Disruption, discontinuity and a licence to live: Responding to cancer diagnoses.

Although a diagnosis of a life-limiting cancer is likely to evoke emotions, such as fear, panic and anxiety, for some people it can also provide an opportunity to live life differently. This article is based on research undertaken in Aotearoa New Zealand on the topic of exceptional cancer trajectories. Eighty-one participants who had been identified as living with a cancer diagnosis longer than clinically expected were interviewed, along with 25 people identified by some of the participants as supporters in their journey. For some participants the diagnosis provided the opportunity to rethink their lives, to undertake lifestyle and consumption changes, to be culturally adventurous, to take up new skills, to quit work and to change relationships with others. The concepts of biographical disruption and posttraumatic growth are considered in relation to these accounts, and it is argued that the event of a cancer diagnosis can give license for people to breach social norms.

The problematic messages of nutritional discourse: A case-based critical media analysis.

Nutritional science has assumed a fundamental importance in shaping food meanings and practices in the developed world. This study critically analysed the content of one weekly nutrition column written by a nutritional expert in a popular New Zealand magazine, from a social constructionist perspective, to investigate how nutritional advice constructs food, food practices and eaters. The analysis identified a range of ways in which the nutrition information communicated in the articles was potentially problematic for readers. The articles advocated eating for health with recommendations based on nutritional science, but depicted nutritional information as inconclusive, changeable and open to interpretation. Fear-based messages were used to motivate making 'healthy' food choices, through linking 'unhealthy' food choices with fatness and chronic ill health. Unhealthy foods were portrayed as more enjoyable than healthy foods, social occasions involving food were constructed as problematic, and exercise was defined only as a way to negate food consumption. Healthy eating was portrayed as a matter of personal choice, obscuring the situational factors that impact on food choice and health. We conclude that the nutritional advice analysed in this study constructs a way of understanding food that, if internalised by eaters, may evoke anxiety, confusion and dissatisfaction around food and eating.

Home as a hybrid centre of medication practice.

This article presents research that explores how medications are understood and used by people in everyday life. An intensive process of data collection from 55 households was used in this research, which included photo-elicitation and diary-elicitation interviews. It is argued that households are at the very centre of complex networks of therapeutic advice and practice and can usefully be seen as hybrid centres of medication practice, where a plethora of available medications is assimilated and different forms of knowledge and expertise are made sense of. Dominant therapeutic frameworks are tactically manipulated in households in order for medication practices to align with the understandings, resources and practicalities of households. Understanding the home as a centre of medication practice decentralises the role of health advisors (whether mainstream or alternative) in wellness practices.

'A healthy lifestyle is a journey': exploring health perceptions and self-defined facilitators to health through photo-elicitation.

OBJECTIVE: The aim of this study was to explore health perceptions and self-defined facilitators to health in general population. An additional aim of the study was to assess if these perceptions were connected with the context of the Covid-19 pandemic. DESIGN: We applied photo-elicitation method by gathering original photographs and narratives (captions) via social media and e-mails. Participants (N = 50) were asked to answer the question: 'What does it mean to be healthy?'. Data were collected online in Poland. We generated and interpreted the main themes associated with common perceptions of health and self-defined facilitators to health using polytextual thematic analysis. RESULTS: The health perception themes were, health as: a 'long journey'; keeping balance; and self-acceptance. The main facilitators to health were: enjoyment of activities that are part of a healthy lifestyle; planning time for rest; contact with nature, and supportive relationships. Participants' perceptions of how Covid-19 impacted on their health differed. CONCLUSIONS: The findings provide evidence for individual health perceptions and self-defined facilitators to health and can support the development of future health interventions.

Blogging for weight loss: personal accountability, writing selves, and the weight-loss blogosphere.

Body weight is a key concern in contemporary society, with large proportions of the population attempting to control their weight. However, losing weight and maintaining weight loss is notoriously difficult, and new strategies for weight loss attract significant interest. Writing about experiences of weight loss in online journals, or blogging, has recently expanded rapidly. Weight-loss bloggers typically write about daily successes and failures, report calorie consumption and exercise output, and post photographs of their changing bodies. Many bloggers openly court the surveillance of blog readers as a motivation for accountability to their weight-loss goals. Drawing from a sample of weight-loss blogs authored by women, we explore three issues arising from this practice of disclosing a conventionally private activity within an online public domain. First, we examine motivations for blogging, focusing on accountability. Secondly, we consider the online construction of self, exploring how weight-loss bloggers negotiate discourses around fatness, and rework selves as their bodies transform. Finally, we consider the communities of interest that form around weight-loss blogs. This 'blogosphere' provides mutual support for weight loss. However, participating in online social spaces is complicated and bloggers must carefully manage issues of privacy and disclosure.

The mobile hermit and the city: considering links between places, objects, and identities in social psychological research on homelessness.

This article explores aspects of a homeless man's everyday life and his use of material objects to maintain a sense of place in the city. We are interested in the complex functions of walking, listening and reading as social practices central to how this man forges a life as a mobile hermit across physical and imagined locales. This highlights connections between physical place, use of material objects, imagination, and sense of self. Our analysis illustrates the value of paying attention to geographical locations and objects in social psychological research on homelessness.

A Personal Projects Analysis: examining adaptation to low back pain.

Personal Projects Analysis (PPA) offers an alternative approach to studying adaptation to illnesses. This study investigated adaptation to low back pain using PPA to examine the relationship between participants' perceptions of pain, and their functioning and well-being. Participants appraised their five most important projects on 26 dimensions, such as project value, success and difficulty. Factor analyses of the project ratings yielded five dispositions (Integrity, Personal Agency, Social Visibility, Pain Salience and Stressfulness). In regression analysis all five dispositions significantly predicted Physical and Social Function, Disruption of Roles, and Well-being. ;Pain Salience' was the strongest predictor of functional outcomes, and ;Stressfulness' was the best predictor of well-being.

Now let me tell you in my own words: narratives of acute and chronic low back pain.

PURPOSE: In the past, qualitative studies have focused on chronic low back pain (LBP), yet 90% of LBP is acute and episodic. The purpose of this study was to examine the broader experience (acute as well chronic) of LBP in the community. METHODS: This study was part of a Personal Project Analysis of adaptation to LBP. Participants answered an open-ended question that invited them to tell researchers about their LBP. The narratives were analysed using thematic content analysis and structure was analysed using the narrative types described in 'The Wounded Storyteller' (Frank A. The Wounded Story Teller: Body, Illness and Ethics. Chicago: The University of Chicago Press; 1995). FINDINGS: Two themes were identified: (1) the challenges to the authenticity of LBP and (2) the consequences of living with LBP, which had two threads: the disruption of life due to physical limitations, and the emotional distress incurred. The narratives were solely told as chaos narratives. CONCLUSIONS: The emotional and behavioural responses of individuals with LBP and the tensions that exist between the individual and others, especially healthcare providers, is explained in the context of LBP as a moral event. Understanding the narratives as chaos narratives provides insight into ways to improve the quality of the interactions between patients and health care providers.

New Zealand optometrists 2006: demographics, working arrangements and hours worked.

BACKGROUND: Optometry is a regulated health profession in NZ, with limited student places. With 650 registered optometrists in 2005, the optometrist to population ratio was 1 : 6,291 with no apparent national shortage. If optometrists registered in NZ do not actually live there, a workforce shortage is possible. This paper presents findings from the New Zealand Association of Optometrists 2006 workforce survey of members, which aimed to profile the NZ optometric workforce and to explore factors relating to workforce capacity, job stress and future planning. METHODS: A questionnaire was developed to collect information on employment status, hours worked and gender distribution of optometrists in New Zealand. It was circulated to 530 active members of the NZ Association of Optometrists representing 86 per cent of the available optometrists. Direct comparisons with the Australian optometric workforce numbers were also undertaken. RESULTS: Of the 243 respondents, 129 (53 per cent) were male. The median age of all respondents was 39 years (46 for males and 34 for females) and 75 per cent of the respondents were aged younger than 50 years. Fifty per cent had practised 15 years or less. Ten per cent of respondents had 'time-out' during their career and this was significantly more likely for females. Nearly half the respondents were self-employed (46 per cent) and eight per cent worked as locums. Part-time employees were more likely to be female and males were more likely to be in full-time self-employment. Half the group was under 40 (51 per cent), which accounted for 86 per cent of the full-time salaried arrangements. Those aged 30 to 39 included 52 per cent of the total part-time salaried workers. The average working week was 34 hours for women and 39 hours for men; the median was 40 hours for both groups. In the typical working week, 80 per cent of an optometrist's time was spent consulting with patients and five per cent was patient-related paperwork. The distribution of work arrangements was remarkably similar among New Zealand optometrists, New Zealand GPs and Australian optometrists. In 2006, there were 619 optometrists assessed as working in New Zealand. This equated to 544 EFTOs and a ratio of EFTO to population of 1 : 7,517. CONCLUSIONS: The New Zealand optometric workforce in 2006 was sufficient to meet the overall population needs. One-third of optometrists chose to work part-time and the proportion of female optometrists has increased over the past 15 years. In the face of expected increasing demand for optometric services, a targeted expansion of the workforce appears desirable.

Constructing health news: possibilities for a civic-oriented journalism.

Health is a very prominent news category. However, we know little about the production processes of journalists leading to the health stories we encounter on a daily basis. Such knowledge is crucial for ensuring a vibrant public sphere for health. This article draws on interviews with eight health journalists in New Zealand to document what they consider to constitute a health story, their professional norms and practices, their perceptions of audiences, and the need for increased civic deliberations regarding health. Journalists privilege biomedical stories involving lifestyle and individual responsibility, and have limited frames for presenting stories that involve socio-political concerns. Stories are strongly shaped by journalists' considerations of their target audience, the sources they draw on, their professional norms, and institutional practices. This results in the omission of stories that have relevance for minority and disadvantaged groups and limits the nature of the stories told to ones that reflect the views of the majority. However, journalists are also reflective about these issues and receptive to ways to overcome them. This raises possibilities for health researchers to engage with journalists in order to repoliticise health and promote a more civic-oriented form of health journalism.

Critical health psychology in New Zealand: Developments, directions and reflections.

We examine how critical health psychology developed in New Zealand, taking an historical perspective to document important influences. We discuss how academic appointments created a confluence of critical researchers at Massey University, how interest in health psychology arose and expanded, how the critical turn eventuated and how connections, both local and international, were important in building and sustaining these developments. We discuss the evolution of teaching a critical health psychology training programme, describe the research agendas and professional activities of academic staff involved and how this sustains the critical agenda. We close with some reflections on progress and attainment.

Nutritionism and the construction of 'poor choices' in families facing food insecurity.

The dominant research approach to both food insecurity and charitable meal provision is nutritionistic, deficit-orientated and ignores wider socio-economic issues. This reinforces existing power dynamics and overlooks the agency of people living food-insecure lives. We critique this dominant approach and draw on the everyday experiences of families facing food insecurity to ground an alternative approach that emphasises food as a social determinant of health.

Health inequalities and homelessness: considering material, spatial and relational dimensions.

Homelessness is a pressing health concern involving material hardship, social marginalization and restrained relationships between homeless and housed people. This article links relational aspects of homelessness, and its health consequences, with material and spatial considerations through the use of photo-elicitation interviews with 12 rough sleepers in London. We highlight the relevance of embodied deprivation for a health psychology that is responsive to the ways in which social inequalities can get under the skin of homeless people and manifest as health disparities.

Developing a critical media research agenda for health psychology.

This article outlines reasons why psychologists should concern themselves with media processes, noting how media are central to contemporary life and heavily implicated in the construction of shared understandings of health. We contend that the present research focus is substantially medicalized, privileging the investigation and framing of certain topics, such as the portrayal of health professionals, medical practices, specific diseases and lifestyle-orientated interventions, and restricting attention to social determinants of health as appropriate topics for investigation. We propose an extended agenda for media health research to include structural health concerns, such as crime, poverty, homelessness and housing and social capital.

Relocating alcohol advertising research: examining socially mediated relationships with alcohol.

This article reviews, critiques and politicises the positivist approaches that presently dominate alcohol advertising health research, and considers the benefits of a culturalist alternative. Positivist research in this area is identified as: (1) atheoretical and methods-driven; (2) restricted in focus, leaving critical issues unconsidered; and (3) inappropriately conceptualizing the 'normal' drinking person as rational and safe. The culturist alternative proposed is argued to present a more adequate framework, which can include and address problematic issues that are presently excluded, including: the pleasures associated with alcohol use, the involvements of 'normal' people in problem drinking, the inadequacy of present risk categories and the complexities of wider mediatory processes about alcohol in society. We argue for the adoption of more informed, culturalist approaches to alcohol advertising research.

How do environmental factors influence walking in groups? A walk-along study.

Insufficient attention has been given to the influence of context on health-related behaviour change. This article reports on walk-along interviews conducted with 10 leaders of walking groups while leading their groups to investigate the influence of contextual factors on walking behaviours in groups. Data analysis used ideas from thematic analysis and grounded theory, approaching the data inductively. We identified that characteristics of place influenced the type of walking that people do in groups and the processes used by walkers to make sense of their behaviours in the places they walk. This research provides insight into how place influences walking in groups. It also suggests recommendations for co-ordinators and policymakers that could be used to facilitate behaviour change, when designing interventions targeting public health within the community.

Moral discourses and pharmaceuticalised governance in households.

This article extends our understanding of the everyday practices of pharmaceuticalisation through an examination of moral concerns over medication practices in the household. Moral concerns of responsibility and discipline in relation to pharmaceutical consumption have been identified, such as passive or active medication practices, and adherence to orthodox or unorthodox accounts. This paper further delineates dimensions of the moral evaluations of pharmaceuticals. In 2010 and 2011 data were collected from 55 households across New Zealand and data collection techniques, such as photo- and diary-elicitation interviews, allowed the participants to develop and articulate reflective stories of the moral meaning of pharmaceuticals. Four repertoires were identified: a disordering society repertoire where pharmaceuticals evoke a society in an unnatural state; a disordering self repertoire where pharmaceuticals signify a moral failing of the individual; a disordering substances repertoire where pharmaceuticals signify a threat to one's physical or mental equilibrium; a re-ordering substances repertoire where pharmaceuticals signify the restoration of function. The research demonstrated that the dichotomies of orthodox/unorthodox and compliance/resistance do not adequately capture how medications are used and understood in everyday practice. Attitudes change according to why pharmaceuticals are taken and who is taking them, their impacts on social relationships, and different views on the social or natural production of disease, the power of the pharmaceutical industry, and the role of health experts. Pharmaceuticals are tied to our identity, what we want to show of ourselves, and what sort of world we see ourselves living in. The ordering and disordering understandings of pharmaceuticals intersect with forms of pharmaceuticalised governance, where conduct is governed through pharmaceutical routines, and where self-responsibility entails following the prescription of other agents. Pharmaceuticals symbolise forms of governance with different sets of roles and responsibilities.

Television documentary in New Zealand and the construction of doctors by lower socio-economic groups.

The medical profession remains central to the provision of health care and the treatment of illness within contemporary society. However, the image of doctors and the relationship of the profession with the public is contested. The public persona of doctors has been subjected to re-negotiation in recent years as a result of factors such as health care reforms, the increased autonomy of other health professionals, the rise of the health consumer, and well-publicised cases of medical misadventure. We argue that television viewing is one influential way through which images of medical doctors are socially negotiated. This paper explores the construction of doctors through an analysis of television health documentary coverage and the accounts of lower SES participants in New Zealand. It demonstrates how televised depictions of doctors are integrated into the lifeworlds of viewers. We show that multiple and often contradictory representations of doctors, within both television health coverage and the accounts of our participants, conflate the traditional characterization of the caring professional with more recently established characterizations such as the medical entrepreneur and the bungling quack. The result is a complex and contextually variable image of doctors that embodies tensions surrounding public anxiety over health care reform. Recourse to this more pluralistic image of doctors provides a way for participants to work through the dilemmas posed by reduced access to medical care and the uncertainties of medical treatment, while still maintaining support for universal access to medical care.

Food and health: expanding the agenda for health psychology.

In this article I consider the changing context and constitution of food in contemporary society, and the variety of ways it is bound up in health, identity and social relations. In particular, I briefly discuss the position of food in health, illness, embodiment, and the ways that food is becoming increasingly medicalized and politicized. I suggest that the treatment of food in health psychology research has frequently been overly simplistic, and argue that we need to take greater account of the complexity of food and its intricate relations to health and illness in our research if we are to investigate this topic comprehensively, and seek to contribute to better understandings and outcomes for people.

Nutritional health messages in women's magazines: a conflicted space for women readers.

Media representations of food are ubiquitous in contemporary society, and healthy eating features predominantly in such texts. This study explores the discursive construction of food and healthy eating in texts appearing in popular women's magazines, and examines the variety of positions and subjectivities offered to women readers of these texts. We find that such texts present quite complex constructions of nutritional health, based on scientific and biomedical discourses of nutrition interwoven with discourses of morality, feminine beauty and mothering. We conclude that these texts offer a conflictual space for women to traverse in efforts to position themselves as good mothers and moral and healthy eaters.