Drawing on a Foucaultian genealogy to consider the constructions of psychopathology and sexualities in young people

This paper employs genealogical strategies to analyse examples from our own research in education relating to the construction of psychopathology and sexualities. We consider the application of four angles of scrutiny, discontinuity, contingency, emergences and subjugated knowledges (Foucault 1977, 1980, 1988). We explain the four angles of scrutiny and consider how these can be used to produce research practices commensurate with Foucaultian inspired genealogical strategies. For instance, we argue that subjugated knowledges form a critical component of the four angles of scrutiny. We propose that through their subjugation, these knowledges offer a different perspective to dominant knowledges on sexuality and psychopathology. It is our argument that it is precisely via this subjugation that these types of knowledges offer valuable perspectives to the construction of young people. Furthermore, highlighting contingency, discontinuity, emergences and subjugated knowledges makes for provocative moments, both substantively and methodologically, in the task of qualitative analysis.

Outsourcing in the Australian health sector : the interplay of economics and politics

Purpose – The paper discusses the reasons and approaches used at three health organisations in introducing outsourcing. It specifically answers the question: why have managers of health organisations outsourced some functions in preference to others?

Design/methodology/approach – This research employs a case study method making use of qualitative analysis. The health organisations were chosen first as representatives of their type, and secondly due to the nature of the outsourcing decisions made. The first health organisation operates in the rural sector; the second is a metropolitan network; and the third is a large metropolitan hospital, which, in contrast to the other two case study organisations, had made only one decision to outsource, producing the largest outsourcing contract in health in Australia. Furthermore, this situation was distinctive as the contract was terminated and re-issued to another private sector organisation.

Findings – The reasons for outsourcing varied within and between health organisations. Although generally they were made on the bases of the characteristics of the labour market, employee skill levels and the nature of industrial relations, the perception of what was core, the level of internal management skills, the ability of internal teams to implement change and the relationship between management and staff. Even though cost savings and a downsized labour force resulted, generally these occurred even when services were not outsourced, through the use of other change processes, such as introducing new technology, changing structures and promoting workforce flexibility. The interplay of political reasons and economic effects was evident along with the political nature of the decision-making and processes used. The paper concludes that the power of managers was a moderating factor between the desire for outsourcing and whether outsourcing actually occurred.

Research limitations/implications – Although this research was conducted solely within the health sector it has implications for other public sector bodies and the private sector.

Practical implications – Managerial decision making can be enhanced with the exploration of the full complement of reasons for the outsourcing decision.

Originality/value – The paper has value to both academics researching in the public sector and public sector managers.

Supermarkets as a setting to promote health eating : some lessons learnt in Victoria

Issue addressed: Supermarkets are a potential setting in which to deliver nutrition promotion to the community. A pilot project was able to examine the requirements for health authorities to form partnerships with other sectors and opportunities and limitations of using industry- based communication strategies to promote healthy eating messages. Methods: Pre-intervention interviews helped determine communication strategies. Post-intervention interviews were used to assess content and appropriateness of nutrition resources, collaboration between key participants, satisfaction with training and barriers/promoters to implementation. An intercept survey with consumers measured the impact of the intervention. Results: The survey of more than 1,120 women indicated only limited success. 12% of respondents from the intervention supermarkets had watched demonstrations and 20% had noticed the recipe leaflets, with only 5% able to name the promotion. Supermarket owners, representatives from participating food companies and demonstrators were supportive of the concept and content used in the promotion and qualitative analysis provides indicators for similar promotions. Conclusions: Health authorities considering 'partnerships' with the food/supermarket industry should recognise the diversity of roles and responsibilities of the organisations involved in the supply of food through the retail market and allow for long term planning when working with them. Head office of the supermarket group has a key coordinating role, however, individual supermarkets will be driven by financial returns. So what?: The recognition and trust in the name of health authorities by consumers means that organisations value an association with them.

Reviewing the learning organisation model in a child and adolescent mental health service

From 1995 onwards, a child and adolescent mental health service (CAMHS) applied Senge's learning organisation model. This review compared service performance with that of peer services 5 years later and explored whether any differences were associated with the application of this model. The comparison methodology used quantitative analysis of external data from the Department of Human Services, together with qualitative analysis of material including interviews with CAMHS directors and service managers. Results showed high evaluation activity and high quality, efficiency and efficacy of care compared with other services. Several restraints to the optimal application of the model were identified, including inadequate training of new managers, service overload, major external organisational change and limited investment in information systems. Other outcomes are discussed.

'I get by with a little help from my friends' : adults with intellectual disability discuss loneliness

Background This study explored 'loneliness' as experienced by adults with intellectual disability, with 'intermittent' to 'limited' support needs.

Method A measure of loneliness was piloted, and qualitative techniques used to develop a greater understanding of the participants' experience.

Results The Loneliness Scale proved valid and reliable and the participants reported loneliness in ways comparable with the general population.

Conclusions The findings demonstrate the effectiveness of combining quantitative and qualitative techniques to enhance understanding of people's perspective when developing support systems to promote their quality of life. Based on participant perspectives, recommendations are made concerning the issues and types of support families and professionals could consider when seeking to assist people with intellectual disability address loneliness. Further investigation of the effects of differing educational and vocational opportunities on people's post-school social networks appears warranted.

When the whole 'bloke' thing starts to crumble : men's access to chronic illness (arthritis) self management programs

This thesis explores the issue of men's access to chronic illness self management programs from a social constructionist perspective. A combination of research methodologies was used; a quantitative analysis to confirm gender differences in levels and patterns of service use; a qualitative analysis to gain an increased understanding of the factors affecting men's access; and a trial to test the application of the research findings. The clients and services of Arthritis Victoria were chosen as the setting for this research. The quantitative analyses were conducted on contingency tables and odds ratios and confirmed that men were under-represented as service users. The analyses also identified gender differences in patterns of service use. The qualitative analysis was based on a series of in-depth, semi-structured interviews. It was undertaken from a grounded theory approach to allow for the development of theoretical explanations grounded in the data. It was found that men's decisions to access chronic illness self management programs were strongly influenced by dominant social constructions of masculinity which constrained help-seeking and health management behaviour. However, the restrictive influence of hegemonic masculinity was progressively undermined by the increasing severity of the chronic condition until a crisis point was reached in terms of the severity of the condition or its impact on lifestyle. This resulted in a reformulation or rejection of hegemonic masculinity. The described conceptual framework was consistent for men from diverse social groupings, although it appeared less prominent in both younger and older men, suggesting that dominant social constructions of masculinity have the greatest influence on health decisions during the middle stage of adulthood when work and family obligations are greatest. The thesis findings informed the development of some guiding principles for reviewing the structure and delivery of chronic illness self management services for men. The guiding principles will have direct application in the planning of Arthritis Victoria programs, and implications for other chronic illness self management programs in Australia, and also in Western countries with a similar health and sociocultural setting to Australia.

Assessing female sexual offenders' motivations and cognitions : an exploratory study

Semi-structured interviews eliciting cognitions and motivations were carried out with 15 incarcerated female child sexual abusers (nearly 50% of the current UK female sexual offender prison population). Qualitative analysis indicated that four of the five motivational schemas (implicit theories) suggested by Ward (Ward, 2000; Ward & Keenan, 1999) to underlie male sexual offenders' cognitions could be clearly identified in women, these were: Uncontrollability (UN, identified in 87% of participants), Dangerous world (DW, 53%), Children as sexual objects (CSO, 47%) and Nature of harm (NH, 20%). Entitlement, the final implicit theory (IT), commonly found in males, was not identified in any participants in the sample. Further analysis indicated that there were four main motivational types of offender based on combinations of these ITs. These were: (1) presence of DW/CSO, indicating sexual motivation and cognitions with fear of violence; (2) presence of DW/no CSO, indicating fear of violence with no sexual cognition or motivation; (3) presence of CSO/no DW, indicating sexual motivation and cognition; the NH IT also strongly featured in this group; and (4) presence of UN/no DW or CSO, indicating lack of control, sometimes with sense of protection for the victim. Suggestions are made on how the results can inform theoretical developments in the field as well as policy and practice.

The identification of sexual and violent motivations in men who assault women : implication for treatment

A qualitative analysis of interview data with 41 rapists determined that five implicit theories (ITs) underlie rapists’ offense supportive beliefs/feelings/motives: (a) dangerous world (DW)—where men have feelings of generalized anger and/or resentment toward others; (b) women are dangerous—where men hold a set of attitudes that are hostile toward women; (c) women as sexual objects (WSO)—where women are seen as primarily sexual objects; (d) male sex drive is uncontrollable—where sexual urges are seen all consuming; (e) entitlement—where men feel that they can do exactly what they want. Consideration of whether DW or WSO ITs were present or absent indicated that three main groups could be identified: Group 1: violently motivated—presence of DW and/or absence of WSO; Group 2: sexually motivated—presence of WSO and/or absence of DW; Group 3: sadistically motivated—presence of DW and WSO. These results are discussed in terms of treatment needs of rapists.

The structural properties of sexual fantasies for sexual offenders : a preliminary model

While the phenomenon of sexual fantasy has been researched extensively, little contemporary inquiry has investigated the structural properties of sexual fantasy within the context of sexual offending. In this study, a qualitative analysis was used to develop a descriptive model of the phenomena of sexual fantasy during the offence process. Twenty-four adult males convicted of sexual offences provided detailed retrospective descriptions of their thoughts, emotions and behaviours—before, during and after their offences. A data-driven approach to model development, known as Grounded Theory, was undertaken to analyse the interview transcripts. A model was developed to elucidate the structural properties of sexual fantasy in the process of sexual offending, as well as the physiological and psychological variables associated with it. The Sexual Fantasy Structural Properties Model (SFSPM) comprises eight categories that describe various properties of sexual fantasy across the offence process. These categories are: origin, context, trigger, perceptual modality, clarity, motion, intensity and emotion. The strengths of the SFSPM are discussed and its clinical implications are reviewed. Finally, the limitations of the study are presented and future research directions discussed.

Identification of five fundamental implicit theories underlying cognitive distortions in child abusers : a preliminary study

Qualitative analysis of interviews with 22 child abusers found strong evidence for Ward and Keenan's (1999) proposal that there are five implicit theories in child abusers that account for the majority of their cognitive distortions/thinking errors. These implicit theories are: Child as a sexual being where children are perceived as being able to and wanting to engage in sexual activity with adults and also are not be harmed by such sexual contact; Nature of harm where the offender perceives that sexual activity does not cause harm (and may in fact be beneficial) to the child; Entitlement where the child abuser perceives that he is superior and more important than others: and hence is able to have sex with whoever, and whenever, he wants; Dangerous world where the offender perceives that that others are abusive and rejecting and he must fight to regain control; and Uncontrollable where the offender perceives the world as uncontrollable and hence he believes that circumstances are outside of his control. There was no evidence for any other type of implicit theory. Results of the study also indicated that there was a significant difference in terms of the endorsement of the Dangerous world implicit theory between participants reporting a history of child sexual abuse and those who did not. Offenders against male victims were significantly more likely to endorse the Child as a sexual being and Dangerous world implicit theories compared to men who had offended against female children.

Looking after well siblings of adolescent girls with anorexia : an important parental role

Background Research has suggested that well siblings of children with chronic and life-threatening illnesses are at risk for negative outcomes and that parents’ responses to the illnesses can influence the adaptation of well siblings. Yet, parents’ efforts to look after well siblings in the context of illness are rarely considered in literature about sibling adaptation. The importance of attending to the needs of well siblings was a major theme to emerge from a qualitative analysis of the experiences of parents of adolescent girls with anorexia nervosa.

Methods In-depth interviews were conducted with 24 parents of adolescent girls with anorexia and analysed using grounded theory method.

Results The data indicated that parents viewed caring for well siblings in the context of anorexia as an important role and responsibility. Parents reported making conscious and active efforts to look after well siblings by: maintaining normality; compensating for changes to routines; protecting siblings; providing emotional support; and managing the consequences.

Conclusions This paper provides a picture of the actions parents take to help well siblings adapt to anorexia in the family. Further research is needed to develop and expand this understanding to families experiencing a wide range of chronic and life-threatening illnesses. The findings underline the importance of clinical attention and further research into the critical parental role of caring for well siblings.

Support for parents of children with anorexia : what parents want

Parents' encounters with health professionals can influence their ability to cope with having a daughter with anorexia nervosa. Using qualitative analysis of in-depth interviews with 24 parents, we examine the question “What support do parents of teenage girls with anorexia want from clinicians?” The analysis shows that parents wanted clinicians to include them in treatment, support and guide them in their daughters' care, and demonstrate positive attitudes toward them. The implications for clinicians are discussed, including being sensitive to parents' vulnerability, ensuring congruence between clinicians' and parents' expectations about treatment, and strengthening formal channels of communication.

Using vignettes to evaluate the outcomes of student learning : data from the evaluation of the new social work degree in England

This paper reports the use of vignettes as a methodology to analyse the extent to which the new social work degree programmes enabled students to develop their analytical and reflective capabilities. Two vignettes, which focused on children and families and adult social care respectively, were developed for the study. Students were asked to respond in writing, from the perspective of a social worker, to a standard set of questions at the beginning (T1) and end of their degree programme (T2). Considering the responses to all questions across the two vignettes, a series of scales was developed to measure the key themes which had been identified by qualitative analysis. These included ‘Attention to process of relationships’ and ‘Social/structural/political awareness’. Responses were also rated as ‘descriptive’, ‘analytic’ or ‘reflective’.

Students from six universities in England participated. From an original sample of 222 students, it was possible to match 79 T1 and T2 responses. Analysis of variance demonstrated statistically significant increases in nine of the 11 themes and increases in ratings for analysis and reflection.

In conclusion, vignettes can be used to produce both qualitative and quantitative data in respect of changes in students’ acquisition of knowledge and skills over time.

Diversity and thermal comfort in outdoor places

Sustainable cities should be livable cities where people from different backgrounds and with different aspirations can meet and interact with each other. Public places being the urban stages where the social interactions happen are considered important parts of cities (Thompson, 2002; Varna, 2009). They can contribute to enhance the quality of life within cities, or contrarily increase isolation and social exclusion (Lo et al., 2003). As a consequence of globalization and the development of global cities, the level of international migration has been growing in the last decades creating a plurality of different cultures in global cities and inspiring in such cities a multicultural nature (O'Byrne, 1997; Short and Kim, 1999; Hawkins, 2006). This created new challenges in urban planning or the management of the coexistence of different people that are having different characteristics that shape their unique identity and needs in the shared spaces (Sandercock, 2004). Ideally, in order to invite a diversity of users, urban outdoor places should provide significant functional and physical qualities, and accessibility to them, which induce the fulfillment of physiological, psychological and social needs (Carr et al., 1992; Jacobs, 1993; Sandholz, 2007). Users’ state of comfort as stated by researchers gives a good indication for how successful is the public outdoor places (Rosheidat et al., 2008; Kwong et al., 2009; Aljawabra and Nikolopoulou, 2010). In order to create a successful open space usable by all members of a community, urban designers need to satisfy their comfort needs in its wider meaning according to a variety of different ages, genders and cultural backgrounds (Knez and Thorsson, 2006; Thorsson et al., 2007). The main aim of the research is to examine the influence of culture and environmental attitude on participants’ thermal requirements in outdoor public places. The paper explores the variables that constitute a successful multicultural design, issues of cultural complexity, and the measuring comfort in specific outdoor public place. Qualitative analysis of a case study provides the main research methodology of the research. The conclusion will provide a set of criteria that guide future design and development of a successful shared outdoor public places.

Building online brand communities : exploring the benefits, challenges and risks in the Australian event sector

The Internet has impacted the tourism sector and tourists substantially. Yet, very little information is known about how tourism organisations are using the second generation of the Internet, Web 2.0, and its various social media platforms in relation to their marketing activities. This article explores ways in which events, as an integral part of the tourism sector, are using Web 2.0 tools to build their online brand communities. While the qualitative analysis highlights benefits for events, it also identifies the risks and challenges that events face in using Web 2.0. These include the capacity to resource this aspect of marketing and the ability to protect their brand from the advent of counter- and alter-brand communities when online brand community building activities are not fully effective.