Medicine on the line? Computer‐mediated social support and advice for people with diabetes

The advent of thousands of Usenet groups on the Internet, covering a vast range of medical and welfare issues and ostensibly devoted to the mutual social support of participating members, has raised the potential for the development of new forms of 'virtual' health care. This article critically analyses the use by people with diabetes of one such Usenet group. It seeks to establish, first, the extent to which such a site provides some demonstrable measure of social support to its participants. This is approached by undertaking a structural analysis of the site to identify the extent of usage, and the nature of supporting interventions using a fivefold classification (instrumental, informational, esteem and social companionship and other). Second, the article attempts to identify any disparity between the lay health-knowledge in evidence and biomedical opinions proffered by the use of a panel of consultant diabetiologists. The results of the analysis suggest that the diabetes newsgroup provides an example of an active forum for largely well-informed participants who routinely use the media as an aid to the reflexive management of their medical condition. It also raises the prospect of a renegotiated relationship between medical knowledge and lay experience based upon shared learning     

Fell runners and walking walls: towards a sociology of living landscapes and aesthetic atmospheres as an alternative to a Lakeland picturesque

This article draws on analysis of data generated by way of an ethnography of fell running in the English Lake District and suggests that participants who have lived and run in the area for many years experience a particular mode of aesthetic. The Lake District has long been valued for its outstanding scenery represented in the aesthetic of the picturesque comprising relatively static landscapes that should be conserved. Established fell runners who have run in the area for many decades apprehend and appreciate the landscape in more complex, rooted and situated ways. The anthropologist Ingold, distinguishes between landscape and landsceppan, and this insight is instructive for grasping the way in which the runners do not simply scope scenery but work with the land: they shape it and are shaped by it. Fell runners are elements within the living environment and along with walls, sheep, becks, sun, rain – what Ingold evocatively calls the ‘weather‐world’ – are mobile. Movement is central to their aesthetic, they enjoy not so much the scenic but rather a fellsceppan and do so through their fast eye‐gait‐footwork and their lively, variable occupation with the terrain. The fells infiltrate and interpenetrate the runners and movement through the fells generates a somatic aesthetic. The pleasure in turn breeds existential capital an embodied gratification that serves as an attractor that binds those who appreciate feelings of being alive with and in the fells.     

In pursuit of virtuosity: gendering ‘master’ pieces of nineteenth-century South African indigenous arts

In nineteenth-century South Africa two different forms of facture of objects were encouraged by European colonial intervention. One, woodcarving, was male and produced many objects which have been declared masterpieces. The other, beadwork, was a female craft and was regarded as less valuable. This article examines the ways in which these values were located in the visible virtuosity of the facture of objects and through the visual representation of objects and people, drawing on well-documented pieces from the collections of the British Museum and nineteenth-century photographs.     

Materializing architecture for social care: Brick walls and compromises in design for later life

This article reports on an ethnography of architectural projects for later life social care in the UK. Informed by recent debates in material studies and “materialities of care” we offer an analysis of a care home project that is sensitive to architectural materials that are not normally associated with care and well-being. Although the care home design project we focus on in this article was never built, we found that design discussions relating to a curved brick wall and bricks more generally were significant to its architectural “making”. The curved wall and the bricks were used by the architects to encode quality and values of care into their design. This was explicit in the design narrative that was core to a successful tender submitted by a consortium comprising architects, developers, contractors, and a care provider to a local authority who commissioned the care home. However, as the project developed, initial consensus for the design features fractured. Using a materialized analysis, we document the tussles generated by the curved wall and the bricks and argue that mundane building materials can be important to, and yet marginalized within, the relations inherent to an “architectural care assemblage.” During the design process we saw how decisions about materials are contentious and they act as a catalyst of negotiations that compromise “materialities of care.”     

Knit Your Own Without a Pattern: Health Promotion Specialists in an Internal Market

The reforms of the National Health Service in England have given an emphasis to "strategic" approaches to health and health care, in that, ideally, purchasing decisions will be made on the basis of evidence from various forms of "needs assessment". Alongside these reforms a strategic approach to the promotion of health has been set out in the "Health of the Nation" (DoH 1992). However, although the promotion of health is high on the policy agenda, the occupational group of health promotion specialists, whose prime function it is to devise, develop and implement health promotion strategies, have been ignored. Drawing on qualitative interview data with these specialists in both provider and purchasing settings in England this paper argues that thus far the reforms have actually hindered the development of a strategic approach to the promotion of health by health promotion specialists. Three main reasons for this are suggested; a confusion over the most appropriate institutional location for health promotion specialists; a lack of clarity by key actors as to the role and function of health promotion specialists; and the emergence of a model of effectiveness and efficiency which is largely antithetical to the philosophy and practice of health promotion.     

The art museum in Africa – a utopia desired?

In this paper, I argue that museums in general are utopias, “no-places” in which categorisations of objects can be opened up for destabilisation. Following a discussion of the ways in which the categories “material culture” and “art” are reflected in museums, I argue that once the museum is transposed to Africa, its function as a space in which heritage is maintained through the conservation and preservation is thrown into disarray. I argue further that this is particularly the case with the most utopian of museums, the art museum. I argue that most African nation states do not have national art museums, and offer an argument about why they have museums of “arts and cultures” instead. I end with an analysis of the history and situation of art museums in South Africa and possibilities for alternative ways of conceiving the art museum as an inclusive rather than exclusive space.     

Disability and mortgage default: an Australian study

Debates on human rights and discrimination regarding housing and disability need to emphasise community care and inclusion as principles for improving policy. A qualitative study of Australian mortgage default reveals special difficulties for households with a member with a disability; that is, illness, impairment or injury limiting everyday activities and enduring for several months. Interviews showed that such households adopted similar strategies to other mortgagors with serious financial difficulties but tended to have fewer and less attractive options. Given the crisis in Australian disability welfare services and the 2010–2011 Productivity Commission inquiry recommending major reforms, these findings can inform policy.     

Order-restricted hypothesis testing in a variation of the normal mixture model

This paper examines likelihood-ratio tests concerning the relationships among a fixed number of univariate normal means given a sample of normal observations whose population membership is uncertain. The asymptotic null distributions of likelihood-ratio test statistics are derived for a class of tests including hypotheses which place linear inequality constraints on the normal means. The use of such tests in the interval mapping of quantitative trait loci is addressed.     

VIRTUAL COMMUNITY CARE? SOCIAL POLICY AND THE EMERGENCE OF COMPUTER MEDIATED SOCIAL SUPPORT

This article argues that the emergence and growth of internet use in Britain has important implications for the analysis of social policy. It attempts to outline a research agenda for social policy in relation to one particular aspect of internet use, that of on-line self-help and social support - what we term here virtual-community care . The article presents data on patterns of home based internet use in Britain and outlines some contemporary debates in social policy about the importance of self-help and social support. It also considers how the internet is being used for self-help and social support with a particular emphasis on the emerging situation in Britain. Three illustrations of on-line self-help and social support are presented: two from newsgroups, which are part of the 'uk.people.* hierarchy': one concerned with disability and one with parenting issues; and one web based forum concerned with issues surrounding mortgage repossession. Drawing upon this illustrative material the article discusses some emergent issues for contemporary social policy discourse: the rise of self-help groups; the privileging of lay knowledge and experience over the 'expert' knowledge of health and welfare professionals; the nature of professional-client relationships; the quality and legitimacy of advice, information and support; dis/empowerment; and social exclusion.     

Engagement, but for what kind of marriage?: community members and local planning authorities

In recent years there has been an international trend to encouragegreater participation by community members in making decisionsover local developments. A small study of the experiences ofcommunity activists residing in the City of Moreland (Australia)indicates that existing political and economic structures areneither flexible nor supportive of greater, substantive, democracy.Indeed the kinds of barriers reported at the grassroots suggestthat deep reforms in the traditional patterns of engagementbetween political and bureaucratic authorities and neighbourhoodcommunities are necessary in order to enhance the power of communitymembers. This analysis of community engagement practices drawsa parallel between the multi-various scales of struggles necessitatedfor women's liberation and the breadth of reforms necessaryfor neighbourhood residents to achieve greater power in decisionmaking over local developments.