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Record W4404553337 · doi:10.33137/utjph.v5i1.44246

Examining How Structural Conditions, Cultural Norms, and Institutional Practices Shape Diagnostic Delays for Women in Ontario: A Critical Qualitative Study

2024· article· en· W4404553337 on OpenAlex
Kelly Gregory, Pia Kontos

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueUniversity of Toronto Journal of Public Health · 2024
Typearticle
Languageen
FieldSocial Sciences
TopicDisability Rights and Representation
Canadian institutionsUniversity Health Network
Fundersnot available
KeywordsEmbodied cognitionFeelingPhenomenology (philosophy)PsychologySocial psychologyShameHealth careMedicineEpistemologyPolitical science

Abstract

fetched live from OpenAlex

There are a number of diseases and conditions that have notoriously long diagnostic periods. Often associated with a downplaying or dismissal of symptoms and feelings of shame, many of these diseases and conditions disproportionately manifest among women. Endometriosis, for instance, takes on average three to ten years to diagnose, and cardiovascular disease, ADHD, and pain conditions such as fibromyalgia and rheumatoid arthritis represent other common examples. During a diagnostic delay – when the period becomes prolonged between seeking care until the point at which a diagnosis is made – women continue to suffer from symptoms, lose confidence in healthcare providers and systems, and experience interruptions to their lives, relationships, and sense of self. While several investigations have produced descriptive accounts of these reasons, they leave unaddressed women’s embodied experiences of diagnostic delays, socio-political structures and power relations, such as gender, and the interrelationships between these two components. To address this gap, I will draw on critical phenomenology to ask: How are diagnostic delays lived as embodied social practices by women?; What do narratives of diagnostic delay reveal about gendered embodiment during illness? and In what ways do women’s embodied experiences of illness resist, reinforce, and revise the cultural expectations and institutional practices that contribute to diagnostic delays?. In doing so, my research aims to understand how socio-political structures and power relations are intertwined with embodied experiences of diagnostic delay, and the ways the relationship between them serves to support and/or disrupt this phenomenon. Critical phenomenology engages with a wide range of critical disciplines to understand rich subjective experiences and how normalizing structures privilege some experiences and marginalize others. Drawing on this methodology, I will interview women with lived experience of diagnostic delay and clinicians who have experienced delays in diagnosing women. I will also review relevant practice guidelines and organizational policies to further contextualize this phenomenon. By exploring the intertwined nature of women’s embodied experiences of illness with social structures, and how these relationships serve to impact diagnostic delays for women, this project will importantly address the lack of specific and critical discourse on this phenomenon. In doing so, it will not only advance scholarship in this area, but will also support the continued discussion and advocacy that is essential to effecting change to this enduring and wicked problem.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Qualitative · Consensus signal: Qualitative
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.509
Threshold uncertainty score0.734

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.003
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.169
GPT teacher head0.442
Teacher spread0.273 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it