One nation, one beer: The mythology of the new South Africa in advertising

Faculty of Humanities 9301506x [email protected] New South Africa came into being on February 2, 1990, with State President F.W. de Klerk’s announcement of the sweeping changes that signalled the end of white minority rule. The New South Africa immediately assumed mythical status, functioning as a structuring, legitimating narrative in the face of a history that carried with it the possibility of inter-racial conflagration. Later, another myth emerged, that of the rainbow nation, together with a latter day epic hero in the form of Nelson Mandela. Together with a third, less defined myth of the freedoms promised by the new Constitution of 1996, these constitute a mythology of the New South Africa. Advertising played an important role in the propagation and interrogation of these myths. Campaigns for an assortment of consumer goods and services tracked momentous shifts in society, politics and culture, often with penetrating insight and incisive humour. Three campaigns, for Castle Lager (beer), Vodacom (cellular network) and Castrol (motor oil), and individual advertisements for Nando’s (fast food chicken), Sales House (retail clothing) and South African Airways, are analysed. The material is approached using a hybrid methodology of a structure that draws upon Fairclough’s (1989, 1995) Critical Discourse Analysis, while analysing the texts themselves using an approach most closely allied to the social semiotics of Barthes (1972). Using this approach, it can be seen, for example, how the Castle Lager ‘Friendship’ campaign is perhaps the most sustained articulation of the ideals embodied in the New South Africa and particularly the myth of the rainbow nation. In contrast, an analysis of the Vodacom ‘Yebo Gogo’ campaign reveals that even at its most dominant, the mythology of the New South Africa was being undermined by prototypical myths that would consolidate under the heading of the African renaissance. An overview of all of the campaigns analysed in this thesis point to the existence of three types of approach to advertising the nation, namely, incantatory, novelistic and identificatory. Incantatory advertising reproduces dominant national myths without questioning them; in contrast, novelistic advertising interrogates the assumptions upon which such myths are based even if it ultimately endorses them. Identificatory advertising focuses on ‘typical’ examples of what constitutes South Africanness, without any attached overt ideological agenda. Incantatory advertising tends to emerge at important national anniversaries or international sporting events, while identificatory advertising became more prominent as the mythology of the New South Africa became less immediate. It is likely that advertising will continue to play a significant role in the imagining of the South African nation

Effectiveness of policy to provide breastfeeding groups (BIG) for pregnant and breastfeeding mothers in primary care: cluster randomised controlled trial

Objective To assess the clinical effectiveness and cost effectiveness of a policy to provide breastfeeding groups for pregnant and breastfeeding women

The effect of health visitors on breastfeeding in Glasgow

Background: The UNICEF Baby Friendly Initiative includes a community component to helpwomen who want to breastfeed. This study aimed to document the health visitor role in promotingand supporting breastfeeding in Glasgow during 2000 and the effect it had on breastfeeding rates.Methods: Glasgow, UK, has a population of 906,000, with approximately 10,000 births per year.Glasgow has high levels of material deprivation and traditionally low breastfeeding rates. This wasa cross-sectional study in January 2000 which used a postal questionnaire to document individualhealth visitors' interventions, activities and attitude towards breastfeeding. Infant's breastfeedingdata collected routinely by the Child Health Surveillance programme from 1 August 1998 to 28February 1999 was directly matched with interventions, activities and attitudes reported by theirown health visitor.Results: 146/216 (68%) health visitors completed and returned the questionnaire. 5401 childhealth records were eligible and 3,294 (58.2%) could be matched with health visitors who returnedquestionnaires. 2145 infants had the first visit from 8 to 20 days of age and the second 3 to 7 weekslater. At the first postnatal visit 835 of 2145 (39%) infants were breastfed (median age of 13 days)and 646 (30%) continued to breastfeed at the second visit (median age 35 days).Infants being breastfed at the first visit were significantly more likely to be fed infant formula at thesecond visit if their health visitors had had no breastfeeding training in the previous two years(OR1.74 95%CI 1.13, 2.68).Conclusion

Significant others, situations and their influences on infant feeding. Secondary analysis of data from: A prospective study exploring the early infant feeding experiences of parents and their significant others during the first 6 months of life: what would make a difference?

This study examines the range of influences on infant feeding behaviour from late pregnancy until six months after birth, which lead parents to introduce formula or solids, or to stop breastfeeding prior to the recommended six months. It reveals that a complex and dynamic combination of people, situations and personal experiences affect feeding behaviour initiation and maintenance and precipitate or prevent change

Significant others, situations and their influences on infant feeding. Secondary analysis of data from: A prospective study exploring the early infant feeding experiences of parents and their significant others during the first 6 months of life: what would make a difference?

This study examines the range of influences on infant feeding behaviour from late pregnancy until six months after birth, which lead parents to introduce formula or solids, or to stop breastfeeding prior to the recommended six months. It reveals that a complex and dynamic combination of people, situations and personal experiences affect feeding behaviour initiation and maintenance and precipitate or prevent change

A serial qualitative interview study of infant feeding experiences: idealism meets realism

Objective: To investigate the infant feeding experiences of women and their significant others from pregnancy until 6 months after birth to establish what would make a difference. Design: Qualitative serial interview study. Setting: Two health boards in Scotland. Participants: 72 of 541 invited pregnant women volunteered. 220 interviews approximately every 4 weeks with 36 women, 26 partners, eight maternal mothers, one sister and two health professionals took place. Results: The overarching theme was a clash between overt or covert infant feeding idealism and the reality experienced. This is manifest as pivotal points where families perceive that the only solution that will restore family well-being is to stop breast feeding or introduce solids. Immediate family well-being is the overriding goal rather than theoretical longer term health benefits. Feeding education is perceived as unrealistic, overly technical and rules based which can undermine women's confidence. Unanimously families would prefer the balance to shift away from antenatal theory towards more help immediately after birth and at 3-4 months when solids are being considered. Family-orientated interactive discussions are valued above breastfeeding-centred checklist style encounters. Conclusions: Adopting idealistic global policy goals like exclusive breast feeding until 6 months as individual goals for women is unhelpful. More achievable incremental goals are recommended. Using a proactive family-centred narrative approach to feeding care might enable pivotal points to be anticipated and resolved. More attention to the diverse values, meanings and emotions around infant feeding within families could help to reconcile health ideals with reality

Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study

BackgroundExclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective.MethodSerial qualitative interviews examined the influences of significant others on women’s feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards.ResultsThe dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers.ConclusionsApplying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of support and education of individual women towards a more holistic, family-centred narrative approach, whilst acknowledging that breastfeeding is a practical skill that women and babies have to learn

A pilot randomised controlled trial of a preconsultation web-based intervention to improve the care quality and clinical outcomes of diabetes outpatients (DIAT)

notes: PMCID: PMC3731775This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com.Diabetes is a chronic condition associated with many long-term complications. People with diabetes need to actively manage their condition, which can be complex. In consultations with healthcare professionals, patients receive advice about their diabetes but do not always discuss things which concern them, perhaps because of the perceived limited time or embarrassment. We want to test a 'preconsultation' intervention in which the patient is supported by a healthcare assistant to complete a web-based intervention aimed at producing an agenda to help them identify important areas for discussion in the consultation. Use of this agenda may enable the patient to play a more active role in that consultation and consequently become more confident, and hence more successful, in managing their condition

A preconsultation web-based tool to generate an agenda for discussion in diabetes outpatient clinics to improve patient outcomes (DIAT): a feasibility study

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this record.OBJECTIVE: To test the feasibility of running a randomised controlled trial of a preconsultation web-based intervention (Presenting Asking Checking Expressing (PACE-D)) to improve the quality of care and clinical outcomes in patients with diabetes. DESIGN AND SETTING: A feasibility study (with randomisation) conducted at outpatient diabetes clinics at two secondary care hospitals in Devon, UK. PARTICIPANTS: People with diabetes (type 1 and type 2) attending secondary care general diabetes outpatient clinics. INTERVENTION: The PACE-D, a web-based tool adapted for patients with diabetes to use before their consultation to generate an agenda of topics to discuss with their diabetologist. OUTCOMES: The percentage of eligible patients who were recruited and the percentage of participants for whom routine glycosylated haemoglobin (HbA1c) data (the putative primary outcome) could be extracted from medical notes and who completed secondary outcome assessments via questionnaire at follow-up were reported. RESULTS: In contrast with the planned recruitment of 120 participants, only 71 participants were randomised during the 7-month recruitment period. This comprised 18.7% (95% CI 14.9% to 23.0%) of those who were eligible. Mean (SD) age of the participants was 56.5 (12.4) years and 66.2% had type 1 diabetes. Thirty-eight patients were randomised to the intervention arm and 33 to the control arm. HbA1c data were available for only 73% (95% CI 61% to 83%) of participants at the 6 months follow-up. The questionnaire-based data were collected for 66% (95% CI 54% to 77%) of the participants at 6 months follow-up. Participants reported that the PACE-D tool was easy to use. CONCLUSIONS: A randomised controlled trial of the preconsultation web-based intervention as set out in our current protocol is not feasible without significant modification to improve recruitment and follow-up of participants. The study also provides insights into the feasibility and challenges of conducting complex intervention trials in everyday clinical practice. TRIAL REGISTRATION: ISRCTN75070242.The research question was generated from a research prioritisation exercise undertaken by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC) and the Patient and Public Involvement Group (PenPIG). The authors are grateful to Andy Barton (Research Design Service South West) for advice provided when developing the proposal. The authors would like to thank the study sponsor: Royal Devon and Exeter NHS Foundation Trust. They are grateful to Donald Cegala (Emeritus Professor of Communication and Family Medicine, Ohio State University) for supporting their use and modification of the PACE intervention. They are grateful to Cosmo White for formatting images for the paper

A preconsultation web-based tool to generate an agenda for discussion in diabetes outpatient clinics to improve patient outcomes (DIAT): A feasibility study

© 2016 Published by the BMJ Publishing Group Limited. Objective To test the feasibility of running a randomised controlled trial of a preconsultation web-based intervention (Presenting Asking Checking Expressing (PACE-D)) to improve the quality of care and clinical outcomes in patients with diabetes. Design and setting A feasibility study (with randomisation) conducted at outpatient diabetes clinics at two secondary care hospitals in Devon, UK. Participants People with diabetes (type 1 and type 2) attending secondary care general diabetes outpatient clinics. Intervention The PACE-D, a web-based tool adapted for patients with diabetes to use before their consultation to generate an agenda of topics to discuss with their diabetologist. Outcomes The percentage of eligible patients who were recruited and the percentage of participants for whom routine glycosylated haemoglobin (HbA1c) data (the putative primary outcome) could be extracted from medical notes and who completed secondary outcome assessments via questionnaire at follow-up were reported. Results In contrast with the planned recruitment of 120 participants, only 71 participants were randomised during the 7-month recruitment period. This comprised 18.7% (95% CI 14.9% to 23.0%) of those who were eligible. Mean (SD) age of the participants was 56.5 (12.4) years and 66.2% had type 1 diabetes. Thirty-eight patients were randomised to the intervention arm and 33 to the control arm. HbA1c data were available for only 73% (95% CI 61% to 83%) of participants at the 6 months follow-up. The questionnaire-based data were collected for 66% (95% CI 54% to 77%) of the participants at 6 months follow-up. Participants reported that the PACE-D tool was easy to use. Conclusions A randomised controlled trial of the preconsultation web-based intervention as set out in our current protocol is not feasible without significant modification to improve recruitment and follow-up of participants. The study also provides insights into the feasibility and challenges of conducting complex intervention trials in everyday clinical practice. Trial registration ISRCTN75070242