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In this article I discuss a story told by the South Australian Ngarrindjeri Aboriginal elder, Aunty Hilda Wilson (nee Varcoe), about the time when, at not quite sixteen, she was sent from the Point Pearce Aboriginal Station to work in the Adelaide Hills, some 500 kilometres away, as a housekeeper for “one of Adelaide’s leading doctors”. Her secondment was part of a widespread practice in early and mid-twentieth century Australia of placing young Aboriginal women “of marriageable age” from missions and government reserves into domestic service. Consciously deploying Indigenous storytelling practices as pedagogy, Hilda Wilson recounted this episode in a number of distinct ways during the late 1990s and early 2000s. Across these iterations, each building on the other, she exhibited a personal resilience in her subjectivity, embedded in Indigenous knowledge systems of relationality, kin and work, which informed her agency and determination in a challenging situation in which she was both caring for a white socially-privileged family of five, while simultaneously grappling with the injustices of a state system of segregated indentured labour. Kirmayer and colleagues propose that “notions of resilience emerging from developmental psychology and psychiatry in recent years address the distinctive cultures, geographic and social settings, and histories of adversity of indigenous peoples”. Resilience is understood here as an ability to actively engage with traumatic change, involving the capacity to absorb stress and to transform in order to cope with it (Luthar et al.). Further to this, in an Indigenous context, Marion Kickett has found the capacity for resilience to be supported by three key factors: family connections, culture and belonging as well as notions of identity and history. In exploring the layers of this autobiographical story, I employ this extended psychological notion of resilience in both a domestic ambit as well as the broader social context for Indigenous people surviving a system of external domination. Additionally I consider the resilience Aunty Hilda demonstrates at a pivotal interlude between girlhood and womanhood within the trajectory of her overall long and productive life, and within an intergenerational history of resistance and accommodation. What is especially important about her storytelling is its refusal to be contained by the imaginary of the settler nation and its generic Aboriginal-female subject. She refuses victimhood while at the same time illuminating the mechanisms of injustice, hinting also at possibilities for alternative and more equitable relationships of family and work across cultural divides. Considered through this prism, resilience is, I suggest, also a quality firmly connected to ideas of Aboriginal cultural-sovereignty and standpoint and to, what Victoria Grieves has identified as, the Aboriginal knowledge value of sharing (25, 28, 45). Storytelling as Pedagogy The story I discuss was verbally recounted in a manner that Westphalen describes as “a continuation of Dreaming Stories”, functioning to educate and connect people and country (13-14). As MacGill et al. note, “the critical and transformative aspects of decolonising pedagogies emerge from storytelling and involve the gift of narrative and the enactment of reciprocity that occurs between the listener and the storyteller.” Hilda told me that as a child she was taught not to ask questions when listening to the stories of an Elder, and her own children were raised in this manner. Hilda's oldest daughter described this as a process involving patience, intrigue and surprise (Elva Wanganeen). Narratives unfold through nuance and repetition in a complexity of layers that can generate multiple levels of meaning over time. Circularity and recursivity underlie this pedagogy through which mnemonic devices are built so that stories become re-membered and inscribed on the body of the listener. When a perceived level of knowledge-transference has occurred, a narrator may elect to elaborate further, adding another detail that will often transform the story’s social, cultural, moral or political context. Such carefully chosen additional detail, however, might re-contextualise all that has gone before. As well as being embodied, stories are also emplaced, and thus most appropriately told in the Country where events occurred. (Here I use the Aboriginal English term “Country” which encompasses home, clan estate, and the powerful complex of spiritual, animate and inanimate forces that bind people and place.) Hilda Wilson’s following account of her first job as a housekeeper for “one of Adelaide’s leading doctors”, Dr Frank Swann, provides an illustration of how she expertly uses traditional narrative forms of incrementally structured knowledge transmission within a cross-cultural setting to tell a story that expresses practices of resilience as resistance and transformation at its core. A “White Doctor” Story: The First Layer Aunty Hilda first told me this story when we were winding along the South Eastern Freeway through the Adelaide hills between Murray Bridge and Mount Barker, in 1997, on our way home to Adelaide from a trip to Camp Coorong, the Ngarrindjeri cultural education centre co-founded by her granddaughter. She was then 86 years old. Ahead of us, the profile of Mt Lofty rose out of the plains and into view. The highest peak in the Mount Lofty ranges, Yurrebilla, as it is known to Kaurna Aboriginal people, or Mt Lofty, has been an affluent enclave of white settlement for Adelaide’s moneyed elite since early colonial times. Being in place, or in view of place, provided the appropriate opportunity for her to tell me the story. It belongs to a group of stories that during our initial period of working together changed little over time until one day two years later she an added contextual detail which turned it inside out. Hilda described the doctor’s spacious hill-top residence, and her responsibilities of caring for Dr Swann’s invalid wife (“an hysteric who couldn't do anything for herself”), their twin teenage boys (who attended private college in the city) along with another son and younger daughter living at home (pers. com. Hilda Wilson). Recalling the exhilaration of looking down over the sparkling lights of Adelaide at night from this position of apparent “privilege” on the summit, she related this undeniably as a success story, justifiably taking great pride in her achievements as a teenager, capable of stepping into the place of the non-Indigenous doctor's wife in running the large and demanding household. Successfully undertaking a wide range of duties employed in the care of a family, including the disabled mother, she is an active participant crucial to the lives of all in the household, including to the work of the doctor and the twin boys in private education. Hilda recalled that Mrs Swann was unable to eat without her assistance. As the oldest daughter of a large family Hilda had previously assisted in caring for her younger siblings. Told in this way, her account collapses social distinctions, delineating a shared social and physical space, drawing its analytic frame from an Indigenous ethos of subjectivity, relationality, reciprocity and care. Moreover Hilda’s narrative of domestic service demonstrates an assertion of agency that resists colonial and patriarchal hegemony and inverts the master/mistress-servant relationship, one she firmly eschews in favour of the self-affirming role of the lady of the house. (It stands in contrast to the abuse found in other accounts for example Read, Tucker, Kartinyeri. Often the key difference was a continuity of family connections and ongoing family support.) Indeed the home transformed into a largely feminised and cross-culturalised space in which she had considerable agency and responsibility when the doctor was absent. Hilda told me this story several times in much the same way during our frequent encounters over the next two years. Each telling revealed further details that fleshed a perspective gained from what Patricia Hill Collins terms an “epistemic privilege” via her “outsider-within status” of working within a white household, lending an understanding of its social mechanisms (12-15). She also stressed the extent of her duty of care in upholding the family’s well-being, despite the work at times being too burdensome. The Second Version: Coming to Terms with Intersecting Oppressions Later, as our relationship developed and deepened, when I began to record her life-narrative as part of my doctoral work, she added an unexpected detail that altered its context completely: It was all right except I slept outside in a tin shed and it was very cold at night. Mount Lofty, by far the coldest part of Adelaide, frequently experiences winter maximum temperatures of two or three degrees and often light snowfalls. This skilful reframing draws on Indigenous storytelling pedagogy and is expressly used to invite reflexivity, opening questions that move the listener from the personal to the public realm in which domestic service and the hegemony of the home are pivotal in coming to terms with the overlapping historical oppressions of class, gender, race and nation. Suddenly we witness her subjectivity starkly shift from one self-defined and allied with an equal power relationship – or even of dependency reversal cast as “de-facto doctor's wife” – to one diminished by inequity and power imbalance in the outsider-defined role of “mistreated servant”. The latter was signalled by the dramatic addition of a single signifying detail as a decoding device to a deeper layer of meaning. In this parallel stratum of the story, Hilda purposefully brings into relief the politics in which “the private domain of women's housework intersected with the public domain of governmental social engineering policies” (Haskins 4). As Aileen Moreton-Robinson points out, what for White Australia was cheap labour and a civilising mission, for Indigenous women constituted stolen children and slavery. Protection and then assimilation were government policies under which Indigenous women grew up. (96) Hilda was sent away from her family to work in 1927 by the universally-feared Sister Pearl McKenzie, a nurse who too-zealously (Katinyeri, Ngarrindjeri Calling, 23) oversaw the Chief Protector’s policies of “training” Aboriginal children from the South Australian missions in white homes once they reached fourteen (Haebich, 316—20). Indeed many prominent Adelaide hills’ families benefited from Aboriginal labour under this arrangement. Hilda explained her struggle with the immense cultural dislocation that removal into domestic service entailed, a removal her grandfather William Rankine had travelled from Raukkan to Government House to protest against less than a decade earlier (The Register December 21, 1923). This additional layer of story also illuminates Hilda’s capacity for resilience and persistence in finding a way forward through the challenge of her circumstances (Luthar et al.), drawing on her family networks and sense of personhood (Kickett). Hilda related that her father visited her at Mount Lofty twice, though briefly, on his way to shearing jobs in the south-east of the state. “He said it was no good me living like this,” she stated. Through his active intervention, reinforcement was requested and another teenager from Point Pearce, Hilda’s future husband’s cousin, Annie Sansbury, soon arrived to share the workload. But, Hilda explained, the onerous expectations coupled with the cultural segregation of retiring to the tin shed quickly became too much for Annie, who stayed only three months, leaving Hilda coping again alone, until her father applied additional pressure for a more suitable placement to be found for his daughter. In her next position, working for the family of a racehorse trainer, Hilda contentedly shared the bedroom with the small boy for whom she cared, and not long after returned to Point Pearce where she married Robert Wilson and began a family of her own. Gendered Resilience across Cultural Divides Hilda explicitly speaks into these spaces to educate me, because all but a few white women involved have remained silent about their complicity with state sanctioned practices which exploited Indigenous labour and removed children from their families through the policies of protection and assimilation. For Indigenous women, speaking out was often fraught with the danger of a deeper removal from family and Country, even of disappearance. Victoria Haskins writes extensively of two cases in New South Wales where young Aboriginal women whose protests concerning their brutal treatment at the hands of white employers, resulted in their wrongful and prolonged committal to mental health and other institutions (147-52, 228-39). In the indentured service of Indigenous women it is possible to see oppression operating through Eurocentric ideologies of race, class and gender, in which Indigenous women were assumed to take on, through displacement, the more oppressed role of white women in pre-second world war non-Aboriginal Australian society. The troubling silent shadow-figure of the “doctor’s wife” indeed provides a haunting symbol of - and also a forceful rebellion against – the docile upper middle-class white femininity of the inter-war era. Susan Bordo has argued that that “the hysteric” is archetypal of a discourse of ‘pathology as embodied protest’ in which the body may […] be viewed as a surface on which conventional constructions of femininity are exposed starkly to view in extreme or hyperliteral form. (20) Mrs Swann’s vulnerability contrasts markedly with the strength Hilda expresses in coping with a large family, emanating from a history of equitable gender relations characteristic of Ngarrindjeri society (Bell). The intersection of race and gender, as Marcia Langton contends “continues to require deconstruction to allow us to decolonise our consciousness” (54). From Hilda’s brief description one grasps a relationship resonant with that between the protagonists in Tracy Moffat's Night Cries, (a response to the overt maternalism in the film Jedda) in which the white mother finds herself utterly reliant on her “adopted” Aboriginal daughter at the end of her life (46-7). Resilience and Survival The different versions of story Hilda deploys, provide a pedagogical basis to understanding the broader socio-political framework of her overall life narrative in which an ability to draw on the cultural continuity of the past to transform the future forms an underlying dynamic. This demonstrated capacity to meet the challenging conditions thrown up by the settler-colonial state has its foundations in the connectivity and cultural strength sustained generationally in her family. Resilience moves from being individually to socially determined, as in Kickett’s model. During the onslaught of dispossession, following South Australia’s 1836 colonial invasion, Ngarrindjeri were left near-starving and decimated from introduced diseases. Pullume (c1808-1888), the rupuli (elected leader of the Ngarrindjeri Tendi, or parliament), Hilda’s third generation great-grandfather, decisively steered his people through the traumatic changes, eventually negotiating a middle-path after the Point McLeay Mission was established on Ngarrindjeri country in 1859 (Jenkin, 59). Pullume’s granddaughter, the accomplished, independent-thinking Ellen Sumner (1842—1925), played an influential educative role during Hilda’s youth. Like other Ngarrindjeri women in her lineage, Ellen Sumner was skilled in putari practice (female doctor) and midwifery culture that extended to a duty of care concerning women and children (teaching her “what to do and what not to do”), which I suggest is something Hilda herself drew from when working with the Swann family. Hilda’s mother and aunties continued aspects of the putari tradition, attending births and giving instruction to women in the community (Bell, 171, Hughes Grandmother, 52-4). As mentioned earlier, when the South Australian government moved to introduce The Training of Children Act (SA) Hilda’s maternal grandfather William Rankine campaigned vigorously against this, taking a petition to the SA Governor in December 1923 (Haebich, 315-19). As with Aunty Hilda, William Rankine used storytelling as a method to draw public attention to the inequities of his times in an interview with The Register which drew on his life-narrative (Hughes, My Grandmother, 61). Hilda’s father Wilfred Varcoe, a Barngarrla-Wirrungu man, almost a thousand kilometres away from his Poonindie birthplace, resisted assimilation by actively pursuing traditional knowledge networks using his mobility as a highly sought after shearer to link up with related Elders in the shearing camps, (and as we saw to inspect the conditions his daughter was working under at Mt Lofty). The period Hilda spent as a servant to white families to be trained in white ways was in fact only a brief interlude in a long life in which family connections, culture and belonging (Kickett) served as the backbone of her resilience and resistance. On returning to the Point Pearce Mission, Hilda successfully raised a large family and activated a range of community initiatives that fostered well-being. In the 1960s she moved to Adelaide, initially as the sole provider of her family (her husband later followed), to give her younger children better educational opportunities. Working with Aunty Gladys Elphick OBE through the Council of Aboriginal Women, she played a foundational role in assisting other Aboriginal women establish their families in the city (Mattingly et al., 154, Fisher). In Adelaide, Aunty Hilda became an influential, much loved Elder, living in good health to the age of ninety-six years. The ability to survive changing circumstances, to extend care over and over to her children and Elders along with qualities of leadership, determination, agency and resilience have passed down through her family, several of whom have become successful in public life. These include her great-grandson and former AFL football player, Michael O’Loughlin, her great-nephew Adam Goodes and her-grand-daughter, the cultural weaver Aunty Ellen Trevorrow. Arguably, resilience contributes to physical as well as cultural longevity, through caring for the self and others. Conclusion This story demonstrates how sociocultural dimensions of resilience are contextualised in practices of everyday lives. We see this in the way that Aunty Hilda Wilson’s self-narrated story resolutely defies attempts to know, subjugate and categorise, operating instead in accord with distinctively Aboriginal expressions of gender and kinship relations that constitute an Aboriginal sovereignty. Her storytelling activates a revision of collective history in ways that valorise Indigenous identity (Kirmayer et al.). Her narrative of agency and personal achievement, one that has sustained her through life, interacts with the larger narrative of state-endorsed exploitation, diffusing its power and exposing it to wider moral scrutiny. Resilience in this context is inextricably entwined with practices of cultural survival and resistance developed in response to the introduction of government policies and the encroachment of settlers and their world. We see resilience too operating across Hilda Wilson’s family history, and throughout her long life. The agency and strategies displayed suggest alternative realities and imagine other, usually more equitable, possible worlds. References Bell, Diane. Ngarrindjeri Wurruwarrin: A World That Is, Was and Will Be. Melbourne: Spinifex, 1998. Bordo, Susan. “The Body and the Reproduction of Femininity.” Writing on the Body: Female Embodiment and Feminist Theory. Eds. Katie Conboy, Nadia Medina, and Sarah Stanbury. New York: Columbia UP, 1997. 90-110. Collins, Patricia Hill. Black Feminist Thought. New York: Routledge, 2000. Fisher, Elizabeth M. "Elphick, Gladys (1904–1988)." Australian Dictionary of Biography. National Centre of Biography, Australian National University, 29 Sep. 2013. ‹http://adb.anu.edu.au/biography/elphick-gladys-12460/text22411>. Grieves, Victoria. Aboriginal Spirituality: Aboriginal Philosophy, The Basis of Aboriginal Social and Emotional Wellbeing, Melbourne University: Cooperative Research Centre for Aboriginal Health, 2009. Haebich, Anna. Broken Circles: The Fragmenting of Indigenous Families. Fremantle: Fremantle Arts Press, 2000. Haskins, Victoria. My One Bright Spot. London: Palgrave, 2005. Hughes, Karen. "My Grandmother on the Other Side of the Lake." PhD thesis, Department of Australian Studies and Department of History, Flinders University. Adelaide, 2009. ———. “Microhistories and Things That Matter.” Australian Feminist Studies 27.73 (2012): 269-278. ———. “I’d Grown Up as a Child amongst Natives.” Outskirts: Feminisms along the Edge 28 (2013). 29 Sep. 2013 ‹http://www.outskirts.arts.uwa.edu.au/volumes/volume-28/karen-hughes>. Jenkin, Graham. Conquest of the Ngarrindjeri. Adelaide: Rigby, 1979. Kartinyeri, Doris. Kick the Tin. Melbourne: Spinifex, 2000. Kartinyeri, Doreen. My Ngarrindjeri Calling, Adelaide: Wakefield, 2007. Kickett, Marion. “Examination of How a Culturally Appropriate Definition of Resilience Affects the Physical and Mental Health of Aboriginal People.” PhD thesis, Curtin University, 2012. Kirmayer, L.J., S. Dandeneau, E. Marshall, M.K. Phillips, K. Jenssen Williamson. “Rethinking Resilience from Indigenous Perspectives.” Canadian Journal of Psychiatry 56.2 (2011): 84-91. Luthar, S., D. Cicchetti, and B. Becker. “The Construct of Resilience: A Critical Evaluation and Guidelines for Future Work.” Child Development 71.3 (2000): 543-62. MacGill, Bindi, Julie Mathews, Ellen Trevorrow, Alice Abdulla, and Deb Rankine. “Ecology, Ontology, and Pedagogy at Camp Coorong,” M/C Journal 15.3 (2012). Mattingly, Christobel, and Ken Hampton. Survival in Our Own Land, Adelaide: Wakefield, 1988. Moreton-Robinson, Aileen. Talkin’ Up to the White Woman. St Lucia: UQP, 2000. Night Cries, A Rural Tragedy. Dir. Tracy Moffatt. Chili Films, 1990. Read, Peter. A Rape of the Soul So Profound. Crows Nest: Allen & Unwin, 2002. Tucker, Margaret. If Everyone Cared. Sydney: Ure Smith, 1977. Wanganeen, Elva. Personal Communication, 2000. Westphalen, Linda. An Anthropological and Literary Study of Two Aboriginal Women's Life Histories: The Impacts of Enforced Child Removal and Policies of Assimilation. New York: Mellen Press, 2011.

"Doctor, will I live longer if I give up alcohol and sex?" "No, but it will seem like it." The paradigm of the self as it is conceptualised in Western society includes an implicit assumption that one of the primary activities of the self is to engage in protective behaviours. This is a basic assumption in mass media promotion of healthy behaviours: 'Quit smoking' to protect yourself from lung cancer; 'Work safe' to protect yourself from injury, etc. Mass media social marketing campaigns inform the general population of the dangers to the self's existence of smoking, drink-driving, unsafe sex, over-eating, under-exercising and so on. These campaigns are based on models such as the Health Belief Model (Janz and Becker), the Fear Drive paradigm (Janis; McGuire), the Parallel Response Model (Leventhal), Thayer's Arousal Model, Roger's Protection Motivation Theory (Rogers & Mewborn; Maddux & Rogers), Ordered Protection Motivation Theory (Tanner, Hunt and Eppright) and the Extended Parallel Process Model (Witte). Fundamental to all these models is the assumption that people are motivated to protect themselves from harm. Information is provided that warns of the severity and likelihood of consequences of unhealthy behaviours. In some cases this information does motivate people to give up harmful behaviours and adopt safer options. However, worldwide, we see an increasing prevalence of diseases such as heart disease, diabetes and cancer that are related to preventable causes such as obesity, smoking and a sedentary lifestyle. To meet this challenge, the media strategy has generally focused on how to get health information across more effectively, that is, by making it more persuasive, more vivid, more salient, more imminent, more probable, and so on. Media exhortations to: 'say no to drugs', 'Quit because you can!', 'Respect yourself' etc. do not always achieve the desired change and may increase frustration, hopelessness and even depression (Henley & Donovan). It may be helpful to consider that this protection motivation paradigm does not take into account the prevalence of paradoxical behaviours, that is, behaviours that are harmful to the self (Apter). When talking about health, I think it is useful to divide paradoxical behaviours into two categories: thrill-seeking behaviours such as sky-diving and bungie-jumping where the individual enjoys the experience of being at risk without (usually) craving it; craved or 'addictive' behaviours (using the term loosely), such as smoking, binge-drinking, over-eating, drug-taking, where the individual craves a certain sensation and the gratification of the craving supersedes protective impulses. In both cases, the individual knows the behaviour is potentially harmful but chooses to engage in it. In the first case, there is a conscious choice that the enjoyment of the thrill experience outweighs the risk. The person feels in control of the decision (even if the decision is to abandon oneself to the feeling of being temporarily out of control). In the second case, there is a need to gratify the craving, regardless of the risk. The person is fully aware that it is not in their long term self-interest but feels out of control of the decision (Lowenstein). This second category of paradoxical behaviours consists of many unhealthy behaviours targeted by health practitioners. This paper discusses 1) the concept of the self in Western society; 2) the concept of paradoxical behaviour, distinguishing it from deviant behaviour; and 3) the suggestion that people may engage in addictive paradoxical behaviours to satisfy the 'empty self' (Cushman). Finally, the paper suggests that this attention to the empty self may be in a perverse way protective (though not healthy), and calls for a health promotion approach that directly addresses the needs of the 'empty self'. Concept of Self The concept of the self varies across cultures and time. Cushman (599) defined the concept of the self as 'the concept of the individual as articulated by the indigenous psychology of a particular cultural group.... the self embodies what the culture believes is humankind's place in the cosmos: its limits, talents, expectations, and prohibitions'. The Eastern concept of self extends 'beyond one's physical and psychosocial identity to include all other people in the world' (Westman & Canter 419) while the concept of self as it has developed in Western society 'has specific psychological boundaries, an internal locus of control, and a wish to manipulate the external world for its own personal ends' (Cushman 600). This Western concept of the self has been traced to Augustine's Confessions, identified by Weintraub (cited in Freeman 26) as the first reflective, autobiographical review of a life history in which selfhood is examined and understood. The concept of self encapsulates the most profound sense of cosmic place, worth and meaning. One of the aspects of the Western concept of self is a sense of mastery, of being able to act upon the world. Paradoxical vs Deviant Behaviour Apter makes a distinction between deviant behaviour, which is defined by social norms, and paradoxical behaviour, which is defined as any behaviour potentially harmful either to the individual or to society. Parachuting would be an example of behaviour potentially harmful to the individual, while celibacy, by threatening the survival of the social group, would be behaviour potentially harmful to society. Neither of these behaviours would be regarded as 'deviant'. Apter (10) calls this sort of behaviour paradoxical 'because it has the opposite effect to that which, from a biological and evolutionary point of view, one would expect behaviour to have'. While there will be considerable overlap in practice between deviant and paradoxical behaviour - child abuse, vandalism, drug and alcohol abuse, suicide, etc. would all be both deviant and paradoxical - there is a distinction in perspective between these two terms. Deviant behaviour, by definition, is always regarded by a society as anti-social (and therefore is often harmful); paradoxical behaviour is, by definition, always regarded by the individual's self-concept as harmful or potentially harmful (and therefore is also often anti-social). As our self-concept is socially learned, it is difficult to arrive at a true separation of these definitions but the following example may clarify the distinction: smoking was a widespread, socially acceptable activity in the 1950s, even glamorised by Hollywood. When the scientific evidence showed that it was harmful to the individual's health, that is, paradoxical behaviour, many people were sufficiently motivated to quit. Since the dangers of passive smoking have been highlighted and smoking is becoming regarded as socially unacceptable, that is, deviant behaviour, many more people are trying to stop, and succeeding. For many people, motivation for change is successful when an activity is recognised as both deviant and paradoxical. Social marketing campaigns have targeted these two areas for years, informing of health risks and dispelling the glamorous image. Yet, people still smoke, even when they know the health dangers and daily experience the open disapproval of others. At the extreme is the person who lies in a hospital bed with both legs amputated, being told and believing that continued smoking will result in the loss of remaining limbs, but who is still not motivated sufficiently to quit; this person is clearly exhibiting extreme paradoxical behaviour. It is useful to call this behaviour paradoxical rather than deviant because it is defined primarily by the extreme injury to the individual rather than the degree to which it departs from social norms. Why an individual would persist in such irrational behaviour is a seemingly unanswerable question. As Menninger has said, 'the extraordinary propensity of the human being to join hands with external forces in an attack upon his own existence is one of the most remarkable of biological phenomena' (cited in Apter 10). In trying to understand it, we look at three alternatives: 1) what people say their reasons may be; 2) how people defend against knowledge of risk; and 3) the role of visceral influences. Van Deurzen-Smith (165-6), an existential counsellor, gives some insight into the complexity of one of her patient's reasons for smoking: The dangers of heart disease or lung cancer had, far from making her want to give up smoking, been a real secret attraction which had been hard to give up. She had experienced smoking as playing with fire and that was highly enjoyable.... smoking in this sense had represented her experience of her body as concretely her own. Inhaling smoke was like breathing fire and feeling extra-alive; exhaling smoke was like seeing her own body's power being projected out of her mouth. Carrying cigarettes and fire on her every minute of the day used to give her a sense of oneness with the substances of the natural world; it was like possessing the secret power of some magical ritual. When smoking she was in command of the physical world, she was master of her own destiny. In other words, smoking had become an integral part of this person's self-concept. An alternative viewpoint is that smokers simply defend against knowledge of the health risks. In an examination of 'psychic defences against high fear appeals', Stuteville identified three techniques which people use to reduce fear-arousal: a) they deny the validity of the information; b) they unconsciously assert 'I am the exception to the rule - it won't happen to me'; and c) they defuse the danger by making it laughable or ridiculous. He suggested that campaigns can be more effective if they involve a threat to significant others, especially children, or are made to seem 'offensive to small group norms' (45), that is, seen as deviant rather than paradoxical. Lowenstein attempted to understand the discrepancies between what people do and what it is in their self-interest to do by postulating the operation of 'visceral factors', drive states relating to hunger, fear, pain, sex and emotions. He suggested that the need to satisfy these drives can supersede virtually all other needs, and that people consistently fail to recognise the strength of the influence of visceral factors in themselves and in others, despite all previous experience and evidence to the contrary. One of the characteristics of visceral factors is the effect of time-shortening so that immediate gratification outweighs long-term goals. Attempts to exercise self-control are made when thinking long-term and usually at the expense of short-term gratification (Lowenstein 288). Although this concept of visceral influences explains some irrational behaviour, Lowenstein made little attempt to explain why some people seem to be more at the mercy of visceral factors than others. For this, it may be helpful to explore Cushman's concept of the 'empty self'. The Hungry 'Empty Self' Cushman (600) identified the configuration of the concept of self in the United States as having developed into an 'empty self ... a self that experiences a significant absence of community, tradition, and shared meaning. It experiences these social absences and their consequences 'interiorly' as a lack of personal conviction and worth, and it embodies the absences as a chronic, undifferentiated emotional hunger'. It is this notion of emotional hunger that may have particular relevance to a discussion of paradoxical behaviours generated by cravings. Cushman referred to a strong desire for consumer products to assuage this hunger, but it may be useful when thinking of health to consider the hunger more literally, as a need to ingest substances (drugs, alcohol, food etc) and experiences (shopping, sex, speed, etc) to fill up the emptiness. Emotional hunger may lead to a number of self-destructive but self-nourishing and addictive habits, identified by Firestone as psychological defences against anxiety. Cushman identified advertising as one of the two professions responsible for healing the empty self (the other was psychotherapy), while recognising that it is also one of the professions that perpetuates and profits from the psychopathology. Perhaps the responsibility falls to social marketing which is concerned with the marketing of ideas, attitudes and beliefs, including health and safety lifestyle issues. At present, it could be said that health promotion tends to make people feel bad (Henley & Donovan), with an emphasis on the dire consequences of unhealthy behaviours. Is it reasonable to suggest that social marketing could be used to try to heal the empty self? Interestingly, this is already happening to some extent. Mental health is a priority issue and a recent mental health campaign in Victoria, Australia, 'Together We Do Better', stresses the need for community and social connection. Western Australia is exploring whether to undertake a similar campaign. The campaign includes messages relating to friendship, parenting, talking about problems, bullying, sledging, and inter-generational communication (Campaign materials). The overall aim is to work towards a more inclusive, caring, connected and tolerant society. Conclusion This paper has discussed the apparent limitation of the current paradigm in health promotion that people are primarily motivated to protect themselves by considering the prevalence of paradoxical behaviours, that is behaviours that are harmful to the self, especially those that are generated by a need to satisfy cravings. One explanation for such paradoxical behaviours is that they are motivated by visceral factors relating to physical and emotional drives. However, this does not explain why some people are more susceptible than others. Cushman's concept of the hungry, empty self, alienated from community and disconnected from social traditions and meaning, may go further to explain why some people are more susceptible to cravings than others. Social marketing could play a helpful role in healing people's sense of isolation in mental health campaigns such as VicHealth's 'Together We Do Better'. Finally, it may be more intuitive to understand apparently paradoxical behaviour as an urgent attempt to heal the empty self. This would make it in a perverse way protective, though not healthy. This way, people are seen as doing the best they can to protect themselves against the most immediate threat to the self, a sense of hollowness and isolation. If so, the fact that this need is able to supersede other major health needs suggests that it is one of the most urgent imperatives of the self. References Apter, M.J. The Experience of Motivation: The Theory of Psychological Reversals. London: Academic Press, 1982. 'Campaign Materials.' Victoria Health 'Together We Do Better Campaign'. http://www.togetherwedobetter.vic.gov.au... [accessed 26 Aug. 2002]. Cushman, P. 'Why the Self is Empty: Toward a Historically Situated Psychology.' American Psychologist (1990, May): 599-611. Firestone, R. W. 'Psychological Defenses Against Death Anxiety.' Death Anxiety Handbook: Research, Instrumentation, and Application. Series in Death Education, Aging, and Health Care. Ed. R. A. Neimeyer. Washington, DC: Taylor & Francis, 1994. 217-241. Henley, N. & Donovan, R. Unintended Consequences of Arousing Fear in Social Marketing. Paper presented at ANZMAC Conference. Sydney, Nov. 1999. Janis, I. L. 'Effects of Fear Arousal on Attitude Change: Recent Developments in Theory and Experimental Research.' Advances in Experimental Social Psychology 3 (1967): 167-225. Janz, N. & M. Becker. 'The Health Belief Model: A Decade Later.' Health Education Quarterly 11 (1984): 1-47. Leventhal, H. 'Findings and Theory in the Study of Fear Communications.' Advances in Experimental Social Psychology 5. Ed. L. Berkowitz . New York: Academic Press, 1970. 119-86. Maddux, J. E. & R.W Rogers. 'Protection Motivation and Self-efficacy: A Revised Theory of Fear Appeals and Attitude Change.' Journal of Experimental Social Psychology 19 (1983): 469-79. Lowenstein, G. 'Out of Control: Visceral Influences on Behaviour.' Organisational Behaviour and Human Decision Processes. 65.3 (1996): 272-92. McGuire, W. J. 'Personality and Attitude Change: An Information-processing Theory.' Psychological Foundations of Attitudes. Ed. A. G. Greenwald, T. C. Brock, and T. M. Ostrom. New York: Academic Press, 1968. pp. 171-96. Rogers, R. W. & C.R. Mewborn. 'Fear Appeals and Attitude Change: Effects of a Threat's Noxiousness, Probability of Occurrence, and the Efficacy of Coping Responses.' Journal of Personality and Social Psychology 34.1 (1976): 54-61. Stuteville, J. R. 'Psychic Defenses against High Fear Appeals: A Key Marketing Variable.' Journal of Marketing 34 (1970): 39-45. Tanner, J. F., J.B. Hunt and D.R. Eppright. 'The Protection Motivation Model: A Normative Model of Fear Appeals.' Journal of Marketing 55 (1991): 36-45. van Deurzen-Smith, E. Existential Counselling in Practice. London: Sage Publications, 1988. Witte, K. 'Putting the Fear Back into Fear Appeals: The Extended Parallel Process Model.' Communication Monographs 59.4 (1992): 329-349. Links http://www.togetherwedobetter.vic.gov.au/resources/campaign.asp Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Henley, Nadine. "The Healthy vs the Empty Self" M/C: A Journal of Media and Culture 5.5 (2002). [your date of access] < http://www.media-culture.org.au/mc/0210/Henley.html &gt. Chicago Style Henley, Nadine, "The Healthy vs the Empty Self" M/C: A Journal of Media and Culture 5, no. 5 (2002), < http://www.media-culture.org.au/mc/0210/Henley.html &gt ([your date of access]). APA Style Henley, Nadine. (2002) The Healthy vs the Empty Self. M/C: A Journal of Media and Culture 5(5). < http://www.media-culture.org.au/mc/0210/Henley.html &gt ([your date of access]).

Scientific Program Oral Presentations Authors Title Abstract CONSTANTIN MUNTEANU, Mihail HOTETEU, Diana MUNTEANU, Gabriela DOGARU - 12 minutes PERSPECTIVES OF BALNEOLOGY - INTERNATIONAL DATA INPUTS, NATIONAL OUTPUTS Link L1 UMBERTO SOLIMENE - 14 minutes CLIMATE AND HEALTH: A NEW CHALLENGE FOR AN OLD SCIENCE Link L2 Zeki KARAGÜLLE - 14 minutes BALNEOLOGICAL TREATMENTS WITH NATURAL HYDROGEN SULFIDE (H2S) Waters Link L3 Constantin Florin Dragan, Liliana Padure, Gelu Onose - 12 minutes SPECIFIC ADVANCED QUANTIFICATIONS ON THE RELATIONSHIP BETWEEN THE ANGULATION OF THE MAIN SCOLIOTIC CURVE AND LEG SWING IN THE GAIT PHASES, IN CHILDREN AND ADOLESCENTS WITH AND WITHOUT POSTURAL TREATMENT Link L4 Irina ALBADI, Camelia CIOBOTARU, Andreea-Alexandra LUPU, Ionela BALASA, Claudiu FATU, Enghin SACHIR, Gelu ONOSE - 12 minutes A MULTIMODAL APPROACHES TO MANAGE REHABILITATION THERAPY OF DISFUNCTIONALS ASPECTS TO A PACIENT WITH GOUT, MIELLITUS DIABETES, ATRIAL FIBRILATION AND MIDDLE CEREBRAL ARTERY STROKE Link L5 ELENA RAEVSCHI - 12 minutes PREVENTION CONSIDERATIONS IN Cardiovascular Diseases regarding the premature mortality reduction Link L6 ANIȘOARA CIMIL - 12 minutes THE EFFECTIVENESS OF THE REHABILITATION PROGRAMME ACCORDING TO THE ETIOPATHOGENESIS OF PROSTHETIC JOINT PATHOLOGY Link L7 TRAIAN -VIRGILIU SURDU, Monica SURDU, Olga SURDU - 10 minutes FOURTH INDUSTRIAL REVOLUTION (INDUSTRY 4.0) AND MODERN THERMAL MEDICINE (THERME 4.0) IN XXIST CENTURY Link L8 Gabriela DOGARU, Akos MOLNAR, Marieta MOTRICALA - 10 minutes EFFECTS OF CARBONATED MINERAL WATER AND MOFETTE IN BĂILE TUŞNAD IN EXPERIMENTALLY INDUCED ISCHEMIC HEART DISEASE Link L9 Q & A – 12 minutes Authors Title Abstract Aurelian Anghelescu, Valentin Deaconu, Catalina Axente,Elena Constantin, Gelu Onose - 12 minutes THERAPEUTIC DIFFICULTIES IN A YOUNG PATIENT WITH MULTIDRUG RESISTANT EPILEPSY (NEEDING VAGAL NERVE ELECTROSTIMULATION), SEQUELAE AFTER CONGENITAL VASCULAR CEREBRAL MALFORMATION, WITH CHRONIC GAIT IMPAIRMENTS AND RECENT TRAUMATIC BRAIN COMPLICATION Link L10 Luminița NIRLU, Alexandru G. 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Introduction The highly contagious COVID-19 virus has presented particularly difficult public policy challenges. The relatively late emergence of an effective treatments and vaccines, the structural stresses on health care systems, the lockdowns and the economic dislocations, the evident structural inequalities in effected societies, as well as the difficulty of prevention have tested social and political cohesion. Moreover, the intrusive nature of many prophylactic measures have led to individual liberty and human rights concerns. As noted by the Victorian (Australia) Ombudsman Report on the COVID-19 lockdown in Melbourne, we may be tempted, during a crisis, to view human rights as expendable in the pursuit of saving human lives. This thinking can lead to dangerous territory. It is not unlawful to curtail fundamental rights and freedoms when there are compelling reasons for doing so; human rights are inherently and inseparably a consideration of human lives. (5) These difficulties have raised issues about the importance of social or community capital in fighting the pandemic. This article discusses the impacts of social and community capital and other factors on the governmental efforts to combat the spread of infectious disease through the maintenance of social distancing and household ‘bubbles’. It argues that the beneficial effects of social and community capital towards fighting the pandemic, such as mutual respect and empathy, which underpins such public health measures as social distancing, the use of personal protective equipment, and lockdowns in the USA, have been undermined as preventive measures because they have been transmogrified to become a salient aspect of the “culture wars” (Peters). In contrast, states that have relatively lower social capital such a China have been able to more effectively arrest transmission of the disease because the government was been able to generate and personify a nationalist response to the virus and thus generate a more robust social consensus regarding the efforts to combat the disease. Social Capital and Culture Wars The response to COVID-19 required individuals, families, communities, and other types of groups to refrain from extensive interaction – to stay in their bubble. In these situations, especially given the asymptomatic nature of many COVID-19 infections and the serious imposition lockdowns and social distancing and isolation, the temptation for individuals to breach public health rules in high. From the perspective of policymakers, the response to fighting COVID-19 is a collective action problem. In studying collective action problems, scholars have paid much attention on the role of social and community capital (Ostrom and Ahn 17-35). Ostrom and Ahn comment that social capital “provides a synthesizing approach to how cultural, social, and institutional aspects of communities of various sizes jointly affect their capacity of dealing with collective-action problems” (24). Social capital is regarded as an evolving social type of cultural trait (Fukuyama; Guiso et al.). Adger argues that social capital “captures the nature of social relations” and “provides an explanation for how individuals use their relationships to other actors in societies for their own and for the collective good” (387). The most frequently used definition of social capital is the one proffered by Putnam who regards it as “features of social organization, such as networks, norms and social trust that facilitate coordination and cooperation for mutual benefit” (Putnam, “Bowling Alone” 65). All these studies suggest that social and community capital has at least two elements: “objective associations” and subjective ties among individuals. Objective associations, or social networks, refer to both formal and informal associations that are formed and engaged in on a voluntary basis by individuals and social groups. Subjective ties or norms, on the other hand, primarily stand for trust and reciprocity (Paxton). High levels of social capital have generally been associated with democratic politics and civil societies whose institutional performance benefits from the coordinated actions and civic culture that has been facilitated by high levels of social capital (Putnam, Democracy 167-9). Alternatively, a “good and fair” state and impartial institutions are important factors in generating and preserving high levels of social capital (Offe 42-87). Yet social capital is not limited to democratic civil societies and research is mixed on whether rising social capital manifests itself in a more vigorous civil society that in turn leads to democratising impulses. Castillo argues that various trust levels for institutions that reinforce submission, hierarchy, and cultural conservatism can be high in authoritarian governments, indicating that high levels of social capital do not necessarily lead to democratic civic societies (Castillo et al.). Roßteutscher concludes after a survey of social capita indicators in authoritarian states that social capital has little effect of democratisation and may in fact reinforce authoritarian rule: in nondemocratic contexts, however, it appears to throw a spanner in the works of democratization. Trust increases the stability of nondemocratic leaderships by generating popular support, by suppressing regime threatening forms of protest activity, and by nourishing undemocratic ideals concerning governance (752). In China, there has been ongoing debate concerning the presence of civil society and the level of social capital found across Chinese society. If one defines civil society as an intermediate associational realm between the state and the family, populated by autonomous organisations which are separate from the state that are formed voluntarily by members of society to protect or extend their interests or values, it is arguable that the PRC had a significant civil society or social capital in the first few decades after its establishment (White). However, most scholars agree that nascent civil society as well as a more salient social and community capital has emerged in China’s reform era. This was evident after the 2008 Sichuan earthquake, where the government welcomed community organising and community-driven donation campaigns for a limited period of time, giving the NGO sector and bottom-up social activism a boost, as evidenced in various policy areas such as disaster relief and rural community development (F. Wu 126; Xu 9). Nevertheless, the CCP and the Chinese state have been effective in maintaining significant control over civil society and autonomous groups without attempting to completely eliminate their autonomy or existence. The dramatic economic and social changes that have occurred since the 1978 Opening have unsurprisingly engendered numerous conflicts across the society. In response, the CCP and State have adjusted political economic policies to meet the changing demands of workers, migrants, the unemployed, minorities, farmers, local artisans, entrepreneurs, and the growing middle class. Often the demands arising from these groups have resulted in policy changes, including compensation. In other circumstances, where these groups remain dissatisfied, the government will tolerate them (ignore them but allow them to continue in the advocacy), or, when the need arises, supress the disaffected groups (F. Wu 2). At the same time, social organisations and other groups in civil society have often “refrained from open and broad contestation against the regime”, thereby gaining the space and autonomy to achieve the objectives (F. Wu 2). Studies of Chinese social or community capital suggest that a form of modern social capital has gradually emerged as Chinese society has become increasingly modernised and liberalised (despite being non-democratic), and that this social capital has begun to play an important role in shaping social and economic lives at the local level. However, this more modern form of social capital, arising from developmental and social changes, competes with traditional social values and social capital, which stresses parochial and particularistic feelings among known individuals while modern social capital emphasises general trust and reciprocal feelings among both known and unknown individuals. The objective element of these traditional values are those government-sanctioned, formal mass organisations such as Communist Youth and the All-China Federation of Women's Associations, where members are obliged to obey the organisation leadership. The predominant subjective values are parochial and particularistic feelings among individuals who know one another, such as guanxi and zongzu (Chen and Lu, 426). The concept of social capital emphasises that the underlying cooperative values found in individuals and groups within a culture are an important factor in solving collective problems. In contrast, the notion of “culture war” focusses on those values and differences that divide social and cultural groups. Barry defines culture wars as increases in volatility, expansion of polarisation, and conflict between those who are passionate about religiously motivated politics, traditional morality, and anti-intellectualism, and…those who embrace progressive politics, cultural openness, and scientific and modernist orientations. (90) The contemporary culture wars across the world manifest opposition by various groups in society who hold divergent worldviews and ideological positions. Proponents of culture war understand various issues as part of a broader set of religious, political, and moral/normative positions invoked in opposition to “elite”, “liberal”, or “left” ideologies. Within this Manichean universe opposition to such issues as climate change, Black Lives Matter, same sex rights, prison reform, gun control, and immigration becomes framed in binary terms, and infused with a moral sensibility (Chapman 8-10). In many disputes, the culture war often devolves into an epistemological dispute about the efficacy of scientific knowledge and authority, or a dispute between “practical” and theoretical knowledge. In this environment, even facts can become partisan narratives. For these “cultural” disputes are often how electoral prospects (generally right-wing) are advanced; “not through policies or promises of a better life, but by fostering a sense of threat, a fantasy that something profoundly pure … is constantly at risk of extinction” (Malik). This “zero-sum” social and policy environment that makes it difficult to compromise and has serious consequences for social stability or government policy, especially in a liberal democratic society. Of course, from the perspective of cultural materialism such a reductionist approach to culture and political and social values is not unexpected. “Culture” is one of the many arenas in which dominant social groups seek to express and reproduce their interests and preferences. “Culture” from this sense is “material” and is ultimately connected to the distribution of power, wealth, and resources in society. As such, the various policy areas that are understood as part of the “culture wars” are another domain where various dominant and subordinate groups and interests engaged in conflict express their values and goals. Yet it is unexpected that despite the pervasiveness of information available to individuals the pool of information consumed by individuals who view the “culture wars” as a touchstone for political behaviour and a narrative to categorise events and facts is relatively closed. This lack of balance has been magnified by social media algorithms, conspiracy-laced talk radio, and a media ecosystem that frames and discusses issues in a manner that elides into an easily understood “culture war” narrative. From this perspective, the groups (generally right-wing or traditionalist) exist within an information bubble that reinforces political, social, and cultural predilections. American and Chinese Reponses to COVID-19 The COVID-19 pandemic first broke out in Wuhan in December 2019. Initially unprepared and unwilling to accept the seriousness of the infection, the Chinese government regrouped from early mistakes and essentially controlled transmission in about three months. This positive outcome has been messaged as an exposition of the superiority of the Chinese governmental system and society both domestically and internationally; a positive, even heroic performance that evidences the populist credentials of the Chinese political leadership and demonstrates national excellence. The recently published White Paper entitled “Fighting COVID-19: China in Action” also summarises China’s “strategic achievement” in the simple language of numbers: in a month, the rising spread was contained; in two months, the daily case increase fell to single digits; and in three months, a “decisive victory” was secured in Wuhan City and Hubei Province (Xinhua). This clear articulation of the positive results has rallied political support. Indeed, a recent survey shows that 89 percent of citizens are satisfied with the government’s information dissemination during the pandemic (C Wu). As part of the effort, the government extensively promoted the provision of “political goods”, such as law and order, national unity and pride, and shared values. For example, severe publishments were introduced for violence against medical professionals and police, producing and selling counterfeit medications, raising commodity prices, spreading ‘rumours’, and being uncooperative with quarantine measures (Xu). Additionally, as an extension the popular anti-corruption campaign, many local political leaders were disciplined or received criminal charges for inappropriate behaviour, abuse of power, and corruption during the pandemic (People.cn, 2 Feb. 2020). Chinese state media also described fighting the virus as a global “competition”. In this competition a nation’s “material power” as well as “mental strength”, that calls for the highest level of nation unity and patriotism, is put to the test. This discourse recalled the global competition in light of the national mythology related to the formation of Chinese nation, the historical “hardship”, and the “heroic Chinese people” (People.cn, 7 Apr. 2020). Moreover, as the threat of infection receded, it was emphasised that China “won this competition” and the Chinese people have demonstrated the “great spirit of China” to the world: a result built upon the “heroism of the whole Party, Army, and Chinese people from all ethnic groups” (People.cn, 7 Apr. 2020). In contrast to the Chinese approach of emphasising national public goods as a justification for fighting the virus, the U.S. Trump Administration used nationalism, deflection, and “culture war” discourse to undermine health responses — an unprecedented response in American public health policy. The seriousness of the disease as well as the statistical evidence of its course through the American population was disputed. The President and various supporters raged against the COVID-19 “hoax”, social distancing, and lockdowns, disparaged public health institutions and advice, and encouraged protesters to “liberate” locked-down states (Russonello). “Our federal overlords say ‘no singing’ and ‘no shouting’ on Thanksgiving”, Representative Paul Gosar, a Republican of Arizona, wrote as he retweeted a Centers for Disease Control list of Thanksgiving safety tips (Weiner). People were encouraged, by way of the White House and Republican leadership, to ignore health regulations and not to comply with social distancing measures and the wearing of masks (Tracy). This encouragement led to threats against proponents of face masks such as Dr Anthony Fauci, one of the nation’s foremost experts on infectious diseases, who required bodyguards because of the many threats on his life. Fauci’s critics — including President Trump — countered Fauci’s promotion of mask wearing by stating accusingly that he once said mask-wearing was not necessary for ordinary people (Kelly). Conspiracy theories as to the safety of vaccinations also grew across the course of the year. As the 2020 election approached, the Administration ramped up efforts to downplay the serious of the virus by identifying it with “the media” and illegitimate “partisan” efforts to undermine the Trump presidency. It also ramped up its criticism of China as the source of the infection. This political self-centeredness undermined state and federal efforts to slow transmission (Shear et al.). At the same time, Trump chided health officials for moving too slowly on vaccine approvals, repeated charges that high infection rates were due to increased testing, and argued that COVID-19 deaths were exaggerated by medical providers for political and financial reasons. These claims were amplified by various conservative media personalities such as Rush Limbaugh, and Sean Hannity and Laura Ingraham of Fox News. The result of this “COVID-19 Denialism” and the alternative narrative of COVID-19 policy told through the lens of culture war has resulted in the United States having the highest number of COVID-19 cases, and the highest number of COVID-19 deaths. At the same time, the underlying social consensus and social capital that have historically assisted in generating positive public health outcomes has been significantly eroded. According to the Pew Research Center, the share of U.S. adults who say public health officials such as those at the Centers for Disease Control and Prevention are doing an excellent or good job responding to the outbreak decreased from 79% in March to 63% in August, with an especially sharp decrease among Republicans (Pew Research Center 2020). Social Capital and COVID-19 From the perspective of social or community capital, it could be expected that the American response to the Pandemic would be more effective than the Chinese response. Historically, the United States has had high levels of social capital, a highly developed public health system, and strong governmental capacity. In contrast, China has a relatively high level of governmental and public health capacity, but the level of social capital has been lower and there is a significant presence of traditional values which emphasise parochial and particularistic values. Moreover, the antecedent institutions of social capital, such as weak and inefficient formal institutions (Batjargal et al.), environmental turbulence and resource scarcity along with the transactional nature of guanxi (gift-giving and information exchange and relationship dependence) militate against finding a more effective social and community response to the public health emergency. Yet China’s response has been significantly more successful than the Unites States’. Paradoxically, the American response under the Trump Administration and the Chinese response both relied on an externalisation of the both the threat and the justifications for their particular response. In the American case, President Trump, while downplaying the seriousness of the virus, consistently called it the “China virus” in an effort to deflect responsibly as well as a means to avert attention away from the public health impacts. As recently as 3 January 2021, Trump tweeted that the number of “China Virus” cases and deaths in the U.S. were “far exaggerated”, while critically citing the Centers for Disease Control and Prevention's methodology: “When in doubt, call it COVID-19. Fake News!” (Bacon). The Chinese Government, meanwhile, has pursued a more aggressive foreign policy across the South China Sea, on the frontier in the Indian sub-continent, and against states such as Australia who have criticised the initial Chinese response to COVID-19. To this international criticism, the government reiterated its sovereign rights and emphasised its “victimhood” in the face of “anti-China” foreign forces. Chinese state media also highlighted China as “victim” of the coronavirus, but also as a target of Western “political manoeuvres” when investigating the beginning stages of the pandemic. The major difference, however, is that public health policy in the United States was superimposed on other more fundamental political and cultural cleavages, and part of this externalisation process included the assignation of “otherness” and demonisation of internal political opponents or characterising political opponents as bent on destroying the United States. This assignation of “otherness” to various internal groups is a crucial element in the culture wars. While this may have been inevitable given the increasingly frayed nature of American society post-2008, such a characterisation has been activity pushed by local, state, and national leadership in the Republican Party and the Trump Administration (Vogel et al.). In such circumstances, minimising health risks and highlighting civil rights concerns due to public health measures, along with assigning blame to the democratic opposition and foreign states such as China, can have a major impact of public health responses. The result has been that social trust beyond the bubble of one’s immediate circle or those who share similar beliefs is seriously compromised — and the collective action problem presented by COVID-19 remains unsolved. Daniel Aldrich’s study of disasters in Japan, India, and US demonstrates that pre-existing high levels of social capital would lead to stronger resilience and better recovery (Aldrich). Social capital helps coordinate resources and facilitate the reconstruction collectively and therefore would lead to better recovery (Alesch et al.). Yet there has not been much research on how the pool of social capital first came about and how a disaster may affect the creation and store of social capital. Rebecca Solnit has examined five major disasters and describes that after these events, survivors would reach out and work together to confront the challenges they face, therefore increasing the social capital in the community (Solnit). However, there are studies that have concluded that major disasters can damage the social fabric in local communities (Peacock et al.). The COVID-19 epidemic does not have the intensity and suddenness of other disasters but has had significant knock-on effects in increasing or decreasing social capital, depending on the institutional and social responses to the pandemic. In China, it appears that the positive social capital effects have been partially subsumed into a more generalised patriotic or nationalist affirmation of the government’s policy response. Unlike civil society responses to earlier crises, such as the 2008 Sichuan earthquake, there is less evidence of widespread community organisation and response to combat the epidemic at its initial stages. This suggests better institutional responses to the crisis by the government, but also a high degree of porosity between civil society and a national “imagined community” represented by the national state. The result has been an increased legitimacy for the Chinese government. Alternatively, in the United States the transformation of COVID-19 public health policy into a culture war issue has seriously impeded efforts to combat the epidemic in the short term by undermining the social consensus and social capital necessary to fight such a pandemic. Trust in American institutions is historically low, and President Trump’s untrue contention that President Biden’s election was due to “fraud” has further undermined the legitimacy of the American government, as evidenced by the attacks directed at Congress in the U.S. capital on 6 January 2021. As such, the lingering effects the pandemic will have on social, economic, and political institutions will likely reinforce the deep cultural and political cleavages and weaken interpersonal networks in American society. Conclusion The COVID-19 pandemic has devastated global public health and impacted deeply on the world economy. Unsurprisingly, given the serious economic, social, and political consequences, different government responses have been highly politicised. Various quarantine and infection case tracking methods have caused concern over state power intruding into private spheres. The usage of face masks, social distancing rules, and intra-state travel restrictions have aroused passionate debate over public health restrictions, individual liberty, and human rights. Yet underlying public health responses grounded in higher levels of social capital enhance the effectiveness of public health measures. In China, a country that has generally been associated with lower social capital, it is likely that the relatively strong policy response to COVID-19 will both enhance feelings of nationalism and Chinese exceptionalism and help create and increase the store of social capital. In the United States, the attribution of COVID-19 public health policy as part of the culture wars will continue to impede efforts to control the pandemic while further damaging the store of American community social capital that has assisted public health efforts over the past decades. References Adger, W. Neil. “Social Capital, Collective Action, and Adaptation to Climate Change.” Economic Geography 79.4 (2003): 387-404. Bacon, John. “Coronavirus Updates: Donald Trump Says US 'China Virus' Data Exaggerated; Dr. Anthony Fauci Protests, Draws President's Wrath.” USA Today 3 Jan. 2021. 4 Jan. 2021 <https://www.usatoday.com/story/news/health/2021/01/03/COVID-19-update-larry-king-ill-4-million-december-vaccinations-us/4114363001/>. Berry, Kate A. “Beyond the American Culture Wars.” Regions & Cohesion / Regiones y Cohesión / Régions et Cohésion 7.2 (Summer 2017): 90-95. Castillo, Juan C., Daniel Miranda, and Pablo Torres. “Authoritarianism, Social Dominance and Trust in Public Institutions.” Annual Scientific Meeting of the International Society of Political Psychology, Istanbul, 9-12 July 2011. 2 Jan. 2021 <https://pdfs.semanticscholar.org/>. Chapman, Roger. “Introduction, Culture Wars: Rhetoric and Reality.” Culture Wars: An Encyclopedia of Issues, Viewpoints, and Voices. Eds. Roger Chapman and M.E. Sharpe. 2010. 8-10. Chen, Jie, and Chunlong Lu. “Social Capital in Urban China: Attitudinal and Behavioral Effects on Grassroots Self-Government.” Social Science Quarterly 88.2 (June 2007): 422-442. China's State Council Information Office. “Fighting COVID-19: China in Action.” Xinhuanet 7 June 2020. 2 Sep. 2020 <http://www.xinhuanet.com/english/2020-06/07/c_139120424.htm?bsh_bid=551709954>. Fukuyama, Francis. Trust: The Social Virtues and the Creation of Prosperity. Hamish Hamilton, 1995. Kelly, Mike. “Welcome to the COVID-19 Culture Wars. Why Are We Fighting about Masks?’ Yahoo News 4 Dec. 2020 <https://www.msn.com/en-us/news/us/welcome-to-the-COVID-19-culture-wars-why-are-we-fighting-about-masks-mike-kelly/ar-BB1bCOHN>. Luigi Guiso, Paola Sapienza, and Luigi Zingales, “Social Capital as Good Culture.” National Bureau of Economic Research Working Paper No. 13712. 2007. 18 ct. 2017 <http://www.nber.org/papers/w13712.pdf>. Malik, Nesrine. “The Right's Culture War Is No Longer a Sideshow to Our Politics – It Is Our Politics.” The Guardian 31 Aug. 2020. 6 Jan. 2021 <https://www.theguardian.com/commentisfree/2020/aug/31/the-rights-culture-war-politics-rightwing-fantasy-elections>. Offe, Carl. “How Can We Trust Our Fellow Citizens?” Democracy and Trust. Ed. M.E. Warren. Cambridge University Press, 1999. 42-87. Ostrom, Elinor, and T.K. Ahn. “The Meaning of Social Capital and Its Link to Collective Action.” Handbook of Social Capital: The Troika of Sociology, Political Science and Economics. Eds. Gert Tinggaard Svendsen and Gunnar Lind Haase Svendsen. Edward Elgar, 2009. 17–35. Paxton, Pamela. “Is Social Capital Declining in the United States? A Multiple Indicator Assessment.” American Journal of Sociology 105.1 (1999): 88-127. People.cn. “Hubeisheng Huanggangshi chufen dangyuan ganbu 337 ren.” [“337 Party Cadres Were Disciplined in Huanggang, Hubei Province.”] 2 Feb. 2020. 10 Sep. 2020 <http://fanfu.people.com.cn/n1/2020/0130/c64371-31565382.html>. ———. “Zai yiqing fangkong douzheng zhong zhangxian weida zhongguo jingshen.” [“Demonstrating the Great Spirit of China in Fighting the Pandemic.”] 7 Apr. 2020. 9 Sep. 2020 <http://opinion.people.com.cn/n1/2020/0407/c1003-31663076.html>. Peters, Jeremy W. “How Abortion, Guns and Church Closings Made Coronavirus a Culture War.” New York Times 20 Apr. 2020. 6 Jan. 2021 <http://www.nytimes.com/2020/04/20/us/politics/coronavirus-protests-democrats-republicans.html>. Pew Research Center. “Americans Give the U.S. Low Marks for Its Handling of COVID-19, and So Do People in Other Countries.” 21 Sep. 2020. 15 Jan. 2021 <https://www.pewresearch.org/fact-tank/2020/09/21/americans-give-the-u-s-low-marks-for-its-handling-of-covid-19-and-so-do-people-in-other-countries/>. Putnam, Robert D. “Bowling Alone: America’s Declining Social Capital.” Journal of Democracy 6.1 (1995): 65-78. ———. Making Democracy Work: Civic Traditions in Modern Italy. Princeton University Press, 1993. Roßteutscher, Sigrid. “Social Capital Worldwide: Potential for Democratization or Stabilizer of Authoritarian Rule?” American Behavioural Scientist 53.5 (2010): 737–757. Russonello, G. “What’s Driving the Right-Wing Protesters Fighting the Quarantine?” New York Times 17 Apr. 2020. 2 Jan. 2021 <http://www.nytimes.com/2020/04/17/us/politics/poll-watch-quarantine-protesters.html>. Shear, Michael D., Maggie Haberman, Noah Weiland, Sharon LaFraniere, and Mark Mazzetti. “Trump’s Focus as the Pandemic Raged: What Would It Mean for Him?” New York Times 31 Dec. 2020. 2 Jan. 2021 <https://www.nytimes.com/2020/12/31/us/politics/trump-coronavirus.html>. Tracy, Marc. “Anti-Lockdown Protesters Get in Reporters’ (Masked) Faces.” New York Times 13 May 2020. 5 Jan. 2021 <https://www.nytimes.com/2020/05/13/business/media/lockdown-protests-reporters.html>. Victoria Ombudsman. “Investigation into the Detention and Treatment of Public Housing Residents Arising from a COVID-19 ‘Hard Lockdown’ in July 2020.” Dec. 2020. 8 Jan. 2021 <https://assets.ombudsman.vic.gov.au/>. Vogel, Kenneth P., Jim Rutenberg, and Lisa Lerer. “The Quiet Hand of Conservative Groups in the Anti-Lockdown Protests.” New York Times 21 Apr. 2020. 2 Jan. 2021 <http://www.nytimes.com/2020/04/21/us/politics/coronavirus-protests-trump.html>. Weiner, Jennifer. “Fake ‘War on Christmas’ and the Real Battle against COVID-19.” New York Times 7 Dec. 2020. 6 Jan. 2021 <https://www.nytimes.com/2020/12/07/opinion/christmas-religion-COVID-19.html>. White, Gordon. “Civil Society, Democratization and Development: Clearing the Analytical Ground.” Civil Society in Democratization. Eds. Peter Burnell and Peter Calvert. Taylor & Francis, 2004. 375-390. Wu, Cary. “How Chinese Citizens View Their Government’s Coronavirus Response.” The Conversation 5 June 2020. 2 Sep. 2020 <https://theconversation.com/how-chinese-citizens-view-their-governments-coronavirus-response-139176>. Wu, Fengshi. “An Emerging Group Name ‘Gongyi’: Ideational Collectivity in China's Civil Society.” China Review 17.2 (2017): 123-150. ———. “Evolving State-Society Relations in China: Introduction.” China Review 17.2 (2017): 1-6. Xu, Bin. “Consensus Crisis and Civil Society: The Sichuan Earthquake Response and State-Society Relations.” The China Journal 71 (2014): 91-108. Xu, Juan. “Wei yiqing fangkong zhulao fazhi diba.” [“Build a Strong Legal ‘Dam’ for Disease Control.”] People.cn 24 Feb. 2020. 10 Sep. 2020 <http://opinion.people.com.cn/n1/2020/0224/c1003-31600409.html>.

BackgroundIn the past twenty years the discourse of the weight-centred health paradigm (WCHP) has attained almost complete dominance in the sphere of public health policy throughout the developed English speaking world. The national governments of Australia and many countries around the world have responded to what is perceived as an ‘epidemic of obesity’ with public health policies and programs explicitly focused on reducing and preventing obesity through so called ‘lifestyle’ behaviour change. Weight-related public health initiatives have been subjected to extensive critique based on ideological, ethical and empirical grounds (Solovay; Oliver; Gaesser; Gard; Monaghan, Colls and Evans; Wright; Rothblum and Solovay; Saguy; Rich, Monaghan and Aphramor; Bacon and Aphramor; Brown). Many scholars have raised concerns about the stigmatising and harmful effects of the WCHP (Aphramor; Bacon and Aphramor; O'Dea; Tylka et al.), and in particular the inequitable distribution of such negative impacts on women, people who are poor, and people of colour (Campos). Weight-based stigma is now well recognised as a pervasive and insidious form of stigma (Puhl and Heuer). Weight-based discrimination (a direct result of stigma) in the USA has a similar prevalence rate to race-based discrimination, and discrimination for fatter and younger people in particular is even higher (Puhl, Andreyeva and Brownell). Numerous scholars have highlighted the stigmatising discourse evident in obesity prevention programs and policies (O'Reilly and Sixsmith; Pederson et al.; Nuffield Council on Bioethics; ten Have et al.; MacLean et al.; Carter, Klinner, et al.; Fry; O'Dea; Rich, Monaghan and Aphramor). The ‘war on obesity’ can therefore be regarded as a social determinant of poor health (O'Hara and Gregg). Focusing on overweight and obese people is not only damaging to people’s health, but is ineffective in addressing the broader social and economic issues that create health and wellbeing (Cohen, Perales and Steadman; MacLean et al.; Walls et al.). Analyses of the discourses used in weight-related public health initiatives have highlighted oppressive, stigmatizing and discriminatory discourses that position body weight as pathological (O'Reilly; Pederson et al.), anti-social and a threat to the viable future of society (White). There has been limited analysis of discourses in Australian social marketing campaigns focused on body weight (Lupton; Carter, Rychetnik, et al.).Social Marketing CampaignsIn 2006 the Australian, State and Territory Governments funded the Measure Up social marketing campaign (Australian Government Department of Health and Ageing "Measure Up"). As the name suggests Measure Up focuses on the measurement of health through body weight and waist circumference. Campaign resources include brochures, posters, a tape measure, a 12 week planner, a community guide and a television advertisement. Campaign slogans are ‘The more you gain, the more you have to lose’ and ‘How do you measure up?’Tomorrow People is the component of Measure Up designed for Indigenous Australians (Australian Government Department of Health and Ageing "Tomorrow People"). Tomorrow People resources focus on healthy eating and physical activity and include a microsite on the Measure Up website, booklet, posters, print and radio advertisements. The campaign slogan is ‘Tomorrow People starts today. Do it for our kids. Do it for our culture.’ In 2011, phase two of the Measure Up campaign was launched (Australian Government Department of Health and Ageing "Swap It, Don't Stop It"). The central premise of Swap It, Don’t Stop It is that you ‘can lose your belly without losing all the things you love’ by making ‘simple’ swaps of behaviours related to eating and physical activity. The campaign’s central character Eric is made from a balloon, as are all of the other characters and visual items used in the campaign. Eric claims thatover the years my belly has ballooned and ballooned. It’s come time to do something about it — the last thing I want is to end up with some cancers, type 2 diabetes and heart disease. That’s why I’ve become a Swapper! What’s a swapper? It’s simple really. It just means swapping some of the things I’m doing now for healthier choices. That way I can lose my belly, without losing all the things I love. It’s easy! The campaign has produced around 30 branded resource items including brochures, posters, cards, fact sheets, recipes, and print, radio, television and online advertisements. All resources include references to Eric and most also include the image of the tape measure used in the Measure Up campaign. The Swap It, Don’t Stop It campaign also includes resources specifically directed at Indigenous Australians including two posters from the generic campaign with a dot painting motif added to the background. MethodologyThe epistemological position in this project was constructivist (Crotty) and the theoretical perspective was critical theory (Crotty). Multimedia critical discourse analysis (Machin and Mayr) was the methodology used to examine the social marketing campaigns and identify the discourses within them. Critical discourse analysis (CDA) focuses on critiquing text for evidence of power and ideology. CDA is used to reveal the ideas, absences and assumptions, and therefore the power interests buried within texts, in order to bring about social change. As a method, CDA has a structured three dimensional approach involving textual practice analysis (for lexicon) at the core, within the context of discursive practice analysis (for rhetorical and lexical strategies particularly with respect to claims-making), which falls within the context of social practice analysis (Jacobs). Social practice analysis explores the role played by power and ideology in supporting or disturbing the discourse (Jacobs; Machin and Mayr). Multimodal CDA (MCDA) uses a broad definition of text to include words, pictures, symbols, ideas, themes or any message that can be communicated (Machin and Mayr). Analysis of the social marketing campaigns involved examining the vocabulary, grammar, sentence structure, visuals and overall structure of the text for textual, discursive and social practices.Results and DiscussionIndividual ResponsibilityThe discourse of individual responsibility is strongly evident in the campaigns. In this discourse, it is ultimately the individual who is held responsible for their body weight and their health. The individual responsibility discourse is signified by the discursive practice of using epistemic (related to the truth or certainty) and deontic (compelling or instructing) modality words, particularly modal verbs and modal adverbs. High modality epistemic words are used to convince the reader of the certainty of statements and to portray the statement-maker as authoritative. High modality deontic words are used to instil power and authority in the instructions.The extensive use of high modality epistemic and deontic words is demonstrated in the following paragraph assembled from various campaign materials: Ultimately (epistemic modality adverb) individuals must take responsibility (deontic modality verb) for their own health, including their and weight. Obesity is caused (epistemic modality verb) by an imbalance in energy intake (from diet) (epistemic modality verb) and expenditure (from activity) (epistemic modality verb). Individually (epistemic modality adverb) we make decisions (epistemic modality verb) about how much we eat (epistemic modality verb) and how much activity we undertake (epistemic modality verb). Each of us can control (epistemic modality) our own weight by controlling (deontic modality) what we eat (deontic modality verb) and how much we exercise (deontic modality verb). To correct (deontic modality verb) the energy imbalance, individuals need to develop (deontic modality verb) a healthy lifestyle by making changes (deontic modality verb) to correct (deontic modality verb) their dietary habits and increase (deontic modality verb) their activity levels. The verbs must, control, correct, develop, change, increase, eat and exercise are deontic modality verbs designed to instruct or compel the reader.These discursive practices result in the clear message that individuals can and must control, correct and change their eating and physical activity, and thereby control their weight and health. The implication of the individualist discourse is that individuals, irrespective of their genes, life-course, social position or environment, are charged with the responsibility of being more self-surveying, self-policing, self-disciplined and self-controlled, and therefore healthier. This is consistent with the individualist orientation of neoliberal ideology, and has been identified in various critiques of obesity prevention public health programs that centralise the self-responsible subject (Murray; Rich, Monaghan and Aphramor) and the concept of ‘healthism’, the moral obligation to pursue health through healthy behaviours or healthy lifestyles (Aphramor and Gingras; Mansfield and Rich). The hegemonic Western-centric individualist discourse has also been critiqued for its role in subordinating or silencing other models of health and wellbeing including Aboriginal or indigenous models, that do not place the individual in the centre (McPhail-Bell, Fredericks and Brough).Obesity Causes DiseaseEpistemic modality verbs are used as a discursive practice to portray the certainty or probability of the relationship between obesity and chronic disease. The strength of the epistemic modality verbs is generally moderate, with terms such as ‘linked’, ‘associated’, ‘connected’, ‘related’ and ‘contributes to’ most commonly used to describe the relationship. The use of such verbs may suggest recognition of uncertainty or at least lack of causality in the relationship. However this lowered modality is counterbalanced by the use of verbs with higher epistemic modality such as ‘causes’, ‘leads to’, and ‘is responsible for’. For example:The other type is intra-abdominal fat. This is the fat that coats our organs and causes the most concern. Even though we don’t yet fully understand what links intra-abdominal fat with chronic disease, we do know that even a small deposit of this fat increases the risk of serious health problems’. (Swap It, Don’t Stop It Website; italics added)Thus the prevailing impression is that there is an objective, definitive, causal relationship between obesity and a range of chronic diseases. The obesity-chronic disease discourse is reified through the discursive practice of claims-making, whereby statements related to the problem of obesity and its relationship with chronic disease are attributed to authoritative experts or expert organisations. The textual practice of presupposition is evident with the implied causal relationship between obesity and chronic disease being taken for granted and uncontested. Through the textual practice of lexical absence, there is a complete lack of alternative views about body weight and health. Likewise there is an absence of acknowledgement of the potential harms arising from focusing on body weight, such as increased body dissatisfaction, disordered eating, and, paradoxically, weight gain.Shame and BlameBoth Measure Up and Swap It, Don’t Stop It include a combination of written/verbal text and visual images that create a sense of shame and blame. In Measure Up, the central character starts out as young, slim man, and as he ages his waist circumference grows. When he learns that his expanding waistline is associated with an increased risk of chronic disease, his facial expression and body language convey that he is sad, dejected and fearful. In the still images, this character and a female character are positioned looking down at the tape measure as they measure their ‘too large’ waists. This position and the looks on their faces suggest hanging their heads in shame. The male characters in both campaigns specifically express shame about “letting themselves go” by unthinkingly practicing ‘unhealthy’ behaviours. The characters’ clothing also contribute to a sense of shame. Both male and female characters in Measure Up appear in their underwear, which suggests that they are being publicly shamed. The clothing of the Measure Up characters is similar to that worn by contestants in the television program The Biggest Loser, which explicitly uses shame to ‘motivate’ contestants to lose weight. Part of the public shaming of contestants involves their appearance in revealing exercise clothing for weigh-ins, which displays their fatness for all to see (Thomas, Hyde and Komesaroff). The stigmatising effects of this and other aspects of the Biggest Loser television program are well documented (Berry et al.; Domoff et al.; Sender and Sullivan; Thomas, Hyde and Komesaroff; Yoo). The appearance of the Measure Up characters in their underwear combined with their head position and facial expressions conveys a strong, consistent message that the characters both feel shame and are deserving of shame due to their self-inflicted ‘unhealthy’ behaviours. The focus on ‘healthy’ and ‘unhealthy’ behaviours contributes to accepted and contested health identities (Fry). The ‘accepted health identity’ is represented as responsible and aspiring to and pursuing good health. The ‘contested health identity’ is represented as unhealthy, consuming too much food, and taking health risks, and this identity is stigmatised by public health programs (Fry). The ‘contested health identity’ represents the application to public health of Goffman’s ‘spoiled identity’ on which much stigmatisation theorising and research has been based (Goffman). As a result of both lexical and visual textual practices, the social marketing campaigns contribute to the construction of the ‘accepted health identity’ through discourses of individual responsibility, choice and healthy lifestyle. Furthermore, they contribute to the construction of the spoiled or ‘contested health identity’ through discourses that people are naturally unhealthy and need to be frightened, guilted and shamed into stopping ‘unhealthy’ behaviours and adopting ‘healthy’ behaviours. The ‘contested health identity’ constructed through these discourses is in turn stigmatised by such discourses. Thus the campaigns not only risk perpetuating stigmatisation through the reinforcement of the health identities, but possibly extend it further by legitimising the stigma associated with such identities. Given that these campaigns are conducted by the Australian Government, the already deeply stigmatising social belief system receives a significant boost in legitimacy by being positioned as a public health belief system perpetrated by the Government. Fear and AlarmIn the Measure Up television advertisement the main male character’s daughter, who has run into the frame, abruptly stops and looks fearful when she hears about his increased risk of disease. Using the discursive practice of claims-making, the authoritative external source informs the man that the more he gains (in terms of his waist circumference), the more he has to lose. The clear implication is that he needs to be fearful of losing his health, his family and even his life if he doesn’t reduce his waist circumference. The visual metaphor of a balloon is used as the central semiotic trope in Swap It, Don’t Stop It. The characters and other items featuring in the visuals are all made from twisting balloons. Balloons themselves may not create fear or alarm, unless one is unfortunate to be afflicted with globophobia (Freed), but the visual metaphor of the balloon in the social marketing campaign had a range of alarmist meanings. At the population level, rates and/or costs of obesity have been described in news items as ‘ballooning’ (Body Ecology; Stipp; AFP; Thien and Begawan) with accompanying visual images of extremely well-rounded bodies or ‘headless fatties’ (Cooper). Rapid or significant weight gain is referred to in everyday language as ‘ballooning weight’. The use of the balloon metaphor as a visual device in Swap It, Don’t Stop It serves to reinforce and extend these alarmist messages. Further, there is no attempt in the campaigns to reduce alarm by including positive or neutral photographs or images of fat people. This visual semiotic absence – a form of cultural imperialism (Young) – contributes to the invisibilisation of ‘real life’ fat people who are not ashamed of themselves. Habermas suggests that society evolves and operationalises through rational communication which includes the capacity to question the validity of claims made within communicative action (Habermas The Structural Transformation of the Public Sphere; Habermas The Theory of Communicative Action: Reason and the Rationalisation of Society). However the communicative action taken by the social marketing campaigns analysed in this study presents claims as uncontested facts and is therefore directorial about the expectations of individuals to take more responsibility for themselves, adopt certain behaviours and reduce or prevent obesity. Habermas argues that the lack or distortion of rational communication erodes relationships at the individual and societal levels (Habermas The Theory of Communicative Action: Reason and the Rationalisation of Society; Habermas The Structural Transformation of the Public Sphere). The communicative actions represented by the social marketing campaigns represents a distortion of rational communication and therefore erodes the wellbeing of individuals (for example through internalised stigma, shame, guilt, body dissatisfaction, weight preoccupation, disordered eating and avoidance of health care), relationships between individuals (for example through increased blame, coercion, stigma, bias, prejudice and discrimination) and society (for example through stigmatisation of groups in the population on the basis of their body size and increased social and health inequity). Habermas proposes that power differentials work to distort rational communication, and that it is these distortions in communication that need to be the focal point for change (Habermas The Theory of Communicative Action: Reason and the Rationalisation of Society; Habermas The Theory of Communicative Action: The Critique of Functionalist Reason; Habermas The Structural Transformation of the Public Sphere). Through critical analysis of the discourses used in the social marketing campaigns, we identified that they rely on the power, authority and status of experts to present uncontested representations of body weight and ‘appropriate’ health responses to it. In identifying the discourses present in the social marketing campaigns, we hope to focus attention on and thereby disrupt the distortions in the practical knowledge of the weight-centred health paradigm in order to contribute to systemic reorientation and change.ConclusionThrough the use of textual, discursive and social practices, the social marketing campaigns analysed in this study perpetuate the following concepts: everyone should be alarmed about growing waistlines and ‘ballooning’ rates of ‘obesity’; individuals are to blame for excess body weight, due to ignorance and the practice of ‘unhealthy behaviours’; individuals have a moral, parental, familial and cultural responsibility to monitor their weight and adopt ‘healthy’ eating and physical activity behaviours; such behaviour changes are easy to make and will result in weight loss, which will reduce risk of disease. These paternalistic campaigns evoke feelings of personal and parental guilt and shame, resulting in coercion to ‘take action’. They simultaneously stigmatise fat people yet serve to invisibilise them. Public health agencies must consider the harmful consequences of social marketing campaigns focused on body weight.ReferencesAFP. "A Ballooning Health Issue around the World." Gulfnews.com 29 May 2013. 17 Sep. 2013 ‹http://gulfnews.com/news/world/other-world/a-ballooning-health-issue-around-the-world-1.1189899›.Aphramor, Lucy. "The Impact of a Weight-Centred Treatment Approach on Women's Health and Health-Seeking Behaviours." Journal of Critical Dietetics 1.2 (2012): 3-12.Aphramor, Lucy, and Jacqui Gingras. "That Remains to Be Said: Disappeared Feminist Discourses on Fat in Dietetic Theory and Practice." The Fat Studies Reader, eds. Esther Rothblum and Sondra Solovay. New York: New York University Press, 2009. 97-105. Australian Government Department of Health and Ageing. "Measure Up." 2010. 3 Aug. 2011 ‹https://web.archive.org/web/20110817065823/http://www.measureup.gov.au/internet/abhi/publishing.nsf/Content/About+the+campaign-lp›.———. "Swap It, Don't Stop It." 2011. 20 Aug. 2011 ‹https://web.archive.org/web/20110830084149/http://swapit.gov.au›.———. "Tomorrow People." 2010. 3 Aug. 2011 ‹https://web.archive.org/web/20110821140445/http://www.measureup.gov.au/internet/abhi/publishing.nsf/Content/tp_home›.Bacon, Linda, and Lucy Aphramor. "Weight Science: Evaluating the Evidence for a Paradigm Shift." Nutrition Journal 10.9 (2011). Bacon, Linda, and Lucy Aphramor. Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight. Dallas: BenBella Books, 2014. Berry, Tanya R., et al. "Effects of Biggest Loser Exercise Depictions on Exercise-Related Attitudes." American Journal of Health Behavior 37.1 (2013): 96-103. Body Ecology. "Obesity Rates Ballooning – Here's What You Really Need to Know to Lose Weight and Keep It Off." 2009. 9 Jun. 2011 ‹http://bodyecology.com/articles/obesity-rates-ballooning.php›.Brown, Harriet. Body of Truth: How Science, History and Culture Drive Our Obsession with Weight – and What We Can Do about It. Boston: Da Capo Press, 2015. Campos, Paul. The Obesity Myth. New York: Gotham Books, 2004. Carter, Stacy M., et al. "The Ethical Commitments of Health Promotion Practitioners: An Empirical Study from New South Wales, Australia." Public Health Ethics 5.2 (2012): 128-39. Carter, Stacy M., et al. "Evidence, Ethics, and Values: A Framework for Health Promotion." American Journal of Public Health 101.3 (2011): 465-72. Cohen, Larry, Daniel P. Perales, and Catherine Steadman. "The O Word: Why the Focus on Obesity Is Harmful to Community Health." Californian Journal of Health Promotion 3.3 (2005): 154-61. Cooper, Charlotte. "Olympics/Uhlympics: Living in the Shadow of the Beast." thirdspace: a journal of feminist theory & culture 9.2 (2010). Crotty, Michael. The Foundations of Social Research: Meaning and Perspective in the Research Process. 1st ed. Crows Nest: Allen and Unwin, 1998. Domoff, Sarah E., et al. "The Effects of Reality Television on Weight Bias: An Examination of the Biggest Loser." Obesity 20.5 (2012): 993-98. Freed, Megan. "Uncommon Phobias: The Fear of Balloons." Yahoo Voices 2007. 17 Sep. 2013 ‹http://voices.yahoo.com/uncommon-phobias-fear-balloons-338043.html›.Fry, Craig L. "Ethical Issues in Obesity Interventions for Populations." New South Wales Public Health Bulletin 23.5-6 (2012): 116-19. Gaesser, Glenn A. "Is It Necessary to Be Thin to Be Healthy?" Harvard Health Policy Review 4.2 (2003): 40-47. Gard, Michael. The End of the Obesity Epidemic. Oxon: Routledge, 2011. Goffman, E. Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, NJ: Prentice Hall, 1963.Habermas, Jürgen. The Theory of Communicative Action: Reason and the Rationalisation of Society. Vol. 1. Cambridge: Polity Press, 2004. ———. The Theory of Communicative Action: The Critique of Functionalist Reason. Vol. 2. Cambridge: Polity Press, 2004.———. The Structural Transformation of the Public Sphere. Cambridge: Polity Press, 2002.Jacobs, Keith. "Discourse Analysis." Social Research Methods: An Australian Perspective, ed. Maggie Walter. South Melbourne, Vic.: Oxford University Press, 2006. Lupton, Deborah. "'How Do You Measure Up?' Assumptions about 'Obesity' and Health-Related Behaviors and Beliefs in Two Australian 'Obesity' Prevention Campaigns." Fat Studies 3.1 (2014): 32-44. Machin, David, and Andrea Mayr. How to Do Critical Discourse Analysis: A Multimodal Introduction. London: Sage Publications 2012. MacLean, Lynne, et al. "Obesity, Stigma and Public Health Planning." Health Promotion International 24.1 (2009): 88-93. Mansfield, Louise, and Emma Rich. "Public Health Pedagogy, Border Crossings and Physical Activity at Every Size." Critical Public Health 23.3 (2013): 356-70. McPhail-Bell, Karen, Bronwyn Fredericks, and Mark Brough. "Beyond the Accolades: A Postcolonial Critique of the Foundations of the Ottawa Charter." Global Health Promotion 20.2 (2013): 22-29. Monaghan, Lee F., Rachel Colls, and Bethan Evans. "Obesity Discourse and Fat Politics: Research, Critique and Interventions." Critical Public Health 23.3 (2013): 249-62. Murray, Samantha. The 'Fat' Female Body. London: Palgrave Macmillan, 2008. Nuffield Council on Bioethics. Public Health: Ethical Issues. London: Nuffield Council on Bioethics, 2007. O'Dea, Jennifer A. "Prevention of Child Obesity: 'First, Do No Harm'." Health Education Research 20.2 (2005): 259-65. O'Hara, Lily, and Jane Gregg. "The War on Obesity: A Social Determinant of Health." Health Promotion Journal of Australia 17.3 (2006): 260-63. O'Reilly, Caitlin. "Weighing In on the Health and Ethical Implications of British Columbia's Weight Centered Health Paradigm." Simon Fraser University, 2011. O'Reilly, Caitlin, and Judith Sixsmith. "From Theory to Policy: Reducing Harms Associated with the Weight-Centered Health Paradigm." Fat Studies 1.1 (2012): 97-113. Oliver, J. "The Politics of Pathology: How Obesity Became an Epidemic Disease." Perspectives in Biology and Medicine 49.4 (2006): 611-27. Pederson, A., et al., eds. Rethinking Women and Healthy Living in Canada. Vancouver, BC: British Columbia Centre of Excellence for Women's Health, 2013. Puhl, Rebecca, and Chelsea Heuer. "Obesity Stigma: Important Considerations for Public Health." American Journal of Public Health 100.6 (2010): 1019. Puhl, Rebecca M., T. Andreyeva, and Kelly D. Brownell. "Perceptions of Weight Discrimination: Prevalence and Comparison to Race and Gender Discrimination in America." International Journal of Obesity 32 (2008): 992-1000.Rich, Emma, Lee Monaghan, and Lucy Aphramor, eds. Debating Obesity: Critical Perspectives. Basingstoke: Palgrave MacMillan, 2011. Rothblum, Esther, and Sondra Solovay, eds. The Fat Studies Reader. New York: New York University Press, 2009. Saguy, Abigail. What's Wrong with Fat? New York: Oxford University Press, 2013.Sender, Katherine, and Margaret Sullivan. "Epidemics of Will, Failures of Self-Esteem: Responding to Fat Bodies in The Biggest Loser and What Not to Wear." Continuum 22.4 (2008): 573-84. Solovay, Sondra. Tipping the Scales of Justice: Fighting Weight-Based Discrimination. New York: Prometheus Books, 2000.Stipp, David. "Obesity — Not Aging — Balloons Health Care Costs." Pacific Standard 2011. 17 Sep. 2013 ‹http://www.psmag.com/health/obesity-aging-cause-ballooning-health-care-costs-31879/›.Ten Have, M., et al. "Ethics and Prevention of Overweight and Obesity: An Inventory." Obesity Reviews 12.9 (2011): 669-79. Thien, Rachel, and Bandar Seri Begawan. "Obesity Balloons among Brunei Students." The Brunei Times 2010. 17 Sep. 2013 ‹http://www.bt.com.bn/news-national/2010/02/10/obesity-balloons-among-brunei-students›.Thomas, Samantha, Jim Hyde, and Paul Komesaroff. "'Cheapening the Struggle:' Obese People's Attitudes towards the Biggest Loser." Obesity Management 3.5 (2007): 210-15. Tylka, Tracy L., et al. "The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss." Journal of Obesity (2014): 18. Article ID 983495.Walls, Helen, et al. "Public Health Campaigns and Obesity – A Critique." BMC Public Health 11.1 (2011): 136. White, Francis Ray. "Fat, Queer, Dead: ‘Obesity’ and the Death Drive." Somatechnics 2.1 (2012): 1-17. Wright, Jan. "Biopower, Biopedagogies and the Obesity Epidemic." Biopolitics and the ‘Obesity Epidemic’: Governing Bodies. Ed. Jan Wright and Valerie Harwood. New York: Routledge, 2009. 1-14.Yoo, Jina H. "No Clear Winner: Effects of the Biggest Loser on the Stigmatization of Obese Persons." Health Communication 28.3 (2013): 294-303. Young, Iris Marion. "Five Faces of Oppression." The Philosophical Forum 19.4 (1988): 270-90.

As a mode of open access public self-expression, blogs are one form of the unfolding massification of culture (Lovink). Though widely varied in content and style, they are characterised by a reverse chronological diary-like format, often produced by a single author, and often intimately expressive of that author’s thoughts and experiences. The purpose of this paper is to explore the use of blogs as a space for the detailed and on-going expression of the day to day experiences of sufferers of serious illness. We might traditionally consider the experience of illness as absolutely private, but illness, along with the process of recovery, retains a social and cultural aspect (Kleinman et al). A growing body of literature has recognised that the Internet has become a significant space for the recovery work that accompanies the diagnosis of serious illness (Orgad; Pitts; Hardey). Empowerment and agency are often emphasised in this literature, particularly in terms of the increased access to information and support groups, but also in the dynamic performances of self enabled by different forms of online communication and Web production. I am particularly interested in the ongoing shifts in the accessibility of “private” personal experience enabled by blog culture. Although there are thousands of others like them, three “illness blogs” have recently caught my attention for their candidness, completeness and complexity, expressing in vivid depth and detail individual lives transformed by serious illness. The late US journalist and television producer Leroy Sievers maintained a high profile blog, My Cancer, and weekly podcast on the National Public Radio website until his death from metastasised colon cancer in August 2008. Sievers used his public profile and the infrastructure of the NPR website to both detail his personal experience and bring together a community of people also affected by cancer or moved by his thoughts and experiences. The blogger Brainhell came to my attention through blogsphere comments and tributes when he died in February 2008. Spanning more than four years, Brainhell’s witty and charming blog attracted a significant audience and numerous comments, particularly toward the end of his life as the signs of his deteriorating motor system as a result of Amyotrophic Lateral Sclerosis (ALS, or “Lou Gherig’s disease”) riddled his intimate posts. Another blog of interest to me here, called Humanities Researcher, incorporates academic Stephanie Trigg’s period of illness and recovery from breast cancer within a pre-existing and ongoing blog about the intersection between professional and personal life. As I had crossed paths with Trigg while at Melbourne University, I was always interested in her blog. But her diagnosis with breast cancer and subsequent accounts of tests, the pain and debilitation of treatment and recovery within her blog also offer valuable insight into the role of online technologies in affecting experiences of illness and for the process of recovery.The subject matter of illness blogs revolves around significant personal transformations as a result of serious illness or trauma: transformations of everyday life, of body and emotional states, relationships, physical appearance, and the loss or recovery of physical ability. It is not my intention in this brief analysis to overgeneralise on the basis of some relatively limited observations. However, many blogs written in response to illness stand out for what they reveal about the shifting location or locatability of self, experience and the events of ongoing illness and thus how we can conceptualise the inherent “privacy” of illness as personal experience. Self-expression here is encompassing of the possibilities through which illness can be experienced – not as representation of that experience, a performance of a disembodied self (though these notions have their merits) – but an expressive element of the substance of the illness as it is experienced over time, as it affects the bodies, thoughts, events and relationships of individuals moving toward a state of full recovery or untimely death. Locating Oneself OnlineMany authors currently examining the role of online spaces in the lives of sufferers of serious illness see online communication as providing a means for configuring experience as a meaningful and coherent story, and thus conferring, or we could say recovering, a sense of agency amidst a tumultuous and ongoing battle with serious illness (Orgad, Pitts). In her study of breast cancer discussion forums, message boards and websites, Orgad (4) notes their role in regaining “the fundamentals disturbed by cancer” (see also Bury). Well before the emergence of online spaces, the act or writing has been seen as “a crucial affirmation of living, a statement against fearfulness, invisibility and silence” (Orgad, 67; Lorde, 61). For many decades scientists have asserted that “brief structured writing sessions can significantly improve mental and physical health for some groups of people” (Singer and Singer 485). The Internet has provided an infrastructure for bringing personal experiences of illness into the public realm, enabling a new level of visibility. Much of the work on illness and the Internet focuses on the liberatory and empowering act of story telling and “disembodied” self-expression. Discussion forums and cancer websites enable the formation of patient led “discourse communities” (Wuthnow). Online spaces such as discussion forums help their participants gain a foothold within a world they share with other sufferers, building communities of practice (Wegner) around specific forms of illness. In this way, these forms of self-expression and communication enable the sufferer of serious illness to counter the modes by which they are made “subjects”, in the Foucauldian sense, of medical discourse. All illness narratives are defined and constructed socially, and are infused with relations of power (Sontag; Foucault, Birth of the Clinic). Forms of online communication have shifted productive practice from professions to patients. Blogs, like discussion forums, websites, email lists etc., have come to play a central role in this contemporary shift. When Lovink (6) describes blogs as a “technology of the self” he points to their role in “self-fashioning”. Blogs written about and in the context of personal illness are a perfect example of this inclination to speak the truth of oneself in the confessional mode of modern culture borne of the church, science and talkshow television. For Foucault (Technologies of the Self, 17), technologies of the self: Permit individuals to effect by their own means or with the help of others a certain number of operations on their own bodies and souls, thoughts, conduct and way of being, so as to transform themselves in order to attain a state of happiness, purity, wisdom, perfection, immortality. Likewise, as a central concept for understanding Internet identity, the notion of performance (eg, Turkle) highlights the creativity with which illness bloggers may present their role as cancer patient in online spaces, perhaps as an act of resistance to “subjectifying” medical discourses and practices. Many bloggers wrest semiotic power through regular discussion of the language of pathology and medical knowledge, treatment processes and drugs. In the early stages of her treatment, Trigg plays with the new vocabulary, searching for etiologies and making her own semantic connections: I’ve learnt two new words. “Spiculated” describes the characteristic shape of a carcinoma on an ultrasound or x-ray. …The other word is at the other end of the spectrum of linguistic beauty: “lumpectomy”. It took me quite a while to realise that this was not really any different from partial mastectomy; or local excision. It’s an example of the powerful semantic connotations of words to realise that these phrases name the same processes: a long cut, and then the extraction of the diseased tissue (Humanities Researcher, 14 Oct. 2006).Partly due to the rarity of his illness, Brainhell goes through weeks of waiting for a diagnosis, and posts prolifically in an attempt to test out self-diagnoses. Amidst many serious and humorous posts analysing test results and discussing possible diagnoses Brainhell reflects on his targeted use of the blog: I am a word person. I think in sentences. I often take complex technical problems at work and describe them to myself in words. A story helps me understand things better. This blog has become a tool for me to organize my own thoughts about the Mystery Condition. (Brainhell, 6 Jan. 2004)The emancipatory potential of blog writing, however, can be easily overstated. While it is valuable to note and celebrate the performative potential of online production, and its “transformative” role as a technology of the self, it is easy to fall back on an unproblematic distinction between the actual and the virtual, the experience of illness, and its representation in online spaces. Textual expression should always refer us to the extra-textual practices that encompass it without imposing an artificial hierarchy of online and offline, actual experience and representation. As with other forms of online communication and production, the blog culture that has emerged around forms of serious illness plays a significant role in transforming our concepts of the relationship between online and offline spaces. In his My Cancer blog, Sievers often refers to “Cancer World”. He notes, for example, the many “passing friends” he makes in Cancer World through the medical staff and other regular patients at the radiation clinic, and refers to the equipment that sustains his life as the accoutrements of this world. His blog posts revolved around an articulation of the intricacies of this “world” that is in some ways a means of making sense of that world, but is also expressive of it. Sievers tries to explain the notion of Cancer World as a transformation of status between insider & outsider: “once we cross over into Cancer World, we become strangers in a strange land. What to expect, what to hope for, what to fear – none of those are clear right now” (My Cancer, 30 June 2008). Part of his struggle with the illness is also with the expression of himself as encompassed by this new “world” of the effects and activities of cancer. In a similar way, in her Humanities Researcher blog Trigg describes in beautiful detail the processes, routines and relationships formed during radiation treatment. I see these accounts of the textures of cancer spaces as lying at the point of juncture between expression and experience, not as a disembodied, emancipatory realm free from the fetters of illness and the everyday “real” self, but always encompassed by, and encompassing them, and in this way shifting what might be understood to remain “private” in personal experience and self-expression. Blogs as Public Diary Axel Bruns (171), following Matthew Rothenberg, characterises blogs as an accessible technological extension of the personal home page, gaining popularity in the late 1990s because they provided more easy to use templates and web publishing tools than earlier webpage applications. Personalised self expression is a defining element. However, the temporal quality of the reverse chronological, timestamped entry is equally significant for Bruns (171). Taking a broader focus to Bruns, who is most interested in the potential democratisation of media in news related blogs, Lovink sees the experimentation with a “public diary” format as fundamental, signalling their “productive contradiction between public and private” (Lovink 6). A diary may be written for posterity but it is primarily a secretive mode of communication. While blogs may mirror the temporal form of a diary, their intimate focus on self-expression of experience, thoughts and feelings, they do so in a very different communicative context.Despite research suggesting that a majority of bloggers report that they post primarily “for themselves” (Lenhart and Fox) – meaning that they do not deliberately seek a broad audience or readership – the step of making experiences and thoughts so widely accessible cannot be overlooked in any account of blogging. The question of audience or readership, for example, concerns Trigg in her Humanities Researcher blog: The immediacy of a blog distinguishes it from a journal or diary. I wrote for myself, of course, but also for a readership I could measure and chart and hear from, sometimes within minutes of posting. Mostly I don’t know who my readers are, but the kindness and friendship that come to me through the blog gave me courage to write about the intimacies of my treatment; and to chart the emotional upheaval it produced. (Trigg)In their ability to produce a comprehensive expression of the events, experiences, thoughts and feelings of an individual, blogs differ to other forms of online communication such as discussion forums or email lists. Illness blogs are perhaps an extreme example, an open mode of self-expression often arising abruptly in reaction to a life transforming diagnosis and tracking the process of recovery or deterioration, usually ending with remission or death. Brainhell’s blog begins with MRI results, and a series of posts about medical examination and self-examination regarding his mystery condition: So the MRI shows there is something on my brain that is not supposed to be there. The doctor thinks it is not a tumor. That would be good news. …As long as you are alive and have someone to complain to, you ain’t bad off. I am alive and I am complaining about a mystery spot on my brain, and lazy limbs. (Brainhell, 24 Dec. 2003)Brainhell spent many weeks documenting his search for a diagnosis, and continued writing up to his final deterioration and death in 2008. His final posts convey his physical deterioration in truncated sentences, spelling errors and mangled words. In one post he expresses his inability to wake his caregiver and to communicate his distress and physical discomfort at having to pee: when he snorted on waking, i shrieked and he got me up. splayed uncomfortably in the wc as he put dry clothes on me, i was gifted with his words: “you choose this, not me. you want to make it hard, what can i do?” (Brainhell, 13 Jan. 2008). The temporal and continuous format of the blog traverses the visceral, corporeal transformations of body and thought over time. The diary format goes beyond a straightforward narrative form in being far more experiential and even experimental in its self-reflective expression of the events of daily life, thoughts, feelings and states of being. Its public format bears directly on its role in shaping the communicative context in which that expression takes place, and thus to an extent shapes the experience of the illness itself. Nowhere does the expressive substance of the blog so fully encompass the possibilities through which the illness could be experienced than in the author’s death. At this point the blog feels like it is more than a catalogue, dialogue or self-presentation of a struggle with illness. It may take on the form of a memorial (see for example Tom’s Road to Recovery) – a recovery of the self expressed in the daily physical demise, through data maintained in the memory of servers. Ultimately the blog stands as a complex trace of the life lived within its posts. Brainhell’s lengthy blog exemplifies this quite hauntingly. Revealing the Private in Public Blogs exemplify a further step in the transformation of notions of public and private brought about by information and screen technologies. McQuire (103) refers to contemporary screen and Internet culture as “a social setting in which personal identity is subject to new exigencies”. Reality television, such as Big Brother, has promoted “a new mode for the public viewing of private life” (McQuire 114) contributing to the normalisation of open access to personal, intimate revelations, actions and experiences. However, privacy is “an elusive concept” that relates as much to information and property as to self-expression and personal experience (McCullagh). That is, what we consider private to an individual is itself constituted by our variable categories of personal information, material or immaterial possessions, or what counts as an expression of personal experience. Some analysts of online storytelling in the context of illness recognise the unsustainability of the distinction between public and private, but nonetheless rely on the notion of a continuum upon which activities or events could be considered as experienced in a public or private space (Orgad, 129-133). One of the characteristics of a blog, unlike other forms of online communication such as chat, discussion forums and email, is its predominantly public and openly accessible form. Though many illness bloggers do not seem to seek anonymity or hold back in allowing massive access to their self-expression and personal experience, a tension always seems to be there in the background. Identification through the proper name simply implies potential broader effects of blog writing, a pairing of the personal expressions with the person who expresses them in broader daily interactions and relationships. As already “public” figures, Stephanie Trigg and Leroy Sievers choose to forego anonymity, while Brainhell adopted his alias from the beginning and guarded his anonymity carefully. Each of these bloggers, however, shows signs of grappling with the public character of their site, and the interaction between the blog and their everyday life and relationships. In his etiquette page, Brainhell seems unclear about his readership, noting that his blog is for “friends and soul-mates, and complete strangers too”, but that he has not shared it with his family or all of his friends. He goes on to say: You may not have been invited but you are still welcome here. I made it public so that anyone could read it. Total strangers are welcome. Invited friends are welcome. But of those invited friends, I ask you to ask me before you out me as the blog author, or share the blog with other people who already know me. (Brainhell, 18 Feb. 2004) After his death Ratty took steps to continue to maintain his anonymity, vetting many comments and deleting others to “honor BH’s wishes as he outline in ‘Ettiquett for This Blog”’ (Brainhell, 2 Feb. 2008). In Leroy Sievers’ blog, one post exploring the conflict raised by publicly “sharing” his experiences provoked an interesting discussion. He relays a comment sent to him by a woman named Cherie: I have stage four colorectal cancer with liver mets. This is a strange journey, one I am not entirely sure I can share with my loved ones. I am scared it might rob them of the hope I see in their eyes. The hope which I sometimes don’t believe in. (My Cancer, 26 July 2006) Sievers struggles with this question: “How do you balance the need to talk about what is happening to you with the tears of a close friend when you tell him or her the truth? There’s no simple answer.” The blog, in this sense, seems to offer a more legitimate space for the ongoing, detailed expression of these difficult and affective, and traditionally private experiences. In some posts the privacy of the body and bodily experiences is directly challenged or re-negotiated. Stephanie Trigg was concerned with the effect of the blog on her interactions with colleagues. But another interesting dilemma presents itself to her when she is describing the physical effects of cancer, surgery and radiation treatment on her breast, and forces herself to hold back from comparing with the healthy breast: “it's not a medical breast, so I can't write about it here” (Humanities Researcher, 10 Jan. 2007). One prostate cancer blogger, identified as rdavisjr, seems to have no difficulties expressing the details of a physical intrusion on his “privacy” in the far more open forum of his blog: The pull-around ceiling mounted screen was missing (laundry?), so Kelly was called into the room and told to make a screen with a bed sheet. So here I am with one woman sticking her finger up my ass, while another woman is standing in front of the door holding an outstretched bed sheet under her chin (guess she wanted a view!)The screen was necessary to ensure my privacy in the event someone accidentally came into the room, something they said was a common thing. Well, Kelly peering over that sheet was hardly one of my more private moments in life! (Prostate Cancer Journal, 23 Feb. 2001). ConclusionWhatever emancipatory benefits may be found in expressing the most intimate of experiences and events of a serious illness online, it is the creative act of the blog as self-expression here, in its visceral, comprehensive, continuous timestamped format that dismantles the sense of privacy in the name of recovery. The blog is not the public face of private personal experience, but expressive of the life encompassed by that illness, and encompassing its author’s ongoing personal transformation. The blogs discussed here are not alone in demonstrating these practices. The blog format itself may soon evolve or disappear. Nonetheless, the massification enabled by Internet technologies and applications will continue to transform the ways in which personal experience may be considered private. ReferencesBruns, Axel. Gatewatching: Collaborative Online News Production. New York: Peter Lang, 2005.Bury, Michael. “Chronic Illness as Biographical Disruption.” Sociology of Health and Illness, 4.2 (1982): 167-182.Foucault, Michel. Birth of the Clinic: An Archaeology of Medical Perception. Trans. A.M. Sheridan. London: Tavistock, 1973.———. “Technologies of the Self” Technologies of the Self: A Seminar with Michel Foucault. Ed. Luther H. Martin, Huck Gutman, Patrick M. Hutton, 1988: 16-49. Hardey, Michael. “‘The Story of My Illness’: Personal Accounts of Illness on the Internet.” Health 6.1 (2002): 31-46Kleinman, Arthur, Veena Das, and Margaret Lock, eds. Social Suffering. Berkeley: University of California Press, 1997. Lenhart, Amanda, and Susannah Fox. Bloggers: A Portrait of the Internet’s New Storytellers. Washington: PEW Internet and American Life Project, 2006. Lorde, Audre. The Cancer Journals. San Francisco: Spinsters Ink, 1980.Lovink, Geert. Zero Comments: Blogging and Critical Internet Culture. London: Routledge, 2008. McCullagh, Karen. “Blogging: Self Presentation and Privacy.” Information and Communications Technology Law 17.1 (2008): 3-23. McQuire, Scott. “From Glass Architecture to Big Brother: Scenes from a Cultural History of Transparency.” Cultural Studies Review 9.1 (2003): 103-123.Orgad, Shani. Storytelling Online: Talking Breast Cancer on the Internet. New York: Peter Lang, 2005. Pitts, Victoria. “Illness and Internet Empowerment: Writing and Reading Breast Cancer in Cyberspace.” Health 8.1 (2004): 33-59.Rothenberg, Matthew. “Weblogs, Metadata, and the Semantic Web”, paper presented at the Association of Internet Researchers conference, Toronto, 16 Oct. 2003. ‹http://aoir.org/members/papers42/rothenberg_aoir.pdf›.Singer, Jessica, and George H.S. Singer. “Writing as Physical and Emotional Healing: Findings from Clinical Research.” Handbook of Research on Writing: History, Society, School, Individual, Text. Ed. Charles Bazerman. New York: Lawrence Erlbaum Associates, 2008: 485-498. Sontag, Susan. Illness as Metaphor; And, AIDS and Its Metaphors. London: Penguin, 1991. Trigg, Stephanie. “Life Lessons.” Sunday Age, 10 June 2007. Turkle, Sherry. Life on the Screen: Identity in the Age of the Internet. New York: Simon and Schuster, 1995. Wenger, Etienne. Communities of Practice: Learning, Meaning and Identity. Cambridge: Cambridge University Press, 1998. Wuthnow, Robert. Communities of Discourse: Ideology and Social Structure in the Reformation, the Enlightenment, and European Socialism. Cambridge, MA: Harvard University Press, 1989.BlogsBrainhell. ‹http://brainhell.blogspot.com/›. rdavisjr. Prostate Cancer Journal. ‹http://pcjournal-rrd.blogspot.com/›. Sievers, Leroy. My Cancer. ‹http://www.npr.org/blogs/mycancer/›. Tom’s Road to Recovery. ‹http://tomsrecovery.blog.com/›. Trigg, Stephanie. Humanities Researcher. ‹http://stephanietrigg.blogspot.com/›.

When we think of disability today in the Western world, Christopher Reeve most likely comes to mind. A film star who captured people’s imagination as Superman, Reeve was already a celebrity before he took the fall that would lead to his new position in the fame game: the role of super-crip. As a person with acquired quadriplegia, Christopher Reeve has become both the epitome of disability in Western culture — the powerful cultural myth of disability as tragedy and catastrophe — and, in an intimately related way, the icon for the high-technology quest for cure. The case of Reeve is fascinating, yet critical discussion of Christopher Reeve in terms of fame, celebrity and his performance of disability is conspicuously lacking (for a rare exception see McRuer). To some extent this reflects the comparative lack of engagement of media and cultural studies with disability (Goggin). To redress this lacuna, we draw upon theories of celebrity (Dyer; Marshall; Turner, Bonner, & Marshall; Turner) to explore the production of Reeve as celebrity, as well as bringing accounts of celebrity into dialogue with critical disability studies. Reeve is a cultural icon, not just because of the economy, industrial processes, semiotics, and contemporary consumption of celebrity, outlined in Turner’s 2004 framework. Fame and celebrity are crucial systems in the construction of disability; and the circulation of Reeve-as-celebrity only makes sense if we understand the centrality of disability to culture and media. Reeve plays an enormously important (if ambiguous) function in the social relations of disability, at the heart of the discursive underpinning of the otherness of disability and the construction of normal sexed and gendered bodies (the normate) in everyday life. What is distinctive and especially powerful about this instance of fame and disability is how authenticity plays through the body of the celebrity Reeve; how his saintly numinosity is received by fans and admirers with passion, pathos, pleasure; and how this process places people with disabilities in an oppressive social system, so making them subject(s). An Accidental Star Born September 25, 1952, Christopher Reeve became famous for his roles in the 1978 movie Superman, and the subsequent three sequels (Superman II, III, IV), as well as his role in other films such as Monsignor. As well as becoming a well-known actor, Reeve gained a profile for his activism on human rights, solidarity, environmental, and other issues. In May 1995 Reeve acquired a disability in a riding accident. In the ensuing months, Reeve’s situation attracted a great deal of international attention. He spent six months in the Kessler Rehabilitation Institute in New Jersey, and there gave a high-rating interview on US television personality Barbara Walters’ 20/20 program. In 1996, Reeve appeared at the Academy Awards, was a host at the 1996 Paralympic Games, and was invited to speak at the Democratic National Convention. In the same year Reeve narrated a film about the lives of people living with disabilities (Mierendorf). In 1998 his memoir Still Me was published, followed in 2002 by another book Nothing Is Impossible. Reeve’s active fashioning of an image and ‘new life’ (to use his phrase) stands in stark contrast with most people with disabilities, who find it difficult to enter into the industry and system of celebrity, because they are most often taken to be the opposite of glamorous or important. They are objects of pity, or freaks to be stared at (Mitchell & Synder; Thomson), rather than assuming other attributes of stars. Reeve became famous for his disability, indeed very early on he was acclaimed as the pre-eminent American with disability — as in the phrase ‘President of Disability’, an appellation he attracted. Reeve was quickly positioned in the celebrity industry, not least because his example, image, and texts were avidly consumed by viewers and readers. For millions of people — as evident in the letters compiled in the 1999 book Care Packages by his wife, Dana Reeve — Christopher Reeve is a hero, renowned for his courage in doing battle with his disability and his quest for a cure. Part of the creation of Reeve as celebrity has been a conscious fashioning of his life as an instructive fable. A number of biographies have now been published (Havill; Hughes; Oleksy; Wren). Variations on a theme, these tend to the hagiographic: Christopher Reeve: Triumph over Tragedy (Alter). Those interested in Reeve’s life and work can turn also to fan websites. Most tellingly perhaps is the number of books, fables really, aimed at children, again, on a characteristic theme: Learning about Courage from the Life of Christopher Reeve (Kosek; see also Abraham; Howard). The construction, but especially the consumption, of Reeve as disabled celebrity, is consonant with powerful cultural myths and tropes of disability. In many Western cultures, disability is predominantly understood a tragedy, something that comes from the defects and lack of our bodies, whether through accidents of birth or life. Those ‘suffering’ with disability, according to this cultural myth, need to come to terms with this bitter tragedy, and show courage in heroically overcoming their lot while they bide their time for the cure that will come. The protagonist for this this script is typically the ‘brave’ person with disability; or, as this figure is colloquially known in critical disability studies and the disability movement — the super-crip. This discourse of disability exerts a strong force today, and is known as the ‘medical’ model. It interacts with a prior, but still active charity discourse of disability (Fulcher). There is a deep cultural history of disability being seen as something that needs to be dealt with by charity. In late modernity, charity is very big business indeed, and celebrities play an important role in representing the good works bestowed on people with disabilities by rich donors. Those managing celebrities often suggest that the star finds a charity to gain favourable publicity, a routine for which people with disabilities are generally the pathetic but handy extras. Charity dinners and events do not just reinforce the tragedy of disability, but they also leave unexamined the structural nature of disability, and its associated disadvantage. Those critiquing the medical and charitable discourses of disability, and the oppressive power relations of disability that it represents, point to the social and cultural shaping of disability, most famously in the British ‘social’ model of disability — but also from a range of other perspectives (Corker and Thomas). Those formulating these critiques point to the crucial function that the trope of the super-crip plays in the policing of people with disabilities in contemporary culture and society. Indeed how the figure of the super-crip is also very much bound up with the construction of the ‘normal’ body, a general economy of representation that affects everyone. Superman Flies Again The celebrity of Christopher Reeve and what it reveals for an understanding of fame and disability can be seen with great clarity in his 2002 visit to Australia. In 2002 there had been a heated national debate on the ethics of use of embryonic stem cells for research. In an analysis of three months of the print media coverage of these debates, we have suggested that disability was repeatedly, almost obsessively, invoked in these debates (‘Uniting the Nation’). Yet the dominant representation of disability here was the cultural myth of disability as tragedy, requiring cure at all cost, and that this trope was central to the way that biotechnology was constructed as requiring an urgent, united national response. Significantly, in these debates, people with disabilities were often talked about but very rarely licensed to speak. Only one person with disability was, and remains, a central figure in these Australian stem cell and biotechnology policy conversations: Christopher Reeve. As an outspoken advocate of research on embryonic stem-cells in the quest for a cure for spinal injuries, as well as other diseases, Reeve’s support was enlisted by various protagonists. The current affairs show Sixty Minutes (modelled after its American counterpart) presented Reeve in debate with Australian critics: PRESENTER: Stem cell research is leading to perhaps the greatest medical breakthroughs of all time… Imagine a world where paraplegics could walk or the blind could see … But it’s a breakthrough some passionately oppose. A breakthrough that’s caused a fierce personal debate between those like actor Christopher Reeve, who sees this technology as a miracle, and those who regard it as murder. (‘Miracle or Murder?’) Sixty Minutes starkly portrays the debate in Manichean terms: lunatics standing in the way of technological progress versus Christopher Reeve flying again tomorrow. Christopher presents the debate in utilitarian terms: CHRISTOPHER REEVE: The purpose of government, really in a free society, is to do the greatest good for the greatest number of people. And that question should always be in the forefront of legislators’ minds. (‘Miracle or Murder?’) No criticism of Reeve’s position was offered, despite the fierce debate over the implications of such utilitarian rhetoric for minorities such as people with disabilities (including himself!). Yet this utilitarian stance on disability has been elaborated by philosopher Peter Singer, and trenchantly critiqued by the international disability rights movement. Later in 2002, the Premier of New South Wales, Bob Carr, invited Reeve to visit Australia to participate in the New South Wales Spinal Cord Forum. A journalist by training, and skilled media practitioner, Carr had been the most outspoken Australian state premier urging the Federal government to permit the use of embryonic stem cells for research. Carr’s reasons were as much as industrial as benevolent, boosting the stocks of biotechnology as a clean, green, boom industry. Carr cleverly and repeated enlisted stereotypes of disability in the service of his cause. Christopher Reeve was flown into Australia on a specially modified Boeing 747, free of charge courtesy of an Australian airline, and was paid a hefty appearance fee. Not only did Reeve’s fee hugely contrast with meagre disability support pensions many Australians with disabilities live on, he was literally the only voice and image of disability given any publicity. Consuming Celebrity, Contesting Crips As our analysis of Reeve’s antipodean career suggests, if disability were a republic, and Reeve its leader, its polity would look more plutocracy than democracy; as befits modern celebrity with its constitutive tensions between the demotic and democratic (Turner). For his part, Reeve has criticised the treatment of people with disabilities, and how they are stereotyped, not least the narrow concept of the ‘normal’ in mainstream films. This is something that has directly effected his career, which has become limited to narration or certain types of television and film work. Reeve’s reprise on his culture’s notion of disability comes with his starring role in an ironic, high-tech 1998 remake of Alfred Hitchcock’s Rear Window (Bleckner), a movie that in the original featured a photojournalist injured and temporarily using a wheelchair. Reeve has also been a strong advocate, lobbyist, and force in the politics of disability. His activism, however, has been far more strongly focussed on finding a cure for people with spinal injuries — rather than seeking to redress inequality and discrimination of all people with disabilities. Yet Reeve’s success in the notoriously fickle star system that allows disability to be understood and mapped in popular culture is mostly an unexplored paradox. As we note above, the construction of Reeve as celebrity, celebrating his individual resilience and resourcefulness, and his authenticity, functions precisely to sustain the ‘truth’ and the power relations of disability. Reeve’s celebrity plays an ideological role, knitting together a set of discourses: individualism; consumerism; democratic capitalism; and the primacy of the able body (Marshall; Turner). The nature of this cultural function of Reeve’s celebrity is revealed in the largely unpublicised contests over his fame. At the same time Reeve was gaining fame with his traditional approach to disability and reinforcement of the continuing catastrophe of his life, he was attracting an infamy within certain sections of the international disability rights movement. In a 1996 US debate disability scholar David T Mitchell put it this way: ‘He’s [Reeve] the good guy — the supercrip, the Superman, and those of us who can live with who we are with our disabilities, but who cannot live with, and in fact, protest and retaliate against the oppression we confront every second of our lives are the bad guys’ (Mitchell, quoted in Brown). Many feel, like Mitchell, that Reeve’s focus on a cure ignores the unmet needs of people with disabilities for daily access to support services and for the ending of their brutal, dehumanising, daily experience as other (Goggin & Newell, Disability in Australia). In her book Make Them Go Away Mary Johnson points to the conservative forces that Christopher Reeve is associated with and the way in which these forces have been working to oppose the acceptance of disability rights. Johnson documents the way in which fame can work in a variety of ways to claw back the rights of Americans with disabilities granted in the Americans with Disabilities Act, documenting the association of Reeve and, in a different fashion, Clint Eastwood as stars who have actively worked to limit the applicability of civil rights legislation to people with disabilities. Like other successful celebrities, Reeve has been assiduous in managing his image, through the use of celebrity professionals including public relations professionals. In his Australian encounters, for example, Reeve gave a variety of media interviews to Australian journalists and yet the editor of the Australian disability rights magazine Link was unable to obtain an interview. Despite this, critiques of the super-crip celebrity function of Reeve by people with disabilities did circulate at the margins of mainstream media during his Australian visit, not least in disability media and the Internet (Leipoldt, Newell, and Corcoran, 2003). Infamous Disability Like the lives of saints, it is deeply offensive to many to criticise Christopher Reeve. So deeply engrained are the cultural myths of the catastrophe of disability and the creation of Reeve as icon that any critique runs the risk of being received as sacrilege, as one rare iconoclastic website provocatively prefigures (Maddox). In this highly charged context, we wish to acknowledge his contribution in highlighting some aspects of contemporary disability, and emphasise our desire not to play Reeve the person — rather to explore the cultural and media dimensions of fame and disability. In Christopher Reeve we find a remarkable exception as someone with disability who is celebrated in our culture. We welcome a wider debate over what is at stake in this celebrity and how Reeve’s renown differs from other disabled stars, as, for example, in Robert McRuer reflection that: ... at the beginning of the last century the most famous person with disabilities in the world, despite her participation in an ‘overcoming’ narrative, was a socialist who understood that disability disproportionately impacted workers and the power[less]; Helen Keller knew that blindness and deafness, for instance, often resulted from industrial accidents. At the beginning of this century, the most famous person with disabilities in the world is allowing his image to be used in commercials … (McRuer 230) For our part, we think Reeve’s celebrity plays an important contemporary role because it binds together a constellation of economic, political, and social institutions and discourses — namely science, biotechnology, and national competitiveness. In the second half of 2004, the stem cell debate is once again prominent in American debates as a presidential election issue. Reeve figures disability in national culture in his own country and internationally, as the case of the currency of his celebrity in Australia demonstrates. In this light, we have only just begun to register, let alone explore and debate, what is entailed for us all in the production of this disabled fame and infamy. Epilogue to “Fame and Disability” Christopher Reeve died on Sunday 10 October 2004, shortly after this article was accepted for publication. His death occasioned an outpouring of condolences, mourning, and reflection. We share that sense of loss. How Reeve will be remembered is still unfolding. The early weeks of public mourning have emphasised his celebrity as the very embodiment and exemplar of disabled identity: ‘The death of Christopher Reeve leaves embryonic-stem-cell activism without one of its star generals’ (Newsweek); ‘He Never Gave Up: What actor and activist Christopher Reeve taught scientists about the treatment of spinal-cord injury’ (Time); ‘Incredible Journey: Facing tragedy, Christopher Reeve inspired the world with hope and a lesson in courage’ (People); ‘Superman’s Legacy’ (The Express); ‘Reeve, the Real Superman’ (Hindustani Times). In his tribute New South Wales Premier Bob Carr called Reeve the ‘most impressive person I have ever met’, and lamented ‘Humankind has lost an advocate and friend’ (Carr). The figure of Reeve remains central to how disability is represented. In our culture, death is often closely entwined with disability (as in the saying ‘better dead than disabled’), something Reeve reflected upon himself often. How Reeve’s ‘global mourning’ partakes and shapes in this dense knots of associations, and how it transforms his celebrity, is something that requires further work (Ang et. al.). The political and analytical engagement with Reeve’s celebrity and mourning at this time serves to underscore our exploration of fame and disability in this article. Already there is his posthumous enlistment in the United States Presidential elections, where disability is both central and yet marginal, people with disability talked about rather than listened to. The ethics of stem cell research was an election issue before Reeve’s untimely passing, with Democratic presidential contender John Kerry sharply marking his difference on this issue with President Bush. After Reeve’s death his widow Dana joined the podium on the Kerry campaign in Columbus, Ohio, to put the case herself; for his part, Kerry compared Bush’s opposition to stem cell research as akin to favouring the candle lobby over electricity. As we write, the US polls are a week away, but the cultural representation of disability — and the intensely political role celebrity plays in it — appears even more palpably implicated in the government of society itself. References Abraham, Philip. Christopher Reeve. New York: Children’s Press, 2002. Alter, Judy. Christopher Reeve: Triumph over Tragedy. Danbury, Conn.: Franklin Watts, 2000. Ang, Ien, Ruth Barcan, Helen Grace, Elaine Lally, Justine Lloyd, and Zoe Sofoulis (eds.) Planet Diana: Cultural Studies and Global Mourning. Sydney: Research Centre in Intercommunal Studies, University of Western Sydney, Nepean, 1997. Bleckner, Jeff, dir. Rear Window. 1998. Brown, Steven E. “Super Duper? The (Unfortunate) Ascendancy of Christopher Reeve.” Mainstream: Magazine of the Able-Disabled, October 1996. Repr. 10 Aug. 2004 http://www.independentliving.org/docs3/brown96c.html>. Carr, Bob. “A Class Act of Grace and Courage.” Sydney Morning Herald. 12 Oct. 2004: 14. Corker, Mairian and Carol Thomas. “A Journey around the Social Model.” Disability/Postmodernity: Embodying Disability Theory. Ed. Mairian Corker and Tom Shakespeare. London and New York: Continuum, 2000. Donner, Richard, dir. Superman. 1978. Dyer, Richard. Heavenly Bodies: Film Stars and Society. London: BFI Macmillan, 1986. Fulcher, Gillian. Disabling Policies? London: Falmer Press, 1989. Furie, Sidney J., dir. Superman IV: The Quest for Peace. 1987. Finn, Margaret L. Christopher Reeve. Philadelphia: Chelsea House Publishers, 1997. Gilmer, Tim. “The Missionary Reeve.” New Mobility. November 2002. 13 Aug. 2004 http://www.newmobility.com/>. Goggin, Gerard. “Media Studies’ Disability.” Media International Australia 108 (Aug. 2003): 157-68. Goggin, Gerard, and Christopher Newell. Disability in Australia: Exposing a Social Apartheid. Sydney: UNSW Press, 2005. —. “Uniting the Nation?: Disability, Stem Cells, and the Australian Media.” Disability & Society 19 (2004): 47-60. Havill, Adrian. Man of Steel: The Career and Courage of Christopher Reeve. New York, N.Y.: Signet, 1996. Howard, Megan. Christopher Reeve. Minneapolis: Lerner Publications, 1999. Hughes, Libby. Christopher Reeve. Parsippany, NJ.: Dillon Press, 1998. Johnson, Mary. Make Them Go Away: Clint Eastwood, Christopher Reeve and the Case Against Disability Rights. Louisville : Advocado Press, 2003. Kosek, Jane Kelly. Learning about Courage from the Life of Christopher Reeve. 1st ed. New York : PowerKids Press, 1999. Leipoldt, Erik, Christopher Newell, and Maurice Corcoran. “Christopher Reeve and Bob Carr Dehumanise Disability — Stem Cell Research Not the Best Solution.” Online Opinion 27 Jan. 2003. http://www.onlineopinion.com.au/view.asp?article=510>. Lester, Richard (dir.) Superman II. 1980. —. Superman III. 1983. Maddox. “Christopher Reeve Is an Asshole.” 12 Aug. 2004 http://maddox.xmission.com/c.cgi?u=creeve>. Marshall, P. David. Celebrity and Power: Fame in Contemporary Culture. Minneapolis and London: U of Minnesota P, 1997. Mierendorf, Michael, dir. Without Pity: A Film about Abilities. Narr. Christopher Reeve. 1996. “Miracle or Murder?” Sixty Minutes. Channel 9, Australia. March 17, 2002. 15 June 2002 http://news.ninemsn.com.au/sixtyminutes/stories/2002_03_17/story_532.asp>. Mitchell, David, and Synder, Sharon, eds. The Body and Physical Difference. Ann Arbor, U of Michigan, 1997. McRuer, Robert. “Critical Investments: AIDS, Christopher Reeve, and Queer/Disability Studies.” Journal of Medical Humanities 23 (2002): 221-37. Oleksy, Walter G. Christopher Reeve. San Diego, CA: Lucent, 2000. Reeve, Christopher. Nothing Is Impossible: Reflections on a New Life. 1st ed. New York: Random House, 2002. —. Still Me. 1st ed. New York: Random House, 1998. Reeve, Dana, comp. Care Packages: Letters to Christopher Reeve from Strangers and Other Friends. 1st ed. New York: Random House, 1999. Reeve, Matthew (dir.) Christopher Reeve: Courageous Steps. Television documentary, 2002. Thomson, Rosemary Garland, ed. Freakery: Cultural Spectacles of the Extraordinary Body. New York: New York UP, 1996. Turner, Graeme. Understanding Celebrity. Thousands Oak, CA: Sage, 2004. Turner, Graeme, Frances Bonner, and David P Marshall. Fame Games: The Production of Celebrity in Australia. Melbourne: Cambridge UP, 2000. Wren, Laura Lee. Christopher Reeve: Hollywood’s Man of Courage. Berkeley Heights, NJ : Enslow, 1999. Younis, Steve. “Christopher Reeve Homepage.” 12 Aug. 2004 http://www.fortunecity.com/lavender/greatsleep/1023/main.html>. Citation reference for this article MLA Style Goggin, Gerard & Newell, Christopher. "Fame and Disability: Christopher Reeve, Super Crips, and Infamous Celebrity." M/C Journal 7.5 (2004). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0411/02-goggin.php>. APA Style Goggin, G. & Newell, C. (Nov. 2004) "Fame and Disability: Christopher Reeve, Super Crips, and Infamous Celebrity," M/C Journal, 7(5). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0411/02-goggin.php>.