bluuebunny/crossref_metadata_2025 huggingface dataset:
The `Bureaucratization' of Professional Roles: The Case of Clinical Directors in UK Hospitals
Authors: Kitchener Martin
Published: March 2007

This article analyses the process by which some hospital doctors have adopted medical-manager hybrid roles by joining the new cadre of clinical directors. The article has two main aims. The first is to enhance understandings of professional role change by contributing empirical evidence to the debate concerning the alleged `de-professionalization' of expert roles. The second is to assess the ways in which institutional forces influence change and inertia in professional roles. Drawing on data collected during a study of UK hospitals between 1991 and 1995, the author attempts to analyse the development of the clinical director role. Particular consideration is given to indicators of de-professionalization such as weakening occupational closure, reduced autonomy and the enhanced managerial control of professional work. The findings demonstrate that the physicians who become clinical directors are, to some extent, `bureaucratized' through their acceptance of increased commercial and managerial responsibility. Less evidence emerges to support the de-professionalization thesis. Rather, it is shown that clinical directors maintain the occupational closure of the medical domain. They also protect high levels of clinical autonomy and resist attempts to enhance the managerial control of medical practice.
Institutionalizing Civic Engagement: Shifting Logics and the Cultural Repackaging of Service-Learning in US Higher Education
Authors: Lounsbury Michael , Pollack Seth
Published: March 2007

Institutionalists in organizational sociology have developed a good deal of evidence about the role of field logics in shaping the practices of organizations. In this paper, we extend this imagery to multiple fields, highlighting how shifting logics in a superordinate field enable the infrastructural development of a subordinate field. In particular, we track how initially marginal, anti-institutional service-learning practices became a legitimate component of mainstream curricula in the field of US higher education. While service-learning proponents have always made claims about the importance of generating knowledge and insight by helping others in the community, service-learning entrepreneurs had to build a field infrastructure to support their claims and culturally repackage the aims of service-learning in a way that articulated with broader logics in the field of higher education. We argue that the shift from an unarticulated closed-system logic to a situation of contending closed-system and open-system logics in the field of higher education facilitated the cultural repackaging of service-learning practices, enabling civic engagement to become a more accepted part of university curricula. Despite this apparently ‘successful’ institutionalization, however, competing logics in the field of higher education have instantiated contradictions in the service-learning field, raising important issues about the future of service-learning as well as the US educational system.
Where Feminist Theory Meets Feminist Practice: Border-Crossing in a Transnational Academic Feminist Organization
Authors: Mendez Jennifer Bickham , Wolf Diane L.
Published: March 2007

This paper focuses on our four years of involvement with a feminist organization within academia that brought `Third World' women activists from a variety of fields as visitors to our US university campus. Based on our experiences as white, US-born feminist sociologists committed to political change, we analyze the challenges and contradictions that we confronted in the daily processes and activities of this organization. By exemplifying complex power dynamics, which often are unacknowledged and unarticulated, our case highlights the need for new theoretical perspectives that take into account power differences that exist along various axes - including axes of domination among women. Transnational processes, we argue, further complicate such power differentials. Serious analyses of the processes and outcomes that are recreated in transnational, international and local feminist development organizations constitute an important political step towards bridging existing gaps between feminist theory and practice.
Modes of Organizing in an Expert Consultancy: A Case Study of Knowledge, Power and Egos
Authors: Robertson Maxine , Swan Jacky
Published: March 2007

This paper presents an empirical study of an `expert' consultancy focusing on the changes that have occurred in the dominant mode of organizing over its 12-year history. From its inception, the firm was deliberately structured in such a way as to stimulate invention and innovation. The paper traces the changes that have occurred with specific reference to frameworks which emphasize modes of knowledge, knowledge communication and power. The research found that the organization had changed in ways not in keeping with that predicted for firms that are `knowledge intensive', becoming formalized over time. Whilst explicit rules and procedures had not been implemented, dominant norms and values had emerged which shaped organizational arrangements and constrained processes of innovation. Thus, we question the sustainability of contemporary modes of organizing.
Dialogic Repression and the Oedipus Complex: Reinterpreting the Little Hans Case
Authors: Billig Michael
Published: March 2007

This paper offers a discursive reinterpretation of the psychoanalytic concept of repression. Language is both expressive and repressive, and, therefore, children, in acquiring language, learn to repress rhetorically. The sort of repressions which, according to classic Freudian theory, occur as a result of the Oedipus Complex are themselves dialogically and socially constituted. In consequence, the processes of repression can be examined by extending the techniques of discursive psychology. These ideas are examined in relation to Freud's case of Little Hans, paying attention to the ways that the adults are implicitly practising and teaching repression. It is argued that Freud, in his interpretations, repressed the themes of parental power and desire. The dialogic details show Hans to be developing within a social world in which dialogic repression is habitually practised by adults. The implications of such notions for developmental and discursive psychology are discussed.
Researcher's Story Told and Participants' Story Still Untold: Commentary on Günther
Authors: Kojima Hideo
Published: March 2007

Guinther's (1998) study is of complicated interactions among cultures. She had to cope with participants' diverse cultural expectations of interpersonal relationships that differed from her own. Implicit approaches of conducting research and styles of report writing that she had been acquainted with might not be completely the same as those of American dissertation committee members. Therefore it is natural that Gunther had many stories to tell, a few of which were constructed in the present article. In spite of notable cultural variations in the way of effectively gaining access to the participants, a generalizable principle is to secure the appropriate social intermediary who connects the researcher to the target social group. I emphasize the collaborative role of the host researcher as intermediary for the visiting researcher and as interpreter of the psychology of the participants, who have their own story of dealing with the task of participation.
Dialogical Thinking and Self-Innovation
Authors: Hermans Hubert J.M.
Published: March 2007

In the tradition of American pragmatism, theorists like James, Mead and Allport have emphasized the self’s capacity for change and innovation. In the tradition of the Russian dialogical school, Bakhtin and his co-workers have dealt with the relationship between dialogue and innovation. These two traditions are brought together in the concept of the ‘dialogical self’, which is taken as the starting point for an empirical investigation. 103 participants were invited to describe a personal problem and, subsequently, think about this problem through a sequence of dialogical steps. Three types of dialogical movement are distinguished representing increasing, decreasing and stabilizing levels of novelty. Moreover, thinking about a problem from the position of a significant other (other-position) and from one’s own point of view (self-position) are compared. The results were analyzed on the group and individual level. On the group level it was found that a sizeable minority of the participants show increasing levels of novelty, and, contrary to expectations, those who think via the other-position demonstrate more cases of stabilizing and decreasing novelty than increasing novelty. On the individual level a series of idiographic analyses was performed demonstrating an intimate relationship between the dialogical processing of a personal problem and changes in the corresponding experience of novelty. Finally, the relevance of the Bakhtinian notion of polyphony and the collaborative relationship between researcher and subject are discussed.
The Modernization of Tradition: Thinking about Madness in Patna, India
Authors: Wagner Wolfgang , Duveen Gerard , Themel Matthias , Verma Jyoti
Published: March 2007

Thirty-nine educated middle-class residents of Patna, India, were interviewed about a vignette describing the behaviour of a seemingly mad man or woman. The interview explored their representations of traditional healing methods and of modern psychiatric notions. Besides explanations for mental illness and madness, the interviews also covered the reaction of families and neighbours to such phenomena. Respondents thought of different causes depending on the context, ranging from frustrated desires, shock and heredity to spirit possession. The majority’s spontaneous preference for modern psychiatric treatment often co-exists with a faith in traditional healing. This faith is strengthened by their family’s traditional preference. The results are discussed as an example of a process of modernization of common sense in which popularized scientific notions become anchored in the traditional setting of social structure and family life. The newly acquired knowledge forms a loosely organized social representation confronting a strongly objectified cultural representation of traditional thinking.
Political Parties, Electoral Systems and Women's Representation in the Regional Legislative Assemblies of Russia, 1995-1998
Authors: Golosov Grigorii V.
Published: March 2007

The paper examines the impact exerted upon women's legislative representation by political parties and electoral systems under the specific conditions of the early phase of party system formation. Using the data from the 1995-8 regional legislative elections in Russia, the paper demonstrates that party nomination tends to replace independent candidacy as the major tool of the legislative recruitment of women. By assuming party labels, women enhance their electoral chances to a larger extent than men do. However, incentives to nominate women are most visible among strong organizations that often monopolize the local arenas of party politics. Under electoral systems with large district magnitudes, the overall importance of political parties increases. At the same time, such electoral systems support political fragmentation that makes ticket-balancing strategies less feasible. This explains why gains in party system development generated by electoral systems are not conductive to increased women's representation.
Let's Discuss this Later
Authors: Aylott Nicholas
Published: March 2007

The issue of European integration has disrupted party politics in Denmark, Norway and Sweden in various ways. This article assesses the impact of internal division over Europe within certain parties, and these parties' responses to it. It is argued that party leaderships have increasingly attempted to compartmentalize the different arenas in which they operate, and to isolate potentially damaging European questions in quarantined areas. This can be observed in, for example, party leaders' resort to referendums to decide contentious EU-related matters, the suspension of party discipline when such matters are debated and the careful sequencing of different party goals. The experiences of the Scandinavian social democratic parties are examined as comparative cases. Finally, some hypotheses that might inform further research are suggested, and some wider consequences of these strategies of compartmentalization are discussed.
Are British Political Parties in Decline?
Authors: Webb Paul D.
Published: March 2007

This article seeks to examine evidence that British political parties may be in decline. A two-dimensional framework for analysis is utilized, which suggests that the overall picture is far from unambiguous. At most, a prima facie case can be made that the popular legitimacy of parties may be dwindling; similarly, party organizations only appear weaker than they were a generation ago at the local level - and even this may be a somewhat simplistic account of the real strengths and weaknesses of British parties given the emergence of the `electoral-professional' model. If we turn to a deeper level of analysis, we must concede that the capacity of parties to fulfil functions on behalf of the wider political system may not be what it once was in some respects; nevertheless, they remain central to the tasks of demand aggregation and political recruitment. In short, political parties in the UK may have their problems, but they remain much more than vestigial phenomena of a bygone age. To a significant extent this is because of their undoubted capacity to adapt to changing environments.
Back to the Future
Authors: Aylott Nicholas
Published: March 2007

Sweden's election of September 1994 returned Ingvar Carlsson's Social Democrats to power following three years of non-socialist coalition government. After a deep recession, observers wondered whether the electoral volatility apparent in 1991, chiefly in Social Democratic losses and New Democracy's arrival, would continue. Moreover, long-established bloc politics was questioned by the governing Liberals entertaining a possible post-election coalition with Carlsson's party. However, the 1994 election results - the Social Democrats' victory (despite an uncertain campaign), the eclipse of New Democracy, the centre parties' decline and the strengthening of the Moderates - seemed to signal bloc politics' continuing salience.
Anti-Political-Establishment Parties
Authors: Schedler Andreas
Published: March 2007

A specter is haunting contemporary party politics: the specter of anti-political-establishment parties. In old as well as in new democracies, fears run high and the literature is booming. Specters are evasive, however. Political scientists have tried to get hold of this one under labels like protest, populist or extremist parties. Yet the `anti-political' ideology which is central for many of these outsider parties has not received the systematic attention it deserves. The present piece of discourse analysis pretends to fill this gap. It argues that anti-political-establishment parties construct two specific cleavages. They contrapose the political elite against citizens, on the one hand, and against themselves, on the other. In its main part, the article analyzes the symbolic strategies anti-political-establishment parties employ in constructing this double conflict. It proceeds to describe their dilemmatic position in between normal and anti-democratic opposition, sketches the possible career paths of anti-political-establishment parties, and concludes with some notes on available counter-strategies.
Local Economic Contexts and Changing Party Allegiances at the 1992 British General Election
Authors: Pattie Charles , Johnston Ron
Published: March 2007

Controversy has surrounded the explanation of one of the most striking features of recent British General Elections: the rapidly changing regional geography of the vote. While some analysts have seen this as evidence of the impact of local electoral contexts on voting decisions, others have claimed that apparent regional effects are merely a consequence of poorly specified models. In this paper, new data from the 1992 British Election Study are employed to demonstrate the independent impact of regional economic context upon the vote-switching behaviour of individual British electors between the 1987 and 1992 General Elections.
Rejecting the European Union
Authors: Geyer Robert , Swank Duane
Published: March 2007

This article analyses data from a survey of 209 members of the SME (Social Democrats Against the EU), the dominant anti-EU group within the Norwegian Labour Party (DNA) during the 1994 EU referendum. We address several questions about the political impacts of the EU issue on Norwegian social democracy. Who were the SME members? Why did they oppose the EU? What were their expectations about staying out of the EU? Which faction of the DNA did they represent? The diverse SME members disproportionately stress threats to democracy and sovereignty and the neoliberal character of the EU as reasons for opposition; large majorities believe that `staying out' will enhance the efficacy of social democratic policies. Moreover, the political orientations of SME members stand in stark contrast to the pro-EU `modernizing' leadership of the party. In conclusion, we discuss the impacts of factional politics and internationalization on Norwegian social democracy.
The Strength of the Partisan Component of Left-Right Identity
Authors: Knutsen Oddbjørn
Published: March 2007

This article examines left-right party polarization among the mass publics in a longitudinal comparative perspective. The analysis comprises eight countries - Belgium, Britain, Denmark, France, Germany, Ireland, Italy and the Netherlands - and trends are analysed from the early 1970s to the early 1990s. The strength of the relationship between party choice and left-right self-placement is analysed by three different measures: a standardized measure and two alternative unstandardized measures. The standardized measure produces a high degree of stability in the strength of the partisan component, while the unstandardized measures show that the partisan component has declined. The analysis shows that party voters locate themselves, quite consistently, more centrist. It is the changing left-right location of voters for the larger established parties in the party system that accounts for most of the change in the partisan component. The centrist tendency is particularly large for voters of the larger established parties in Belgium, France, Italy and the Netherlands.
Party Responsiveness and Socio-Economic Problem-Solving in Western Democracies
Authors: Pennings Paul
Published: March 2007

What factors influence party responsiveness to socio-economic problems in OECD countries? Four alternative regression equations are tested that model the influence of objective conditions, public preferences and party ideology. It appears that the way political parties respond to socio-economic problems is mainly determined by their left-right ideology. The influence of alternative factors is much weaker. Furthermore, party responsiveness is not only bounded by left-right ideology, but also by the institutional environment in which parties operate, i.e the welfare state regime.
New Parties/New Politics?
Authors: Seyd Patrick
Published: March 2007

Britain's two major parties have rediscovered their members. For a variety of reasons both the Labour and Conservative parties have adopted pro-active recruitment strategies. At the same time, they have introduced direct democracy as an important part of their internal procedures. A detailed study of Labour's reforms suggests various possible implications for the future, including the fact that the plebiscitarian party might be an increasingly common feature in modern democracies.
Religious Conservatives, the Republican Party and Evolving Party Coalitions in the United States
Authors: Knuckey Jonathan
Published: March 2007

The growing importance of religious conservatives within the Republican Party is one of the most interesting aspects of evolving party coalitions in the USA. However, their identification has proved to be difficult because of different operational definitions of religious conservatives. In this paper, an alternative operational definition is posited, identifying conservative Republicans for whom religion is an important part of their lives. The paper proceeds by using this definition to estimate the number of religious conservatives in the mass electorate, and their political distinctiveness compared to other Republicans. While the definition used in this paper is a broad one, it is demonstrated that in terms of voting behavior and issue preferences, a `religious' conservative Republican is qualitatively distinct from a `secular' conservative Republican.
A Divided-Government-Based Explanation for the Decline in Resignations from the US Senate, 1834-1996
Authors: Brunell Thomas L. , Koetzle William
Published: March 2007

We note the declining number of US Senate resignations that have occurred from 1834 through to 1996. While certainly this trend is related to the rise of careerism in Congress, we analyze it from the perspective of divided government (where the channels of power are shared by both parties). The results of our analysis show that most of the resignations that do occur happen when the party of the outgoing senator will retain the seat being vacated. We link the declining number of resignations to an increase in a specific instance of divided government: namely, divided partisan control of one or both Senate seats relative to the body that fills Senate vacancies in the event of a resignation. The desire on the part of senators to resign only when their party will remain in control has remained constant over time, but the proportion of senators who could resign with this assurance has decreased.
Electoral Effects on Party Behavior and Development
Authors: Montgomery Kathleen A.
Published: March 2007

The effort to achieve a more party-orientated set of House Rules in Hungary's newly democratized National Assembly provides evidence about the behavior and development of political parties in a transitional setting. Using data drawn from in-depth interviews, records of MP activities and minutes of plenary discussions, this paper chiefly finds that the distribution of mandates in Hungary's hybrid electoral system determined the relative cohesiveness of the emerging parties and that, as the system has settled down, new information on the electoral value of party cohesion has caused parties to adapt their behavior and rule preferences.
Parental, Peer, Teacher and Sporting Hero Influence on the Goal Orientations of Children in Physical Education
Authors: Carr Sam , Weigand Daniel A.
Published: March 2007

The purpose of this study was to examine the relationship between goal orientations and perceptions of the motivational climate emphasized by parents, peers, teachers and sporting heroes for children in physical education (PE). Additionally, gender differences in goal orientations and perceptions of the motivational climate were examined. A total of 266 male and female secondary school PE pupils from the United Kingdom completed a survey assessing personal goal orientations for PE and perceptions of the motivational climateemphasized by parents, peers, teachers and sporting heroes. Results indicated that goal orientations were related to these perceptions.

Specifically,task orientation was related to perceptions of a learning-oriented climate from parents, peers and teachers and to perceptions of a mastery orientationinsporting heroes. In contrast, an ego orientation was related to perceptions of a comparison climate from parents, peers and teachers, and to perceptions of an ego orientation in sporting heroes. Results are discussed in terms of the implications that the influence of significant others might have for intervention efforts designed to enhance the quality of youngsters’ motivational development in PE.
The Limits of Constructivism in Evaluation
Authors: Kushner Saville
Published: March 2007

If evaluators do not borrow from the natural and social sciences for their methods, what do their enquiries look like? Many who seek to answer that question pursue naturalistic or case study or qualitative approaches, conceived of as a reaction to scientism to produce a more faithful response to the social and political nature of the world being evaluated. Among those approaches is constructivism, familiar in the philosophy of science, science education and psychology. This is a general critique of science for its failure to acknowledge that theories and realities are not 'out there' waiting to be discovered or uncovered, but are constructed in the minds of individuals or in the discourses of groups. This article looks critically at constructivism as it has appeared in the field of evaluation and presents it as an overreaction to the problems of objective reality.
Evaluation and Consultation
Authors: Drewett Alison
Published: March 2007

The article suggests that in evaluations of health and social care in the UK, especially those that are officially sponsored, users have occupied a minimal role. It is argued that this is largely because such studies are conducted in the context of a dominant positivistic paradigm, particularly in medicine, that emphasizes 'scientific' as opposed to lay knowledge and the merits of experimental designs. The article focuses mainly on mental health where de institutionalization policies, and a growing emphasis on social treatments, together create a greater need for evaluations to incorporate users in more empowering ways. At the same time, a current interest in 'consultation' has generated many innovative and exciting new inputs for service users—for example, citizens' juries—that offer important lessons for user participation in evaluation. The paper argues that although much consultation has not been assessed itself, lessons may still be learned about the value of lay involvement, and which participation models exist that can be used to inform the future development of evaluations in health and social care.
`The Face-Off Between Will and Fate': Artistic Identity and Neurological Style in de Kooning's Late Works
Authors: FRASER MARIAM
Published: March 2007

This article explores representations of the artist Willem de Kooning who, during the last few years of his creative life, produced a large number of paintings at the same time as he was thought to be suffering from Alzheimer's disease. My focus is on the way that these representations mobilize themes which Jane Goodall identifies as belonging to a discourse of anxiety. In a bid to suggest that the artist is uniquely positioned to adapt to the progression of the disease, commentators betray a particular concern with the relation between will and intuition. This relation is negotiated, first, by privileging the hand of the artist as a body part possessed of a brain and a will of its own and, second, by drawing on neurological explanations of the nervous system which have the effect of removing `will' from the sphere of voluntarism. Although these representations go some way to refigure conventional notions of artistic identity and creative processes, the reliance on neurology supports an elitism which justifies the exclusion of certain figures (the insane, the naive, the computer) not just from the subject-position `artist', but also from the category `human'.
This Body Which is Not One: Dealing with Differences
Authors: SHILDRICK MARGRIT
Published: March 2007

While body modification might generally seem to take the form of denaturalizing a biological given, this article looks at the same practice as normalizing the always already unstable corpus. The dominant discourse of the post-Enlightenment relies on the notion of the centrality of the individual subject within the singular and separate body, where distinctions between self and other are secure. Against this the incidence of monstrosity in general, with its disordered crossing of the boundaries of the proper, offers a gross insult. I look in particular at instances of conjoined twinning to demonstrate that the body can only be regarded as one by a process of material and discursive modification, which nonetheless finally fails to efface the trace of the monstrous other that frustrates the closure of the self-same.
Parasite Visions: Alternate, Intimate and Involuntary Experiences
Authors:   STELARC Hamburg City.
Published: March 2007

In previous actions the body has performed with technology attached (the Third Hand- actuated with EMG signals), technology inserted (the Stomach Sculpture- a self-illuminating, sound-emitting, opening/closing, extending and retracting mechanism operating in the stomach cavity) and Net-connected (the body becoming accessed and remotely activated by people in other places). The body has been augmented, invaded and now becomes a host- not only for technology, but also for remote agents. Just as the Internet provides extensive and interactive ways of displaying, linking and retrieving information and images it may now allow unexpected ways of accessing, interfacing and uploading the body itself. And instead of seeing the Internet as a means of fulfilling out-moded metaphysical desires of disembodiment, it offers on the contrary, powerful individual and collective strategies for projecting body presence and extruding body awareness. The Internet does not hasten the disappearance of the body and the dissolution of the self- rather it generates new collective physical couplings and a telematic scaling of subjectivity. Such a body's authenticity will not be due to the coherence of its individuality but rather to its multiplicity of collaborating agents. What becomes important is not merely the body's identity, but its connectivity- not its mobility or location, but its interface....
What Pharmakos? From Pseudotheology to Presence
Authors: FRANK ARTHUR W.
Published: March 2007

The article considers some problems with the pairing of joking and disability, and then questions whether the world of the ill is pseudotheological, as Stronach and Allan quote Kundera saying it is. Aspects of Kundera's argument that Stronach and Allan omit suggest a more complex relation between disability, the body and the presence of the person in the multiple texts that end up being involved: Stronach and Allan's text, autobiographical texts such as Robert Murphy's, and the text of several jokes, including one of my own which frames the article.
Disability Humor: What's in a Joke?
Authors: ALBRECHT GARY L.
Published: March 2007

Disability humor raises a hidden paradox that makes people feel uncomfortable. What is so funny about having a disability when others think that it is a tragedy? This article analyzes the social creation, context, purposes and consequences of disability humor. Disability humor is seen to be anchored simultaneously in tragedy and comedy so that both literary vehicles give meaning to the disability experience.
Back-Translation for Cross-Cultural Research
Authors: Brislin Richard W.
Published: March 2007

Two aspects of translation were investigated: (1) factors that affect translation quality, and (2) how equivalence between source and target versions can be evaluated. The variables of language, content, and difficulty were studied through an analysis of variance design. Ninety-four bilinguals from the University of Guam, representing ten languages, translated or back-translated six essays incorporating three content areas and two levels of difficulty. The five criteria for equivalence were based on comparisons of meaning or predictions of similar responses to original or translated versions. The factors of content, difficulty, language and content-language interaction were significant, and the five equivalence criteria proved workable. Conclusions are that translation quality can be predicted, and that a functionally equivalent translation can be demonstrated when responses to the original and target versions are studied.
Attitudes to Learning of the Asian Student Studying in the West
Authors: Noesjirwan Jennifer
Published: March 2007

An hypothesis that the Asian student has an attitude to learning that is markedly different from his Western counterpart is presented. He is more dependent on authority, less able to think independently, and more dependent on memorization. Such an attitude is an impediment to successful academic performance in a Western university. A questionnaire measuring various aspects of this attitude was administered to a group of Asian students and to a similar group of Australian students. The items were subjected to a components analysis and three factors were extracted. The first two factors described the attitudes as hypothesized, and both significantly discriminated Asian from Australian groups. The first factor was found to predict academic performance for the Asian group to a significant extent.
Mirrored Grief: The Systemic Context of Paediatric Heart/Heart-Lung Transplantation
Authors: Parsons Ross , Goodwin Mary , Bickerton Annemaree , Lask Bryan
Published: March 2007

Children referred for heart/heart-lung (HIHL) transplantation are desperately ill, and their impending death raises particularly painful issues for families and health professionals. The H/HL transplant team at Great Ormond Street Hospital for Children (GOSH) assessed 264 children since 1988, of whom 90 have been transplanted. A policy of shared care between GOSH and the local referring centre operated throughout. As in similar situations of serious ill health, maladaptive patterns are identified within the family and between the family and the health professionals teams involved. The patterns of avoidance and denial in the family are reflected in the functioning of teams, with potentially damaging effects, and are described in detail; we discuss various interventions designed to improve family and team functioning.
What is Sufficient Understanding?
Authors: Reder Peter , Fitzpatrick Geraldine
Published: March 2007

Children's `sufficient understanding' is deemed a critical factor in determining their capacity to consent to treatment or give informed opinions about their future care. However, the concept has remained undefined. We propose that it should refer not only to the child's cognitive development, but also to the influence of personal and interpersonal conflicts. Assessment is through clinical interview, during which the clarity of communication, complexity of the issues and the child's emotional state should also be considered.
Managing Pervasive Refusal Syndrome: Strategies of Hope
Authors: Nunn Kenneth P. , Thompson Susan L. , Moore Sharon G. , English Margaret , Burke Elizabeth A. , Byrne Noela
Published: March 2007

The management of pervasive refusal syndrome illustrates the practical application of hope promoting principles in clinical work. It involves a multidisciplinary team approach and a structured yet flexible management plan with a clear rationale employed over months to years. This article details the components of such a plan, including nursing management, physiotherapy, individual and family therapy. Pre-admission expectations, the necessary assessments on admission, and the establishment of management goals are also discussed. The issue of consent is elaborated, emphasizing the problematic role that refusal plays. Steps to ensure the child's survival and optimal development are outlined. Specific problem behaviours in the child and the family are described, and the need for adequate support within the treatment team to deal with these problems is considered. Attitudes that facilitate staff survival of the long haul of treating these children are described. Despite the difficulties, however, the typically favourable outcome of treatment is reported. The high cost, in terms of money and morale, means that more efficient management plans need to be developed.
Ways of Seeing: Changing Directions in the Health of Indigenous Populations
Authors: Hunter Ernest
Published: March 2007

Nearly a decade ago (1988) Australians celebrated the bicentennial of British settlement in New South Wales. Indigenous Australians, despite their small numbers, were prominent at that time - not, however, in celebration, but protest. Rather than joining the self-congratulatory activities of the mainstream, they drew attention to the continuing disadvantage of indigenous populations, bleakly emphasized at that time by the emerging findings of the Royal Commission into Aboriginal Deaths in Custody (1991). That report documented profound social disadvantage and its physical and emotional consequences. Few of those findings were new then and, sadly, little has changed since. Australians are now trying to digest the findings of another major investigation, the Human Rights and Equal Opportunity Commission's National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from Their Families (1997). Perhaps the cumulative weight of reports and recommendations will ultimately tell. In this article changing non-indigenous constructions of Aboriginal Australians over the last half-century and the volatile contemporary political arena are explored. Using the concept of social capital, the consequences of colonization for indigenous societies is explored. The implications of this analysis for a public health approach to addressing problems of indigenous social and emotional well-being in Australia are presented, with reflection on the roles of mental health clinicians.
Promoting a Consumer Orientation to Health Care and Health Promotion
Authors: Kreps Gary L.
Published: March 2007

There is a compelling need to establish a consumer orientation to health care to address the troubling imbalance of power between providers and consumers in the modem health-care system. This power imbalance has systematically disenfranchised and marginalized health-care consumers. Adoption of a consumer orientation that focuses institutional attention and resources specifically on fulfilling the physical and psychological needs of the consumer, equalizing influence and control between health-care providers and consumers, and empowering consumers to make informed decisions about their health care will help promote social justice within the modem health-care system. Strategies are suggested to help providers and consumers develop and promote a consumer orientation in modem health care.
John Wesley's Primitive Physick
Authors: Malony H. Newton
Published: March 2007

John Wesley was an 18th- century Anglican priest whose evangelistic efforts led to the establishment of Methodist Societies in England, Ireland and America. He became greatly concerned for the spiritual and physical health of the poor. Wesley wrote a book entitled Primitive Physick: Or, an Easy and Natural Method of Curing Most Diseases. He was deeply impressed with the few physicians who called for the prevention of disease through healthy living and who recommended time-honored, inexpensive methods of cure. This article reviews Wesley's ideas and prescriptions for healthy living. The discussion reflects on his contribution to the development of a psychology of health and credits Wesley with being ahead of his time in his dietetic and hygienic recommendations. Using Matarazzo's (1982) definition the article shows that over 200 years ago Wesley dealt with each of the major concerns of health psychology and behavioral medicine.
Exploring a Model of Symbolic Social Communication
Authors: Flora June A. , Schooler Caroline , Mays Vickie M. , Cochran Susan D.
Published: March 2007

We propose a model of symbolic social communication to explain the process whereby sociocultural identity mediates relationships among receivers, sources and messages to shape message effects. This exploratory study examines how two at-risk groups of African American men responded to various HIV prevention messages delivered by celebrity and professional sources. We interviewed 47 men from a homeless shelter and 50 male college students. Members of both groups were likely to select Johnson as the best person to deliver HIV prevention messages among a list of African American celebrity and professional sources. Results suggest the symbolic meanings embedded in celebrities and message topics are important and enduring influences on message effects. The images and ideas that a source represents are transferred to the advocated behavior, attitude or knowledge change and thus shape how messages are interpreted and received. Further understanding of how culture influences the effects of persuasive messages is critical for the improvement of health-communication campaigns.
A Comparative Study of Sexual Experiences
Authors: May Brenda , Boyle Mary , Grant David
Published: March 2007

There has been little detailed study of the sexual outcome of women suffering from congenital adrenal hyperplasia, a condition which results in masculinization of the external genitalia and possible genital ambiguity at birth in chromosomal females. This study, combining qualitative and quantitative methods, reports the sexual outcome for a sample of women with congenital adrenal hyperplasia (CAH; N = 19), compared to that for an age-matched sample of women with early diagnosed diabetes ( N =17). The results are given under the headings of sexual interest; sexual activity with partners; reasons for engaging in sexual behaviour; sexual activities; stimuli eliciting a sexual response; physical problems connected with sexual activities, and general issues. CAH women were found to be less sexually experienced in all areas, and reported higher levels of penetration difficulties, pain, and lubrication problems than the diabetic women. It is proposed that the contribution of psychological factors to these problems may be at least as great as that of medical/ surgical factors. Implications for management are considered.
The Rhetoric and Reality of Psychosocial Theories of Health
Authors: Ogden Jane
Published: March 2007

Textbooks in health psychology and medical sociology describe these disciplines as a challenge to the biomedical model. In particular, they purport to contest biomedicine's concepts of illness causality, a dualistic individual and outcomes. This article examines support for this 'rhetoric' and examines the discrepancy between the stated aims of these disciplines and the 'reality' of their explanatory frameworks. In addition, this discrepancy is analysed in terms of the implicit acceptance and privileging of a biomedical perspective within psychosocial theories. The article then examines explanations for this discrepancy first in terms of the potential function of the 'rhetoric' and then in terms of the reflections of this rhetorical challenge in the construction and dissolution of the boundaries of the human body.
Transactional Analysis of Communication Styles in HIV/AIDS Advertisements
Authors: Maclachlan Malcolm , Carr Stuart C. , Fardell Sean , Maffesoni Gail , Cunningham James
Published: March 2007

Television advertising has been an important medium for health promotion campaigns addressing HIV/AIDS. This study sought to evaluate the 'Grim Reaper' and 'Multiple Beds' advertisements frequently broadcasted throughout Australia. Our model for evaluation was based on a theoretical synthesis of television advertising, transactional analysis (TA) and recall congruence. Eighty-three participants viewed each advertisement and rated which ego state the source of the message was attempting to 'hook' in the audience. They also predicted their own ego state during sexual intercourse and rated the effectiveness of the advertisements. As predicted by TA theory, a crossed transaction was associated with significantly less psychological impact than a parallel transaction for the 'Grim Reaper' advertisement. A similar trend was apparent for the 'Multiple Beds' advertisement. Important issues which warrant further research in order to evaluate whether transactional analysis could be a useful tool in promoting health are discussed.
Applying the Transtheoretical Model to the Study of Exercise on Prescription
Authors: Clarke Patricia , Eves Frank
Published: March 2007

This study examines the application of key constructs of the transtheoretical model and an integrated perceived barrier construct to exercise behaviour. Research participants were middle-aged, sedentary, males and females ( N = 393) who were referred by their general practitioner for a three-month prescription of exercise. Partial support for the use of the transtheoretical model in a UK sample was found. The decisional balance measure, in particular the cons of exercising, reflected hypothesized differences across the stages of change. However, in contrast to previous studies, scores on efficacy items were not significantly associated with stage. A potentially influential effect of barriers to exercise on different stages of behaviour was evident. Implications for recruitment, intervention and research are discussed.
Health Psychology 2000:The Development of Professional Health Psychology
Authors: Marks David F. , Brücher-Albers Carola , Donker Frank J.S. , Jepsen Zenia , Rodriguez-Marin Jesus , Sidot Sylvaine , Backman Brit Wallin
Published: March 2007

This Final Report of the European Federation of Professional Psychologists' Associations (EFPPA) Task Force on Health Psychology defines the nature and scope of health psychology and its possible future development to the year 2000 and beyond. Training needs and objectives are specified for professional health psychologists working in Europe. Practical and policy implications of medical progress and societal changes are discussed. The future development of health psychology as a profession depends on putting theory and policy into practice through the implementation of high quality training. Currently there are relatively few European countries where this has yet happened. Training programmes need to be introduced in all European countries within the framework of each member- country's national laws, regulations and practices.
Playing With Things
Authors: Dant Tim
Published: March 2007

The sociology of leisure traditionally focuses on human relations, treating any material objects used as marginal to the activity. This article argues that some recreational activity is realized through interaction with material objects and uses the example of windsurfing to show how. Three approaches to understanding the sociological features of the human-object interaction are considered. The first looks at playing as a distinctive type of social activity; how playing with a windsurfer involves 'ilinx' type play (Caillois, 1961) and how it may lead to 'play-excitement' (Elias and Dunning, 1986). The second argues that consumption, through the exchange of value and signs in a variety of discourses, socially locates the play activity of wind surfing. The third approach looks at the way that the user interacts (Mead, 1962; 1980) with the objects of the windsurfer to engage in play.

These three approaches together show that playing with things like wind surfers provides a particular type of emotional outlet, situates the sailor in particular social contexts and shapes particular lines of action, including imaginative and discursive action.