Representations of swinging London in 1960s British cinema : Blowup (1966), Smashing Time (1967), and Performance (1970)

This thesis explores the representation of Swinging London in three examples of 1960s British cinema: Blowup (Michelangelo Antonioni, 1966), Smashing Time (Desmond Davis, 1967) and Performance (Donald Cammell and Nicolas Roeg, 1970). It suggests that the films chronologically signify the evolution, commodification and dissolution of the Swinging London era. The thesis explores how the concept of Swinging London is both critiqued and perpetuated in each film through the use of visual tropes: the reconstruction of London as a cinematic space; the Pop photographer; the dolly; representations of music performance and fashion; the appropriation of signs and symbols associated with the visual culture of Swinging London. Using fashion, music performance, consumerism and cultural symbolism as visual narratives, each film also explores the construction of youth identity through the representation of manufactured and mediated images. Ultimately, these films reinforce Swinging London as a visual economy that circulates media images as commodities within a system of exchange. With this in view, the signs and symbols that comprise the visual culture of Swinging London are as central and significant to the cultural era as their material reality. While they attempt to destabilize prevailing representations of the era through the reproduction and exchange of such symbols, Blowup, Smashing Time, and Performance nevertheless contribute to the nostalgia for Swinging London in larger cultural memory.

A Narrative Study of Patient Encounter Accounts of Physicians, Nurses, and Medical Receptionists after Two Decades of a Paradigm of Patient-Centered Care

Despite recent well-known advancements in patient care in the medical fields, such as patient-centeredness and evidence-based medicine and practice, there is rather less known about their effects on the particulars of clinician-patient encounters. The emphasis in clinical encounters remains mostly on treatment and diagnosis and less on communicative competency or engagement for medical professionals. The purpose of this narrative study was to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols within the context of the physicians’, nurses’, and medical receptionists’ perspectives and experiences. Literature on narrative medicine, phenomenology and medicine, therapeutic relationships, cultural and communication competency, and non-Western perspectives on human communication provided the guiding theoretical frameworks for the study. Three data sets including 13 participant interviews (5 physicians, 4 nurses, and 4 medical receptionists), policy documents (physicians, nurses, and medical receptionists) and a website (Communication and Cultural Competency) were used. The researcher then engaged in triangulated analyses, including N-Vivo, manifest and latent, Mishler’s (1984, 1995) narrative elements and Charon’s (2005, 2006a, 2006b, 2013) narrative themes, in recursive, overlapping, comparative and intersected analysis strategies. A common factor affecting physicians’ relationships with their clients was limitation of time, including limited time (a) to listen, (b) to come up with a proper diagnosis, and (c) to engage in decision making in critical conditions and limited time for patients’ visits. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic to patients, being an attentive listener, developing rapport, and being conventionally polite to patients. Participants with the least iv amount of training and preparation (medical receptionists) appeared to be more committed to working narratively in connecting with patients and establishing human relationships as well as in listening to patients’ stories and providing support to narrow down the reason for their visit. The diagnostic and intake “success stories” regarding patient clinical encounters for other study participants were focused on a timely securing of patient information, with some acknowledgement of rapport and emapathy. Patient-centeredness emerged as a discourse practice, with ambiguous or nebulous enactment of its premises in most clinical settings.