'Savoir fare': are cooking skills a new morality

There has been a recent surge of interest in cooking skills in a diverse range of fields, such as health, education and public policy. There appears to be an assumption that cooking skills are in decline and that this is having an adverse impact on individual health and well-being, and family wholesomeness. The problematisation of cooking skills is not new, and can be seen in a number of historical developments that have specified particular pedagogies about food and eating. The purpose of this paper is to examine pedagogies on cooking skills and the importance accorded them. The paper draws on Foucault’s work on governmentality. By using examples from the USA, UK and Australia, the paper demonstrates the ways that authoritative discourses on the know how and the know what about food and cooking – called here ‘savoir fare’ – are developed and promulgated. These discourses, and the moral panics in which they are embedded, require individuals to make choices about what to cook and how to cook, and in doing so establish moral pedagogies concerning good and bad cooking. The development of food literacy programmes, which see cooking skills as life skills, further extends the obligations to ‘cook properly’ to wider populations. The emphasis on cooking knowledge and skills has ushered in new forms of government, firstly, through a relationship between expertise and politics which is readily visible through the authority that underpins the need to develop skills in food provisioning and preparation; secondly, through a new pluralisation of ‘social’ technologies which invites a range of private-public interest through, for example, television cooking programmes featuring cooking skills, albeit it set in a particular milieu of entertainment; and lastly, through a new specification of the subject can be seen in the formation of a choosing subject, one which has to problematise food choice in relation to expert advice and guidance. A governmentality focus shows that as discourses develop about what is the correct level of ‘savoir fare’, new discursive subject positions are opened up. Armed with the understanding of what is considered expert-endorsed acceptable food knowledge, subjects judge themselves through self-surveillance. The result is a powerful food and family morality that is both disciplined and disciplinary.

The prevalence and perception of pain amongst hospital in-patients

The aim of this paper is to describe the prevalence and perceptions of pain and pain management amongst hospital in-patients. A cross-sectional descriptive survey of 205 patients was conducted. Presence and severity of pain was assessed using verbal descriptor and visual analogue scales, and perceptions of pain were assessed using multi-item scales. Although the severity of pain reported was consistent across age groups and clinical areas, women in the study sample were significantly more likely to report high levels of pain than men. Differences in how men and women communicate their pain were observed, with women indicating that they were less willing to ask for help with their pain. Results suggest that pain continues to be an important problem for a large number of men and women in hospital, and that the experience of pain impacts negatively upon their well-being. Gender differences in the experience of and response to pain remain important considerations for clinical nurses who have major responsibilities for the management of pain in hospitalized patients.

Communication predicaments of older health care consumers : what can 'we' do about it?

Focuses on the importance of communication to the well-being of older people in Australia. Role of communication for the design, delivery and evaluation of health services for the elderly; Impact of aging on communication; Importance of communication between health care providers and nursing home residents.

The use of CCTV to police public spaces : a case of big brother or big friend?

This paper considers the role of CCTV (closed circuit television) in the surveillance, policing and control of public space in urban and rural locations, specifically in relation to the use of public space by young people. The use of CCTV technology in public spaces is now an established and largely uncontested feature of everyday life in a number of countries and the assertion that they are essentially there for the protection of law abiding and consuming citizens has broadly gone unchallenged. With little or no debate in the U.K. to critique the claims made by the burgeoning security industry that CCTV protects people in the form of a ‘Big Friend’, the state at both central and local levels has endorsed the installation of CCTV apparatus across the nation. Some areas assert in their promotional material that the centre of the shopping and leisure zone is fully surveilled by cameras in order to reassure visitors that their personal safety is a matter of civic concern, with even small towns and villages expending monies on sophisticated and expensive to maintain camera systems. It is within a context of monitoring, recording and control procedures that young people’s use of public space is constructed as a threat to social order, in need of surveillance and exclusion which forms a major and contemporary feature in shaping thinking about urban and rural working class young people in the U.K. As Loader (1996) notes, young people’s claims on public space rarely gain legitimacy if ‘colliding’ with those of local residents, and Davis (1990) describes the increasing ‘militarization and destruction of public space’, while Jacobs (1965) asserts that full participation in the ‘daily life of urban streets’ is essential to the development of young people and beneficial for all who live in an area. This paper challenges the uncritical acceptance of widespread use of CCTV and identifies its oppressive and malevolent potential in forming a ‘surveillance gaze’ over young people (adapting Foucault’s ‘clinical gaze’c. 1973) which can jeopardise mental health and well being in coping with the ‘metropolis’, after Simmel, (1964).

Arts-health intersections : a model of practice for consistency in the arts-health sector

The field of Arts-Health practice and research has grown exponentially in the past 30 years. While researchers are using applied arts as the subject of investigation in research, the evaluation of practice and participant benefits has a limited general focus. In recent years, the field has witnessed a growing concentration on the evaluation of health outcomes, outputs and tangential benefits for participants engaging in Arts-Health practice. The wide range of methodological approaches applied arts practitioners implement make the field difficult to define. This article introduces the term Arts-Health intersections as a model of practice and framework to promote consistency in design, implementation and evaluative processes in applied arts programmes promoting health outcomes. The article challenges the current trend to solely evaluate health outcomes in the field, and promotes a concurrent and multidisciplinary methodological approach that can be adopted to promote evaluation, consistency and best practice in the field of Arts-Health intersections. The article provides a theoretical overview of Arts-Health intersections, and then takes this theoretical platform and details a best model of practice for developing Arts-Health intersections and presents this model as a guide.

Calling for help : a responsive evaluation of Child Health Line

The project examined the responsiveness of the telenursing service provided by the Child Health Line (hereinafter referred to as CHL). It aimed to provide an account of population usage of the service, the call request types and the response of the service to the calls. In so doing, the project extends the current body of knowledge pertaining to the provision of parenting support through telenursing. Approximately 900 calls to the CHL were audio-recorded over the December 2005-2006 Christmas-New Year period. A protocol was developed to code characteristics of the call, the interactional features between the caller and nurse call-taker, and the extent to which there was (a) agreement on problem definition and the plan of action and (b) interactional alignment between nurse and caller. A quantitative analysis examined the frequencies of the main topics covered in calls to the CHL and any statistical associations between types of calls, length of calls and nurse-caller alignment. In addition, a detailed qualitative analysis was conducted on a subset of calls dealing with the nurse management of calls seeking medical advice and information. Key findings include: • Overall, 74% of the calls discussed parenting and child development issues, 48% discussed health/medical issues, and 16% were information-seeking calls. • More specifically: o 21% discussed health/medical and parenting and child development issues. o 3% discussed parenting and information-seeking issues. o 5% discussed health/medical, parenting/development and information issues. o 18% exclusively focussed on health and medical issues and therefore were outside the remit of the intended scope of the CHL. These calls caused interactional dilemmas for the nurse call-takers as they simultaneously dealt with parental expectations for help and the CHL guidelines indicating that offering medical advice was outside the remit of the service. • Most frequent reasons for calling were to discuss sleep, feeding, normative infant physical functions and parenting advice. • The average length of calls to the CHL was 7 minutes. • Longer calls were more likely to involve nurse call-takers giving advice on more than one topic, the caller displaying strong emotions, the caller not specifically providing the reason for the call, and the caller discussing parenting and developmental issues. • Shorter calls were characterised by the nurse suggesting that the child receive immediate medical attention, the nurse emphasising the importance or urgency of the plan of action, the caller referring to or requesting confirmation of a diagnosis, and caller and nurse call-taker discussion of health and medical issues. • The majority of calls, 92%, achieved parent-nurse alignment by the conclusion of the call. However, 8% did not. • The 8% of calls that were not aligned require further quantitative and qualitative investigation of the interactional features. The findings are pertinent in the current context where Child Health Line now resides within 13HEALTH. These findings indicate: 1. A high demand for parenting advice. 2. Nurse call-takers have a high level of competency in dealing with calls about parenting and normal child development, which is the remit of the CHL. 3. Nurse call-takers and callers achieve a high degree of alignment when both parties agree on a course of action. 4. There is scope for developing professional practice in calls that present difficulties in terms of call content, interactional behaviour and call closure. Recommendations of the project: 1. There are numerous opportunities for further research on interactional aspects of calls to the CHL, such as further investigations of the interactional features and the association of the features to alignment and nonalignment. The rich and detailed insights into the patterns of nurse-parent interactions were afforded by the audio-recording and analysis of calls to the CHL. 2. The regular recording of calls would serve as a way of increasing understanding of the type and nature of calls received, and provide a valuable training resource. Recording and analysing calls to CHL provides insight into the operation of the service, including evidence about the effectiveness of triaging calls. 3. Training in both recognising and dealing with problem calls may be beneficial. For example, calls where the caller showed strong emotion, appeared stressed, frustrated or troubled were less likely to be rated as aligned calls. In calls where the callers described being ‘at their wits end’, or responded to each proposed suggestion with ‘I’ve tried that’, the callers were fairly resistant to advice-giving. 4. Training could focus on strategies for managing calls relating to parenting support and advice, and parental well-being. The project found that these calls were more likely to be rated as being nonaligned. 5. With the implementation of 13HEALTH, future research could compare nurse-parent interaction following the implementation of triaging. Of the calls, 21% had both medical and parenting topics discussed and 5.3% discussed medical, parenting and information topics. Added to this, in 12% of calls, there was ambiguity between the caller and nurse call-taker as to whether the problem was medical or behavioural.

Refugee Mental Health Interventions

There is great diversity in the type of interventions carried out under the rubric of “refugee mental health.” This is partly due to the holistic ecological and psychosocial approaches that have come to dominate research and humanitarian understandings of refugee mental health. The diverse application of psychosocial principles in refugee mental health is also extended by the many varied locations in which such interventions are carried out. Guidelines have been developed to aid would-be practitioners of mental health care amongst refugee communities. However, challenges remain in demonstrating the effectiveness of the approaches used. The maxim “do no harm” which must guide all interventions in this area has nonetheless been threatened at times by well-meaning, yet misguided actions. Despite these issues, there is much promise that together with refugees themselves, steps can be taken to promote well-being and relieve distress in communities of people displaced by conflict.

Thai family support (TFS) : working with families of young substance users in primary health care

Living with substance users negatively impacts upon family members in many ways, and distress is common. Despite these deep and wide-ranging impacts, supportive interventions for family members in their own right are rarely available. Thailand has substantial and growing problems with substance use, and there is very little support or family members of drug users, especially in community setting. The Thai Family Support (TFS) program was designed for implementation in primary health care units (PCUs) in Thailand. TFS was based on two approaches with existing empirical support in Western contexts—the 5-step method and CRAFT—with adaptations to a Thai setting that included integration with Buddhist practices. Its aims were to increase well-being of family members, reduce mental distress, improve family relationships between family members, and engage substance users in behaviour change. A small-scale randomised controlled trial on TFS with a Delayed Treatment control was conducted, with assessments at 8 weeks (Post 1) and 20-24 weeks (Post 2). Structured interviews with participants and PCU staff and an examination of five case studies augmented the quantitative results. Mixed Model Analyses were applied to quantitative outcomes, and thematic analysis was used for qualitative data. Thirty-six participants (18 in each of Immediate and Delayed Conditions) were recruited. A significant difference at Baseline between the two conditions was observed on the Thai GHQ-28 and Gender, but it was not possible to statistically control for these effects. There was a significant Time by Condition interaction on the Thai GHQ-28, WHOQOL-BREF-THAI and FAS, reflecting greater improvements in the Immediate condition by Post 1, but with the Delayed condition meeting or exceeding that effect by Post 2. On FES Cohesion and Conflict, there were falls across conditions at Post 2, but only Cohesion also showed a Time by Condition interaction, and that effect was consistent with a delayed impact of treatment. Overall, TFS by PCU staff in the Delayed Condition gave similar results to TFS conducted by the researcher, supporting the viability of its dissemination to standard health services. Qualitative data also confirmed the quantitative results. Most participants reported physiological and psychological improvements even though their substance-using relative did not change their drug use behaviour. After completing TFS, participants reported increased knowledge, group support and sharing feeling, having positive patient-professional relationship, having greater knowledge of substance abuse and social support. In particular, they changed their behaviour towards the substance user, resulting in improvements to family relationships. PCU staff gave similar responses on the efficacy of TFS, and saw it as feasible for routine use, although some implementation challenges were identified. The cultural adaptation and in particular the religious activities, were recognised by participants and PCU staff as an important component of TFS to support psychological health and well-being. Findings from this study showed the impact of substance use on family members and difficulties that they experienced when living with the substance users, resulting distresses and burden that may develop severe mental health disease. Drug use policies should be modified to support family members and response to their needs effectively for early prevention. This study also gave preliminary support for application of the TFS program in rural primary care settings and identified some policies that will be required for it to be disseminated more broadly.

Posttraumatic growth and posttraumatic depreciation as predictors of psychological adjustment

Informed by current trauma literature, this study explored the relationships between Posttraumatic Growth (PTG; Tedeschi & Calhoun, 1995), Posttraumatic Depreciation (PTD; Cann et al., 2010) and other post-trauma outcomes including well-being, psychological flourishing, and psychological distress. The predictive utility of PTG and PTD was also examined. The sample comprised 104 trauma survivors who completed the Posttraumatic Growth Inventory – 42 (Baker et al., 2008) and several outcome measures. As expected, PTD showed strong linear correlations with well-being, flourishing and distress, and emerged as a significant predictor of scores on such measures. However, PTG showed negligible correlations with well-being, flourishing and distress. This reaffirms that PTG and PTD measure conceptually distinct and independent dimensions of experience, which has implications for therapeutic practice.

Working with refugee survivors of torture and trauma : an opportunity for vicarious posttraumatic growth

Clinical work with people who have survived trauma carries a risk of vicarious traumatisation for the service provider, but also the potential for vicarious posttraumatic growth. Despite growing interest in this area, the effects of working with survivors of refugee-related trauma have remained relatively unexplored. The aim of the current study was to examine the lived experiences of people working on a daily basis with survivors of torture and trauma who had sought refuge in Australia. Seventeen clinical, administrative, and managerial staff from a not-for-profit organisation participated in a semi-structured interview that was later analysed using interpretive phenomenological analysis. Analysis of the data demonstrated that the entire sample reported symptoms of vicarious trauma (e.g., strong emotional reactions, intrusive images, shattering of existing beliefs) as well as vicarious posttraumatic growth (e.g., forming new relationships, increased self-understanding, greater appreciation of life). Moreover, effortful meaning making processes appeared to facilitate such positive changes. Reduction in the risks associated with this work, enhancement of clinician well-being, and improvement of therapeutic outcomes is a shared responsibility of the organisation and clinician. Without negating the distress of trauma work, clinicians are encouraged to more deeply consider the unique positive outcomes that supporting survivors can provide.

Education for social responsibility: Ethics and imagination for engaging students and teachers in educational reform

In this chapter we make assumptions about the primary role of education for the life of its beneficiaries and for society. Undoubtedly, formal education plays an important role in enhancing the likelihood for participation in future social life, including enjoyment and employment, by the student as well as the development of the well being of society in general. Similarly, education is often seen as a main means for intergenerational transmission of knowledge and culture. However, as Dewey (1916) argues, in liberal societies, education has the capacity of enhancing democratic participation in society that goes beyond passive participation by its members. One can argue that the achievement of the ideals of democracy demands a free and strong education system. In other words, while education can function as an instrument to integrate students into the present society, it also has the potential to become an instrument for its transformation by means of which citizens can develop an understanding of how their society functions and a sense of agency towards its transformation. Arguably, this is what Freire (1985) meant when he talked about the role of education to “read and write” the world. A stream of progressive educators (e.g., Apple (2004), Freire, (1985), Giroux (2001) and McLaren (2002)) taught us that the reading of the world that is capable of leading into writing the world is a critical reading; i.e., a reading that poses “Why” questions and imagines “What else can be” (Carr & Kemmis, 1987).

The Capacity to Share : A Study of Cuba's International Cooperation in Educational Development

Since 1959, international cooperation has been a key feature of Cuba’s commitment to egalitarian social well-being. Aspects of this experience have been well documented , in general and with reference to specific initiatives across human development and occupational sectors. Others have been little examined, of which education is one. This book describes the internationalism of Cuban education policy as practised in Cuba and in other parts of the Global “South.”

Quality of life in chronic fatigue syndrome

Whilst the debilitating fatigue experienced in patients suffering from Chronic Fatigue Syndrome (CFS) results in a subjective marked impairment in functioning, little research has investigated the impact of this disorder on quality of life. Forty-seven subjects with a confirmed diagnosis of CFS and 30 healthy controls were compared using the Sickness Impact Profile (SIP). A subgroup of subjects were interviewed regarding the impact CFS has had on their social and family relationships, work and recreational activities. Results from both the SIP and the interview revealed that CFS subjects had significantly impaired quality of life, especially in areas of social functioning. These findings highlight the importance of addressing the social isolation and loss of role functioning experienced by CFS sufferers.

Coping resources, coping strategies and adaptation to organisational change : direct or buffering effects?

This study examined the effects of personal and social resources, coping strategies and appraised stress on employees' levels of anxiety and depression. In relation to the effects of resources and coping strategies, two different models were tested. The main effects model proposes that, irrespective of the level of stress, coping resources and coping strategies have direct effects on well-being. In contrast, the buffering model predicts that the buffering effects of coping resources and strategies are only evident at high levels of stress. One hundred lawyers completed a structured self-administered questionnaire that measured their personal and social resources, use of problem-focused and emotion-focused coping strategies, and appraisals of the stressfulness of the situation. Results revealed generally strong support for the main effects model in the prediction of employee levels of anxiety and depression. Lower levels of anxiety were linked to judgements of lower levels of organizational change, greater self-confidence, greater internality of control beliefs and less use of emotion-focused coping strategies. Lower levels of depression in employees were also linked to judgements of lower levels of organizational change, greater use of resources and less appraised stress. There was only limited support for the buffering effects model. Due to the small size of the sample, the findings need to be explored further in other contexts.

Education : South Asia

South Asia, a source of great literary and literacy traditions and a generator of great philosophies, also contains a large percentage of illiterate people, the majority of them women. South Asia includes India, Pakistan, Bhutan, Nepal, Sri Lanka, Bangladesh, Burma and Afghanistan. The progress of these countries is dependent on female literacy because health, hygiene, and nutrition problems can be partly overcome through educating women. “Illiteracy is closely related to underdevelopment and poverty, and the elimination of illiteracy represents an essential condition for the development and well-being of peoples and nations" (UNESCO PROAP, 1989: II ). In South Asia, women constitute nearly two- thirds of illiterate adults. There is an inherent contradiction in the region between modern amenities, modern educational systems, and advanced communication systems, on the one hand, and the high level of illiteracy and significant backwardness, on the other.