scholarly journals Policies Make Coherent Care Pathways a Personal Responsibility for Clinicians: A Discourse Analysis of Policy Documents about Coordinators in Hospitals

2018 ◽  
Vol 18 (3) ◽  
pp. 5 ◽  
Author(s):  
Audhild Høyem ◽  
Deede Gammon ◽  
Gro Rosvold Berntsen ◽  
Aslak Steinsbekk
Keyword(s):  
Discourse Analysis ◽  
Personal Responsibility ◽  
Care Pathways ◽  
Policy Documents

scholarly journals The chimera of choice in UK food policy 1976–2018

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Duika Louise Burges Watson ◽  
Alizon Draper ◽  
Wendy Wills
Keyword(s):  
Public Health ◽  
Discourse Analysis ◽  
Critical Discourse Analysis ◽  
Food Policy ◽  
Personal Responsibility ◽  
Actor Model ◽  
Policy Documents ◽  
Content Type ◽  
The Uk ◽  
Intention To Change

PurposeThis paper presents a critical discourse analysis of “choice” as it appears in UK policy documents relating to food and public health. A dominant policy approach to improving public health has been health promotion and health education with the intention to change behaviour and encourage healthier eating. Given the emphasis on evidence-based policy making within the UK, the continued abstraction of choice without definition or explanation provoked us to conduct this analysis, which focuses on 1976 to the present.Design/methodology/approachThe technique of discourse analysis was used to analyse selected food policy documents and to trace any shifts in the discourses of choice across policy periods and their implications in terms of governance and the individualisation of responsibility.FindingsWe identified five dominant repertoires of choice in UK food policy over this period: as personal responsibility, as an instrument of change, as an editing tool, as a problem and freedom of choice. Underpinning these is a continued reliance on the rational actor model, which is consonant with neoliberal governance and its constructions of populations as body of self-governing individuals. The self-regulating, self-governing individual is obliged to choose as a condition of citizenship.Research limitations/implicationsThis analysis highlights the need for a more sophisticated approach to understanding “choice” in the context of public health and food policy in order to improve diet outcomes in the UK and perhaps elsewhere.Originality/valueThis is the first comprehensive analysis of the discourse of choice in UK food policy.

Socially Constructing Healthy Eating: A Foucauldian Discourse Analysis of Healthy Eating Information and Advice

2021 ◽  
pp. 104973232110234
Author(s):  
Jo Mackenzie ◽  
Esther Murray
Keyword(s):  
United Kingdom ◽  
Discourse Analysis ◽  
Healthy Eating ◽  
Personal Responsibility ◽  
Nutritional Composition ◽  
Health Issues ◽  
Subject Positions ◽  
The United Kingdom ◽  
Moral Citizenship ◽  
Moral Discourses

A variety of materials offering healthy eating advice have been produced in the United Kingdom to encourage people to eat well and avoid diet-related health issues. By applying a Foucauldian discourse analysis, this research aimed to uncover the discourses used in six healthy eating texts (two state-produced and four commercial texts), how people positioned themselves in relation to these discourses, and the power relations between institutions and the U.K. public. Ten discourses including scientific, thermodynamics, natural, family/caring, emotional, medical, and moral discourses were uncovered and offered up subject positions in relation to moral citizenship and personal responsibility. Through the use of biopower, foods appeared to be categorized as “good” or “bad” foods in which bad foods were considered to be risky to health due to their nutritional composition. Most texts assumed people have the agency to follow the advice provided and failed to consider the readers’ personal contexts.

The pragmatic application of attachment theory in medical decision making regarding emotionally unstable personality disorder presentations to healthcare settings

2020 ◽  
Vol 5 (2) ◽  
pp. 135-147
Author(s):  
Daniel James Armstrong
Keyword(s):  
Decision Making ◽  
Therapeutic Potential ◽  
Personal Responsibility ◽  
Healthcare Setting ◽  
Clinical Decision ◽  
Medical Decision ◽  
Care Pathways ◽  
Best Interest ◽  
Therapeutic Goals ◽  
Compulsory Care

A hypothesis is formulated whereby individuals with adverse childhood experiences can come to have a disrupted attachment system and this can impact the manner in which individuals engage in healthcare. Maslow's hierarchy of needs suggests a motivation for safety and it is proposed that the healthcare system can come to represent the secure base. Behaviours that lead an individual into the healthcare setting can thus be positively reinforced by satisfying such a dynamic need. Prescribing behaviours are examined relating to this notion. The spectrum of intention-to-die type presentations in an acute healthcare setting are considered. The contribution of the concept of risk and uncertainty to decision makers is examined as a possible component to the propagation of unhelpful care pathways, where risk averse decision making leads to interventions of limited clinical utility for an individual. An introduction to the notion of a "corrupted capacity assessment" is made, which refers to the process of a doctor concluding that an individual lacks capacity without considering that this may be the outcome desired by a patient with capacity. Pragmatic strategies are suggested as a way to minimise iatrogenic harms and maximise therapeutic potential at clinical encounters where risk is a facet. Longitudinal assessments with an acknowledgement of the harms in preceding compulsory care pathways are promoted as well as an articulation of the clinician's anxiety for the purposes of reflection, in order to arrive at a clinical decision that is solely in the patient's best interest. It is suggested that ambivalence over the patient's perception of value to life is explicitly validated at such junctures. Personal responsibility and capacity for individuals presenting should be therapeutic goals if an individual has come to, or is doubting, their own autonomy and wishing to invest such factors in compulsory care pathways.

Constructing Fatality Review: A Policy Analysis of the Emergence of Domestic Homicide Reviews in England and Wales

2021 ◽  
pp. 107780122110680
Author(s):  
James Rowlands
Keyword(s):  
Discourse Analysis ◽  
Policy Analysis ◽  
Domestic Abuse ◽  
Policy Initiative ◽  
Domestic Homicide ◽  
Policy Documents ◽  
England And Wales

In England and Wales, Domestic Homicide Reviews (DHRs) examine domestic abuse-related deaths to identify lessons to be learned. However, their emergence as a policy initiative has been little considered. To address this gap, a thematic discourse analysis of policy documents to 2011 was undertaken, examining the justification for, and conceptualization of, DHRs before their implementation. It is argued that DHRs were constructed as a taken-for-granted good, through which multi-agency partners would generate learning while the (gendered) subject was silenced. Attending to aspirations, contradictions, and tensions in the emergence of DHRs has implications for their understanding and operationalization in the present.

Dueling discourses, power, and the construction of the recovering addict: When social assistance confronts addiction in Toronto, Canada

2019 ◽  
Vol 40 (1) ◽  
pp. 130-150 ◽  
Author(s):  
Amber Gazso
Keyword(s):  
Discourse Analysis ◽  
Social Control ◽  
Labour Market ◽  
Critical Discourse Analysis ◽  
Social Assistance ◽  
Subject Position ◽  
Critical Discourse ◽  
Policy Documents ◽  
Work First ◽  
Depth Interviews

In this article, I undertake a critical discourse analysis of policy documents and in-depth interviews with seven caseworkers and 28 benefit recipients to explore how two discourses, ‘work first’ and ‘distance from the labour market,’ inform how persons living with addiction access and then experience social assistance in Toronto, Ontario, Canada. Drawing in Foucauldian insights on power, I reveal the conceptualisation of benefit recipients’ eligibility for Ontario Works through these two discourses and how this is replete with ideological assumptions and disciplining power relations, constitutive of a subject position of ‘the recovering addict’, and suggestive of social control implications. I argue that the coercion and regulation of benefit recipients’ lives on Ontario Works has not disappeared but transmuted for Torontonians living with addiction, and conclude by considering the governance of this population as biopower.

scholarly journals ICT Capacity Building: A Critical Discourse Analysis of Rwandan Policies from Higher Education Perspective

2016 ◽  
Vol 19 (2) ◽  
pp. 46-62 ◽  
Author(s):  
Jean Claude Byungura ◽  
Henrik Hansson ◽  
Kamuzinzi Masengesho ◽  
Thashmee Karunaratne
Keyword(s):  
Higher Education ◽  
Discourse Analysis ◽  
Capacity Building ◽  
Critical Discourse Analysis ◽  
National Level ◽  
Critical Discourse ◽  
Institutional Policies ◽  
Policy Documents ◽  
Ict Infrastructure ◽  
Implementation Level

Abstract With the development of technology in the 21st Century, education systems attempt to integrate technology-based tools to improve experiences in pedagogy and administration. It is becoming increasingly prominent to build human and ICT infrastructure capacities at universities from policy to implementation level. Using a critical discourse analysis, this study investigates the articulation of ICT capacity building strategies from both national and institutional ICT policies in Rwanda, focusing on the higher education. Eleven policy documents were collected and deeply analyzed to understand which claims of ICT capacity building are made. The analysis shows that strategies for building ICT capacities are evidently observed from national level policies and only in two institutional policies (KIST and NUR). Among 25 components of ICT capacity building used, the ones related to human capacity are not plainly described. Additionally, neither national nor institutional policy documents include the creation of financial schemes for students to acquire ICT tools whilst learners are key stakeholders. Although there is some translation of ICT capacity building strategies from national to some institutional policies, planning for motivation and provision of incentives to innovators is not stated in any of the institutional policies and this is a key to effective technology integration.

The American gaze east

2017 ◽  
Vol 2 (2) ◽  
pp. 175-205 ◽  
Author(s):  
Emma Trentman ◽  
Wenhao Diao
Keyword(s):  
Discourse Analysis ◽  
Study Abroad ◽  
Critical Discourse Analysis ◽  
Language Learners ◽  
21St Century ◽  
Critical Discourse ◽  
Critical Examination ◽  
Intercultural Learning ◽  
Policy Documents ◽  
Studying Abroad

Abstract The 21st century has seen an emphasis in US media and policy documents on increasing the numbers of US students studying abroad and also the amount of US students studying ‘critical’ languages. This paper examines the intersection of these discourses, or the experiences of critical language learners abroad. We analyze this intersection by using critical discourse analysis to examine US media and policy documents and data from students studying Arabic in Egypt and Mandarin in China. This analysis reveals considerable discrepancies between rhetoric and experience in terms of language and intercultural learning. We argue that a critical examination of current discourses of study abroad (SA) reveals that they in fact recreate the colonial map, mask global inequalities, and create a new global elite. We conclude that language and intercultural learning abroad will remain a source of tension until SA students and programs critically engage with these discourses.

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