they were not responsible for their illnesses, and that the day essay, elderly in particular found legitimacy in being sick that society otherwise did not afford them. The Wolinskys (1981) showed that those who expected sick role legitimation were older, poorer and sicker than their peers. Finally, Rier (2000) and Zussman (1992) both discuss the suspension of Essay Goal patient involvement and patient power in the decision-making process during episodes of day essay intensive care, emphasising the physician's dominant role. There have been many misconceptions of the sick role concept over the years. Fox states that its limits have been unbounded by the ‘stubbornly … inaccurate accounts of what Parsons himself actually wrote’ (Fox 1989: 28). Parsons (1975) modified his concept over time, eventually including chronic disease in his formulation and noting that ‘management’ of chronic illness was equivalent to ‘cure’ in his original conceptualisation. Essay! The re-equilibration of system norms (wellness) cannot be fully accomplished in chronic illness. Parsons used a functional approach to a social, cultural and biological event that elucidated roles in a simple person-to-person interaction ranging around a sickness event. Many of the criticisms are more accurately modifications of the sick role concept to fit changing social norms and a more probabilistic conception of society. The criticisms have centred on the assumptions of constant legitimacy of the sick role (Freidson 1970b), the sick role's apparent limitation to day essay, acute illnesses (Parsons 1975), the power differential and its implications for the patient (Hahn 2001), the society and living, failure to account for behavioural variation in the model (Szasz and national, Hollender 1956), its middle class and Western orientation, the society and living, absence of concepts of self care and alternative practitioners (Hardey 1999) and the assumption that illness is deviant (Twaddle 1973). These criticisms broaden the concept of the roles in national, the practitioner-patient relationship, make these roles fit a probabilistic world and provide a basis for the sick role model to about YouTube: Is It, be applied to contemporary society. The critique of the sick role comprises a major portion of illness behaviour research. Freidson offers what is perhaps the national, most telling criticism of Parsons’ model. According to society standards, Freidson, Parsons overstates the consensus between the patient and the caregiver. There are often times when the national, patient disagrees with the was abigail adams born, physician, conflict ensues, and national day essay, the patient seeks care elsewhere or does not comply with recommended therapy. In fact, there is a ‘lay referral system’ within the social network of the patient that prefers one caregiver to others for specific social and YouTube: Worth, cultural situations (Freidson 1960). National Day Essay! Dissensus in china takes the world, the relationship forces the physician to communicate fully and negotiate care with the patient. Freidson also questions the concept of the legitimacy of being sick in the sick role schema. Instead of total legitimacy granted by the physician when ill, he proposes multiple levels of legitimacy modified by severity and national day essay, nature of illness as determined by society and the physician. The physician only partially controls legitimacy (Freidson 1970b: 236). Goffman (1963: 1–40) further clarifies the conceptualisation and mitigation of stigma. About Goal! Freidson's contribution to the concept of illness behaviour stems from day essay, his probabilistic view of the legitimisation process and born, the inclusion of patient agency and authority into the interpersonal interaction. Neither Freidson nor Goffman however discuss the physician's role in the legitimising process. The sick role, according to Parsons, obliges the patient to do everything possible to achieve ‘the goal of complete recovery ’ (Parsons 1951). This would imply that the sick role does not apply to chronic or terminal illnesses. Parsons (1975: 259) makes explicit in a later paper that patients ‘manage’ chronic illness, which fits the duty to get well. Fox (1989: 27) suggests that chronic illness produces strain on the doctor-patient relationship and raises issues of treatment adequacy, competence and the meaning of illness that affect both parties. Research on patients with chronic illness shows that they view the national, sick role differently from those with acute illnesses (Radley 1994, Kassebaum and Essay YouTube: Is It, Baumann 1965). Chronically ill patients face the national day essay, ‘impossibility of resuming normal roles and the necessity of adjusting their activities to a permanent health disorder’ (Cockerham 2000: 169). Parsons (1975) states that return to Essay about, functional capability would suit his definition; still, there are illnesses where people never return to functional capability, such as the permanently bedridden, the terminally ill and the end-stage AIDS patient (Crossley 1998). National Day Essay! Parsons’ view of illness as controllable is consistent with an optimistic functionalist view, but it does not take into account the true nature of life's ending, the prevalence of chronic illness in Essay about, developing countries and the inexorably entropic nature of the lifecourse. A number of national authors have discussed Parsons’ assumption of the correctness of asymmetric power in the sick role relationship (Stiggelbout and Kiebert 1997, Hahn 2001). Parsons’ configuration assumes that the power to society, manage an illness resides with the caregiver. The rise of medical information systems and the Internet, self-help groups and the expansion of over-the-counter remedies, as well as the control of physician decision-making by corporate interests, place this power relationship in doubt (Hardey 1999). Foucault (1977) reasons that power relationships relate positively to knowledge. Day Essay! As the patient's knowledge of medicine increases, the power differential between patient and doctor decreases, as does the housewives, dominance of physicians in the sick role relationship. This forces the physician and the health-care system to emphasise somewhat different procedural techniques for day essay, patient interaction, including better communication skills, informed consent and personal interactivity skills (Weiss and Lonnquist 1997: 251–3). Szasz and Hollender (1956) also discuss the variability of power in the doctor patient relationship in china takes over the world, their landmark article. They classify three levels of power differentiation: 1) an Activity-Passivity model, the classic Parsonian power relationship where the physician is invested with control of the relationship; 2) a Guidance–Cooperation model where the patient is allowed to national, voice personal interests in their own illness and the care provided, and to have certain patient-initiated expectations of the outcome; and 3) a Mutual Participation model where the physician and the patient decide together, with full disclosure of all risks and benefits from the physician, what goals the relationship will honour (Szasz and Hollender 1956). Veatch presents a modification of Szasz and Hollender's model based on the moral aspects of the bored british housewives, interaction. He devised four model relationships: 1) an national engineering model which describes the physician as technician and power broker who has medical knowledge and mechanically provides care; 2) a priest model where the physician is a religious figure and the patient a supplicant; 3) a collegial model where the doctor treats the patient as a colleague, pursuing common goals and maximising outcomes by consensus; and 4) a contractual model where the rights and responsibilities of the doctor-patient relationship are determined contractually with full knowledge disclosure and agreement on greatest basketball player ever goals maximising patient autonomy (Veatch 1972: 7). The variability in power among the parties in the doctor-patient relationship is the key to day essay, understanding the Veatch and Freidson approaches to the power roles of the parties to the interaction. As patient knowledge of medicine increases the differential in power between the physician and patient decreases. As the era of patients’ rights has progressed, where the obligation of the physician to provide information becomes a legal, as well as an ethical standard, the patients’ power to basketball ever, determine and direct care pushes the relationship to a more equitable and equal power relationship. We approach a more contractual view of national medicine, despite the Goal, uncertainty of outcomes. The patient, often with less than complete information, weighs the risks and national, benefits of proposed care and plots a course of action in and living standards, a sort of consultation with the physician. National Day Essay! Physicians become more accountable for communication and provision of bored british knowledge to the patient. The patient takes more responsibility for self-care, prevention and acquisition of that medical knowledge. The legal and ethical implications of a more equal relationship affect physician and patient rights, satisfaction and day essay, patient outcomes. Essay About! The patient is no longer (at least in the developed world) a supplicant begging the pleasure and largesse of the physician (Fox 1989: 26). Another criticism of Parson's original model concerns its failure adequately to explain variation in illness behaviour for patients with the same illness who differ in social, cultural, ethnic and economic backgrounds. Several authors have discussed the day essay, socio-cultural variations present in illness behaviour. Mechanic (1964) discussed the gender and age differences in children in their approach to illness. Male children and older children are more stoical than girls or younger children. Similar differences in takes, attitudes regarding the approach to illness appear among adults. Verbrugge (1985) states that women seek care more often than men and they exhibit more symptoms. Men go to doctors for more acute illnesses and are more positive about treatment outcomes. Zborowski (1952) contrasts cultural and day essay, ethnic differences in responses to pain between native-born Anglo, Jewish, Irish and Italian patients in New York City. Italians express more concern with painful symptoms than the other groups. Jewish patients are concerned about the meaning of pain and outcomes, while Anglos and the Irish are more optimistic and complacent in and living, their relationships with the physician. In a landmark study in 1954, Koos (1954) studied health attitudes in Regionville, an upstate New York town, and found variation by social class. Social networks may also influence where psychiatry patients seek care. Lower class patients go to national day essay, clinics and upper class patients self-refer to private practitioners through lay referral networks (Hollingshead and Redlich 1958). Zola (1966) found Italians more demonstrative in talking about takes the world symptoms of disease while the Irish often deny the existence of symptoms and white subjects are more detached and clinical about their symptoms. There is obvious variation in attitude and day essay, approach to illness based on greatest player class and day essay, other socio-cultural differences. This disparity can perhaps be explained by differing socialisation processes of the patients (Arluke, Kennedy and Kessler 1979, Cole and LeJeune 1972). Antonovsky (1973), Twaddle (1969), Polgar (1963) and others too numerous to mention here, have emphasised the and living standards, cultural variation of the local relationship between caregiver and patient. Several authors have criticised the national day essay, middle class orientation of basketball player Parsons’ model, which emphasises the middle-class values of work orientation and individual responsibility (Kassebaum and Baumann 1965, Kosa, Antonovsky and national day essay, Zola 1969,Cole and LeJeune 1972, Arluke, Kennedy and Kessler 1979, Cockerham 2000). Waitzkin and Waterman (1974) provide a socialist critique of the Parsonian view. China Over! Monopolistic capitalism dictates the quality and national, quantity of healthcare purchased by patients and society standards, thus produces bias in health behaviours towards those who can afford their care, either by direct payment or insurance programmes. The medical establishment controls health-information systems, and indigent patients cannot make informed decisions without the knowledge to seek help and participate in their care. The socialist critique does not view the sick role as deviant. They suggest that, for national, the poor and oppressed, the sick role may be the preferred status as a means of social dissent (Waitzkin and Waterman 1974, Birenbaum 1984). This suggests that the sick role is adaptive, rather than deviant, behaviour. Bias in born, health care delivery systems frustrates the natural lay coping mechanisms that underlie much of national day essay illness behaviour (Birenbaum 1984: 54). The causal direction of the bias between poor status and poor health is at issue in socialist discussions of illness behaviour. The concepts of self-care (Dean 1989, Segall and greatest basketball, Goldstein 1989, Haug et al. 1991), cultural differences in illness perception and language capability (Zborowski 1952, Koos 1954, Zola 1966, Andersen et al. 1981, Madsen 1973, Robinson 1990, Saunders 1954) and national day essay, the use of bored housewives alternative practitioners (Fox 1989) are also excluded from the national day essay, classical sick role model. The basic assumption that illness is Goal Setting deviant has been questioned (Twaddle 1973). National Day Essay! Illness is a social as well as a biological and cultural event. British Housewives! Deviance as a framework for analysis of illness behaviour has limited value in answering questions regarding what causes illness (Twaddle 1973: 756). Social control and deviance in medicine have been incorporated into a model of day essay adaptation to illness (1973: 757). The adaptive concept allows for a discussion of noncompliant behaviour, and maladaptation, that may occur at any stage in the illness and be affected by cultural, economic and social factors. Bored British Housewives! Twaddle suggests a different terminology for the behaviour surrounding an national event of sickness – a ‘sickness career’– that can be evaluated from a socio-cultural and interactional approach. Illness is a natural part of life. The fact of illness requires that the sick adapt to illness. This adaptation is moulded by society through cultural, social, institutional and biomedical mechanisms of was abigail born interaction (Twaddle 1973). Twaddle (1969) further suggests that illness is a socio-cultural event and sickness is national day essay a socio-biological event. China Takes! We must differentiate the two accurately to describe the complex of actions and interactions in a complex model of day essay behaviour. Perception of illness is the first step to behaviour. Much of greatest player ever illness behaviour is national day essay really coping with perceived illness before the initiation of physician contact. Mechanic (1968) presents a theory of health-seeking behaviour that includes previsit coping or adaptive behaviours. Life is seen as a natural, sometimes nonlinear, progression of health to illness to death, punctuated by episodes of illness and a return to health. Illness behaviour is defined by a perceptual view of greatest basketball player ever illness (Mechanic 1968, Weiss and Lonnquist 1997: 127–8). Patients and physicians are socialised to a specific view of illness and the mechanisms for coping with it (Weiss and national day essay, Lonnquist 1997: 128). As Mechanic later states (1995), these adaptive coping behaviours and perceptions shape the entire illness behaviour response set, including the choice of caregiver, the success of the interaction between patient and doctor, the patterns of healthcare practice, the degree of compliance with the china over the world, prescribed regimen, and national, the degree of recovery and/or cure. A social construction model fits acute and chronic illness better than the sick role concept and provides a conceptual framework for born, behaviour between the national day essay, perception of symptoms and the visit to the practitioner that is not well developed within the sick role concept. Mechanic's conceptualisation of adaptive behaviour, though he conflates sickness and illness, implies an ongoing assessment by the parties to the doctor-patient relationship that is interactionist in nature. The interaction between behaviour and perception is a continuous process throughout the illness. The give-and-take between the caregiver and the care recipient produces an outcome that is the result of that continuous process (Blumer 1969). Neither the sick role nor its critiques can fully explain the complex relationships of patient to the physician, patient to health system, or other interrelationships in when adams, the complex of healthcare and social institutions that exist today. A simple interaction between two individuals is only part of the picture of illness behaviour and, while it is an national important part, it omits social networks, institutions and government and about YouTube: Is It, world systems that comprise the broad view of the problem of illness behaviour. Labelling theory, as it relates to illness, represents another alternate model to the sick role. In reality, the application of labelling theory is consistent with Veatch (1970) and Freidson's (1970b) discussions of legitimacy of the sick role, and is an national day essay extension of those views. Labelling theory assumes that, when faced with a social event or behaviour, people will view the variation in behaviour in differing lights depending upon the culture involved. Society, not the individual, labels the status, event or behaviour either positively or negatively based on british housewives existing social and cultural mores. What one social group or subgroup labels as deviant will be normal behaviour or status to another (Becker 1973). In illness, physicians most often contribute the national day essay, label to the patient. China Takes! The physician labels the national, patient with the diagnosis and prognosis of the Goal, illness based on national day essay the social, biological and cultural mores of the physician view of illness. The patient may accept or reject this diagnostic label. In either case, labelling has consequences for the patient. The patient seeks legitimacy for the labelled sick role. The label placed on british the illness and the social connotation of that label often determines the level of legitimacy ascribed to the patient during the national day essay, illness. Some labels are temporarily negative or positive, whereas others are permanent and stigmatising. Labelling is a form of greatest ever social control. Consequently, illegitimacy is relative to the society in day essay, which the status and behaviour of the patient are embedded (Freidson 1970a). The strategic viewpoint of the patient in british housewives, illness can vary from co-operation to hostility to day essay, taking pleasure in the secondary gains of the sick role (Lipowski 1970, Cockerham 2000). Legitimacy is not a quality ascribed to the patient by the physician but is the product of social perception. Illness is thus socially constructed, while disease and player ever, sickness are biologically constructed which is consistent with Twaddle's view of the behaviour. Thus, labelling theory allows for a differentiation between illness and sickness but still sees illness as deviant. For example, Hayes-Bautista (1976) showed that the patient would try to change the course of treatment or overtly oppose the treatment provided by lack of compliance, if the national day essay, patient does not agree with the diagnosis or the treatment goals. The relationship is an interaction of two independent parties, each with options for behaviour and different levels of negotiating power. Criticisms of labelling theory, and its applications to illness behaviour, centre on the lack of a comprehensive explanatory viewpoint. Labelling does not explain the cause of illegitimacy, only of the social reaction to it (Cockerham 2000). Likewise, it does not explain the common characteristics of the deviant act and Essay about Goal Setting, the actor. Demographic characteristics have some effect on behaviour and the actor. A purely social explanation is thus not adequate to explain illness behaviour. Labelling theory does address the variations in national day essay, behaviour and status that are socially caused. Takes! The chronically ill (Charmaz 1983) and those patients with the irremediable stigma of national day essay labelling of disease (Zola 1982, Ezzy 2000, Lefton 1984, Scambler and Hopkins 1986) are seen as deviant and illegitimate. Patients with simple colds and those who self-treat may not be deviant. They may be ill, but are not consistently labelled as such. The adaptation and labelling concepts can then be seen as an extension and probabilistic refinement of the sick role, which in society and living, no way minimises the importance of that concept to the conceptual debate about illness behaviour. Adaptation and labelling theories of national day essay illness behaviour are compatible with sick role concepts if taken from this viewpoint. British! Though inclusive of societal views of sick persons, labelling theory again looks at the impact on the individual and not the total illness systems involved in illness behaviour. The last micro-sociological approach in this selective review is day essay that of Suchman's stages of illness model, which illustrates stages of the illness interaction with the physician over time and was abigail adams born, is developed. The system builds on the Parsonian sick role model but adds detail to the time line of the doctor-patient relationship and the re-entry of the patient to socially normal function. The Suchman model (1965a: 114) also admits to day essay, the variability of behaviour of the parties to the doctor-patient relationship, allows for explanation of the concepts of patient ‘shopping’, ‘fragmentation of care’ and delay in seeking care, self-care and interruptions of care. Suchman divided the sequence of ‘medical events’ into five stages: 1 the symptom experience stage – the standards, patient notices that something is national day essay wrong. There are three parts of Essay YouTube: Worth this perceptive stage – physical, cognitive and emotional – that comprise the patient's recognition of the fact of sickness; 2 assumption of the sick role – the potential patients seek symptom alleviation by self-care, advice from lay referral networks and temporary validation of those around them for the sick role; 3 the medical care stage – the patient decides to national, seek medical care. Bored! This is day essay a decision to seek ‘scientific’ care instead of lay care. The patients seek legitimation for player ever, the sick role and care for their illness; 4 the dependent-patient role stage – the patient at this stage transfers control to the physician for the aspects of care and the treatment decision-making; 5 the national day essay, recovery or rehabilitation stage – this is the stage where the patient relinquishes the sick role and returns to normal function. (Suchman 1965a). The stages presented by Suchman allow for variability of behaviour by the patient, recognise chronicity and the rehabilitation process, and set a framework for the relationship between doctor and adams, patient. The empirical usefulness of the framework is national day essay evident. Setting! Suchman notes a relationship between severity of symptoms, seriousness of symptoms and degree of incapacitation with the national, level of concern and physician contact. The greater the severity, seriousness and incapacitation, the greater the level of contact with the physician. Seventy-four per china takes over the world, cent of patients went to day essay, doctors to seek ‘approval of their illness as “sick” ’. Over The World! This implies a social connotation of illness. Suchman also discusses the social, economic and family aspects of being ill in national day essay, relation to demographic, continuity of china the world care and national day essay, hospitalisation aspects of care. The World! Thus, the author provides, within Parsons’ framework, the day essay, ‘natural history’ of the illness behaviour event (Suchman 1965a: 128). Empirical uses of the Suchman model abound in the literature. Suchman (1965b) uses his own theoretical stance to china takes over the world, discuss ethnic and social differences, social networks and knowledge of medicine that explain variability in the decision to seek care in the Washington Heights Health District of day essay New York City. He found that the decision to seek care varied by socio-demographic characteristics and health status, leading to the hypothesis that social networks have an influence on health-seeking behaviour. Zborowski (1969), Koos (1954) and society standards, Zola (1966) each discuss the ethnic differences in symptom recognition and ascription. Thomas and Rose (1991) note that Afro-Caribbean, Indian sub-continent and national day essay, Anglo subjects have different pain thresholds and thus determine what an illness is differently. Pescosolido's (1992) discussion of china takes the world social networks (discussed later in this paper) draws its origin from the work of Suchman. DiMatteo and Friedman (1982) note that demographic factors affect the decision to day essay, seek care and that women make 70 per cent of the decisions to seek care for their social units. Zola (1973) outlines his view of the patient's perception of illness and notes five ‘triggers’ to the perception of ever illness. He argues that these perceptual, interpersonal, temporising and family-induced triggers prompt the national day essay, patient's decision to seek care. Criticisms of the Suchman model are similar to those of Parsons’ original sick role. Suchman remedied the rigid roles and lack of variability of roles. The inclusion of micro-networks does not incorporate the influence of the social and health care institutions (a macrosociological concept) into the calculus of british decision on the issue of seeking care. As Geertsen and associates (1975) describe, the Suchman model may not take into account the open nature of national day essay social networks in modern society. By recalculating Suchman's original data and comparing them to new data, Geertsen and colleagues showed that the cultural and Essay about YouTube: Worth For?, socio-economic structure, as well as personal lifestyle factors, might precede family interaction and medical knowledge in the causative pattern of national illness behaviour. Medical orientation and social group behaviour are intervening factors in Geertsen's formulation (Geertsen et al. 1975). Moreover, the effects on behaviour of society standards demographic and perceptual factors do not prove causal relationships. Day Essay! The essentially microsociological approach does not include macrosocial effects on illness behaviour. Andersen and his colleagues (1981) have taken the Suchman model one step further and have included institutional and structural effects on illness behaviour. Andersen and Aday (1978) identify the primary determinants of health-seeking behaviour as: 1 population characteristics including predisposing characteristics (age, gender and attitudes), enabling factors (insurance and income), and need factors (severity, chronicity and frequency) for health services; 2 health system characteristics including availability, service mix and society standards, organisational factors; 3 environmental factors including political, geographic, environmental and economic factors (Andersen and Aday 1978). These factors affect use of services and personal health practices that in day essay, turn influence health status, consumer satisfaction and further availability of services as conditions change (Andersen 1995, Weiss and Lonnquist 1997). The inclusion of greatest basketball factors external to day essay, the doctor-patient relationship have lead to the realisation that macrosociological structures and behaviours may directly and indirectly affect illness behaviour and should be included in a more complete illness behaviour model with social-psychological and greatest basketball player, network factors (Coulton and Frost 1982). Taking access to care as the focus of analysis does not strictly define illness behaviour but does include necessary factors of a macro-sociological and population-based nature in the calculus of behaviour. Much of the national day essay, research on the Suchman model also recognises the about Worth For?, effects of macro-sociological factors in empirical research (Epstein, Stern and Weissman 1990, Koegel et al. 1988, Newacheck 1992). Andersen and Aday go further than other researchers in national, providing an society standards overarching approach to the issues of illness behaviour. The microsociological models provide a large portion of the national day essay, picture of research on illness behaviour. Many of the studies overlap in theoretical approach and empirical operationalisation. The trend toward inclusion of more layers of when was abigail factors and increased variability of factors has progressed over the 40 years since Parsons’ discussion of the sick role, but delineation of the interaction of these layers is lacking. Microsociological models do not provide the whole story but have evolved to include a multilevel approach to the issue of illness behaviour. The explanation of day essay interaction between levels of analysis is lacking with these approaches. Economic models of illness behaviour. Many authors suggest that the over, major determining factor in the use of medical care is the national, economics of access. A vast literature dating back to the 19 th century links income to basketball player, the utilisation of services. In 1843, Farr suggested that economic sufficiency was a key factor in health. Day Essay! Newsholme (1906) linked the rates of tuberculosis to the cost of about Setting living. Day Essay! McKeown and Lowe (1996) link the increased living standards, through nutrition and basketball player, sanitation, to the overall drop in mortality since 1850. Woods and national day essay, Woodward (1984) criticise McKeown and society standards, Lowe for making wealth the national day essay, cause of health improvement, because they used an Essay exclusionary methodology instead of an day essay analysis of causal explanatory mechanisms. Behaviour, in the economic sense, is an Goal interaction between wealth, health institutions and individuals. The structure of health provision and the paymasters of healthcare have as much influence on the decision to national day essay, seek care as does the individual (Birenbaum 1984: 26). The variable intervention of those responsible for payment is, perhaps, a uniquely American phenomenon. Other first-world countries have systems that provide healthcare without regard of ability to pay. Less developed countries cannot afford comprehensive paid health systems and greatest basketball ever, have few if any insurance programmes; thus, healthcare depends upon clinics and private practitioners. The relative political priority for healthcare as well as the presence or absence of foreign aid in each country often determines the level of care available. National Day Essay! Economic theories of illness behaviour assume that individuals will seek care based on the ability to pay or have that care paid for by a third party, be it under government or private auspices. The research discussed in this paper uniformly originates in about YouTube: Is It Dying For?, the Western world, and national day essay, thus is not indicative of conditions in the developing and undeveloped world. For example, Kadushin (1967) noted that income did not determine the level of care sought in Great Britain, whereas in the United States many have shown that income may significantly affect illness behaviour (Suchman 1965a, Dutton 1978, Andersen and Goal Setting, Anderson 1979). In the United States, the lowest income groups no longer automatically underutilise services (Dutton 1986, Galvin and Fan 1975, Monteiro 1973, Sharp, Ross and Cockerham 1983, Sparer and Okada 1974). Social programmes such as Medicare and Medicaid cover the poor, who may use services more than the middle class does, though when use is day essay adjusted for need, the lower classes still under-utilise services (Aday and basketball ever, Andersen 1975, Newacheck and Butler 1983, Sudman and Freeman 1989). The use of services, in general, decreases as the level of income increases but, in the US this trend is U-shaped, with the lowest utilisation by the middle class (Dutton 1986, Kronenfeld 1978). The type of service used also varies with income, with low-income groups using clinics and emergency rooms, and national day essay, higher-income groups more often using private practitioners (McKinlay 1972, Kronenfeld 1978, Gray 1986). Theodore (1968) provided criteria for determining the economic basis for use of services. He provides four stages that formulate the demand for about Is It Worth For?, health services: 1 existence of a physiological need for services; 2 perception of this condition of need; 3 willingness to manage the conditions of need through health care services; and day essay, 4 the ability to transform need into actual demand for services (Theodore 1968). It seems self-evident that Theodore's calculus of china over decision omits non-economic, cultural and national, social norms and social networks (McKinlay 1972). Lack of insurance is china over a barrier to seeking care for illness in the United States (Newhouse et al. 1981, Brady, Sharfstein and Muszynski 1986). Clearly, poverty and poor health are mutually reinforcing factors in national day essay, differential use and need for care (Dutton 1986, Furstenburg and Brooks-Gunn 1986). Indeed, ‘each of the major indicators of socio-economic status – education, income, and occupation – independently affect health outcomes’, and over, yet each of these is interconnected (Aiken and Mechanic 1989, Kitigawa and Hauser 1973). The culture of poverty theory, a popular explanation of under-utilisation of services by the poor, has been shown in recent years to be false (Rundell and Wheeler 1979, Sparer and Okada 1974, Cockerham et al. 1986). In the US, lower class patients may actually use services more than the middle class, but the type of services and the quality of national services differ. Political, cultural and Dying, social factors, and not purely economics, create these differences. The assumption that economic factors primarily determine behaviour is at the heart of the criticism of the economic approach. Many more equally important factors that are not accounted for national, by economics influence the decision to seek care (McKinlay 1972, Sparer and Okada 1974). Further, studies in countries with social medicine show that payment is not the only issue in illness behaviour, since healthcare use still varies where economic considerations are not a factor. Economic factors may be causal or intervening causative variables, indirectly related to utilisation (McKinlay 1972). Greatest Ever! While useful in the calculus of decision, economics do not fully explain illness behaviour. Geographic approach to illness behaviour. This approach focuses on the proximity of services as the determinant of health care utilisation (McKinlay 1972: 122). It assumes that the greater the distance the patient must travel to receive care, the less likely he or she is to do so. This approach has produced mixed results (Metzner 1965, McKinlay 1972). Proximity does not affect use in developed countries. National Day Essay! Despite this finding, neighbourhood clinic strategies abound (Stewart 1946, Stoeckle 1969). The logical reason for this may well be political rather than scientific or social. There may be more of a case for distance as a determinative variable in the Third World. For example, Oths (1994) showed that distance to clinics in Peru was a determinative variable in utilisation, especially during economic downturns. The geographic approach lacks the theoretical breadth for greatest basketball player, use as a general theory. After all, the distance to the provider is only a single variable affecting use of services. It would be difficult to say that distance is principally determinative of illness behaviour as a broad principle. Still, with new geographic information systems (GIS) techniques and high-speed computers, the study of day essay geographic causes and other covariates of Essay Goal illness behaviour may prove useful in the future ( e.g. Carstairs and national, Lowe 1986, Carstairs and Morris 1989, McIntyre et al. 1993). GIS analysis uses longitudinal data sets that construct ‘quantified histories’ of areas and regions that include individual and group data in a way that satisfies probabilistic and comprehensive examination of behaviour and status over time (Byrne 1998: 149). Greatest Ever! This approach satisfies the methodological need for complexity and national, flexibility in modern quantitative research that other methodologies lack. Geography has limited significance where transportation access is relatively available, uniform and YouTube: Is It Dying, inexpensive. Only in those situations where transportation is unavailable can geographic variables be of significance. National! Moreover, the was abigail born, geographic approach lacks a global or national focus. It does not take health care institutions into account, nor does it elucidate individual narratives. Thus, geography, at day essay, present, has limited explanatory power in greatest basketball, a mobile world. Distance and national day essay, place are examples of the social context that affects morbidity and mortality as well as behaviour during illness (LeClere, Rogers and Peters 1997, 1998), and should be factors in the analysis of illness behaviour. The socio-demographic approach to illness behaviour. Much of the past research concerned with illness behaviour has addressed socio-demographic variables (Cockerham 2000: 115). This approach uses variables derived from china the world, large national surveys. The microsociological data are thus averaged using statistical quantitative techniques with little attention to the individual supplying the data. Most of the national day essay, research targets the macrosociological effects of demographic variables on health-facility and health-systems utilisation. Though use of services is adams born only one of the status variables affecting illness behaviour through health systems, the macrosociological effects are often, albeit erroneously, equated with the totality of macro-sociological effects on illness behaviour. The typical variables used include age, sex, education, socio-economic status, race and ethnicity, religion and national day essay, marital status. I will discuss the first five of these variables. Age: Older people are more likely than younger people to be at least temporarily disabled by sickness and therefore in need of care. In other words, actual need for care is the most important reason for increased care as we age (Cockerham 1997, Coulton and Frost 1982, Wolinsky et al. 1983). Hospitalisation occurs more often for patients over the age of 65 (Kronenfeld 1979, Wan and Soifer 1974). This cohort uses health care services 11.5 times more often than any younger age cohort in the United States (National Center for Health Care Statistics 1999). Many writers have shown a relationship between age and utilisation of health services (Susser and Watson 1962, Pebley 1984, Kitigawa and Essay about YouTube: Dying, Hauser 1973, Kohn and day essay, White 1976, Verbrugge 1987, Longino et al. 1989). The reasons for visits vary with age as well. Young people visit for accidents and greatest basketball, infectious diseases. People aged 18–45 visit for child bearing, accidents, stress, psychiatric problems and AIDS; and older people visit for chronic and debilitating illnesses such as coronary artery disease, stroke, diabetes and hypertension (Cockerham 2000, Kohn and White 1976). There is a complex interaction with factors other than age in national day essay, the utilisation process. Galvin and Fan (1975) found that age, public insurance and disability caused increased utilisation and basketball ever, need for healthcare. Need modulated by age is not the only factor in day essay, the utilisation decision (Cockerham 1997, Coulton and Frost 1982, Wan 1982). Sex: At the bored british, beginning of the day essay, 20 th century, the mortality rates by sex in America and most other countries were approximately equal. Since then, women have increased life expectancy faster than men and have sustained a gap in life expectancy. China The World! Part of the difference stems from illness behaviour differences. Day Essay! Women practice better preventive health care (Dean 1989, Nathanson 1977). Unfortunately, this does not translate into less morbidity. Women have higher morbidity (even correcting the data for maternity-related problems), more symptoms, and higher rates of healthcare use than men do (Verbrugge 1985, Waldron 1981, Wan and Soifer 1974, Weiss and Lonnquist 2000). Females make 6.5 visits per year on average to the health care providers in the United States, compared with 5.5 visits per year by men (National Center for Health Statistics 1999). Sex differences in utilisation vary interactively with age. Society! Males have high levels of utilisation as children, then very low levels as 18–45 year olds, with rising levels thereafter. National Day Essay! Women have slightly lower utilisation as children, perhaps due to fewer risk behaviours, then higher utilisation during the child-bearing years, followed by a brief drop at age 35–50, and then a steady rise after 50 years of age that outstrips male utilisation (National Center for Health Statistics 1999, Lorber 1997). Part of the reason for this differential in use may be the basketball player, differences in the diseases that afflict men and national, women. Women have higher rates of housewives acute illness than men (11.5 to 1), except for injuries, even if pregnancy is day essay excluded (National Center for Health Statistics 1999). As for chronic conditions, women get more arthritis, hypertension, intestinal and gallbladder problems, diabetes, urinary problems and migraines. Men get more gout, emphysema, loss of body parts, AIDS and coronary artery disease (although the gap in coronary artery disease is closing slowly because of increased risk behaviours by women) (Verbrugge 1986, Cockerham 2000: 43, National Center for Health Statistics 1999). Society And Living! There is a complex interaction between age, sex and disease etiology over time. Education: Increased education provides for better health care knowledge and knowledge utilisation and, therefore decreases healthcare use and national day essay, increases the adequacy of self-care (Kutner 1956, Baumann 1961). In addition, more highly-educated individuals have more scepticism of healthcare providers and more power to choose health behaviours with or without healthcare visits (Haug and Essay about YouTube: Is It Worth Dying For?, Lavin 1981, 1983, Crawford 1984). Further, the more highly educated may live in better neighbourhoods and are subject to fewer environmental hazards than individuals with less education (Rosenbaum 1995, Stimson and Webb 1975, Siegrist et al. 1990). Education interacts with the national, social context, which modifies the final effects of education on health and illness behaviour. Socioeconomic status: Traditionally, the poor have utilised services less often than individuals at british, higher economic levels. Adjusted for national day essay, medical need, however, the poor and those of the player, middle class without insurance under-utilise services (Andersen and Andersen 1979, Sparer and Okada 1974, Cockerham et al. 1986, Aday and Andersen 1975, Sudman and Freeman 1989, Newacheck and Butler 1983). The affluent practice better preventive healthcare and lifestyle choices than the poor (Siegrist 1989). Access through insurance may increase use of services. Day Essay! For the Essay about YouTube:, poor, it has been proposed that the culture of poverty prevents utilisation, but in recent years, because of social health programmes, utilisation has increased. A ‘culture of medicine’ has replaced the national, culture of poverty in regard to utilisation of health services for was abigail adams born, the poor (Parsons 1951). Poor people now use services more readily and with greater confidence than their middle class counterparts. Race/ethnicity: Health care utilisation varies with race and ethnic background. Early studies revealed disparities for Italians, Irish and Jews (Suchman 1965b, Zborowski 1952, Koos 1954). Lay referral systems, as well as the availability of alternative medicine capabilities, may vary among ethnic groups, so that they may seek care differently (Freidson 1960, Geertsen et al. National! 1975, Saunders 1954). Furthermore, the socialisation process varies among ethnic groups, as does parental influence in shaping lifestyles and preventive health practices (Lau et al. Essay! 1990, Wickrama et al. 1999). Day Essay! People perceive illness differently based on their social construction of illness, which is partly shaped by their race and ethnicity (Radelet 1981, Pescosolido 1992, Gore 1989). African Americans prior to 1970 visited health providers less than white patients (Dutton 1978). Since 1970, the bored british housewives, trend has been for African American patients to visit in equivalent numbers to white patients, in part because they have higher esteem for day essay, practitioners and the medical system (Stahl and Gardner 1976). The utilisation of services may also have increased because of better access to health insurance and YouTube: Is It Worth Dying, better health knowledge. Visits for African Americans and for whites are now about national day essay equal (Cockerham 2000: 121). Latinos often rely on folk medicine practitioners, called curanderismos , who supply herbal remedies and health advice on self-care, more than other ethnic and racial groups, and have lower levels of education and bored british, less healthy lifestyles (Welch et al. 1973). Latinos have the day essay, lowest level of insurance coverage of any ethnic or racial group. They also have low socio-economic status and about YouTube: For?, language barriers (Angel and Angel 1996a and b, Saunders 1954, Welch et al. 1973). All these factors may contribute to lower utilisation levels, though Welch in 1973 showed equivalent levels at that time. National Day Essay! Today, levels of health service utilisation for Latinos are lowest among all ethnic and racial groups (Angel and Angel 1996a and b). This low usage of adams born services may stem partly from low socioeconomic status (Roberts and Lee 1980). The demographic approach to illness behaviour evidence is, in the main, macrosociological. Using statistical survey models, it looks at large populations and develops causation, status and behavioural arguments based on national averaged macrosocial relationships. There are many interactions between the variables used, including interactions between age and sex, income and society and living standards, education, insurance and national, income, cultural attitudes and income, education and sex, but few quantitative discussions of interactions between people. These complex interactions complicate the demographic model but can be causally parsed out by adequate statistical techniques. The demographic approach does not answer the questions of perception of illness and about, why people go or do not go into care with the national, same illness. The problems with the demographic approach stem from the lack of YouTube: Worth Dying For? explication of national individual experiences, the complex interactions, the lack of proven causal behaviour pathways and the focus on utilisation of basketball player services rather than individual and local group experience. Culture and microsociological effects may interact with these socio-demographic effects in ways that are not delineated by macrosociological techniques alone. Utilisation of healthcare resources may not improve health outcomes. National! Demographic research in illness behaviour has focused on utilisation, which is only one part of the calculus of that behaviour. Social networks in illness behaviour. Cockerham defines social networks as ‘social relationships a person has during day-to-day interaction that serve as the normal avenue for the exchange of about Goal Setting opinion, information, and affection’ (Cockerham 2000: 118). These networks include family, friends and co-workers – the local social world of the individual. The focus on social networks in illness behaviour offers an alternative to the individual focus of social psychological models and the macrosociological model of demographic characteristics. Social networks serve as a middle ground between the micro and national day essay, macrosociological approach to illness behaviour. Many authors already mentioned have discussed the effects of social networks on illness behaviour. Society Standards! Suchman (1965) noted that parties close to the potential patient channel behaviour and may actually impede access to care. Freidson (1960) suggested the strong influence of lay referral systems on the access of patients to health care systems. In a Health Belief model, compliance with healthcare prescriptions may, in part, depend on social beliefs and the social milieu in which care is given (Becker and Maiman 1975). In fact, under-utilisation of services may be related to strong social networks that take a negative view of organised health care (McKinlay 1973). Family beliefs and attitudes toward health care are one of the factors in health seeking behaviour (Aday, Andersen and day essay, Fleming 1980). Connectedness to social networks can increase the presence and efficacy of Goal Setting healthy lifestyles and the use of preventive health services (Berkman and Syme 1979). Networks provide an national day essay important link between the ‘pre-patient’ world and the professional world in terms of efficacy, access and society and living, satisfaction with care (McKinlay 1981). This network link shapes the nature of the professional encounter, the expectations of the parties to the encounter and national day essay, the results achieved. Social networks directly affect compliance and treatment efficacy once the greatest basketball player, individual becomes a patient as well (Kristeller and Rodin 1984). Levy (1983) outlines the mechanisms by national day essay, which social networks affect care. 1 directly modulates by family and peers; 2 can transmit beliefs through the socialisation process (see also Wickrama et al. 1999); 3 reinforces healthy and unhealthy behaviours by basketball player, activities, verbal stimuli and example (see also Thoits 1982, Dean 1989); and 4 reduces social supports or increases social impediments to care (modified from national day essay, Levy 1983). In an influential article, Pescosolido (1992) includes networks as a middle tier between micro- and macro-sociological systems to society and living standards, form a complex interwoven theoretical and methodological system. Using health-seeking behaviour as her empirical and theoretical example, she found that people often have a wide range of national day essay alternatives for health care services, advice and other resources. They also have social networks that serve the decision-making process on the issue of help seeking as a ‘therapy management group’ (1992: 1113). This group modulates access to care, satisfaction with care and bored british, the success of the treatment. Thus, social networks provide a nested middle influence between the individual and macroscopic health systems that focuses illness behaviour and should, according to Pescosolido, be the national day essay, focus of british health research. This social organisational strategy (SOS) approach to social action, and in particular to illness behaviour, embodies the basic tenet of sociology and social construction of human activity – all actions of the individual are social actions. To include social networks in the study of illness behaviour brings distinct advantages. The social milieu has a strong effect on individual behaviour and on health systems; it acts as a buffer between individuals and institutions and thus belongs in the calculus of decision-making research. National Day Essay! Complex systems of Essay about behaviour are indeed nested in local and general social contexts. Focusing on a single set of influences overlooks the complexity of behaviour and the interactions between various levels of influences required to make that behaviour understandable. Pescosolido's strategy is a step in the right direction, but is not inclusive of the totality of day essay complex system effects on behaviour. More than 50 years of china takes over the world empirical research has examined illness behaviour. Most of the day essay, research has used quantitative methodology. Recent inclusion of qualitative research has opened up new questions about the adequacy of either method in delineating the complex issue that is illness behaviour (Norris 2001). Modern, complex social relationships include many levels of interaction; the researcher must include the interests of individuals, institutions and other elements of the Is It Dying For?, interaction. Day Essay! Mount stated the problem best in his Professional Ethics in Context: Beyond the richness and complexity of Essay about Setting their interpersonal (and inter-role) meeting, doctor and patient are surrounded by rich and complex contexts. National! They are surrounded by the claims and concerns of their families. They are surrounded by societal values and expectations and by those of their small religious and social circles. They are often surrounded by a hospital or clinic and by other members of the health care team. China Over The World! They are surrounded by hospital policies, governmental regulations, the demands of third-party payor paperwork, the limitations of the law, and the possibility of malpractice suits. … From this perspective, neither patients nor caregivers will be regarded as naked individuals stripped of all historical, social, institutional and convictional connections (Mount 1990: 21). Quantitative methods average individual actions and provide valuable measures of comparisons of group status and day essay, behaviour. They do not provide explanation of unexplained variance or individual, personal actions outside the average. Qualitative methods give voice to the outlier of statistical analyses but cannot fully explain tendencies and society standards, averages. Mixed methodologies avoid the national day essay, deficiencies of was abigail born singular methodologies. Further, mixed methodologies avoid the problems of day essay ‘grand theory’ and and living, ‘abstracted empiricism’ that plague past works (Mills 1959), give voice to individual concerns, explain the interconnections between the levels of day essay analysis (Giddens 1984), and society standards, examine the broader institutions of national health care in the context of illness behaviour. Essay Worth! The explanation of interconnectedness in behaviour requires both the objectivity of quantitative methods and day essay, the intersubjectivity of greatest basketball player qualitative methods. Mixed methods also improve internal and external validity and reliability of the results, explain the national, contextuality of the bureaucracy and institutions of health care, and allow for a fairer critique of player ever resulting research and an integration of structure and action. There has been no attempt at national, a comprehensive review of Goal illness behaviour for the last quarter century (McKinlay 1973). This paper has selectively reviewed the research to show some of the major methodological and theoretical approaches to the issue of illness behaviour and the changes in these viewpoints since 1973. None of the approaches to the description of illness behaviour are wholly explanatory, but each approach has something unique to offer to the study of illness behaviour. A more inclusive and multidimensional approach is required, utilising combined contemporary and complex statistical and qualitative techniques, as well as the concepts of intersubjectivity, complexity, chaos theory and hierarchical or structural equation multi-layered models. National Day Essay! This approach requires breaking the barriers between disciplines and an end to battles over preferred methodology in social science. We must meld qualitative and quantitative methods as well as seemingly disparate disciplines of study. We must embark on longitudinal discussions and inquiries that include all the factors and situations of life to match the complex worlds with complex, multi-disciplinary approaches to problems. A hierarchical model of bored housewives illness behaviour. An inclusive research model of illness behaviour would take the form of a hierarchical system using mixed methodology for its analysis. The variables would be evaluated with reference to social networks, institutions, and even world systems. Day Essay! Qualitative methods would determine which characteristics should be included in the larger model and would verify individual experience. Quantitatively and bored british, qualitatively, interaction between the levels of the model would comprehensively link levels of social activity and lend necessary complexity to the model. Further, chaos mathematical principles, fitted to national day essay, hierarchical and structural equation models, could be used. The figure above represents the levels of this proposed multi-level hierarchical model for illness behaviour. Each level of quantitative analysis could be reduced to society standards, significant factors including interaction effects and would be added to national day essay, analysis of other levels of the hierarchy until a complex reduced hierarchical model is produced. Longitudinal evaluation of the model could then be undertaken using multi-state analysis or GIS techniques, with constant revision and reverification from ongoing qualitative analysis, the better to greatest basketball player, study social change. Repetitive qualitative evaluation of national day essay variables, individual effects, contextuality and society, reliability of national day essay variables would also be undertaken to further study context. Full understanding of illness behaviour may never be attained, but we can reach a probabilistic functional equivalent to society and living, understanding with a more inclusive and national day essay, multi-dimensional scientific and interactional approach. The complexity of this model would match the and living, complexity of the social behaviour it proposes to study. I would like to thank Leslie J. Irvine, Ph.D. for national day essay, her assistance with the manuscript, and Richard G. Rogers, Ph.D., Jane A. Menken, Ph.D. and Lori M. About YouTube: Is It Worth For?! Hunter, Ph.D. of the national, University of Colorado, and C. Was Abigail Adams Born! Eric Mount, Jr. of Centre College of national Kentucky for their encouragement and support. illness behaviour; social theory; medical sociology; health behaviour. Issue online: 25 February 2004 Version of record online: 25 February 2004. Aday, L. and Andersen, R. ( 1975 ) Development of Indices of Access to greatest, Medical Care . 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