Media content analysis of the introduction of a “soft opt‐out” system of organ donation in Wales 2015‐17

In an attempt to improve organ donation rates, some countries are considering moving from “opt‐in” systems where citizens must express their willingness to be an organ donor, to “opt‐out” systems where consent is presumed unless individuals have expressed their wishes otherwise, by, for example, joining an “opt‐out” register. In Wales—a part of the United Kingdom—the devolved government recently legislated for an “opt‐out” system. For the change to be effective, a public awareness campaign was critical to the policy's success. Using quantitative and qualitative content analysis, we explored media coverage of the change to better understand the relationship between the state, policy actors, media and the public when such policy changes take place. Our findings illustrate how a state communication campaign can effectively set the media agenda within which we saw a degree of interdependency created with the state using the media to promote policy, and the media relying on the state for credible information. Yet we also found that the media is not uncritical and observed how it uses its autonomy to influence policy setting. Over the period of study, we found that a change in tone and view towards deemed consent organ donation has taken place in the media. However, while this may influence or reflect public attitudes, it is yet to be seen whether the media campaign translates into behavioural change that will result in increases in organ donations.     

The vaccination debate in the “post‐truth” era: social media as sites of multi‐layered reflexivity

This paper analyses the contemporary public debate about vaccination, and medical knowledge more broadly, in the context of social media. The study is focused on the massive online debate prompted by the Facebook status of the digital celebrity Mark Zuckerberg, who posted a picture of his two‐month‐old daughter, accompanied by a comment: ’Doctor's visit – time for vaccines!’ Carrying out a qualitative analysis on a sample of 650 comments and replies, selected through systematic random sampling from an initial pool of over 10,000 user contributions, and utilising open and axial coding, we empirically inform the theoretical discussion around the concept of the reflexive patient and introduce the notion of multi‐layered reflexivity. We argue that the reflexive debate surrounding this primarily medical problem is influenced by both biomedical and social scientific knowledge. Lay actors therefore discuss not only vaccination, but also its political and economic aspects as well as the post‐truth information context of the debate. We stress that the reflexivity of social actors related to the post‐truth era re‐enters and influences the debate more than ever. Furthermore, we suggest that the interconnection of different layers of reflexivity can either reinforce certainty or deepen the ambiguity and uncertainty of reflexive agents.     

“Potentially” contaminating behavioural practices in the preparation, feeding and storage of “ogi” — an infant cereal in a rural Nigerian community

Thirty households with children aged 6-18 months from four villages in the Badagry Local Government Area of Lagos State, Nigeria were studied. Open-ended unstructured ethnographic interviews were used to collect information on “potentially” contaminating food handling behaviour with particular reference to the preparation, feeding and storage of “ogi” an infant cereal. Focus group studies were conducted for women aged 18-45 years in the four villages to obtain more information.

Improper handwashing, widespread acceptance and use of feeding bottles, long storage and safety of place of storage were some of the “potentially” contaminating behavioural patterns identified.

Intensive health education on the dangers of feeding bottles, improper hand-washing and long storage of cooked “ogi” to the health of infants and young children is strongly recommended.     

“I luv u :)!”: A Descriptive Study of the Media Use of Individuals in Romantic Relationships

In this study, we address the communication technologies individuals within romantic relationships are using to communicate with one another, the frequency of use, and the association between the use of these technologies and couple's positive and negative communication. Participants consisted of individuals involved in a serious, committed, heterosexual relationship. The Relationship Evaluation Questionnaire instrument was used to assess a variety of relationship variables. The majority of individuals within the study frequently used cell phones and text messaging to communicate with their partner, with “expressing affection” being the most common reason for contact. Younger individuals reported using all forms of media (except for e‐mail) more frequently than older participants. Relationship satisfaction did not predict specific use of media but predicted several reasons for media use. Additional analyses revealed that text messaging had the strongest association with individuals' positive and negative communication within their relationships. Specifically, text messaging to express affection, broach potentially confrontational subjects, and to hurt partners were associated with individuals' view of positive and negative communication within their relationship. Implications of the results are discussed.     

Integrated care in action: opening the “black box” of implementation

The aim of this contribution is to explain how healthcare professionals implement policies for integrated care. More specifically, we aim to understand how these policies are received, interpreted and executed by primary care professionals. By opening the “black box” of policy implementation, we also explain how and why the process of implementation of the same policy diverges in practice. The research is framed according to both the neo‐institutional and the change management perspectives. The empirical investigation is conducted through a documental analysis and a multiple‐embedded case study. The results show that three forces affect and explain differences in the implementation processes: the unstable level of internal communication among the professionals involved, the limited use of power to resist to change and the poor learning process on the part of both the professionals and policy makers. The pressure of external institutions does not play a role in shaping the process. Through our study, we further knowledge about how healthcare professionals implement policies for integrated care, and we believe this is interesting, according to emerging evidence that variations in the effectiveness of policy outcomes may be explained by choices and potential distortions made during the initial stages of the policy implementation process. Copyright © 2015 John Wiley & Sons, Ltd. StartCopTextCopyright © 2015 John Wiley & Sons, Ltd.     

Adolescent girls, illegal abortions and “sugar-daddies” in Dar es Salaam: vulnerable victims and active social agents

Adolescent girls’ early sexual activity, early pregnancy, induced abortions and the increase in HIV infections have become major concerns in Sub-Saharan Africa. Efforts, though, to understand their sexual behaviour and to prevent reproductive health problems are almost non-existent. Adolescent girls are normally seen as victims and easy preys of (often older and married) men's sexual exploitation. This article, which is based on a qualitative study of 51 adolescent girls who had just had an illegal abortion in Dar es Salaam, Tanzania, reveals that these girls are not only victims but also willing preys and active social agents engaging in high-risk sexual behaviour. In order to get material benefits they expose themselves to serious health risks, including induced abortion — without realising their own vulnerability. In our study, one out of four girls had more than one partner at the time they became pregnant, and many counted on an illegally induced abortion if they got pregnant. Even if adolescents are now allowed free access to family planning information, education and services, our study shows that this remains in the realm of theory rather than practice. Moreover, most adolescent girls are not aware about their right to such services. The paper concludes that the vulnerability of adolescent girls increases without the recognition that sexuality education and contraceptive services do not constitute a licence to practice illicit sex — but rather a means to create more mature and responsible attitudes and to increase sexual and reproductive health.