The End of the Beginning

This is it. I finally made up my mind and decided on what kind of research project I’ll be doing for my final dissertation.

It all came clear to me while I was sitting on the bus, somewhere near Greenwich Park, back from a long and exhausting day with the Red Cross. I looked up at the posed ads inside the bus and noticed a screening campaign for the STI Chlamydia. And I must admit I am glad I to gave found  this campaign the way it reaches out to its target audience : On public transport. Does this means it has been effective? Not quite.

Recent reports from the BBC have revealed that the screening campaign had failed in raising awareness in UK’s 16-24 years of age, where one out of ten is likely to carry the bug.  Considering that London is the UK capital of Chlamydia, I’ve decided to analyze websites related to the campaign in order to find out if internet and Web 2.0 is an efficient means to reach out to UK’s youth and how its interactivity plays an important role in raising awareness in safer sex, STIs and the motivation to get tested…

I am also interested in the campaign’s communities’ involvement  and at how such an initiative has been orchestrated and leveled throughout the city

I believe such websites will enable me to do semiotic analysis, as well as interviews with the NHS Islington and Camden personnel, producers of such sites and, (even though this is deemed as a very touchy subject), discussions (focus groups!)  with the participants of this campaign.

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Check out the little bunnies at the check UR self campaign below :

Checkurself Chlamydia Campaign

Audrey

Back to where I started…

Personally, I find the idea that the more social capital you have, the more likely you are of leading a healthy life very appealing. Recent studies have established a correlation between people’s social networks and their self-rated health. Basically, the more implicated you are in you community, the more are your chances of leading a health lifestyle. Social capital is embedded with notions of civic virtue, reciprocity and trustworthiness in your neighbors and local community. It can also refer to your membership to a rowing club. It has everything to do with a sense of belonging to a certain group and giving a dam about others.

The more I read about social capital, the more enthusiastic I became of concentrating  on this concept for my Masters’ final dissertation. I had it all figured out. I wished to assess the social capital level of the Red Cross Care in the Home participants for a duration of 6 weeks and evaluation if the daily visits and companionship of volunteers would increase their self-rated health status.  All of this without even having being trained by the Red Cross yet.

While discussing this with my supervisor, I realized I had issues with turning my voluntary participation into a cultural research project. Looking back, I am almost tempted to tell myself: How unethical ?  And even now, I read through and through the definition of social capital provided by Robert Putnam and I am not even sure if it still applies to the beneficiaries of the Red Cross services.

Social capital– that is, social networks and the associated norms of reciprocity, comes in many different shapes and sizes with many different uses Your extended family represents a form of social capital, so do your Sunday class, the regulars who play poker on your commuter train, your college roommates, the civic organizations to which you belong, the Internet chat groups in which you participate, and the network of professional acquaintances recorded in your address book.  p.21

If social capital relies on such broad social networks,does it apply to isolated and lonely elderly who count weekly visits by the Red Cross to regain their autonomy and dignity? Mas o menos I guess.

Truth be told, I now hold a big interest in the field of public health and health promotion… and I feel that this final essay is a great opportunity for me to further research and (no, I am not even kidding) enrich my social capital and connections on the field. Call me an opportunist, but I have been considering researching the social impact of Swine Flu.  I had dinner with a friend last night who told me it would be such a shame not to take advantage of the enormous pig flu media coverage  and make this my future research project.  And I think I’m starting to agree. So there I am. Back to where I started. Thinking of analyzing the Swine Flu impacts on Londoners….

At least I find comfort in the fact that I have found in social capital  another topic for which I have a HUGE interest. Who knows, I might focus on this one for a PhD final thesis ?

Putnam, R. (2001) Bowling Alone, New York: Simon & Schuster

Social Capital, The Red Cross and My Very Own Dissertation Issues.

In preparing a much needed meeting with my dissertation supervisor, I came across a few ethical issues in relations to my future dissertati

on. Since I believe writing them down and posting them on my blog will increase my chances of finding solutions to them, I would like to raise a few  matters with you. All comments or feedback will be much appreciated !

I recently enrolled with the British Red Cross to volunteer for a program called Care in the Home. This initiative provides Camden elderly people with volunteering carers to help in their rehabilitation process after a long stay in a hospital. Carers follow and monitor these patients for a period of 6 weeks, while assisting them in their weekly tasks such as running errands, paying monthly bills, regaining autonomy, etc.

But most importantly, carers offer their support and companionship, as most of these people suffer from solitude and isolation.

As I am currently being trained as a carer, I can only share a very educational perspective in regards to this programme.  But from what I’ve learned so far, this program offers a great example of community-based partnership with the NHS, and truly helps in providing, albeit a very temporary, solution to these lonely and ill people.

I have asked myself the reason why I have decided to commit with the Red Cross and came across several interesting and revealing answers. First of all, I think I need to get involved in my community as much as these patients need the Red Cross support. It is a means for m

e to better settled in London and make new acquaintances with Red Cross Staff. But it is also a way to fight my very individualistic and selfish needs… and to get in touch with what I consider ‘the real world’. (Quite often, I do feel like my easy-going student life doesn’t quite correspond or fit to what’s really tanking place in my neighborhood.)

Writing a masters’ dissertation can also make you feel like you have way too much time on your hands… and I felt that I probably should use this time a little more wisely.  Besides, aren’t we all more productive when we have a deadline anyway ? The busier I get, the more effective I become.

But mostly, since I developed a growing interest in the field of public health, the least I could do is to go out there and give some of my free time. I feel the need  to stop getting my nose into dozens of books and get firsthand health promotion experience!  Volunteering seemed like the best and easiest option.

But I also asked myself (honestly!) if I was considering this voluntary work opportunity mostly for my upcoming dissertation. And quite frankly, the answer is no. This is just a genuine need to help out others, meet new people, and get out of my comfort zone.  This opportunity has, however, made me explore further aspects of the public health domain. Through my readings, I discovered the concept of social capital, which has in turn, made me reflect upon the Red Cross services and the Care in the home program.  My dissertation is really a work in progress, and its topic keeps being refined every day. But let’s just say that the idea of social capital has become one of my main focus, which I intend to explore further.

Thus, what  I am interested in, and what I am about to present to my supervisor, is the correlation between these patients social capital and their self-rated health status. There is a strong body of evidence which suggests that social capital, i.e. social networking, integration, civic participation and community trust, is linked to improved health and that its support may be more cost-effective than t

he traditional manipulation of lifestyles and behaviors.

Since these people are still recovering from a long stay in the hospital, we can assume that their health is rather fair or poor. However, based on preliminary studies linking social capital and health patterns, evidence suggested that their association had a beneficial impact on patents’ overall own health evaluation.

Hence, I am interested in analyzing if (and how) this 6-week Red Cross program is indeed improving the health of these patients/clients. Is the fact that they are volunteers and not paid social-workers impacting in any ways on the established relationship and trust between carers and patients ? And how are these people defining and self-rate their health ? Since I strongly believe concepts of health are culturally defined and largely mediated, I also would like to measure how are these concepts understood and integrated in to society, focusing on the elderly.

But at this time, I find myself struggling with my research design. How should I collect my data? I thought of conducting semi-structured interviews with the coordinators of the Care in the home programs and to keep a field-diary of my observations. But I feel the need to also inform patients about my research projects. And this is where it becomes a little more complex. I do not want these patients to position themselves as subjects of a research. After all, my priority and main focus will remain my role as a carer, not as a researcher. Still, I believe it is possible to combine both positions, but in which way? Do I wish to remain very objective in this research process or can I immerse myself in my role as a carer and turn this research into a very professional but also very subjective experience? Will it be possible to formally interview them or will this data be collected through informal, casual and dispersed chats?

There is also the possibility of adopting a participative approach, where subjects fully engage in every step of the research process. But I fear these subjects/clients will be in no condition to take part as such is this dissertation research.

So far, that’s where I am at. Hopefully, this picture will get clearer within the next few days… and I will get a few answers back from the Red Cross.

First-Hand NHS Experience

My boyfriend,  having registered to sweaty sessions of Bikram Yoga, came home one night with an infected knee.  When he finally decided to consult a GP, (on a Saturday!) no clinic could take him since he had not yet registered with his local practice. I’ll spare you the dull details of his many phone calls the to NHS direct line.  However  his infection got worse diring the weekend.   (Again, I could go though all the  yucky details of his open wound but let’s just say that it looked very bad!)  Boyfriend finally managed to see a GP the following Monday, where a nurse kindly cleaned his abscess and sent him home with a prescription of antibiotics.  However, a few days later, it became obvious that the medicine was not working at all. His condition had worsen again and his leg was swollen all the way down to his ankle.  He could barely walk.  The clinic finally referred him to the nearest Emergency Room, where we waited together for approximately 2 hours.

Boyfriend saw a very friendly intern and a senior doctor, who performed a very small incision into the wound.  We were out of the hospital in no time, with again, stronger antibiotics.  He is currenlty back on his feet, how and about, wandering the streets of London.

Having recently discovered Medical Anthropology, I took a particular interest in the relations of power between  hospital staff and  patients. Having worked in a ER as a receptionist myself, I have a good knowledge of how this system works. Being referred to Accidents and Emergency means you’ll  need to go through the triage process.  Basically, the ER staff briefly assesses your health condition and makes sure you can handle waiting a few hours in the waiting room.  Nurses usually take your temperature, make a brief review of your medical history,  but mostly  assign you a priority number, which , in brief, determines how much time you’ll spend waiting once they send you back to the waiting room.  This wait, unfortunately, is nothing like waiting to be served in a restaurant, where first arrived and usually first served.  A & E waiting rooms work so that priority cases are being called up first.  (Which at times, can be a little frustrating!)

But one thing that I noticed was the tension between the waiting patients. Most of the people in the waiting room were trying to compare the severity of their condition to that of others and thus predict in which order they were most likely to be called.  This is exactly what my boyfriend was up to. And he found himself being wrong most of the time. Being sick can change one attitude and turn yourself into a more self-concerned behavior, which, I must add, is absolutely normal. There was often no consideration for other patients’ state. People seemed very focused on themselves, and worry, fear and tiredness could be sensed inside the room.

As it is often stated that the vulnerability of sick/injured patients places them into a dependent and inferior position toward medical staff, I found that this could also be felt among fellow ER patients. And even though some patients did socialize, most of them kept to themselves, and seemed to consider other cases as a real nuisance…

Isn’t it fascinating!

Enlightning Meeting

I had a very inspiring meeting with Robert Ferguson a couple of weeks ago.  Erasmus students from the Institute of Education had to informally discuss their final dissertation’s interests and objectives so as to gain feedback, reaction and comments on their future research projects.

I did my 10-minute presentation without  difficulty, detailing my fields of interest, explaining what Public health exactly stands for, and my particular enthusiasm towards social epidemiology.  I stated that a focus on health was the key in Public health, rather then a focus on illness and the need to understand people’s attitude in order to challenge their negative and toxic beliefs. I also brought up the HUGE necessity to empower people, in building their confidence and skills and eventually lead them to take control of their lives.

Once  my little spiel was over, Robert simply said to me : ‘Audrey, all of these ideas are great, but they don’t really integrate any media concepts.  You’re looking more at a psychological [behavioral] approaches and are not considering  any media or communication analysis.

And he was absolutely right! I went back to my books and and spent a few  at the library to finally came across interesting bodies of work that combined both public health and cultural studies.  Not only did I feel completely relieved, but even more inspired.

I think my main focus will be in Medical Anthropology (MA). MA seeks to explain people’s ideas and behaviour in relation to health by examining the influence of their culture (Naidoo, 2008:187). It is also looking at how identity is linked to health, how illness is treated and how people adapt to changed bodies or circumstances as a result of illness.  It is considering how lay people relate to health and how certain concept and representations of health have become dominant in our society.  (Particularly if they are being disseminated through the mass media).

Hence, I am now considering writing a chapter on UK’s recent public health campaigns, including the ongoing Swine Flu protection campaign, but I still have a strong interest of Bourdieu and Coleman’s concepts of Social capital, where one’s personal network and membership to social groups and organizations can be accounted for improved health situation. Working with the British Red Cross Care in the home programme, I would like to assess if and in which ways  this new 4-6 week networking and caring experience plays a part in the health improvement of their clients.

In addition, I’d like to explore the possibilities of improving this programme by giving health promotion training to their current volunteers and maybe turn this initiative into a pilot programme…

Health Promotion Video

I have come across these Thai health promotion TV ads earlier this week. Although there is an ongoing debate about the efficacy of such mediated public health campaigns, I believe they can trigger the need or the willingness to change one’s attitude in terms of health behavior. The implementation of such public health strategies are, I believe, much more effective when combined with good old face-to-face discussions, interpersonal communication and community-based initiatives.

For some reason, if these ads aimed at being funny, they have succeeded in making me feel utterly uncomfortable.  The gloomy settings, the dramatic scenarios and the clever twists are a common marketing plan…and they are quite catchy…

The more I think about this campaign, the more I realize that the very fact that I’m finding these ads quite disturbing might just be exactly what they intended to do : Create a lingering and unsettling impact upon viewers.

Enjoy!

Define Pandemic.

I have just come across a very interesting article featured in the HEALTH section of the New York Times.

It assesses the real meaning of a Pandemic, what it entails and how it has been used over the recent years.

As the article brilliantly states :

“One of the biggest problems in public health is communicating risk assessment”. Thus, how is a pandemic defined ?

Enjoy !

It This A Pandemic?

The New Public Health: A Multidisciplinary Effort.

I have been occupying my time with very interesting readings recently. Public Health and Health Promotion (1998) by Jennie Naidoo puts forward useful information in regards to the fundamental concepts of Public Health (PH)  and Health Promotion (HP),  their distinction, but mostly  their complementary and overlapping field of practice.  Since these two disciplines are repeatedly correlated in the field, I believed essential to understand how are they defined and what do they exactly entail.  Since I am currently in the process of getting familiar with HP terminology and scope of action, I felt the need to grasp the inherent concepts, methodology and new theories applied to the field.

Building on Jennie Naidoo, public health can be described as follows:  the science and art of preventing diseases, prolonging life and promoting health through the organized effort of society (Acheson, 1988).  Consequently, health promotion, being inherently part of Public Health, can be seen as the efforts to precent ill health and promote positive health.

While desperately trying to find a place where I could fit in the PH domain, I found comfort in that HP now calls for a multi-disciplinary effort and the need for several different types of skills and practitioners.  In fact,  PH and HP field can now be looked at from two distinct perspectives:  Medically skilled and non-medically skilled.  It  is now open to a wide range of social practitioners and not exclusively reserved to medically trained professionals.

This new approach to public health, simply called ‘New Public Health’ calls for a broader social view of Public Health and recognizes that promoting health is a multi-agency task. It involves community work, intersectorial collaboration and local partnerships.  Hence, it now concerns pretty much everyone.  It also entails a focus on health and not on illness! I now, more than ever, believe public health and health promotion is based on strategic communication and management… which I find extremely motivating. This field of study seems to offer so many possibilities to new comers like me… that I don’t even know where to start.  But I still feel I need to keep on reading.

I previously wished to specialize in PH nutrition… but I am re-evaluating this present situation. I’ve recently been in touch with the Red Cross in order to do ‘Care in the homes’ voluntary work in a London Hospital.  At first, this opportunity seemed, to me, just a means to give back to my community and to get involved. But my recent reading about HP has convinced me that this type of ‘work’ or involvement can also be deemed as HP initiative. Or at least, it will be!

I have also discovered two very useful websites, which I am still getting familiar with at this time.

www.cochrane.org
www.skillsforhealth.org.uk
www.redcross.org.uk

I’ve also found out that the Red Cross is actively looking for new International Delegates, to help out and get involved in developing countries, mostly around Africa. Although they only hire highly skilled workers, this could also be an interesting opportunity in the distant future. Their effort, at this time, is mainly focusing on public heath management. For more info, please visit the British Red Cross website.

My Blog Manifesto !

Yesterday’s residential has made me reconsider my blog entirely. The insightful exchanges and the shared experiences of our most recent blogging participation have made be come to terms with my personal blogging issues.  I acknowledged that fact that I had been absolutely terrified at the idea of keeping a blog and decided that, in order to get the most out this Internet Cultures course, important changes needed to be done.

In a bid to keep me motivated and gradually become more committed to this space, I have rejuvenated the formula, by modifying both its title and design. An significant attitude change also has be performed!   Blogging should not be considered as an assignment or a task, but rather as a pleasurable and useful experience. A moment where I get to focus and reflect upon my ongoing  research project. This blog should then be seen as an interactive space where I can share, post and dwell upon new ideas as well as look into better structuring  my thoughts. It should also be deemed as a valuable tool which serves significant archiving and reviewing purposes.

But most importantly, it shall consider its author (!) as a primary audience.
In an attempt to get rid of this blogging fear, writing for myself will become my main priority!

I am now happy to re-introduce this online space that the high hopes that it will mirror who I truly am and hopefully offer a more personal discourse.

Paranoia, Paranoia, Everybody’s coming to get me.

I really need to catch up on my reading, as I haven’t really found the time to monitor Swine Flu crisis during the past week.

Which makes me think that this situation might have been blown out of proportion by the  media. Which in turn, had to keep the public informed about the progression of this virus. Is the media answering public’s demand for constant updates on the virus spread or is it fueling further some kind of small-scale world-wide panic ?

WHO raising the threat to Level 5 surely did not help in settling things.  But does a pandemic necessarily means that millions of people will get sick ?

[thinking out loud]

Isn’t being at risk alarming enough Audrey ? Yes.
And who’s more at risk ? Developing countries ? Industrial cities ? Working classes ? Middle classes ?  Pretty much everyone, is this globalization era ?  [note to myself : research this further on WHO official site]

I’ve got  a feeling that this might slow down a little over summer, before it will hit us again in a few months.  Anyway, I need to get back to my cyber-papers and catch up with what has been happening in the past couple of days before I blog on this matter.
In response to Holly’s comment, I also believe the UK Swine Flu prevention campaign will trigger some kind of side reaction. People do react badly now when someone sneezes or coughs in public places… especially public transport.
For one thing, it has definitely changed the way I sneeze. I now imagine all of these little droplets lingering for hours.

Germs. Out in a second. Around for hours.

Catchy enough !

I have also been told that kids in the US are being taught to cough in their elbow, so as to not get germs on their hands… (Now, that cannot be a good prevention means… !)

But I’m thinking a of this new uneasiness regarding coughing or sneezing might be a sign that the campaign has left its mark. I will not say that is has been effective, since it has just been launched, but I feel people have been noticing it. That picture looks pretty convincing to me.  No big semiotic analysis required here.

On a different note,

while I was in Ireland, I found these little free hand-outs from the in various hostels around the country.
Are tourists perceived as an easy STD target or threat to locals ?  Assuming that youth hostels encourage encounters of every kind, these little leaflets must find their way into diverse hands.

But are they significantly efficient ? Do tourists pay any attention to they.  And if so, is the message really sinking in ?  Has it been combined to any kind of face to face talk or interpersonal communication ? What’s the overall campaign design ?

Loads of questions I need to investigate further.