Wellbeing Machine shows how wellbeing arises in the intimate processes of everyday life. To avoid... more Wellbeing Machine shows how wellbeing arises in the intimate processes of everyday life. To avoid the blaming associated with the individual notion of wellbeing, McLeod shifts analytic attention to the collective body. This approach generates a conceptual entity called the 'wellbeing machine', which comprises four assemblages that represent different responses to the challenges of everyday life experienced by people with depression. In this manner, wellbeing emerges from assemblages that transform in a sustainable way over time. Assemblages associated with illbeing are generative and vital to the production of wellbeing. Wellbeing Machine shifts discussion about the wellbeing bioeconomy into new terrain. It investigates the intersections between emergent wellbeing and labour, power and capitalism, and produces knowledge about wellbeing that does not contribute negative associations about individual's wellbeing levels.
We start by acknowledging we are writing on the unceded lands of the palawa and pakana peoples of... more We start by acknowledging we are writing on the unceded lands of the palawa and pakana peoples of lutrawita (Tasmania), and the Yugambeh and Kombumerri peoples. This is important because contemporary sociological paradigms such as posthumanism, the subject of this editorial, sometimes overlook how the politics of colonisation continues to shape academic knowledge production (which this editorial goes on to discuss). The figure of the post 'human' is entangled in a set of dilemmas that are useful for informing sociological ways of thinking through health matters in more than human worlds. The complexities of living in a COVID society (Lupton & Willis, 2021; Matthewman & Huppatz, 2020), the challenges of climate change and persistent inequalities all emphasise the need to better understand the material and discursive forces shaping the conditions of health for people who exist in a dynamic relation with the planet. Posthuman approaches are generative here, making visible the more than human forces and power relations that constitute subjectivity and health practices (Fox & Alldred, 2016; Pyyhtinen, 2016; Willcox, Hickey-Moody, & Harris, 2021). Moving beyond the sociological parameters of social structure and human agency, posthumanism challenges us to engage more deeply with the ontoethical-epistemological assumptions that inform all research approaches (Barad, 2007). Troubling long-held humanist assumptions about health, illness and wellbeing also calls for sociologists to attunetheoretically and methodologically-to the entangled relations or ecologies that instantiate realities. The articles in this special issue explore a range of posthuman dilemmas across diverse health issues as they grapple with the ethical, ontological and epistemological relations of knowing and doing health. In this editorial, we discuss how the papers in this special issue harness posthuman approaches to further a range of productive lines of enquiry and knowledge-making for health sociology. Using posthuman perspectives enables the authors to generate health sociology knowledge beyond humanist assumptions, ideals and logics and rethink health care, experiences, subjects and interventions. We go on to argue that although posthumanism enables health sociologists to progress particular agendas, it is important to further problematise the posthuman decentring of the human by bringing sustained attention to bear on the ethical and political implications of this approach to knowledge-making in health. In the latter half of this editorial, we explore three strategies for responding to the limitations, gaps and silences in posthuman thinking about health that have been inspired by Indigenous, decolonial and feminist scholars with respect to unlearning Western privilege (traditions, logics and notions of selfhood, etc). The strategies include orientating to posthuman thinking as a provincial (
It is widely acknowledged that teachers need to interrogate and transform how Eurocentrism underp... more It is widely acknowledged that teachers need to interrogate and transform how Eurocentrism underpins educational practice. This paper argues that teachers can actively engage with decolonial frameworks and concepts to productively expose how Eurocentric categories of thought shape teaching practice and curriculum. We describe how six teachers "walked with" the decolonial concept of the pluriverse (a sense of multiple co-existing differences) during collaborative reflections about our diversity teaching of culturally safe healthcare. Our research processes drew on the principles of collaborative, reflective practice. We co-participated in conversations, which aimed to collectively explore how the pluriverse concept intersected with our teaching and undertook qualitative co-analysis of themes emerging across these dialogues. The paper outlines how employing the pluriverse concept as a companion to our reflective process enabled us to ask critical questions about Eurocentrism in our teaching practice and content. Our questioning, in turn, generated principles for embedding the pluriverse in the curriculum, pedagogical approaches, and teacher dispositions. The paper discusses what enables and hinders the pluriverse being embedded in curriculum materials and classroom activities and the limitations of our activities in relation to the broader project of decolonising pedagogy.
In this article we make the case that ‘unlearning’ is an important dimension of professional refl... more In this article we make the case that ‘unlearning’ is an important dimension of professional reflective practice that can offer new insights when done collaboratively. We do so as an interdisciplinary group of academics interested in ‘undoing’ the conventional and individualising norms of reflective practice in academic settings, particularly when it comes to planning and reflecting on group processes for research. In the process of planning a project to investigate mentoring in the professions of social work and teaching, we reflected on our own collaborative academic practices through co-facilitated discussion, the creation of visual ‘d/artaphacts’, written reflections on our perceptions of ‘unlearning’ and academic collaboration, and reviewing how our diverse disciplines have engaged with unlearning in research literature and practice. These responses generated insights into the intricacies of the collaborative practice of unlearning in a professional research environment. We draw on these conversations, d/artaphacts, and reflections to compose five principles for a pedagogy of unlearning that can be applied in mentoring and professional practice settings. The principles highlight the importance of approaching unlearning as a collaborative activity for sustainable professional practice and for supporting the development of professional identities in fluid and complex relational work environments.
A key concern for qualitative inquiry is finding ways to account for nonhuman and emergent forms ... more A key concern for qualitative inquiry is finding ways to account for nonhuman and emergent forms of life. Toward this, researchers are experimenting with research practices that decenter the human subject. Deleuze’s (1977) assemblage concept has proved a useful resource for these methodological experiments. Most often, the assemblage concept has informed analysis and writing processes. This article puts the assemblage concept to work during each stage of an empirical research project exploring how people experience antidepressant use. It details seven ways that assemblages are used during concrete research processes across the span of the project. This strategy generates a sensibility toward qualitative inquiry described as orientating to assembling. The sensibility decenters the human as the focus of qualitative research. It enables the presence of nonhuman objects, not as acted-upon, but agents in the research processes. The article contributes to the challenges posed to human-centered qualitative research by reframing the focus entirely. It shows how using a sensibility that consistently decenters the human across all stages of empirical research projects, is a way that qualitative inquiry can account for more-than-human worlds.
How do antidepressants work? This often-asked question continues to attract debate. The depressed... more How do antidepressants work? This often-asked question continues to attract debate. The depressed individual features in many debates about antidepressants’ action. With this focus, discussion oscillates over whether antidepressants work to remedy chemical imbalances in the brains of depressed people, or produce inauthentic states of being. This article argues shifting the analytic focus away from the depressed individual and onto the collective body, or assemblage, moves debates about how antidepressants work into more productive terrain. This provides a new way of looking at how antidepressants work to facilitate recovery from depression through a series of collaborative connections or relationships. Drawing on the charts, photos, and narratives from research encounters with people who take antidepressants, the article illustrates how medication facilitates the creation of active associations in an assemblage of forces. The article concludes by discussing the new ways of thinking about depression, medication and recovery suggested by this understanding of antidepressant action.
To date, discussions of visual research ethics have largely focussed on the effects for participa... more To date, discussions of visual research ethics have largely focussed on the effects for participants, with increasing attention on how researchers are ethically affected by visual research. However, there has been no sustained examination into how visual materials themselves have ethical consequences in visual research. In this paper we argue that visual research presents with particular ethical challenges because of the capacities of visual materials themselves to act in research encounters. The paper draws on a research project where participants generated two different kinds of visual materials: timeline charts and photos. We show how timeline charts and photos elicit different kinds of imaginative, bodily and sensory responses, and activate memory in contrasting ways. We argue these capacities give visual materials agency, or the power to act. The agentic capacities of the visual materials act in specific ways to co-create a network of relations across the research encounters. This network of relations has the capacity to act in particular ethical ways with serious consequences, not just for research participants, but also for researchers. We propose that the action of visual materials needs to be added to discussion about visual research ethics. Drawing on the concept of ethical sustainability, we advocate for extending situated ethics and researcher reflexivity to include consideration of the agentic capacities of visual materials.
Discussion about visual research ethics predominantly focuses on the effects of visual research m... more Discussion about visual research ethics predominantly focuses on the effects of visual research methodologies on participants. The effect of visual research methodologies on researchers has received little attention and there has been no sustained investigation into how visual materials generated by the research methodology can impact on the researcher. This chapter draws on a research project where participants created photographs to share their experiences of antidepressant use and wellbeing. It shows how photographs act in particular ways with serious ethical consequences for researchers. The effect that photographs can enact on the researcher introduces an ethical issue that requires further attention and articulation by visual researchers. We discuss some of the implications of considering the action of photographs themselves to ethical discussion about visual research.
Aims and objectives: Public health nurses attended a 3‐day course to learn the use of visual meth... more Aims and objectives: Public health nurses attended a 3‐day course to learn the use of visual methods in health dialogue with adolescents. The aim of this study was to explore how to use visual methods to promote health among adolescents in a school nursing context. Background: Photovoice is a visualising technique that enables adolescents to participate in health promotion projects in a school setting. Photovoice also enhances work of public health nurses and other health professionals. Design: This was a qualitative action research study. We developed and conducted a course in visual methods and used data from focus group discussions in combination with participant observations involving public health nurses working in school health services. Methods: We conducted focus group interviews (n = 40) using separate semi‐structured discussion guides before and after a course in visual methods. The interviews were audio recorded and transcribed verbatim, and we documented the workshops (n = 8) through field notes. We collected the data from January–October 2016. Data were analysed and coded into themes and subthemes using systematic text condensation. We reported the study in accordance with the COREQ checklist. Findings: Public health nurses found photovoice useful in school nursing. The use of images offered pupils an active role in dialogues and more control in defining the topics and presenting their stories. When nurses allowed adolescents to bring images into conversations, they discovered new insights into public health promotion. The public health nurses pointed out the benefits and challenges of using new methods in practice. Conclusion: Public health nurses considered photovoice to be useful in health pro‐motion and other public health issues. Involving pupils in bringing images to conversations offered them an active role and voice in health promotion. Relevance to clinical practice: We recommend the use of photovoice and visual technologies (e.g., smartphones) in health promotion activities for adolescents.
Aims:We aimed to explore how using visual methods might improve or complicate the dynamics of the... more Aims:We aimed to explore how using visual methods might improve or complicate the dynamics of the health dialogue between public health nurses (PHNs) and school pupils. This was done from the perspective of PHNs, specifically examining how they understood their role and practice as a PHN and the application of visual methods in this practice.Background:The health dialogue is a method used by PHNs in school nursing inNorway. In this practice, there can be communicative barriers between pupils andPHNs. Investigating how PHNs understand their professional practice can lead to ways of addressing these communicative barriers, which can affect pupil satisfaction and achievement of health-related behaviours in the school context. Specifically, the use of visual methods by PHNs may address these communicative barriers.Design:The research design was qualitative, using focus groups combined with visual methods.Methods:We conducted focus group interviews using a semi-structured discussion guide and visual methods with five groups of PHNs (n=31) working in northernNorwegian school health services. The data were collected during January andFebruary 2016. Discussions were audio recorded, transcribed and coded into themes and sub-themes using systematic text condensation and drawings were analysed using interpretive engagement, a method of visual analysis.Findings:Drawings and focus group discussions showed that PHNs perceived their professional practice as primarily a relational praxis. The PHNs used a variety ofvisual methods as part of the health dialogue with school pupils. This active use of visualization worked to build and strengthen relations when words were inadequate and served to enhance the flexible and relational practice employed by the PHNs.Conclusions:PHNs used different kinds of visualization methods to establish relations with school pupils, especially when verbalization by the pupils was difficult.PHNs were aware of both the benefits and challenges of using visualization with school pupils in health education. We recommend the use of visual methods in schools because they are useful for PHNs, other health professionals and teachers working with children and young people in developing relations, particularly where verbal communication may be a challenge.
Background:
Visual technologies are central to youth culture and are often the preferred communic... more Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance.
We examine pregnant women’s experiences with routinised obstetric ultrasound as entailed in their... more We examine pregnant women’s experiences with routinised obstetric ultrasound as entailed in their antenatal care during planned pregnancies. This paper highlights the ambiguity of ultrasound technology in the constitution of maternal–foetal connections. Our analysis focusses on Australian women’s experiences of the ontological, aesthetic and epistemological ambiguities afforded by ultrasound. We argue that these ambiguities offer possibilities for connecting to the foetus in ways that maintain a kind of unknowability; they afford an openness and ethical responsiveness irrespective of the future of the foetus. This suggests that elucidating women’s experience has implications for theorising ethics across maternal–foetal relations and, more specifically, for the ‘moral pioneering’ (Rapp, 2000) that reproductive technologies can demand of women. Moral pioneering cannot be reduced to moments or processes of decision-making; it must allow for greater recognition of the affective commitments entailed in and incited by ultrasound. Furthermore, focussing on experiences of the ambiguity of ultrasound allows for understanding the ways in which affectivity circulates across domains commonly understood as medical or social, public or private. In doing so, it contributes to undermining a series of tensions that currently shape feminist analysis of obstetric ultrasound, often at the expense of the experience of women.
Obstetric ultrasound is key to opposing ways of valuing foetuses, that is, both to the ascription... more Obstetric ultrasound is key to opposing ways of valuing foetuses, that is, both to the ascription of foetal personhood and to foetal selection and termination of pregnancy. Whilst ultrasound images are increasingly common within the public sphere there has been relatively little public discussion of its role in identifying actual or potential foetal anomaly and the consequences of this. This paper examines how professionals working with obstetric ultrasound encounter, navigate and make sense of the different uses of this technology. Professionals commonly delineate their work (as providing information) from women’s autonomous choices. Emphasising “women’s choice” can obscure consideration of different collective ways of valuing foetuses with anomalies. It can also deflect consideration of the fundamentally ambiguous information that ultrasound can produce. Distinguishing information from choice is underpinned by a questionable fact–value distinction. We describe alternate professional practices which involve questioning these binaries and foregrounding clinicians’ responsibilities for women’s current and future experience. Public discussion of ultrasound’s different roles in valuing foetuses would be enriched if the discourses and practices shaping professionals’ attempts to facilitate ethical decision-making were included for collective consideration.
Objective: To examine the resettlement experiences of former refugees living in regional Australi... more Objective: To examine the resettlement experiences of former refugees living in regional Australia, focusing on mental health and mental health and support services, including barriers to access. Design: A phenomenological approach utilising a combination of six qualitative, semi-structured, face-to-face focus groups (n = 24) and seven individual interviews. Data were analysed thematically using NVivo 10 software. Setting: Launceston, Tasmania. Participants: Adult and youth former refugees from Afghanistan, Bhutan, Burma, Sierra Leone, Sudan and Iran, and essential service providers, residing in Launceston. Main outcome measures: Participants were asked about experiences of resettlement and mental health. Results: Participants reported that their mental health had improved since resettlement ; however, major stressors impacted mental health and resettlement included employment and housing access and mastering the English language. Past experiences continued to impact current functioning, with trauma commonly experienced inter-generationally through parenting and attachment and ongoing trauma and feelings of guilt and responsibility experienced with families left behind. Participants noted barriers to accessing services: (a) Language difficulties including lack of interpreters; and (b) lack of culturally sensitive and trauma-informed practices. Discrimination was experienced through the inconsistent provision of interpreters and lack of due consideration of cultural and religious differences. The use of children as interpreters enhanced several risk including miscommunication of medical information, exposure to age-inappropriate information, and the resulting increased risk of trauma for the child. Conclusion: Culturally sensitive, trauma-informed and discrimination-free practices should be employed across services, where Western-views surrounding this medical model are not imposed, cultural differences are respected, and timely access to interpreters provided.
Refugees experience traumatic life events with impacts amplified in regional and rural areas due ... more Refugees experience traumatic life events with impacts amplified in regional and rural areas due to barriers accessing services. This study examined the factors influencing the lived experience of resettlement for former refugees in regional Launceston, Australia, including environmental, social, and health-related factors. Qualitative interviews and focus groups were conducted with adult and youth community members from Burma, Bhutan, Sierra Leone, Afghanistan, Iran, and Sudan, and essential service providers (n = 31). Thematic analysis revealed four factors as primarily influencing resettlement: English language proficiency; employment, education and housing environments and opportunities; health status and service access; and broader social factors and experiences. Participants suggested strategies to overcome barriers associated with these factors and improve overall quality of life throughout resettlement. These included flexible English language program delivery and employment support, including industry-specific language courses; the provision of interpreters; community events fostering cultural sharing, inclusivity and promoting well-being; and routine inclusion of nondiscriminatory, culturally sensitive, trauma-informed practices throughout a former refugee's environment, including within education, employment, housing and service settings.
The smoking behavior of friends is a major risk factor for adolescent smoking uptake. To explore ... more The smoking behavior of friends is a major risk factor for adolescent smoking uptake. To explore the social context of smoking experimentation and consolidation with a particular focus on friends, the authors interviewed both members of 14 young adult identical twin pairs who were discordant for smoking. The different smoking status of twins was connected to their different friendship groups and development of different identities. Smoking respondents gravitated to the behaviors and images of the peer group who smoked. Many nonsmokers felt strong pressure from their peers not to smoke and spoke about how the images conveyed by smoking were inconsistent with their peer group's image. Adolescents and young adults are aware of the messages that smoking can convey to others and exploit these images to construct a social identity.
Background: This study aims to show how smokers were represented in smoking-related news articles... more Background: This study aims to show how smokers were represented in smoking-related news articles, editorials, letters and columns in a major Australian newspaper over an 11-year period from January 1995 to December 2005.
Methods: Qualitative content analysis was conducted on a sample of 618 articles to identify 21 representational categories (RCs) of the smoker. Articles were also examined for statements that lent organisational support to either tobacco control or the promotion of tobacco.
Results: The construction of the smoker as a “regulated citizen” due to being subjected to tobacco policy was the most prevalent RC, occurring in 43.4% of articles. Of the 13 most prevalent RCs, eight were constructions of the smoker that lent support to tobacco control outcomes, two were supportive of the promotion of tobacco, and three could be used by both parties. 30.6% of articles contained at least one statement from a tobacco control advocacy source, compared with only 13.6% of articles having a statement towards the promotion of tobacco.
Conclusion: These results indicate that constructions of the smoker that support tobacco control have dominated smoking-related discourse in this Australian newspaper and that representations favouring a tobacco industry viewpoint appeared less often. However, the pro-tobacco representations of smokers in reports relating to legal issues highlight an area of media discourse in which tobacco control advocates should remain vigilant.
News coverage of tobacco issues influences both individual behavior change and policy pro- gressi... more News coverage of tobacco issues influences both individual behavior change and policy pro- gression. Thus, media advocacy is increasingly recognized as important for promoting pub- lic health. Letters to the editor (LTE) are a basic form of media advocacy, serving to demon- strate community sentiment on a given issue. Such letters are yet to receive systematic analytic consideration. The authors conducted an ethnographic content analysis of LTE on tobacco issues from a sample of 11 Australian daily newspapers over a 3-year period (2001 to 2003, N = 361). They argue that letters are artifacts of active engagement in a public debate and note that various stakeholders adopt similar strategies to pursue their objectives. They illustrate how identifying personal and collective identities is crucial in the assertion of legit- imacy of voice in LTEs. Better understanding is needed of both the particular issues that spark public engagement, and the salient rhetoric employed by advocates of disparate positions.
To describe the main media narratives in the reportage of singer Kylie Minogue's illness with... more To describe the main media narratives in the reportage of singer Kylie Minogue's illness with breast cancer; and to assess the impact of this coverage on bookings for screening for breast cancer by mammography in four Australian states. Government sponsored BreastScreen programs in Queensland, Victoria, Tasmania and Western Australia. Narratives on breast cancer in television news programs 17-27 May 2005; initial and re-screening bookings for mammograms. Women aged > or = 40 years who booked for mammograms in BreastScreen programs in the 19 weeks before, the 2 weeks during, and the 6 weeks after the publicity. There was a 20-fold increase in news coverage of breast cancer, which emphasised that young women do get breast cancer and that early detection was critical. Overall screening bookings rose 40% in the 2 weeks of the publicity, with a 101% increase in non-screened women in the eligible age-group 40-69 years. Six weeks after the publicity, bookings remained more than a th...
Wellbeing Machine shows how wellbeing arises in the intimate processes of everyday life. To avoid... more Wellbeing Machine shows how wellbeing arises in the intimate processes of everyday life. To avoid the blaming associated with the individual notion of wellbeing, McLeod shifts analytic attention to the collective body. This approach generates a conceptual entity called the 'wellbeing machine', which comprises four assemblages that represent different responses to the challenges of everyday life experienced by people with depression. In this manner, wellbeing emerges from assemblages that transform in a sustainable way over time. Assemblages associated with illbeing are generative and vital to the production of wellbeing. Wellbeing Machine shifts discussion about the wellbeing bioeconomy into new terrain. It investigates the intersections between emergent wellbeing and labour, power and capitalism, and produces knowledge about wellbeing that does not contribute negative associations about individual's wellbeing levels.
We start by acknowledging we are writing on the unceded lands of the palawa and pakana peoples of... more We start by acknowledging we are writing on the unceded lands of the palawa and pakana peoples of lutrawita (Tasmania), and the Yugambeh and Kombumerri peoples. This is important because contemporary sociological paradigms such as posthumanism, the subject of this editorial, sometimes overlook how the politics of colonisation continues to shape academic knowledge production (which this editorial goes on to discuss). The figure of the post 'human' is entangled in a set of dilemmas that are useful for informing sociological ways of thinking through health matters in more than human worlds. The complexities of living in a COVID society (Lupton & Willis, 2021; Matthewman & Huppatz, 2020), the challenges of climate change and persistent inequalities all emphasise the need to better understand the material and discursive forces shaping the conditions of health for people who exist in a dynamic relation with the planet. Posthuman approaches are generative here, making visible the more than human forces and power relations that constitute subjectivity and health practices (Fox & Alldred, 2016; Pyyhtinen, 2016; Willcox, Hickey-Moody, & Harris, 2021). Moving beyond the sociological parameters of social structure and human agency, posthumanism challenges us to engage more deeply with the ontoethical-epistemological assumptions that inform all research approaches (Barad, 2007). Troubling long-held humanist assumptions about health, illness and wellbeing also calls for sociologists to attunetheoretically and methodologically-to the entangled relations or ecologies that instantiate realities. The articles in this special issue explore a range of posthuman dilemmas across diverse health issues as they grapple with the ethical, ontological and epistemological relations of knowing and doing health. In this editorial, we discuss how the papers in this special issue harness posthuman approaches to further a range of productive lines of enquiry and knowledge-making for health sociology. Using posthuman perspectives enables the authors to generate health sociology knowledge beyond humanist assumptions, ideals and logics and rethink health care, experiences, subjects and interventions. We go on to argue that although posthumanism enables health sociologists to progress particular agendas, it is important to further problematise the posthuman decentring of the human by bringing sustained attention to bear on the ethical and political implications of this approach to knowledge-making in health. In the latter half of this editorial, we explore three strategies for responding to the limitations, gaps and silences in posthuman thinking about health that have been inspired by Indigenous, decolonial and feminist scholars with respect to unlearning Western privilege (traditions, logics and notions of selfhood, etc). The strategies include orientating to posthuman thinking as a provincial (
It is widely acknowledged that teachers need to interrogate and transform how Eurocentrism underp... more It is widely acknowledged that teachers need to interrogate and transform how Eurocentrism underpins educational practice. This paper argues that teachers can actively engage with decolonial frameworks and concepts to productively expose how Eurocentric categories of thought shape teaching practice and curriculum. We describe how six teachers "walked with" the decolonial concept of the pluriverse (a sense of multiple co-existing differences) during collaborative reflections about our diversity teaching of culturally safe healthcare. Our research processes drew on the principles of collaborative, reflective practice. We co-participated in conversations, which aimed to collectively explore how the pluriverse concept intersected with our teaching and undertook qualitative co-analysis of themes emerging across these dialogues. The paper outlines how employing the pluriverse concept as a companion to our reflective process enabled us to ask critical questions about Eurocentrism in our teaching practice and content. Our questioning, in turn, generated principles for embedding the pluriverse in the curriculum, pedagogical approaches, and teacher dispositions. The paper discusses what enables and hinders the pluriverse being embedded in curriculum materials and classroom activities and the limitations of our activities in relation to the broader project of decolonising pedagogy.
In this article we make the case that ‘unlearning’ is an important dimension of professional refl... more In this article we make the case that ‘unlearning’ is an important dimension of professional reflective practice that can offer new insights when done collaboratively. We do so as an interdisciplinary group of academics interested in ‘undoing’ the conventional and individualising norms of reflective practice in academic settings, particularly when it comes to planning and reflecting on group processes for research. In the process of planning a project to investigate mentoring in the professions of social work and teaching, we reflected on our own collaborative academic practices through co-facilitated discussion, the creation of visual ‘d/artaphacts’, written reflections on our perceptions of ‘unlearning’ and academic collaboration, and reviewing how our diverse disciplines have engaged with unlearning in research literature and practice. These responses generated insights into the intricacies of the collaborative practice of unlearning in a professional research environment. We draw on these conversations, d/artaphacts, and reflections to compose five principles for a pedagogy of unlearning that can be applied in mentoring and professional practice settings. The principles highlight the importance of approaching unlearning as a collaborative activity for sustainable professional practice and for supporting the development of professional identities in fluid and complex relational work environments.
A key concern for qualitative inquiry is finding ways to account for nonhuman and emergent forms ... more A key concern for qualitative inquiry is finding ways to account for nonhuman and emergent forms of life. Toward this, researchers are experimenting with research practices that decenter the human subject. Deleuze’s (1977) assemblage concept has proved a useful resource for these methodological experiments. Most often, the assemblage concept has informed analysis and writing processes. This article puts the assemblage concept to work during each stage of an empirical research project exploring how people experience antidepressant use. It details seven ways that assemblages are used during concrete research processes across the span of the project. This strategy generates a sensibility toward qualitative inquiry described as orientating to assembling. The sensibility decenters the human as the focus of qualitative research. It enables the presence of nonhuman objects, not as acted-upon, but agents in the research processes. The article contributes to the challenges posed to human-centered qualitative research by reframing the focus entirely. It shows how using a sensibility that consistently decenters the human across all stages of empirical research projects, is a way that qualitative inquiry can account for more-than-human worlds.
How do antidepressants work? This often-asked question continues to attract debate. The depressed... more How do antidepressants work? This often-asked question continues to attract debate. The depressed individual features in many debates about antidepressants’ action. With this focus, discussion oscillates over whether antidepressants work to remedy chemical imbalances in the brains of depressed people, or produce inauthentic states of being. This article argues shifting the analytic focus away from the depressed individual and onto the collective body, or assemblage, moves debates about how antidepressants work into more productive terrain. This provides a new way of looking at how antidepressants work to facilitate recovery from depression through a series of collaborative connections or relationships. Drawing on the charts, photos, and narratives from research encounters with people who take antidepressants, the article illustrates how medication facilitates the creation of active associations in an assemblage of forces. The article concludes by discussing the new ways of thinking about depression, medication and recovery suggested by this understanding of antidepressant action.
To date, discussions of visual research ethics have largely focussed on the effects for participa... more To date, discussions of visual research ethics have largely focussed on the effects for participants, with increasing attention on how researchers are ethically affected by visual research. However, there has been no sustained examination into how visual materials themselves have ethical consequences in visual research. In this paper we argue that visual research presents with particular ethical challenges because of the capacities of visual materials themselves to act in research encounters. The paper draws on a research project where participants generated two different kinds of visual materials: timeline charts and photos. We show how timeline charts and photos elicit different kinds of imaginative, bodily and sensory responses, and activate memory in contrasting ways. We argue these capacities give visual materials agency, or the power to act. The agentic capacities of the visual materials act in specific ways to co-create a network of relations across the research encounters. This network of relations has the capacity to act in particular ethical ways with serious consequences, not just for research participants, but also for researchers. We propose that the action of visual materials needs to be added to discussion about visual research ethics. Drawing on the concept of ethical sustainability, we advocate for extending situated ethics and researcher reflexivity to include consideration of the agentic capacities of visual materials.
Discussion about visual research ethics predominantly focuses on the effects of visual research m... more Discussion about visual research ethics predominantly focuses on the effects of visual research methodologies on participants. The effect of visual research methodologies on researchers has received little attention and there has been no sustained investigation into how visual materials generated by the research methodology can impact on the researcher. This chapter draws on a research project where participants created photographs to share their experiences of antidepressant use and wellbeing. It shows how photographs act in particular ways with serious ethical consequences for researchers. The effect that photographs can enact on the researcher introduces an ethical issue that requires further attention and articulation by visual researchers. We discuss some of the implications of considering the action of photographs themselves to ethical discussion about visual research.
Aims and objectives: Public health nurses attended a 3‐day course to learn the use of visual meth... more Aims and objectives: Public health nurses attended a 3‐day course to learn the use of visual methods in health dialogue with adolescents. The aim of this study was to explore how to use visual methods to promote health among adolescents in a school nursing context. Background: Photovoice is a visualising technique that enables adolescents to participate in health promotion projects in a school setting. Photovoice also enhances work of public health nurses and other health professionals. Design: This was a qualitative action research study. We developed and conducted a course in visual methods and used data from focus group discussions in combination with participant observations involving public health nurses working in school health services. Methods: We conducted focus group interviews (n = 40) using separate semi‐structured discussion guides before and after a course in visual methods. The interviews were audio recorded and transcribed verbatim, and we documented the workshops (n = 8) through field notes. We collected the data from January–October 2016. Data were analysed and coded into themes and subthemes using systematic text condensation. We reported the study in accordance with the COREQ checklist. Findings: Public health nurses found photovoice useful in school nursing. The use of images offered pupils an active role in dialogues and more control in defining the topics and presenting their stories. When nurses allowed adolescents to bring images into conversations, they discovered new insights into public health promotion. The public health nurses pointed out the benefits and challenges of using new methods in practice. Conclusion: Public health nurses considered photovoice to be useful in health pro‐motion and other public health issues. Involving pupils in bringing images to conversations offered them an active role and voice in health promotion. Relevance to clinical practice: We recommend the use of photovoice and visual technologies (e.g., smartphones) in health promotion activities for adolescents.
Aims:We aimed to explore how using visual methods might improve or complicate the dynamics of the... more Aims:We aimed to explore how using visual methods might improve or complicate the dynamics of the health dialogue between public health nurses (PHNs) and school pupils. This was done from the perspective of PHNs, specifically examining how they understood their role and practice as a PHN and the application of visual methods in this practice.Background:The health dialogue is a method used by PHNs in school nursing inNorway. In this practice, there can be communicative barriers between pupils andPHNs. Investigating how PHNs understand their professional practice can lead to ways of addressing these communicative barriers, which can affect pupil satisfaction and achievement of health-related behaviours in the school context. Specifically, the use of visual methods by PHNs may address these communicative barriers.Design:The research design was qualitative, using focus groups combined with visual methods.Methods:We conducted focus group interviews using a semi-structured discussion guide and visual methods with five groups of PHNs (n=31) working in northernNorwegian school health services. The data were collected during January andFebruary 2016. Discussions were audio recorded, transcribed and coded into themes and sub-themes using systematic text condensation and drawings were analysed using interpretive engagement, a method of visual analysis.Findings:Drawings and focus group discussions showed that PHNs perceived their professional practice as primarily a relational praxis. The PHNs used a variety ofvisual methods as part of the health dialogue with school pupils. This active use of visualization worked to build and strengthen relations when words were inadequate and served to enhance the flexible and relational practice employed by the PHNs.Conclusions:PHNs used different kinds of visualization methods to establish relations with school pupils, especially when verbalization by the pupils was difficult.PHNs were aware of both the benefits and challenges of using visualization with school pupils in health education. We recommend the use of visual methods in schools because they are useful for PHNs, other health professionals and teachers working with children and young people in developing relations, particularly where verbal communication may be a challenge.
Background:
Visual technologies are central to youth culture and are often the preferred communic... more Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance.
We examine pregnant women’s experiences with routinised obstetric ultrasound as entailed in their... more We examine pregnant women’s experiences with routinised obstetric ultrasound as entailed in their antenatal care during planned pregnancies. This paper highlights the ambiguity of ultrasound technology in the constitution of maternal–foetal connections. Our analysis focusses on Australian women’s experiences of the ontological, aesthetic and epistemological ambiguities afforded by ultrasound. We argue that these ambiguities offer possibilities for connecting to the foetus in ways that maintain a kind of unknowability; they afford an openness and ethical responsiveness irrespective of the future of the foetus. This suggests that elucidating women’s experience has implications for theorising ethics across maternal–foetal relations and, more specifically, for the ‘moral pioneering’ (Rapp, 2000) that reproductive technologies can demand of women. Moral pioneering cannot be reduced to moments or processes of decision-making; it must allow for greater recognition of the affective commitments entailed in and incited by ultrasound. Furthermore, focussing on experiences of the ambiguity of ultrasound allows for understanding the ways in which affectivity circulates across domains commonly understood as medical or social, public or private. In doing so, it contributes to undermining a series of tensions that currently shape feminist analysis of obstetric ultrasound, often at the expense of the experience of women.
Obstetric ultrasound is key to opposing ways of valuing foetuses, that is, both to the ascription... more Obstetric ultrasound is key to opposing ways of valuing foetuses, that is, both to the ascription of foetal personhood and to foetal selection and termination of pregnancy. Whilst ultrasound images are increasingly common within the public sphere there has been relatively little public discussion of its role in identifying actual or potential foetal anomaly and the consequences of this. This paper examines how professionals working with obstetric ultrasound encounter, navigate and make sense of the different uses of this technology. Professionals commonly delineate their work (as providing information) from women’s autonomous choices. Emphasising “women’s choice” can obscure consideration of different collective ways of valuing foetuses with anomalies. It can also deflect consideration of the fundamentally ambiguous information that ultrasound can produce. Distinguishing information from choice is underpinned by a questionable fact–value distinction. We describe alternate professional practices which involve questioning these binaries and foregrounding clinicians’ responsibilities for women’s current and future experience. Public discussion of ultrasound’s different roles in valuing foetuses would be enriched if the discourses and practices shaping professionals’ attempts to facilitate ethical decision-making were included for collective consideration.
Objective: To examine the resettlement experiences of former refugees living in regional Australi... more Objective: To examine the resettlement experiences of former refugees living in regional Australia, focusing on mental health and mental health and support services, including barriers to access. Design: A phenomenological approach utilising a combination of six qualitative, semi-structured, face-to-face focus groups (n = 24) and seven individual interviews. Data were analysed thematically using NVivo 10 software. Setting: Launceston, Tasmania. Participants: Adult and youth former refugees from Afghanistan, Bhutan, Burma, Sierra Leone, Sudan and Iran, and essential service providers, residing in Launceston. Main outcome measures: Participants were asked about experiences of resettlement and mental health. Results: Participants reported that their mental health had improved since resettlement ; however, major stressors impacted mental health and resettlement included employment and housing access and mastering the English language. Past experiences continued to impact current functioning, with trauma commonly experienced inter-generationally through parenting and attachment and ongoing trauma and feelings of guilt and responsibility experienced with families left behind. Participants noted barriers to accessing services: (a) Language difficulties including lack of interpreters; and (b) lack of culturally sensitive and trauma-informed practices. Discrimination was experienced through the inconsistent provision of interpreters and lack of due consideration of cultural and religious differences. The use of children as interpreters enhanced several risk including miscommunication of medical information, exposure to age-inappropriate information, and the resulting increased risk of trauma for the child. Conclusion: Culturally sensitive, trauma-informed and discrimination-free practices should be employed across services, where Western-views surrounding this medical model are not imposed, cultural differences are respected, and timely access to interpreters provided.
Refugees experience traumatic life events with impacts amplified in regional and rural areas due ... more Refugees experience traumatic life events with impacts amplified in regional and rural areas due to barriers accessing services. This study examined the factors influencing the lived experience of resettlement for former refugees in regional Launceston, Australia, including environmental, social, and health-related factors. Qualitative interviews and focus groups were conducted with adult and youth community members from Burma, Bhutan, Sierra Leone, Afghanistan, Iran, and Sudan, and essential service providers (n = 31). Thematic analysis revealed four factors as primarily influencing resettlement: English language proficiency; employment, education and housing environments and opportunities; health status and service access; and broader social factors and experiences. Participants suggested strategies to overcome barriers associated with these factors and improve overall quality of life throughout resettlement. These included flexible English language program delivery and employment support, including industry-specific language courses; the provision of interpreters; community events fostering cultural sharing, inclusivity and promoting well-being; and routine inclusion of nondiscriminatory, culturally sensitive, trauma-informed practices throughout a former refugee's environment, including within education, employment, housing and service settings.
The smoking behavior of friends is a major risk factor for adolescent smoking uptake. To explore ... more The smoking behavior of friends is a major risk factor for adolescent smoking uptake. To explore the social context of smoking experimentation and consolidation with a particular focus on friends, the authors interviewed both members of 14 young adult identical twin pairs who were discordant for smoking. The different smoking status of twins was connected to their different friendship groups and development of different identities. Smoking respondents gravitated to the behaviors and images of the peer group who smoked. Many nonsmokers felt strong pressure from their peers not to smoke and spoke about how the images conveyed by smoking were inconsistent with their peer group's image. Adolescents and young adults are aware of the messages that smoking can convey to others and exploit these images to construct a social identity.
Background: This study aims to show how smokers were represented in smoking-related news articles... more Background: This study aims to show how smokers were represented in smoking-related news articles, editorials, letters and columns in a major Australian newspaper over an 11-year period from January 1995 to December 2005.
Methods: Qualitative content analysis was conducted on a sample of 618 articles to identify 21 representational categories (RCs) of the smoker. Articles were also examined for statements that lent organisational support to either tobacco control or the promotion of tobacco.
Results: The construction of the smoker as a “regulated citizen” due to being subjected to tobacco policy was the most prevalent RC, occurring in 43.4% of articles. Of the 13 most prevalent RCs, eight were constructions of the smoker that lent support to tobacco control outcomes, two were supportive of the promotion of tobacco, and three could be used by both parties. 30.6% of articles contained at least one statement from a tobacco control advocacy source, compared with only 13.6% of articles having a statement towards the promotion of tobacco.
Conclusion: These results indicate that constructions of the smoker that support tobacco control have dominated smoking-related discourse in this Australian newspaper and that representations favouring a tobacco industry viewpoint appeared less often. However, the pro-tobacco representations of smokers in reports relating to legal issues highlight an area of media discourse in which tobacco control advocates should remain vigilant.
News coverage of tobacco issues influences both individual behavior change and policy pro- gressi... more News coverage of tobacco issues influences both individual behavior change and policy pro- gression. Thus, media advocacy is increasingly recognized as important for promoting pub- lic health. Letters to the editor (LTE) are a basic form of media advocacy, serving to demon- strate community sentiment on a given issue. Such letters are yet to receive systematic analytic consideration. The authors conducted an ethnographic content analysis of LTE on tobacco issues from a sample of 11 Australian daily newspapers over a 3-year period (2001 to 2003, N = 361). They argue that letters are artifacts of active engagement in a public debate and note that various stakeholders adopt similar strategies to pursue their objectives. They illustrate how identifying personal and collective identities is crucial in the assertion of legit- imacy of voice in LTEs. Better understanding is needed of both the particular issues that spark public engagement, and the salient rhetoric employed by advocates of disparate positions.
To describe the main media narratives in the reportage of singer Kylie Minogue's illness with... more To describe the main media narratives in the reportage of singer Kylie Minogue's illness with breast cancer; and to assess the impact of this coverage on bookings for screening for breast cancer by mammography in four Australian states. Government sponsored BreastScreen programs in Queensland, Victoria, Tasmania and Western Australia. Narratives on breast cancer in television news programs 17-27 May 2005; initial and re-screening bookings for mammograms. Women aged > or = 40 years who booked for mammograms in BreastScreen programs in the 19 weeks before, the 2 weeks during, and the 6 weeks after the publicity. There was a 20-fold increase in news coverage of breast cancer, which emphasised that young women do get breast cancer and that early detection was critical. Overall screening bookings rose 40% in the 2 weeks of the publicity, with a 101% increase in non-screened women in the eligible age-group 40-69 years. Six weeks after the publicity, bookings remained more than a th...
This paper provides a thematic frame analysis of Australian newspaper reporting of the outcome an... more This paper provides a thematic frame analysis of Australian newspaper reporting of the outcome and implications of the trial of Rolah McCabe versus British American Tobacco Australasia (BATA). In this trial, a Melbourne woman was awarded A$700 000 damages for smoking-attributable lung cancer when the defendant, BATA, had its case dismissed due to document destruction. In 60 commentaries from Australian national or capital city newspapers between 12 April and 9 May 2002, a total of 79 instances of eight tobacco-related frames were identified. Overall, 43% of the 79 instances were positive for tobacco control, 46% were negative for tobacco control and 11% were neutral. The most common frame that was negative for tobacco control (in 35% of articles) was the conception that smokers exert ‘free will’ in deciding to smoke and should therefore be personally responsible for their smoking and any disease that arises as a result of it.
A related, but less commonly employed frame (in 18% of articles) was the expressed fear of a ‘slippery slope’ of litigation, which portrayed smoking as similar to eating fast food or other ‘vices’. The most common frame that was positive for tobacco control (in 35% of articles) was the notion that the tobacco industry was ‘evil’ and, to a lesser extent, that the government should ‘do more’ to control smoking (15% of articles). These findings provide a sobering public health challenge to improve public communication efforts about the powerful forces that conspire to induce people to start smoking and keep them smoking for decades, despite a strong desire to quit. There is a need to fund public education programs and quit smoking services more adequately to address the complex education task of understanding the nature of addiction to tobacco and the enormity of the health risk.
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Papers by Kim McLeod
Background: Photovoice is a visualising technique that enables adolescents to participate in health promotion projects in a school setting. Photovoice also enhances work of public health nurses and other health professionals.
Design: This was a qualitative action research study. We developed and conducted a course in visual methods and used data from focus group discussions in combination with participant observations involving public health nurses working in school health services.
Methods: We conducted focus group interviews (n = 40) using separate semi‐structured discussion guides before and after a course in visual methods. The interviews were audio recorded and transcribed verbatim, and we documented the workshops (n = 8) through field notes. We collected the data from January–October 2016. Data were analysed and coded into themes and subthemes using systematic text condensation. We reported the study in accordance with the COREQ checklist.
Findings: Public health nurses found photovoice useful in school nursing. The use of images offered pupils an active role in dialogues and more control in defining the topics and presenting their stories. When nurses allowed adolescents to bring images into conversations, they discovered new insights into public health promotion. The public health nurses pointed out the benefits and challenges of using new methods in practice.
Conclusion: Public health nurses considered photovoice to be useful in health pro‐motion and other public health issues. Involving pupils in bringing images to conversations offered them an active role and voice in health promotion. Relevance to clinical practice: We recommend the use of photovoice and visual technologies (e.g., smartphones) in health promotion activities for adolescents.
Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns.
Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents.
Research design: This is a qualitative study utilizing data from focus group discussions.
Participants and research context: We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation.
Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent.
Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals.
Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies.
Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance.
Methods: Qualitative content analysis was conducted on a sample of 618 articles to identify 21 representational categories (RCs) of the smoker. Articles were also examined for statements that lent organisational support to either tobacco control or the promotion of tobacco.
Results: The construction of the smoker as a “regulated citizen” due to being subjected to tobacco policy was the most prevalent RC, occurring in 43.4% of articles. Of the 13 most prevalent RCs, eight were constructions of the smoker that lent support to tobacco control outcomes, two were supportive of the promotion of tobacco, and three could be used by both parties. 30.6% of articles contained at least one statement from a tobacco control advocacy source, compared with only 13.6% of articles having a statement towards the promotion of tobacco.
Conclusion: These results indicate that constructions of the smoker that support tobacco control have dominated smoking-related discourse in this Australian newspaper and that representations favouring a tobacco industry viewpoint appeared less often. However, the pro-tobacco representations of smokers in reports relating to legal issues highlight an area of media discourse in which tobacco control advocates should remain vigilant.
Background: Photovoice is a visualising technique that enables adolescents to participate in health promotion projects in a school setting. Photovoice also enhances work of public health nurses and other health professionals.
Design: This was a qualitative action research study. We developed and conducted a course in visual methods and used data from focus group discussions in combination with participant observations involving public health nurses working in school health services.
Methods: We conducted focus group interviews (n = 40) using separate semi‐structured discussion guides before and after a course in visual methods. The interviews were audio recorded and transcribed verbatim, and we documented the workshops (n = 8) through field notes. We collected the data from January–October 2016. Data were analysed and coded into themes and subthemes using systematic text condensation. We reported the study in accordance with the COREQ checklist.
Findings: Public health nurses found photovoice useful in school nursing. The use of images offered pupils an active role in dialogues and more control in defining the topics and presenting their stories. When nurses allowed adolescents to bring images into conversations, they discovered new insights into public health promotion. The public health nurses pointed out the benefits and challenges of using new methods in practice.
Conclusion: Public health nurses considered photovoice to be useful in health pro‐motion and other public health issues. Involving pupils in bringing images to conversations offered them an active role and voice in health promotion. Relevance to clinical practice: We recommend the use of photovoice and visual technologies (e.g., smartphones) in health promotion activities for adolescents.
Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns.
Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents.
Research design: This is a qualitative study utilizing data from focus group discussions.
Participants and research context: We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation.
Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent.
Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals.
Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies.
Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance.
Methods: Qualitative content analysis was conducted on a sample of 618 articles to identify 21 representational categories (RCs) of the smoker. Articles were also examined for statements that lent organisational support to either tobacco control or the promotion of tobacco.
Results: The construction of the smoker as a “regulated citizen” due to being subjected to tobacco policy was the most prevalent RC, occurring in 43.4% of articles. Of the 13 most prevalent RCs, eight were constructions of the smoker that lent support to tobacco control outcomes, two were supportive of the promotion of tobacco, and three could be used by both parties. 30.6% of articles contained at least one statement from a tobacco control advocacy source, compared with only 13.6% of articles having a statement towards the promotion of tobacco.
Conclusion: These results indicate that constructions of the smoker that support tobacco control have dominated smoking-related discourse in this Australian newspaper and that representations favouring a tobacco industry viewpoint appeared less often. However, the pro-tobacco representations of smokers in reports relating to legal issues highlight an area of media discourse in which tobacco control advocates should remain vigilant.
A related, but less commonly employed frame (in 18% of articles) was the expressed fear of a ‘slippery slope’ of litigation, which portrayed smoking as similar to eating fast food or other ‘vices’. The most common frame that was positive for tobacco control (in 35% of articles) was the notion that the tobacco industry was ‘evil’ and, to a lesser extent, that the government should ‘do more’ to control smoking (15% of articles). These findings provide a sobering public health challenge to improve public communication efforts about the powerful forces that conspire to induce people to start smoking and keep them smoking for decades, despite a strong desire to quit. There is a need to fund public education programs and quit smoking services more adequately to address the complex education task of understanding the nature of addiction to tobacco and the enormity of the health risk.