Browsing by Author "Brown, Brian J."
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Item Open Access 'Am I normal?' Teenagers, sexual health and the internet.(Elsevier, 2007-08-01) Brown, Brian J.; Crawford, Paul; Harvey, K. J.; Macfarlane, A.; McPherson, AnnThe development of new communication technologies has created a wide variety of new fields in which human beings can construct identities. The past decade has seen a proliferation of opportunities to use the internet for health related advice and information and many new sites have been created where participants can construct identities, formulate problems and seek solutions concerning health related issues. This paper will report on a study of emails written in to a UK-based website concerned with health issues for young people. Our analysis was driven by corpus linguistics, a computational methodology for interrogating extensive datasets, and we have combined both quantitative and qualitative approaches to the study of language. We interrogated a 400,000 word dataset of messages and were able to identify terms whose usage was elevated compared to the English language as a whole. As well as personal pronouns, these included many terms related to sexual ! health and bodily development, as well as terms such as "normal" and "worried" which were identified for further exploration. Whereas previous research on sexual health has discovered the use of vague terms and euphemisms, here, young people described themselves, their anatomy and their identities in meticulous detail. This study enables us to define the role of health topics raised, the presentation of health concerns, and contributes towards the discovery of a distinctive ˜genre" of health messages concerning sexual health which differs from that found by other researchers concentrating on face to face encounters. In conclusion we suggest that for researchers and practitioners working in health with young people in the medium of English there could be valuable lessons in communication to be learned from examination of corpora of the health care language concerned.Item Metadata only Applying corpus linguistics in a health care context.(Equinox, 2004) Adolphs, S.; Brown, Brian J.; Carter, Bob; Crawford, Paul; Sahota, O.Item Open Access 'Betwixt and between' Liminality in recovery stories from people with Myalgic Encephalitis (ME) or chronic fatigue syndrome (CFS)(Wiley, 2017-02-27) Huszar, K; Brown, Brian J.; Chapman, R.This paper explores experiences of sixteen people claiming to have recovered from Myalgic Encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) using the concept of liminality. Liminality describes the status of those falling between socially recognised and medically sanctioned categories, and illuminates both the experience of illness and the process of recovery from ME/CFS. The liminality experienced during illness was akin to that described by Turner (1969) with a degree of communitas among sufferers. As recovery progressed, participants stressed the percentage to which they had improved, and compared themselves with peers and themselves prior to the illness. Recovery did not mean transition into a post liminal phase, but involved a new liminality, characterised by straddling boundaries between illness and wellness. Participants continued strategies such as rest, pacing and meditation. This second liminal state included difficulty in communicating the experience convincingly, and estrangement from the ME/CFS community. Thus, recoverees moved from the liminality of illness to a second, and less legible state of sustained liminality in recovery, described as having one foot in the ill world, one foot in the well world. This suggests that more needs to be understood about the recovery experience to assist those making the transition toward wellness.Item Metadata only Boundaries and blurred roles: Interdisciplinary working in community mental health(2001) Crawford, Paul; Brown, Brian J.; Darongkamas, J.Item Open Access The clinical governance of the soul: 'deep management' and the self-regulating subject in integrated community mental health teams(Elsevier, 2003-01-01) Brown, Brian J.; Crawford, PaulHealth professionals have often been described as if they were in conflict with the new managerialist spirit in health care. However, because of their distributed and mobile sites of intervention, the work of community teams presents particular problems for traditional notions of management. In this UK study we identify how mental health team members are regulated by means of a subtle "deep management". Team members point to a lack of management direction from senior colleagues, even though some of them participate in the management process themselves. However, the lack of overt management leads them to prioritise clients and foreground professional identities in performing their duties and much additional administrative work besides. This also meant that the organisational structure of the team was defined in subjective terms. Participants had become self-regulating "deep managed" subjects under a largely hands-off management regime.Item Metadata only Clinical governmentality: A critical linguistic perspective on clinical governance in health care organisations.(Equinox, 2005) Brown, Brian J.; Crawford, Paul; Mullany, LouiseItem Open Access Communicating climate change: conduits, content, and consensus(Wiley, 2015-11-01) Pearce, W.; Nerlich, B.; Koteyko, N.; Brown, Brian J.Climate change has been the subject of increasing efforts by scientists to understand its causes and implications; it has been of growing interest to policymakers, international bodies, and a variety of nongovernment organizations; and it has attracted varied amounts of attention from traditional and, increasingly, online media. These developments have been aligned with shifts in the nature of climate change communication, with changes in how researchers study it and how a variety of actors try to influence it. This article situates the theory and practice of climate change communication within developments that have taken place since we first reviewed the field in 2009. These include the rise of new social media conduits for communication, research, and practice aimed at fine tuning communication content, and the rise to prominence of scientific consensus as part of that content. We focus in particular on continuing tensions between a focus on the part of communicators to inform the public and more dialogic strategies of public engagement. We also consider the tension between efforts to promote consensus and certainty in climate science and approaches that attempt to engage with uncertainty more fully. We explore the lessons to be learnt from climate communication since 2009, highlighting how the field remains haunted by the deficit model of science communication. Finally, we point to more fruitful future directions for climate change communication, including more participatory models that acknowledge, rather than ignore, residual uncertainties in climate science in order to stimulate debate and deliberation.Item Metadata only Communication(Elsevier Science, 2009) Crawford, Paul; Brown, Brian J.Item Open Access Conflicting experiences of health and habitus in a poor urban neighbourhood: A Bourdieusian ethnography(Wiley, 2021-04-01) Scott-Arthur, Tom; Brown, Brian J.; Saukko, PaulaAn ethnographic study of health and wellbeing was undertaken in a deprived urban neighbourhood in the UK Midlands. Drawing on Bourdieu's concepts of habitus, capital and field, we discerned three different, even conflicting, ways of understanding and acting on health: (i) older adults discussed their wellbeing in relation to the local context or field, walking the dog, helping at the community centre and visiting the off licence, (ii) young professionals and students who lived in the neighbourhood were oriented towards leisure facilities, career opportunities and supermarkets outside of the neighbourhood, disdaining local facilities and (iii) community activists and carers discussed health in terms of providing for others but not themselves. Bourdieu is frequently used in medical sociology to highlight how poor people's lifestyle is constrained by their habitus; we suggest paying more attention to its both enabling and differentiating contradictions as well as the constraints it entails. Empirically and in terms of health promotion findings suggest that supposedly healthy activities, such as going to the gym, may also be a means of rejecting the local community; similarly, older people's pottering about in the neighbourhood, which is not usually recognised as a healthy activity, may enhance wellbeing in this context.Item Open Access Conflicting philosophies of inclusion: the contestation of knowledge in widening participation(Taylor and Francis, 2007) Sheeran, Yanina; Brown, Brian J.; Baker, SallyThis paper explores the conflicting philosophies within the widening participation debate. Two categories of inclusive educators are identified, \'meritocrats\' and \'democrats\'. Among the democratic educators, a subgroup, \'transformative\' educators, exists, which seeks to invoke changes in society and the education system. The positions taken by some of these authors are weakened by their neglect of sociological theory. For the debate to progress and for inclusion to be successful, a renewed understanding of sociological theory is needed. This will help those contributing to the debate to grasp fully the political and economic constraints on students and institutions that have limited inclusion.Item Metadata only Creative practice as mutual recovery in mental health(Emerald, 2013) Crawford, Paul; Lewis, Lydia; Brown, Brian J.; Manning, NickItem Metadata only The dead parrot and the dying swan: The role of metaphor scenarios in UK press coverage of avian flu in the UK in 2005-2006(Psychology Press, 2008) Koteyko, Nelya; Brown, Brian J.; Crawford, PaulItem Open Access The design of compassionate care(Wiley, 2014) Crawford, Paul; Brown, Brian J.; Kvangarsnes, Marit; Gilbert, P.Aims and objectives. To investigate the tension between individual and organisational responses to contemporary demands for compassionate interactions in health care. Background. Health care is often said to need more compassion among its practitioners. However, this represents a rather simplistic view of the issue, situating the problem with individual practitioners rather than focusing on the overall design of care and healthcare organisations, which have often adopted a production-line approach. Design. This is a position paper informed by a narrative literature review. Methods. A search of the PubMed, Science Direct and CINAHL databases for the terms compassion, care and design was conducted in the research literature published from 2000 through to mid-2013. Results. There is a relatively large literature on compassion in health care, where authors discuss the value of imbuing a variety of aspects of health services with compassion including nurses, other practitioners and, ultimately, among patients. This contrasts with the rather limited attention that compassionate practice has received in healthcare curricula and the lack of attention to how compassion is informed by organisational structures and processes. We discuss how making the clinic more welcoming for patients and promoting bidirectional compassion and compassion formation in nursing education can be part of an overall approach to the design of compassionate care. Conclusions. We discuss a number of ways in which compassion can be enhanced through training, educational and organisational design, through exploiting the potential of brief opportunities for communication and through initiatives involving patients and service users, as well as practitioners and service leaders. Relevance to clinical practice. The development of contemporary healthcare systems could usefully address the overall design of compassionate care rather than blame individual practitioners for a lack of compassion.Item Embargo Digital Health Humanities(Routledge, 2017) Brown, Brian J.In this chapter we will examine the newly emerging health humanities and the opportunities these afford for explorations of patterns of language and culture, and novel examinations of the context and culture of health and illness. The health humanities represent a new departure in scholarship and practice as they attempt to include the full range of health professions as well as informal carers, creative therapies and service users themselves. Drawing on a variety of data sources from the previous decade of the author’s exploration of these themes we will examine how language use in creative activities may be associated with recovery, how literary traditions illuminate the informal storytelling of mental health practitioners and how concepts such as recovery and mutuality in health care can be productively dissected using literary-analytical techniques to indicate productive ways forward.Item Open Access Education as an exit strategy for community mental health nurses: a thematic analysis of narratives(Pavillion, 2008) Brown, Brian J.; Crawford, Paul; Majomi, PamelaA study of the narratives of community mental health nurses, with an emphasis on education and training, identified education as offering a 'stepping stone' out of a profession that struggles for recognition and status. This paper describes those narratives and the challenges facing healthcare organisations seeking to assimilate and retain the talent of those who have achieved academic success. The authors suggest that encouraging an expertise that integrates academic and practice skills might be achieved through more widespread appointment of clinical professorships.Item Metadata only Elicitation hooks’: A discourse analysis of chaplain-patient interaction in pastoral and spiritual care(The Journal of Pastoral Care Publications, Inc., 2008) Harvey, K.; Brown, Brian J.; Crawford, PaulItem Open Access An evaluation of a DVD trigger based assessment of communication and care delivery skills.(Elsevier, 2009) Brown, Brian J.; Crawford, Paul; Aubeeluck, Aimee; Cotrel-Gibbons, Liz; Porock, Davina; Baker, CharleyThis article describes the implementation and evaluation of a novel form of assessment of communication skills and knowledge for nursing students in a multi-campus UK Midlands university. The assessment took the form of a recorded scenario which was presented on DVD and a series of assessment questions inviting students to consider communicative aspects of the events depicted. This 'DVD trigger' assessment yielded theoretically informed, practically relevant answers from the students, over 80% of whom passed. Student reactions to the assessment were elicited via a specially designed questionnaire which indicated broad approval for the assessment and yielded a high degree of internal reliability, and suggested that attitudes to the assessment could be grouped into three major factors. The first factor comprised items relating to the practical aspects of the examination, the second to teaching, learning resources and exam support and the final factor repres! ented the perceived relationship between the examination and the skills involved in care delivery and communication in professional practice. This highlights the value of evaluating students' responses to assessment in developing new forms of examination and in harmonising assessments with learning resources, teaching and appropriate preparation for exams. Moreover, we argue that the face validity of assessments is important in ensuring students' engagement with the learning tasks and assessment activities and may contribute to the broader validity of the assessment enterprise in predicting and enhancing skills in subsequent professional practice.Item Metadata only Evidence based research: Dilemmas and debates in health care.(Open University Press, 2003) Brown, Brian J.; Crawford, Paul; Hicks, CarolynItem Open Access Fast healthcare: Brief communication, traps and opportunities(Elsevier, 2010-12-01) Crawford, Paul; Brown, Brian J.Resource considerations have meant that brevity in health care interventions is a high priority, and have led to a constant striving after ever more impressive time efficiency. The UK's National Health Service may be described as a kind of ‘fast healthcare’, where everyone is task busy, time is money, bed spaces are frenetically shuffled so as to accommodate the most needy and there appears to be ‘no time to talk’. Indeed, a great many health care encounters are taking place in short ‘blips’ often of 5 min or less across a range of sites and involving a vast number of practitioners. In this paper we explore how brief communication can both alienate and be therapeutic for patients. We theorise brief interactions by considering a number of traditions of work in anthropology, linguistics and sociology and conclude that health care providers need to invest much more in the skills and strategies for how best to communicate briefly if it to retain its core tradition of caring for others.Item Open Access Genealogies of recovery: The framing of therapeutic ambitions(2017-10-20) Brown, Brian J.; Manning, NickThe notion of recovery has become prominent in mental health care discourse in the UK, but it is often considered as if it were a relatively novel notion, and as if it represented an alternative to conventional treatment and intervention. In this paper we explore some of the origins of the notion of recovery in the early 20th century in movements such as Alcoholics Anonymous and Recovery Inc. Whilst these phenomena are not entirely continuous with recovery in the present day, some important antecedents of the contemporary notion can be detected. These include the focus on the sufferers’ interior space as a key theatre of operations and the reinforcement and consolidation of medical ways of seeing the condition without any immediate medical supervision of the actors being necessary. This has resonance with many contemporary examples of recovery in practice where the art of living with a mental health condition is emphasised without the nature of the psychopathological condition itself being challenged.