Ethnodrama : constructing participatory, experiential and compelling action research through performance

Through the use of illustrative script and other data drawn from a number of emancipatory research projects, this chapter endeavours to portray the construction of a new form of participatory and interactional; theatre that negotiates and constructs understandings and meanings in conjunction with its participants and audiences. In this context, critical ethnography has been combined with performance to construct the new form of theatre which we have labelled ethnodrama. The ethnodramas described seek to translate action research into reflexive, reflective performances which are both educational tools for teaching nursing and medical students and a form of voicing to service providers by health consumers

An act of subversion : night workers on the fringe of dawn - from bow-wave to deluge

In our experimentation with an innovative ethnographic form, through which we have sought to challenge our readers and audiences using our research-based offerings as the basis for ethnodramatic performance interactions, we may at times have had little understanding of the full range of implications of our creativity. Professional therapists have compulsory sets of guidelines and ethical protocols to which they refer, and may draw upon the wisdom and advice of peers and mentors by thumbing through the pages of their professional bibles. In the developmental and emergent spaces of social science research, which performance ethnography and health promotion - that which we have labeled ethnodrama - occupies, we are writing the guidelines as we go. That is, we are sometimes engaged in the retrospective application of efficacy to our research products: those scripts and performances which constitute the ethnodramatic report. This then, is not a confessional tale, but a recognition of some undesirable outcomes and new responsibilities emanating from performance ethnography

Extreme dilemmas in performance ethnography : unleashed emotionality of performance in critical areas of suicide, abuse, and madness

The use of drama to influence social, political, and health practices has a long and well-understood tradition, dating from Greek and classical times. Within the modern era, we can see that the works of Dario Fo, for example, represent not only fine examples of drama, but in addition represent a significant mode of political and cultural critique. The themes of such works as The Accidental Death of an Anarchist can be seen to resonate as strongly in contemporary society as they did in the 1970s in Italy. Similarly, ethnodrama, as first described by Mienczakowski,25 should be interpreted as the staged performance of cultural texts developed, written, and authenticated by health care patients, their associated health care specialists, academics, and the general public (as audience)

Reading and rioting: Student politics beyond the university

Students are ‘universally’ subjected to debt and financialisation; a subjectivation which has most recently defined the University of Auckland student movement. This movement currently consists of two intersecting groups: Reclaim UoA and Petty and Vindictive. The logics of finance construct students as investors and enclose the commons of the university, necessitating the creation of an ‘Undercommons’. The theory of the Undercommons (Harney & Moten, 2004) suggests we must look beyond the university for progressive alternatives. The student movement must find a ‘universal’ response to financialisation which does not subsume the ‘particular’ struggles of those who make up that movement

Emotion regulation strategies and parenting practices among parents of children with clinic-referred conduct problems

This study examined the cognitive-affective strategies used by parents of young children with conduct problems to regulate emotions. Key questions concerned the extent to which these emotion regulation strategies are associated with positive and negative parenting practices and predict quality of parenting through interplay with parental depression. Design. Participants were families of toddlers (n = 84) referred to a tertiary-level health service for the treatment of disruptive behavior problems. Parenting practices were indexed through observational coding of parent–child interactions and self-report data on multiple dimensions of positive and negative parenting. Parents self-reported their use of cognitive reappraisal and expressive suppression—the two emotion regulation strategies that are most robustly associated with psychosocial functioning in adults. Results. Associations between emotion regulation strategy and quality of parenting were moderated by parental depressive symptom severity, with distinct effects seen for positive and negative parenting practices. In terms of positive parenting, more frequent use of cognitive reappraisal was associated with increased use of labeled praise among parents with lower levels of depressive symptoms, whereas parents who had higher levels of depressive symptoms engaged in less such praise regardless of how frequently they used reappraisal. In terms of negative parenting, frequent use of cognitive reappraisal and expression suppression were associated with reduced levels of negative parenting, but only among parents with high levels of depression. Conclusions. These findings add to growing support for the integration of emotion regulation strategies into family process models of early-onset conduct problems and related clinical interventions

Anticholinergic medicines in an older primary care population: A cross-sectional analysis of medicines' levels of anticholinergic activity and clinical indications

WHAT IS KNOWN AND OBJECTIVES: Adverse clinical outcomes have been associated with cumulative anticholinergic burden (to which low-potency as well as high-potency anticholinergic medicines contribute). The clinical indications for which anticholinergic medicines are prescribed (and thus the 'phenotype' of patients with anticholinergic burden) have not been established. We sought to establish the overall prevalence of prescribing of anticholinergic medicines, the prevalence of prescribing of low-, medium- and high-potency anticholinergic medicines, and the clinical indications for which the medicines were prescribed in an older primary care population. METHODS: This was a cross-sectional analysis of a cohort study of Australian early-career general practitioners' (GPs') clinical consultations - the Registrar Clinical Encounters in Training (ReCEnT) study. In ReCEnT, GPs collect detailed data (including medicines prescribed and their clinical indication) for 60 consecutive patients, on up to three occasions 6 months apart. Anticholinergic medicines were categorized as levels 1 (low-potency) to 3 (high-potency) using the Anticholinergic Drug Scale (ADS). RESULTS: During 2010-2014, 879 early-career GPs (across five of Australia's six states) conducted 20 555 consultations with patients aged 65 years or older, representing 35 506 problems/diagnoses. Anticholinergic medicines were prescribed in 10·4% [95% CIs 9·5-10·5] of consultations. Of the total anticholinergic load of prescribed medicines ('community anticholinergic load') 72·7% [95% CIs 71·0-74·3] was contributed by Level 1 medicines, 0·8% [95% CIs 0·5-1·3] by Level 2 medicines and 26·5% [95% CIs 24·8-28·1] by Level 3 medicines. Cardiac (40·0%), Musculoskeletal (16·9%) and Respiratory (10·6%) were the most common indications associated with Level 1 anticholinergic prescription. For Level 2 and 3 medicines (combined data), Psychological (16·1%), Neurological (16·1%), Musculoskeletal (15·7%) and Urological (11·1%) indications were most common. WHAT IS NEW AND CONCLUSION: Anticholinergic medicines are frequently prescribed in Australian general practice, and the majority of the 'community' anticholinergic burden is contributed by 'low'-anticholinergic potency medicines whose anticholinergic effects may be largely 'invisible' to prescribing GPs. Furthermore, the clinical 'phenotype' of the patient with high anticholinergic burden may be very different to common stereotypes (patients with urological, psychological or neurological problems), potentially making recognition of risk of anticholinergic adverse effects additionally problematic for GPs

Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study

Background: The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility. Methods: We did an ecological study to examine the association between the regional proportion of infections with the SARS-CoV-2 B.1.1.7 variant and reported symptoms, disease course, rates of reinfection, and transmissibility. Data on types and duration of symptoms were obtained from longitudinal reports from users of the COVID Symptom Study app who reported a positive test for COVID-19 between Sept 28 and Dec 27, 2020 (during which the prevalence of B.1.1.7 increased most notably in parts of the UK). From this dataset, we also estimated the frequency of possible reinfection, defined as the presence of two reported positive tests separated by more than 90 days with a period of reporting no symptoms for more than 7 days before the second positive test. The proportion of SARS-CoV-2 infections with the B.1.1.7 variant across the UK was estimated with use of genomic data from the COVID-19 Genomics UK Consortium and data from Public Health England on spike-gene target failure (a non-specific indicator of the B.1.1.7 variant) in community cases in England. We used linear regression to examine the association between reported symptoms and proportion of B.1.1.7. We assessed the Spearman correlation between the proportion of B.1.1.7 cases and number of reinfections over time, and between the number of positive tests and reinfections. We estimated incidence for B.1.1.7 and previous variants, and compared the effective reproduction number, Rt, for the two incidence estimates. Findings: From Sept 28 to Dec 27, 2020, positive COVID-19 tests were reported by 36 920 COVID Symptom Study app users whose region was known and who reported as healthy on app sign-up. We found no changes in reported symptoms or disease duration associated with B.1.1.7. For the same period, possible reinfections were identified in 249 (0·7% [95% CI 0·6–0·8]) of 36 509 app users who reported a positive swab test before Oct 1, 2020, but there was no evidence that the frequency of reinfections was higher for the B.1.1.7 variant than for pre-existing variants. Reinfection occurrences were more positively correlated with the overall regional rise in cases (Spearman correlation 0·56–0·69 for South East, London, and East of England) than with the regional increase in the proportion of infections with the B.1.1.7 variant (Spearman correlation 0·38–0·56 in the same regions), suggesting B.1.1.7 does not substantially alter the risk of reinfection. We found a multiplicative increase in the Rt of B.1.1.7 by a factor of 1·35 (95% CI 1·02–1·69) relative to pre-existing variants. However, Rt fell below 1 during regional and national lockdowns, even in regions with high proportions of infections with the B.1.1.7 variant. Interpretation: The lack of change in symptoms identified in this study indicates that existing testing and surveillance infrastructure do not need to change specifically for the B.1.1.7 variant. In addition, given that there was no apparent increase in the reinfection rate, vaccines are likely to remain effective against the B.1.1.7 variant. Funding: Zoe Global, Department of Health (UK), Wellcome Trust, Engineering and Physical Sciences Research Council (UK), National Institute for Health Research (UK), Medical Research Council (UK), Alzheimer's Society.</p

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Analysis of the spread and frequency of SARS-CoV-2 D614G in the United Kingdom suggests a selective advantage for this strain that is associated with higher viral loads in younger patients but not higher COVID-19 clinical severity or mortality