Under the carpet : the politics and trauma of patient harm

Few studies have investigated iatrogenic outcomes from the viewpoint of patient experience. To address this anomaly, the broad aim of this research is to explore the lived experience of patient harm. Patient harm is defined as major harm to the patient, either psychosocial or physical in nature, resulting from any aspect of health care. Utilising the method of Consensual Qualitative Research (CQR), in-depth interviews are conducted with twenty-four volunteer research participants who self-report having been severely harmed by an invasive medical procedure. A standardised measure of emotional distress, the Impact of Event Scale (IES), is additionally employed for purposes of triangulation. Thematic analysis of transcript data indicate numerous findings including: (i) difficulties regarding patients‘ prior understanding of risks involved with their medical procedure; (ii) the problematic response of the health system post-procedure; (iii) multiple adverse effects upon life functioning; (iv) limited recourse options for patients; and (v) the approach desired in terms of how patient harm should be systemically handled. In addition, IES results indicate a clinically significant level of distress in the sample as a whole. To discuss findings, a cross-disciplinary approach is adopted that draws upon sociology, medicine, medical anthropology, psychology, philosophy, history, ethics, law, and political theory. Furthermore, an overall explanatory framework is proposed in terms of the master themes of power and trauma. In terms of the theme of power, a postmodernist analysis explores the politics of patient harm, particularly the dynamics surrounding the politics of knowledge (e.g., notions of subjective versus objective knowledge, informed consent, and open disclosure). This analysis suggests that patient care is not the prime function of the health system, which appears more focussed upon serving the interests of those in the upper levels of its hierarchy. In terms of the master theme of trauma, current understandings of posttraumatic stress disorder (PTSD) are critiqued, and based on data from this research as well as the international literature, a new model of trauma is proposed. This model is based upon the principle of homeostasis observed in biology, whereby within every cell or organism a state of equilibrium is sought and maintained. The proposed model identifies several bio-psychosocial markers of trauma across its three main phases. These trauma markers include: (i) a profound sense of loss; (ii) a lack of perceived control; (iii) passive trauma processing responses; (iv) an identity crisis; (v) a quest to fully understand the trauma event; (vi) a need for social validation of the traumatic experience; and (vii) posttraumatic adaption with the possibility of positive change. To further explore the master themes of power and trauma, a natural group interview is carried out at a meeting of a patient support group for arachnoiditis. Observations at this meeting and members‘ stories in general support the homeostatic model of trauma, particularly the quest to find answers in the face of distressing experience, as well as the need for social recognition of that experience. In addition, the sociopolitical response to arachnoiditis highlights how public domains of knowledge are largely constructed and controlled by vested interests. Implications of the data overall are discussed in terms of a cultural revolution being needed in health care to position core values around a prime focus upon patients as human beings.

Enlightenment out of chaos : power, politics and The Chaser’s War on Everything

This paper focuses on the satirical Australian television show The Chaser’s War on Everything, and uses it to critically explore the potential ramifications of what McNair (2006) has called ‘cultural chaos’. Through an analysis of several examples from this particular program, alongside interviews with its production team and qualitative audience research, this paper argues that this TV show’s engagement with political issues in a creative, entertaining way that departs from the conventions of traditional journalism, allows it to present a perhaps more authentic image of political agents than is often cultivated in the mainstream news media. This paper therefore provides clear evidence that the shift from homogeneity to heterogeneity in the news media presents a significant challenge to those who wish to heavily control public opinion. It also provides further support for an optimistic re-appraisal of entertainment which emphasises its central (not merely periphery) role in political discourse.

When the right to be counted doesn’t count : the politics and challenges of researching the health of asylum seekers

A fundamental prerequisite of population health research is the ability to establish an accurate denominator. This in turn requires that every individual in the study population is counted. However, this seemingly simple principle has become a point of conflict between researchers whose aim is to produce evidence of disparities in population health outcomes and governments whose policies promote(intentionally or not) inequalities that are the underlying causes of health disparities. Research into the health of asylum seekers is a case in point. There is a growing body of evidence documenting the adverse affects of recent changes in asylum-seeking legislation, including mandatory detention. However, much of this evidence has been dismissed by some governments as being unsound, biased and unscientific because, it is argued, evidence is derived from small samples or from case studies. Yet, it is the policies of governments that are the key barrier to the conduct of rigorous population health research on asylum seekers. In this paper, the authors discuss the challenges of counting asylum seekers and the limitations of data reported in some industrialized countries. They argue that the lack of accurate statistical data on asylum seekers has been an effective neo-conservative strategy for erasing the health inequalities in this vulnerable population, indeed a strategy that renders invisible this population. They describe some alternative strategies that may be used by researchers to obtain denominator data on hard-to-reach populations such as asylum seekers.

Stockholm Syndrome : architecture, politics and the human body

The exchange between the body and architecture walks a fine line between violence and pleasure. It is through the body that the subject engages with the architectural act, not via thought or reason, but through action. The materiality of architecture is the often the catalyst for some intense association; the wall that defines gender or class, the double bolted door that incarcerates, the enclosed privacy of the bedroom to the love affair. Architecture is the physical manifestation of Lefebvre’s inscribed space. It enacts the social and political systems through bodily occupation. Architecture, when tested by the occupation of bodies, anchors ideology in both space and time. The architect’s script can be powerful when rehearsed honestly to the building’s intentions and just as beautiful when rebuked by the act of protest or unfaithful occupation. This research examines this fine line of violence and pleasure in architecture through performance, in the work of Bryony Lavin’s play Stockholm and Revolving Door by Allora & Calzadilla as part of the recent Kaldor Public Art Projects exhibition 13 Rooms in Sydney. The research is underpinned by the work of Architect and theorist, Bernard Tschumi in his two essays, Violence of Architecture and The Pleasure of Architecture. Studying architecture through the lens of performance shifts the focus of examination from pure thought to the body; because architecture is occupied through the body and not the mind.

The politics and poetics of coexistence : experiments at the intersection of art and environmental engineering

This research project explores how interdisciplinary art practices can provide ways for questioning and envisaging alternative modes of coexistence between humans and the non-humans who together, make up the environment. As a practiceled project, it combines a body of creative work (50%) and this exegesis (50%). My interdisciplinary artistic practice appropriates methods and processes from science and engineering and merges them into artistic contexts for critical and poetic ends. By blending pseudo-scientific experimentation with creative strategies like visual fiction, humour, absurd public performance and scripted audience participation, my work engages with a range of debates around ecology. This exegesis details the interplay between critical theory relating to these debates, the work of other creative practitioners and my own evolving artistic practice. Through utilising methods and processes drawn from my prior career in water engineering, I present an interdisciplinary synthesis that seeks to promote improved understandings of the causes and consequences of our ecological actions and inactions.

Cultural politics and iconography : an introduction

This collection of papers reflects on the many dimensions of contemporary narratives of iconography in public culture in Australia and Asia. The idea for the volume arose from a series of seminars held at the Centre for Cross-Cultural Research in 2002. The series ‘Iconographies’ was convened by Penny Edwards and centred on research undertaken in the Asia-Pacific, with papers that interrogated national and cultural icons. Just as a biography might examine the makings of a particular personality and her or his shaping of inner and outer worlds, so also iconographic narratives that trace and explore both the evolution and appropriation of particular icons help us mark key moments in the cultural politics of communities, nations and global public spheres. The present volume has two papers (Taylor and Seth) from that series and others on the themes of iconography and iconoclasm that were solicited from a group of interdisciplinary authors working on these themes.

Earnings management and the role of the audit committee: an investigation of the influence of cross-listing and government officials on the audit committee

This paper extends research on the corporate governance practices of transitional economies by examining whether the ability of the audit committee to constrain earnings management in Chinese firms is associated with the listing environment and the presence of government officials on the audit committee. Despite considerable regulatory reforms by the Chinese Securities Regulatory Commission, there remain incentives for Chinese firms to manage earnings. However, government initiatives to encourage domestic firms to cross-list on the Hong Kong Stock Exchange are accompanied by improved governance. We find that the expertise and independence of the audit committee for cross-listed (CL) Chinese firms are associated with lower abnormal accruals, our measure of earnings management. Both domestic only listed firms and CL Chinese firms appoint government officials as independent members on the audit committee. However, due to the political connection between government officials and the controlling shareholder (the State), these appointments can severely mitigate audit committee independence. Subsequently, we find a significant and positive association between audit committee independence and experience and earnings management when there are government officials on the audit committee.

NRM engagement between remote dryland communities and government agencies : success factors from Australia

The management of dryland environments involves the interaction of multiple government agencies and citizens, and is required to respond to a wide range of responsibilities and aspirations for a given region. This paper focuses on the characteristics of engagement between management agencies and citizens in a dryland region, presented here as a series of success factors. These factors are based on empirical research carried out in the Lake Eyre Basin in Australia, one of the world’s largest inwardly draining basins. The results reinforce generic and dryland-specific factors supporting successful community engagement. The former, such as building trust, working in partnership, supporting community champions, and maintaining transparency, are necessary but insufficient for achieving successful community engagement in the case study region. In addition, community engagement in the case study region also required respecting the extreme conditions and extraordinary variability of the Basin and committing to longer timeframes even if the outcomes of community engagement are slow to accrue, in order to take advantage of opportunities in more prosperous times.

Paradigm shifts : global copyright politics and disability rights

Governments around the world need to take immediate coordinated action to reverse the 'book famine.' Disability rights don't conflict with 'normal exploitation' but copyright owners have been wary about all of the possible solutions to providing greater access. The Marrakesh Treaty promises to level out some of the disparity of access between people in developed and developing nations and remove the need for each jurisdiction to digitise a separate copy of each book. It is one of the only international agreements to mandate positive exceptions and may be the start of a pardigm shift in global copyright politics, made all the more remarkable in the face of heated opposition by global copyright industry representatives. It's not a legal problem, but one of political will. Resistance comes from a conflict with ideology: exceptions should be limited and international law should set only minimum standards.

Easy data, hard data : the politics and pragmatics of Twitter research after the computational turn

In this chapter, we draw out the relevant themes from a range of critical scholarship from the small body of digital media and software studies work that has focused on the politics of Twitter data and the sociotechnical means by which access is regulated. We highlight in particular the contested relationships between social media research (in both academic and non-academic contexts) and the data wholesale, retail, and analytics industries that feed on them. In the second major section of the chapter we discuss in detail the pragmatic edge of these politics in terms of what kinds of scientific research is and is not possible in the current political economy of Twitter data access. Finally, at the end of the chapter we return to the much broader implications of these issues for the politics of knowledge, demonstrating how the apparently microscopic level of how the Twitter API mediates access to Twitter data actually inscribes and influences the macro level of the global political economy of science itself, through re-inscribing institutional and traditional disciplinary privilege We conclude with some speculations about future developments in data rights and data philanthropy that may at least mitigate some of these negative impacts.

Politics and the Press in Indonesia : Understanding an Evolving Political Culture

This book explores the evolving political culture in Indonesia, by discussing the country's dominant political philosophies, then showing how those philosophies affect the working lives of ordinary Indonesian citizens. It focuses in particular on the working lives of news journalists, a group that occupies a strategic social and political position.

Book review: Politics and the media in twenty-first century Indonesia: Decade of democracy

This is the third (but first edited) volume in Sen and Hill’s corpus on Indonesian media. An anthology built from contributions to a 2006 workshop, it is necessarily more fragmented than the editors’ earlier monographs. While this fragmented character helps to evoke a fractured context, it also makes for unwieldiness...