Routine journeys, complex networks: media-centrism, the dispositif of road safety, and practices of commuting by car in everyday Ireland

Road safety is regarded as one of the most significant public health issues in the world. In Ireland, strategies for the mitigation of the effects of road traffic accidents appear in policy documents such as the Road Safety Strategy which is then disseminated via various media outlets. Such an approach highlights the centrality of mediation in the social acceptance of policy initiatives, relying on an assumption of media-centricity – that the mainstream media are central to social formation. This thesis problematizes this assumption. Drawing together the disparate elements of a dispositif of road safety in the under-researched Irish setting, this study explores the complex range of actors implicated in the mediation of policy. It examines the mediated policy context of the worst road accident in Irish history, as well as the introduction of a network of speed cameras, to explore how policy initiatives output in print media reports, as well as online discussion. Through analysis of car-commuters’ focus group interactions, it also examines the ways in which mediated policy understandings are immanent and circulate in how car-commuters talk about their commuting practices. The study highlights how mediated policy actions attempt to curb the unfettered expression of car-based freedoms through the construction of individual responsibility as the ultimate expression of road safety. However, commuters’ freedoms are also shaped and constrained by responsibilities in terms of work, study, and family, as well as by the types of social action automobility makes conceivable, facilitates, and disrupts. In addition, the research shows that while rational choices and rationality are a dominant framework within policy contexts, mediation about road safety is actually enmeshed in multiple rationalities that surface as circumstances require. Exploration of driving practices reveals how commuters are nodes in their own networks of rationalities around automobility that adhere and disjoin to varying degrees with the concerns of media representation. The study also highlights the mainstream media consensus constructed around speed cameras, even though forms of resistance to this consensus manifest, especially online. Commuters’ car-based activities can often also be resistant to discourses of road safety. Yet commuters fight to defend the space and time spent on forms of work performed in the car that reinforce the exigencies of neoliberalism. Overall, the thesis finds that media are but one of the many sets of actors that constitute the complex networks of neoliberal automobility in Ireland

Routine journeys, complex networks: media-centrism, the dispositif of road safety, and practices of commuting by car in everyday Ireland

Road safety is regarded as one of the most significant public health issues in the world. In Ireland, strategies for the mitigation of the effects of road traffic accidents appear in policy documents such as the Road Safety Strategy which is then disseminated via various media outlets. Such an approach highlights the centrality of mediation in the social acceptance of policy initiatives, relying on an assumption of media-centricity – that the mainstream media are central to social formation. This thesis problematizes this assumption. Drawing together the disparate elements of a dispositif of road safety in the under-researched Irish setting, this study explores the complex range of actors implicated in the mediation of policy. It examines the mediated policy context of the worst road accident in Irish history, as well as the introduction of a network of speed cameras, to explore how policy initiatives output in print media reports, as well as online discussion. Through analysis of car-commuters’ focus group interactions, it also examines the ways in which mediated policy understandings are immanent and circulate in how car-commuters talk about their commuting practices. The study highlights how mediated policy actions attempt to curb the unfettered expression of car-based freedoms through the construction of individual responsibility as the ultimate expression of road safety. However, commuters’ freedoms are also shaped and constrained by responsibilities in terms of work, study, and family, as well as by the types of social action automobility makes conceivable, facilitates, and disrupts. In addition, the research shows that while rational choices and rationality are a dominant framework within policy contexts, mediation about road safety is actually enmeshed in multiple rationalities that surface as circumstances require. Exploration of driving practices reveals how commuters are nodes in their own networks of rationalities around automobility that adhere and disjoin to varying degrees with the concerns of media representation. The study also highlights the mainstream media consensus constructed around speed cameras, even though forms of resistance to this consensus manifest, especially online. Commuters’ car-based activities can often also be resistant to discourses of road safety. Yet commuters fight to defend the space and time spent on forms of work performed in the car that reinforce the exigencies of neoliberalism. Overall, the thesis finds that media are but one of the many sets of actors that constitute the complex networks of neoliberal automobility in Ireland

Electrical Stimulation of the Auditory System

In many healthcare systems electrical stimulation of the human auditory system, using cochlear implants, is a common treatment for severe to profound deafness. This chapter will describe how electrical stimulation manages to compensate for sensory-neural hearing loss by bypassing the damaged cochlea. The challenges involved in the design and application of cochlear implants will be outlined, including the programming of clinical systems to suit the needs of implanted patients. Today’s variety of patient will be reviewed: unilaterally and bilaterally implanted, bimodal users of a cochlear implant as well as a contralateral hearing aid, CROS device users having either asymmetrical hearing loss or single-sided deafness. Alternative devices such as auditory brainstem implants will be described, and additionally the more experimental auditory mid-brain implants and intraneural stimulation approaches. Research that is likely to bring medium term benefits to the clinical application of cochlear implants will also be described

The Role of Cognitive Insight, Hope, Self-Stigma, and Symptomatology in Predicting Treatment Engagement in Individuals Diagnosed with Serious Mental Illnesses

Adherence to and engagement with treatment is a complex and multifaceted issue encountered throughout many medical and helping professions, particularly in the fields of psychology and psychiatry. Adherence to treatment/service engagement is especially an issue in the treatment of serious mental illnesses; studies have shown that up to 80% of individuals do not adhere to their treatment (Tait et al., 2003). This study investigated if cognitive insight, as measured by the Beck Cognitive Insight Scale ([BCIS] Beck et al., 2004), and clinical insight are related to the recovery concepts of hope and self-stigma as well as symptomatology in predicting treatment adherence/service engagement in a sample of individuals diagnosed with severe mental illness. The sample consisted of volunteers under treatment in outpatient facilities utilizing the Assertive Community Treatment model. Data was collected from 35 participants from two different ACT team treatment sites. Initial T-tests showed that there was a significant difference between the sex of participants t(33) = 2.276, p = .029 and treatment site of participants t(33) = -2.453, p = .020 in regard to scores on the dependent variable measure, a self-designed service engagement scale. A hierarchical multiple regression analysis was conducted in order to test whether the independent variables of cognitive insight as measured by the Self-Reflectiveness and Self- Certainty subscales of the Beck Cognitive Insight Scale, i.e., clinical insight, hope, four factors of self-stigma (aware, agree, apply, and hurts self), and symptomatology, could significantly predict the dependent variable of service engagement/adherence. Model 1 of the regression (site and sex) was found to be significant (p = .011), but model 2 (predictor variables) was found not to be significant (p = .122). Scores from the Beck Cognitive Insight Scale Self-Reflectiveness subscale were positively correlated at the .01 level of significance with scores on the Insight Scale (r = .544), providing further evidence of the construct validity of the BCISR. No significant relationship was found between the Beck Cognitive Insight Scale Self-Certainty subscale and the Birchwood Insight Scale as predicted. Several correlations were found between variables. Small sample size and lack of an accurate measure to gauge service engagement were identified as the greatest limitations of the study. Areas of future research on the constructs of insight, hope, self-stigma, and treatment adherence/service engagement are discussed

An observational comparison of FACT and ACT in the Netherlands and the US

Assertive Community Treatment (ACT) is a well-defined service delivery model for the care and treatment of the most severely mentally ill in the community with American origins. The Dutch have adapted the model in order to accommodate a broader range of needs and allow more flexible implementation. Functional Assertive Community Treatment (FACT) provides the intensity of care needed to help participants sustain life in the community as well as continuity of care over time for many vulnerable client populations