Exploring Paradigms in Postpartum Depression Research: The Need for Feminist Pragmatism

Postpartum depression (PPD) is an important area of women's health research internationally and across disciplines. There is no guiding paradigm, however, to ensure that PPD research results translate to women on a global level. This commentary builds on the work of Doucet, Letourneau, and Stoppard (2010 Doucet, S.A., Letourneau, N.L., & Stoppard, J.M. (2010). Contemporary paradigms for research related to women's mental health. Health Care for Women International, 31, 296–312.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) to determine a “best fit” paradigm with which to guide PPD research. Postpositivism, critical theory, constructivism, and pragmatism are combined with a feminist ideology and critiqued as potential guiding paradigms for PPD research. After thorough examination, I conclude the need for further use of a feminist pragmatist paradigm in PPD research.     

A Further Extension of the Extended Parallel Process Model (E-EPPM): Implications of Cognitive Appraisal Theory of Emotion and Dispositional Coping Style

For two decades, the extended parallel process model (EPPM; Witte, 1992 Witte, K. 1992. Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs, 59: 330–349. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) has been one of the most widely used theoretical frameworks in health risk communication. The model has gained much popularity because it recognizes that, ironically, preceding fear appeal models do not incorporate the concept of fear as a legitimate and central part of them. As a remedy to this situation, the EPPM aims at “putting the fear back into fear appeals” (Witte, 1992 Witte, K. 1992. Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs, 59: 330–349. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar], p. 330). Despite this attempt, however, this article argues that the EPPM still does not fully capture the essence of fear as an emotion. Specifically, drawing upon Lazarus's (1991 Lazarus, R. S. 1991. Emotion and adaptation, New York, NY: Oxford University Press.  [Google Scholar]) cognitive appraisal theory of emotion and the concept of dispositional coping style (Miller, 1995 Miller, S. M. 1995. Monitoring versus blunting styles of coping influence the information patients want and need about cancer: Implications for cancer screening and management. Cancer, 76: 167–177. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), this article seeks to further extend the EPPM. The revised EPPM incorporates a more comprehensive perspective on risk perceptions as a construct involving both cognitive and affective aspects (i.e., fear and anxiety) and integrates the concept of monitoring and blunting coping style as a moderator of further information seeking regarding a given risk topic.     

Food Insecurity,Food and Nutrition Programs,and Aging: Experiences from Georgia

Food insecurity and hunger are real and growing problems in the United States. Among older adults, the prevalence of food insecurity is at a 14-year high and occurred in more than 8% of households with older adults in 2008 according to USDA. However, the rate is at least 10% higher when less severe degrees of food insecurity are considered. Emerging research suggests that several segments of the older adult population are particularly vulnerable to food insecurity, including those receiving or requesting congregate meals, home-delivered meals, and other community-based services. Thus, national and state estimates of food insecurity may obscure problems in specific subgroups of older adults. Older adults are at high risk of chronic health problems that can be exacerbated by food insecurity, poor nutritional status, and low physical activity. To help improve targeting of food and nutrition programs to those most in need because of food insecurity and/or nutrition-related chronic health problems, the purposes of this review are (1 U.S. Administration on Aging. A profile of older Americans. 2009 . Accessed at http://www.aoa.gov/aoaroot/aging_statistics/Profile/index.aspx on 10 March 2010.  [Google Scholar]) to define the prevalence and consequences of food insecurity; (2 Wolff JL , Starfield B , Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly . Arch Intern Med. 2002 ; 162 ( 20 ): 2269 – 76 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) to discuss the outcomes of some food, nutrition, disease prevention, and health promotion programs targeted to older adults in Georgia, the state with the 3rd highest prevalence of food insecurity; and (3 Kamp BJ , Wellman NS , Russell C. Food and nutrition programs for community-residing older adults—position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education . J Am Diet Assoc. 2010 ; 110 ( 3 ): 463 – 72 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) to make recommendations for research, service, and advocacy related to monitoring and alleviating food insecurity and related health problems in older adults.     

The Milspouse Battle Rhythm: Communicating Resilience Throughout the Deployment Cycle

Military spouses (milspouses) enact resilience through communication before, during, and after military deployments. Based on an organizing framework of resilience processes (Buzzanell, 2010 Buzzanell, P. M. 2010. Resilience: Talking, resisting, and imagining new normalcies into being. Journal of Communication, 60: 1–14. [Crossref], [Web of Science ®] , [Google Scholar]), this study examined milspouses’ communicative construction of resilience during an increasingly rapid military deployment cycle. Narratives from in-depth interviews with military spouses (n?=?24) revealed how resilience is achieved through communication seeking to reconcile the often contradictory realities of milspouses who endure physical, psychological, and social difficulties due to prolonged separations from their partners.     

Screening for health risks: A second editorial

This editorial discusses nine papers concerned with health risk screening, and two papers reporting original research on risk management for children and adolescents. Five of the screening papers were published in a previous issue of Health, Risk & Society (Vol. 12, No. 1) along with an analytic editorial. This issue (Vol. 12, No. 2) contains an annexe with four additional screening papers plus a second editorial covering all nine papers. The papers illustrate the increasing scope of screening applications ‘from the cradle to the grave’. They cover risk screening for Down's syndrome (Gross 2010 Gross, S.E. 2010. ‘The alien baby’: Risk, blame and prenatal indeterminacy. Health, risk & society, 12(1): 21–31. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), child welfare and protection (Munro 2010 Munro, E. 2010. Conflating risks: Implications for accurate risk prediction in child welfare services. Health, risk & society, 12(2): 119–130. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Parton 2010 Parton, N. 2010. `From dangerousness to risk': The growing importance of screening and surveillance systems for safeguarding and promoting the well-being of children in England. Health, risk & society, 12(1): 51–64. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), Chlamydia (Balfe 2010 Balfe, M. 2010. Why don't young women go for Chlamydia testing? A qualitative study employing Goffman's stigma framework. Health, risk & society, 12(2): 131–148. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), mental health service user violence (Langan 2010 Langan, J. 2010. Challenging assumptions about risk factors and the role of screening for violence risk in the field of mental health. Health, risk & society, 12(2): 85–100. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), Huntingdon's disease (Leontini 2010 Leontini, R. 2010. Genetic risk and reproductive decisions with respect to Huntingdon's disease. Health, risk & society, 12(1): 7–20. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), coronary heart disease (Peckham and Hann 2010 Hann, A. and Peckham, S. 2010. Cholesterol screening and the Gold effect. Health, risk & society, 12(1): 33–50. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), cancer (Craddock Lee 2010 Craddock Lee, S. J. 2010. Uncertain futures: Individual risk and social context in decision-making in cancer screening. Health, risk & society, 12(2): 101–117. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), and dementia (Milne 2010 Milne, A. 2010. Dementia screening and early diagnosis: The case for and against. Health, risk & society, 12(1): 65–76. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]). The screening papers fall into two strands: one questioning the utility of current systems (Langan 2010 Langan, J. 2010. Challenging assumptions about risk factors and the role of screening for violence risk in the field of mental health. Health, risk & society, 12(2): 85–100. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Milne 2010 Milne, A. 2010. Dementia screening and early diagnosis: The case for and against. Health, risk & society, 12(1): 65–76. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Munro 2010 Munro, E. 2010. Conflating risks: Implications for accurate risk prediction in child welfare services. Health, risk & society, 12(2): 119–130. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Parton 2010 Parton, N. 2010. `From dangerousness to risk': The growing importance of screening and surveillance systems for safeguarding and promoting the well-being of children in England. Health, risk & society, 12(1): 51–64. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Peckham and Hann 2010 Hann, A. and Peckham, S. 2010. Cholesterol screening and the Gold effect. Health, risk & society, 12(1): 33–50. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]); the other presenting original findings concerning the perspectives of eligible candidates (Balfe 2010 Balfe, M. 2010. Why don't young women go for Chlamydia testing? A qualitative study employing Goffman's stigma framework. Health, risk & society, 12(2): 131–148. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Craddock Lee 2010 Craddock Lee, S. J. 2010. Uncertain futures: Individual risk and social context in decision-making in cancer screening. Health, risk & society, 12(2): 101–117. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Gross 2010 Gross, S.E. 2010. ‘The alien baby’: Risk, blame and prenatal indeterminacy. Health, risk & society, 12(1): 21–31. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], Leontini 2010 Leontini, R. 2010. Genetic risk and reproductive decisions with respect to Huntingdon's disease. Health, risk & society, 12(1): 7–20. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]). The two papers concerned with children and adolescents, published in the second part of the present issue, also consider risk perspectives, with particular reference to cultural comparisons. These papers focus on attitudes to and knowledge about sexual health in relation to uncertainty about the future (Davis and Niebes-Davis 2010 Davis, M. J. and Niebes-Davis, A. J. 2010. Ethnic differences and influence of perceived future certainty on adolescent and young adult sexual knowledge and attitudes. Health, risk & society, 12(2): 149–167. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]), and parental views about children's exposure to environmental pollution (Dabrowska and Wismer 2010 Dabrowska, E. and Wismer, S. K. 2010. Inclusivity matters: Perceptions of children's health and environmental risk including Old Order Mennonites from Ontario, Canada. Health, risk & society, 12(2): 169–188. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]).     

An ecological model for understanding culture as a determinant of women's health

In combination with gender and culture, the authors argue that the migratory experience must be considered as a determinant of the health of immigrant women in its own right. Gender and other symbolic institutions are seen as intertwined in an ecological model of health. Bronfenbrenner's (1986 Bronfenbrenner, U. 1986. Ecology of the family as a context for human development: research perspectives. Developmental Psychology, 22(6): 723–742. [Crossref], [Web of Science ®] [Google Scholar]) systems theory and a combination of theories of social cognition, social exchange and symbolic interaction articulated by Howard and Hollander (1997 Howard, JA and Hollander, J. 1997. Gendered Situations, Gendered Selves, Thousand Oaks, CA: Sage.  [Google Scholar]) expand the ecological model. Cognitive schemas of gender and culture help explain the process of integration in a new locality over time. Success in addressing the health of immigrant women will be limited if the impact of migration and at the meso- and macro-levels is ignored in favour of a focus on the individual.     

A Meta-Analysis of the Effectiveness of Health Belief Model Variables in Predicting Behavior

The Health Belief Model (HBM; Rosenstock, 1966 Rosenstock, I. M. 1966. Why people use health services. Milbank Memorial Fund Quarterly, 44: 94–127. [Crossref], [PubMed] , [Google Scholar]) was constructed to explain which beliefs should be targeted in communication campaigns to cause positive health behaviors. The model specifies that if individuals perceive a negative health outcome to be severe, perceive themselves to be susceptible to it, perceive the benefits to behaviors that reduce the likelihood of that outcome to be high, and perceive the barriers to adopting those behaviors to be low, then the behavior is likely for those individuals. A meta-analysis of 18 studies (2,702 subjects) was conducted to determine whether measures of these beliefs could longitudinally predict behavior. Benefits and barriers were consistently the strongest predictors. The length of time between measurement of the HBM beliefs and behavior, prevention versus treatment behaviors, and drug-taking regimens versus other behaviors were identified as moderators of the HBM variables' predictive power. Based on the weakness of two of the predictors, the continued use of the direct effects version of the HBM is not recommended.     

Redefining Boundaries: A Grounded Theory Study of Recidivism in Women

Incarceration rates for women in the United States are at least three times greater than those of any other nation (National Council on Crime and Delinquency, 2006 Sandelowski, M. and Barroso, J. 2002. Finding the findings in qualitative studies. Journal of Nursing Scholarship, 34: 213–219. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Recidivism, reoffense following prior conviction for a crime, compounds this problem, with nearly seven out of 10 convicted persons in the United States rearrested within 3 years of release (Hughes & Wilson, 2003 Hutchinson, S. A. and Wilson, H. 2001. “Understanding clients’ health care decisions: A grounded-theory approach”. In Qualitative methods for nursing research , 2nd ed., Edited by: Munhall, P. 245–276. Sudbury, MA: Jones and Bartlett Publishers.  [Google Scholar]). Our purpose in this article is to present a grounded theory of recidivism from the perspective of incarcerated women and to discuss the public health and other societal implications. While the participants in this research were U.S. women, we hope to provide a new perspective on the decision making of some women that results in recidivism, in order to initiate dialogue that could lead to more effective interventions worldwide.     

‘The Troubles’, geographies of mental health in Northern Ireland and re-conceptualizing social capital

Current research suggests that the presence of social capital (Putnam, 1993 Putnam, RD. 1993. The prosperous community: Social capital and public life. American prospect, 13: 35–42.  [Google Scholar]) in a community setting positively affects physical and psychological health and well-being. Indeed, McKenzie et al. (2002 McKenzie, K, Whitley, B and Weich, S. 2002. Social capital and mental health. British journal of psychiatry, 181: 280–283. [Crossref], [PubMed], [Web of Science ®] [Google Scholar]) highlighted the impact of social context on mental health and noted that social capital may be influential in the incidence and prevalence of mental illness. The authors suggested that studies of the geographies of mental health could also be useful in understanding the relationship between social capital and psychological health and well-being but note that this relationship is likely to be complex. The purpose of this paper is to develop the commentary from McKenzie et al. further and consider the relationship between social capital, psychological health and a society experiencing conflict. Social capital is often described as the glue that holds society together, producing a positive environment for a community to foster and thrive. Little attention has focused on the relationship between social capital and psychological health and well-being when specific communities experience (and/or contribute to) political strife and civil disorder. One would assume that social capital at the horizontal level is minimal in these cases as civil conflict acts as a barrier to its production. This would have a deleterious effect on psychological health and well-being. The issues outlined above are explored in the context of one region of the United Kingdom currently experiencing civil conflict: Northern Ireland. Social capital theory is re-conceptualized in this light.     

The Impact of the Cox-2 Inhibitor Issue on Perceptions of the Pharmaceutical Industry: Content Analysis and Communication Implications

The field of risk communication has its roots in the environmental, chemical, space, and nuclear arenas. As a number of these sectors have now vastly improved their communication strategies, attention is being placed on sectors that have been more problematic as of late. Examples of such sectors, include the food industries and the pharmaceutical/health sector. This article focuses on how large, multinational pharmaceutical companies can better communicate risks by analysis of one specific case, namely, that of the Cox-2 controversy. ^{1 1}It should be noted that this article focuses strictly on the risk communication aspects surrounding the COX-2 scare. It does not deal with the science of COX-2 drugs, nor does it attempt to come to grips with their actual benefits and risks, as this is beyond the scope of this article and has been discussed elsewhere (e.g., Psaty & Furberg, 2005 Psaty , B. M. & Furberg , C. D. ( 17 March , 2005 ). Cox-2 inhibitors—Lessons in drug safety . New England Journal of Medicine , 352 , 1133 – 1135 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). For purposes of this article, risk communication is best described as “the flow of information and risk evaluations back and forth between academic experts, regulatory practitioners, interest groups and the general public,” and “big pharma” refers to the more traditional R & D-based, innovative pharmaceutical companies.     

Intentional Seroconversion in the Gay Community: The Social Work Role in Assessment and Intervention

ABSTRACT

There is a reported increase of intentional seroconversion in the United States over the past several years in the gay community (Crossley, 2004 Crossley, M. 2004. Making sense of bare backing: Gay men's narratives on unsafe sex. Resistance Habitus. British Journal of Social Psychology, 43(2): 225–244. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Trinufol, 2003). This article reports on a sample (n = 24) of men who identify their motivations behind their pursuit of seroconversion. Respondents were asked to identify what motivations were connected to their attempt to become seropositive. Three general variables emerged as potential indicators: (1) seeking relief from emotional HIV fatigue, (2) the wish to be closer with one's HIV positive partner, and (3) the expectation to become HIV positive. By identifying these possible motivations (both psychological and sociocultural), sex educators and therapists providing counseling to the gay male community may be better equipped to more effectively identify clients at high risk for intentional seroconversion. Recommendations for assessment and intervention with those at high risk for such behaviors are provided by the authors.     

Does Psychotherapy Supervision Contribute to Patient Outcomes? Considering Thirty Years of Research

After a century of psychotherapy supervision and over half a century of supervision research, what do we know empirically about the contribution of psychotherapy supervision to patient outcomes? In this article, I address that question by (1) assembling all identified supervision-patient outcome studies, from 1981 to 2006, referenced in four reviews (Ellis & Ladany, 1997 Ellis , M. V. , & Ladany , N. ( 1997 ). Inferences concerning supervisees and clients in clinical supervision: An integrative review . In C. E. Watkins , Jr. (Ed.), Handbook of psychotherapy supervision (pp. 447 – 507 ). New York : Wiley . [Google Scholar]; Freitas, 2002 Freitas , G. J. ( 2002 ). The impact of psychotherapy supervision on client outcome: A critical examination of 2 decades of research . Psychotherapy , 39 , 354 – 367 .[Crossref], [Web of Science ®] , [Google Scholar]; Inman & Ladany, 2008 Inman , A. G. , & Ladany , N. ( 2008 ). Research: The state of the field . In A. K. Hess , K. D. Hess , & T. H. Hess (Eds.), Psychotherapy supervision: Theory, research, and practice ( , 2nd ed. , pp. 500 – 517 ). Hoboken , NJ : Wiley . [Google Scholar]; Wheeler & Richards, 2007 Wheeler , S. , & Richards , K. ( 2007 ). The impact of clinical supervision on counselors and therapists, their practice and their clients: A systematic review of the literature . Counselling and Psychotherapy Research , 7 , 54 – 65 .[Taylor & Francis Online] , [Google Scholar]) and (2) identifying additional post-review studies by means of computer searches, spanning January 2006 through May 2011. A total of 18 supervision outcome studies emerged, spanning the past generation of supervision scholarship. Unfortunately, after closely scrutinizing each investigation, eliminating misidentified studies (constituting over one-third of the 18 studies), and weighing the gravity of various methodological deficiencies across investigations, the collective data appeared to shed little new light on the matter: We do not seem to be any more able to say now (as opposed to 30 years ago) that psychotherapy supervision contributes to patient outcome. What did emerge of considerable promise, however, were three recent studies that were developed, organized, and prosecuted with the primary objective of evaluating the effects of supervision on patient outcome. Those investigations were highlighted because, in my view, they point the way for future studies to follow (in ways not done before) and are prototypal in their design and execution. Although the difficulty in researching the supervision-patient outcome matter has long been lamented in the supervision literature, those few studies (especially Bambling, King, Raue, Schweitzer, & Lambert, 2006) indeed show us for the first time that research on supervision-patient outcome can be done and be done well.     

Media Use and Health Information Seeking: An Empirical Test of Complementarity Theory

This study compares cancer victims and cancer-free adults' use of communication channels for health information. It tests the complementarity theory (Dutta-Bergman, 2004a Dutta-Bergman, M. J. 2004a. Complementarity in consumption of news types across traditional and new media. Journal of Broadcasting & Electronic Media, 48: 41–60. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar], 2004b Dutta-Bergman, M. J. 2004b. Interpersonal communication after 9/11 via telephone and Internet: a theory of channel complementarity. New Media & Society, 6: 659–673. [Crossref], [Web of Science ®] , [Google Scholar]) with a subsample of the Health Information National Trends Survey data. The complementarity of communication channels for health information use is confirmed on 3 different levels: complementarity among mass media channels, including traditional media and the Internet; complementarity between the interpersonal channel and mass media channels; and complementarity between the interpersonal channel and mass media channels after controlling for illness severity. This study provides strong support for complementarity theory, and extends the complementarity hypothesis into the realm of interpersonal channels of communication. Finally, this investigation suggests cancer victims use the media for health information differently than adults who have not been diagnosed with cancer.     

Critical reflections on the field of tobacco research: The role of tobacco control in defining the tobacco research agenda

In recent years, tobacco research, as a field of investigative practices, has come to be seen as a major contributor to broader tobacco control efforts and a ‘significant component of the global health agenda’ (World Health Organization (1999 World Health Organisation. 1999. Confronting the epidemic: A global agenda for tobacco control research, Geneva: WHO.  [Google Scholar]). Confronting the epidemic: A Global Agenda For Tobacco Control Research. Geneva: WHO, p. 14; Warner, K. E. (2005 Warner, K. E. 2005. The role of research in international tobacco control. American Journal of Public Health, 95: 976–984.  [Google Scholar]). The role of research in international tobacco control. American Journal of Public Health, 95(6), 976–984). However, despite some discussion about the research-specific implications of, for instance, the Framework Convention on Tobacco Control (FCTC) (World Health Organisation (2003a World Health Organisation. 2003a. The framework convention on tobacco control, Geneva: WHO. ratified 2005 [Google Scholar]) (ratified 2005). The Framework Convention on Tobacco Control. Geneva: WHO, Articles 20–22), questions remain about what the exact nature of the relationship between tobacco research and tobacco control should be. Guided by that central question, this article draws attention to recent attempts to define this relationship, in particular that embodied in the Global Tobacco Research Network (GTRN), in order to facilitate debate on how such definitions attempt to shape the research agenda. Throughout, the main critical focus will be the attempt to generate characterizations of the field, through entities like the GTRN, which relate tobacco-related research practices vis-à-vis their relationship to tobacco control. It is argued that such characterizations present a distorted and oversimplified picture of how we might assess the empirical work we find across the field as a whole. Tracing these difficulties back to the narrow normative position embodied within the GTRN and World Health Organization approach to tobacco research, the article concludes by arguing that there is a need to recognize, rather than correct for, the overlapping and diverse bodies of work which the study of tobacco-related questions has helped establish.     

The sociology of risk and uncertainty: A response to Judith Green's ‘Is it time for the sociology of health to abandon “risk”?’

This article responds to Judith Green's (2009 Green, J. 2009. Is it time for the sociology of health to abandon ‘risk’?. Health, Risk & Society, 11(6): 493–508. [Taylor & Francis Online], [Web of Science ®] [Google Scholar], p. 493–508, this issue) contribution ‘Is it time for the sociology of health to abandon “risk”?’ It agrees with some of Green's criticisms of risk studies, but argues that rather than abandoning the concept of risk it should be refined and developed. Even though Green is right to have concerns about narrow approaches to social reality she follows a narrow perspective herself, which is atypical for sociological approaches to risk. She starts with criticism of the overemphasis on risk in research on the sociology of health but seem to shift to a general critique of risk research and focuses on one particular approach. Sociological risk research, I would argue, provides a critique of precisely those reductionist approaches to risk which Green sees as narrowing the focus of risk to concepts of rational decision making, technical calculation and risk assessment. Her examples, however, indicate a range of problems, but less with the concept of risk but rather methodological weaknesses, issues of operationalisation of macro theory and a technical understanding of risk which are altogether problematic not only in the realm of risk but for sociological approach to social reality in general. Instead of questioning risk I point to ways in which sociological risk research can be systematised. I show that Green's analysis has weaknesses that are conceptually important. In particular, she does not clearly distinguish between several levels of analysis such as institutional self representation and everyday practice, the risk society as a specific theory and the sociology of risk and uncertainty as an area of research and risk as an analytical approach and a research object. I argue that sociological approaches to risk already work with other distinctions than rational/subjective and some research even shows how such distinctions can be overcome to open further perspectives for risk research.     

Making the journey to school: The gendered and generational aspects of risk in constructing everyday mobility

In an increasingly mobile and risk-centred world, the focus of academic attention is often on global movements of people, commodities, wages, finance and information, and on global risks such as environmental deterioration, pandemics and terrorism (Beck 1992 Beck, U. 1992. Risk society: towards a new modernity, London: Sage. [Crossref] [Google Scholar], Adams 1999 Adams, J. 1999. The social implications of hypermobility, Paris: OECD.  [Google Scholar], 2005, Urry 2000 Urry, J. 2000. Sociology beyond societies, mobilities for the twenty-first century, London: Routledge.  [Google Scholar]). However, everyday life, with everyday mobilities and everyday risk are more often the predominant concern of the majority of citizens in the West (Tulloch and Lupton 2003 Tulloch, J. and Lupton, D. 2003. Risk and everyday life, London: Sage.  [Google Scholar]). This paper is situated at this more local level, aimed at understanding a microcosm of everyday life: the corporeal mobilities of the journey to school, drawing out broader implications for a society shaped by both risk and mobility. In particular, the discussion here follows on from Jenkins' (2006 Jenkins, N. E. 2006. ‘You can't wrap them up in cotton wool!’ Constructing risk in young people's access to outdoor play. Health, risk & society, 8(4): 379–393. [Taylor & Francis Online], [Web of Science ®] [Google Scholar]) paper on risk, parenting and young people in using socio-cultural theory to question the assumptions made about parental management of risks to their children and particularly theories of ‘paranoid parenting’ (Furedi 2001 Furedi, F. 2001. Paranoid parenting, London: Penguin.  [Google Scholar]). It is argued here that it is localised everyday risk discourses, and their construction according to gender and generation, that are most significant in shaping mobility.     

Label Management: Investigating How Confidants Encourage the Use of Communication Strategies to Avoid Stigmatization

In modified labeling theory, Link and colleagues (1987 Link, B. G., Cullen, F. T., Frank, J. and Wozniak, J. F. 1987. The social rejection of former mental patients: Understanding why labels matter. American Journal of Sociology, 92: 1461–1500. [Crossref], [Web of Science ®] , [Google Scholar], 1989) Link, B. G., Cullen, F. T., Struening, E. L., Shrout, P. E. and Dohrenwend, B. P. 1989. A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54: 400–423. [Crossref], [Web of Science ®] , [Google Scholar] explicate how people use communication to cope with being labeled as members of a stigmatized group. In this paper, we change perspectives and investigate how a confidant's awareness of discrimination and devaluation associated with being labeled as a member of a stigmatized group (“mentally ill” or “smoker”) motivates him or her to encourage a labeled loved one to engage in secrecy, withdrawal, or education to avoid the adverse actions associated with stigmatization. Results showed that a model of relationships among perceived devaluation and discrimination, coping strategies, and future disclosures extended well to unexpected confidants of a labeled loved one. This advice included encouraging the labeled loved one not to tell different people about their condition, which included health care providers. These findings also showed that people with experience in the labeling condition may have particular concern about stigmatization or rejection from different types of listeners, including close friends and health care providers.     

Cystic fibrosis adults' perception and management of the risk of infection with Burkholderia cepacia complex

The risk of infection for cystic fibrosis patients from Burkholderia cepacia complex pathogens is of increasing concern to doctors and scientists. This paper reports on how these patients perceive and manage the risk of cepacia infection using Douglas and Calvez's (1990 Douglas, M. and Calvez, M. 1990. The self as a risk taker: A cultural theory of contagion in relation to AIDS. The Sociological Review, 38: 445–464. [Crossref], [Web of Science ®] [Google Scholar]) typology of four cultures of the community (the central community, dissenting enclaves, isolates, and individualists) and Douglas' works on pollution, risk, and culture. We attempt to develop Douglas's cultural theory in the light of the data, which were drawn from in-depth interviews with 31 adults with cystic fibrosis attending a specialist treatment centre in the UK. We found that our respondents' group membership depended on their health state and contact with the hospital. The central community of adults was found to be dispersing to form a series of isolates, perceiving others who may potentially have infection as individualists. Due to the nature of cepacia infection, no dissenting enclave was identified for this group. Medical and lay uncertainty in testing for infection and managing the risk of its spread was expressed by the majority of adults, many of whom admitted that they limited hospital attendance as a part of managing such risk.     

The Heroic Supervisor: Using the Hero's Journey to Facilitate Development in Supervisors-in-Training

This qualitative study explored the perspectives of nine supervisors-in-training to understand how they used metaphoric stories containing the hero's/heroine's journey to conceptualize their process of transitioning from counselor to supervisor. Analysis revealed a three-phase process of counselor supervisor development similar to the process of development and transformation described in both the constructivist model of change (Mahoney, 2006 Mahoney, M. J. (2006). Constructive psychotherapy: Theory and practice. New York, NY: The Guilford Press. [Google Scholar]) and the hero's journey (Campbell, 1988 Campbell, J. (1988). The power of myth. New York, NY: Doubleday. [Google Scholar]). Results also indicated that conceptualizing their development as supervisors using the stories provided students with a valuable opportunity for critical self-reflection and meaning making. Suggestions for clinical supervision practice, training, and future research are discussed.