Since March 2020, throughout the world people have been paying tribute to health care workers for their commitment in the context of the COVID-19 pandemic. In Wuhan they cheer in the night, in Italy they sing from balconies, in Canada they bang pots, and in the United Kingdom they clap for carers. Within the milieu of tangled popular media discourse, heroism has emerged strongly and consistently to describe health care workers, and in particular, nurses. In early May, a powerful contribution to this discourse arrived at the Southampton Hospital, donated by the famous street artist, Banksy. The framed artwork, entitled 'game changer' depicts a young boy kneeling on the floor playing with a brand-new superhero doll. In the background, a waste bin holds two well-known but now discarded superheroes, Batman and Spiderman. The boy's attention is on his new toy, SuperNurse. She is clad in a traditional nursing outfit, including a knee length nursing dress, sensible shoes, a nursing cap and apron. In addition, SuperNurse wears a white theatrical mask, surgical mask, and cape. The painting is black and white, with the exception of The Red Cross, painted on the bib of SuperNurse's apron. This painting is described as "surprisingly earnest" and generous tribute to the workers of the United Kingdom's National Health Service (NHS), somewhat of an anomaly to Banksy's usual style of sharp social critique and political commentary (Goldstein, 2020). The painting was accompanied with a note from the artist that reads, "Thanks for all you are doing, I hope this brightens the place up a bit, even if it's only black and white" (Goldstein, 2020). Banksy has given form to a new discursive figuration of the nurse. SuperNurse has great timing, she has arrived in the early months of the International Year of the Nurse and Midwife, named by the World Health Organization in honour of the 200 th year since the birth of Florence Nightingale. While contemporary, SuperNurse is modest, brave,
Objectives: Deciding to disclose a mental illness in the workplace requires thoughtful informed decision making. Decision aids are increasingly used to help people make complex decisions, but need to incorporate relevant factors for the context. This study aimed to identify factors and processes that influence decision making about such disclosure to inform the development of a disclosure decision aid tool for employees in male dominated industries.Methods: We invited 15 partner organisations in male dominated industries to facilitate the recruitment of employees who either had disclosed a mental health condition in their workplace; or occupied a position to whom employees disclosed to focus groups addressing the aims.Results: The majority of the organisations had explicit policies that employees must disclose and so were unable to be seen countenancing non-disclosure as an option. Two focus groups were conducted (n = 13) with mainly male (62%), full-time employees (85%), and both disclosed (46%) and authority (54%) groups. Six themes, all barriers, were identified as influencing decision making processes: knowledge about symptoms, and self-discrimination (internal), stigma and discrimination by others, limited managerial support, dissatisfaction with services, and/or a risk of job or financial loss (external).Conclusion: Decisions to disclose mental health conditions, even by those who had done so, appear driven entirely by consideration of negative aspects. This suggests that anti-discrimination policy, legislation, awareness campaigns, and manager training have yet to change negative perceptions, and that any decision aid tool needs to incorporate counterfactual positive aspects that appear not to be an important consideration in such male dominated workplaces. There is a disconnect between organisational policies favouring disclosure and employees favouring non-disclosure that has caused tension within the organisational culture. Decision aid tools may assist employees with an active disclosure without waiting for an event to occur, giving the control of the decision back to the employee.
Open Dialogue approaches fall broadly into the area of systemic psychotherapeutic practices. They encourage active participation of families and social networks, and emphasize genuine collaboration within highly integrated systems of health‐care service delivery. These approaches are currently being implemented in a growing number of services across the globe, and in this review, we summarize and discuss insights from papers concerned with the implementation of Open Dialogue. We used a scoping review method, which included systematic literature searches and summarizing data extraction as well as consultation with eight Open Dialogue implementation stakeholders who were invited to comment on preliminary review findings and a draft paper. We included 18 studies in the review and present their content under four thematic headings: 1. Training, 2. Family and network experiences, 3. Staff members’ experiences, and 4. Structural and organizational barriers and resistance to implementation. In general, the studies did not include rich descriptions of the implementation contexts, which made it difficult to draw conclusions across studies about effective implementation practices. The discussion draws on Jamous and Peloille’s (Professions and professionalisation, 1970, Cambridge University Press, 109‐152) concepts of “indeterminacy” and “technicality,” and we argue that the indeterminacy that dominates Open Dialogue is a challenge to implementation efforts that favor specific and standardized practices. We conclude by encouraging the development of implementation initiatives that theorize Open Dialogue practices with higher levels of technicality without corrupting the fundamental spirit of the approach.
The purpose of this article is to identify the implications of commonly held ideologies within theories of child development. Despite critiques to doing so, developmental theory assumes that children's bodies are unitary, natural and material. The recent explosion of neuroscience illustrates the significance of historical, social and cultural contexts to portrayals of brain development, offering the opportunity for a critical departure in thinking. Instead, this neuroscience research has been taken up in ways that align with biomedical traditions and neoliberal values. This article uses a critical discursive approach, supported by Haraway's ideas of technoscience, to analyse a population-based early child development research initiative. This initiative organises a large-scale surveillance of children's development, operating from the premise that risks to development are best captured early to optimise children's potential. The analysis in this article shows an intermingling of health and economic discourses and clarifies how the child is a figure of significant contemporary social and political interests. In a poignant example of technobiopolitics, the collusion between health research, technologies and the state enrols health professionals to participate in the production of children as subjects of social value, figured as human capital, investments in the future, or alternatively, as waste. The analysis shows how practices that participate in what has become a developmental enterprise also participate in the marginalisation of the very children they intend to serve. Hence, there is the need to rethink practices critically and move towards innovative conceptualisations of child development that hold possibilities to resist these figurations.
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