Reframing Process Research Articles

A concept in flux: questioning accountability in the context of global health cooperation.

BackgroundAccountability in global health is a commonly invoked though less commonly questioned concept. Critically reflecting on the concept and how it is put into practice, this paper focuses on the who, what, how, and where of accountability, mapping its defining features and considering them with respect to real-world circumstances. Changing dynamics in global health cooperation - such as the emergence of new health public-private partnerships and the formal inclusion of non-state actors in policy making processes - provides the backdrop to this discussion.DiscussionAccountability is frequently reduced to one set of actors holding another to account. Changes in the global health landscape and in relations between actors have however made the practice of accountability more complex and contested. Currently undergoing a reframing process, participation and transparency have become core elements of a new accountability agenda alongside evaluation and redress or enforcement mechanisms. However, while accountability is about holding actors responsible for their actions, the mechanisms through which this might be done vary substantially and are far from politically neutral.Accountability in global health cooperation involves multipolar relationships between a large number of stakeholders with varying degrees of power and influence, where not all interests are realised in that relationship. Moreover, accountability differs across finance, programme and governance subfields, where each has its own set of policy processes, institutional structures, accountability relations and power asymmetries to contend with. With reference to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, this paper contributes to discussions on accountability by mapping out key elements of the concept and how it is put into practice, where different types of accountability battle for recognition and legitimacy.SummaryIn mapping some defining features, accountability in global health cooperation is shown to be a complex problem not necessarily reducible to one set of actors holding another to account. Clear tensions are observed between multi-stakeholder participatory models and more traditional vertical models that prioritise accountability upwards to donors, both of which are embodied in initiatives like the Global Fund. For multi-constituency organisations, this poses challenges not only for future financing but also for future legitimacy.

Bioethics and the Framing of Climate Change's Health Risks.

Cheryl Cox Macpherson recently argued, in an article for this journal, that 'Climate Change is a Bioethics Problem'. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed in public health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields.

When idealists evade taxes: the influence of personal moral philosophy on attitudes to tax evasion – a Lebanese study

This paper explores attitudes regarding tax evasion and the relationship between personal moral philosophy and such attitudes in a weak tax environment. The results confirm the multidimensionality of tax evasion attitudes. Idealism was negatively related to self‐interest tax evasion attitudes while relativism was positively related to such attitudes. Idealism was also positively related to tax evasion attitudes stemming from concerns about the justice of the tax system. Idealists in a weak tax environment seemingly go through a cognitive reframing process where they recognize that the tax system is unfair, and accordingly tax evasion is a way to serve a different moral absolute, that is of equity, rather than another different moral absolute, which is fulfilling obligations to governments. The results are also explained in light of the suggested low moral intensity of tax evasion among respondents. Policy implications are presented.

Unsettled Framing: Institutional Dynamics of Essentially Contested Concepts

Framing contests arise when actors dispute the meaning of concepts. Institutional studies have shed light on the manner in which this contestation takes place after the introduction of multi-interpretable concepts. However, extant studies have failed to explain why many ethical, political, and academic debates in contemporary societies are subject to permanent contestation. The protracted academic debate around the terminology and interpretation of the contribution of business to society exemplifies recursive processes of framing, contestation, and reframing. We draw on insights from political theory, in particular, the debate around ‘essentially contested concepts’ (ECCs). We identify three key characteristics of ECCs (normativity, complexity, and commensuration), which contain the seeds of three mechanisms (inherent evangelism, unaccomplished discovery, and epistemic rivalry) that drive actors to engage in permanent framing contests over the ‘right’ or ‘optimal’ interpretation of ECCs. While controversy...

Towards a Post-radical Front National? Patterns of Ideological Change and dédiabolisation on the French Radical Right

Academic analyses of the French radical right tend to converge in their assessment that, since Marine Le Pen took over the campaign management of the 2007 presidential election and succeeded her father as party president, the Front National has undergone a path of image change and ideological deradicalization or, at least, that most radical and polemic stances have been toned down. Demonstrating that ideological change must be understood as a complex and multiform process, this article examines whether the dédiabolisation preached by Marine Le Pen has led to the emergence of a post-radical Front National. The analysis is based on a qualitative content analysis of campaign speeches and programmatic documents produced between 2007 and June 2012. The results reveal that, rather than an all-encompassing deradicalization, the FN has undergone a process of selective moderation, issue reframing and integration of republican lieux de mémoire accompanied by a radicalization of its programmatic responses to European integration.

Negotiating river restoration: The role of divergent reframing in environmental decision-making

In this paper we employ rhetoric culture theory, and a case study of upland channel truncation in the UK, to explore the nuanced processes of negotiation associated with environmental decision-making. In contrast to much of the literature on rhetoric in environmental management, which focuses on the means by which decisions are communicated and justified to an external audience, we focus on the dynamics of interaction and persuasion in and amongst a small group of decision-makers, and how, despite initial misgivings and conflict, they arrived at a decision consensus. We reflect on the importance of the rhetorical situation as a determinant of action and demonstrate how antagonisms were caused by competing moral notions of environmental restoration. We show that consensus was finally achieved through a process of divergent reframing, as individuals reframed the problem according to their own prior values. The outcome, therefore, was a consensus of action but a divergence of opinion, which sheds new light on the role of reframing in environmental management. Finally, we argue for a better understanding of how nuanced interactional processes influence not only small-scale interventions, but all environmental decision processes.

Discourses of legitimation in New Zealand’s film policy

This article highlights the difficulties and implications of attempts to build legitimacy for state-funded cinema. Through a framing analysis of political debates and policy developments in New Zealand, and informed by international concepts and perspectives from critical and cultural policy studies, it examines the discourses employed to justify offering public funds to New Zealand filmmakers, from the 1960s through to the late 2000s. By tracing the emergence and subsequent institutionalisation of cultural nationalism as a policy frame, the author explains how the New Zealand government came to fund, and justify its support of, the production of fictional films. While this frame has continued to legitimate cultural policy, it has had to make room for the discourse of economic rationalism, which undermines traditional justifications for film funding. Recent ‘creative industries’ discourse has not effectively reconciled these competing narratives. An inclusive and deliberative reframing process would be needed to institute a more widely supported legitimating discourse for publicly funded cinema.

Diagnostic reframing of intractable environmental problems: Case of a contested multiparty public land-use conflict

Intractable conflicts are omnipresent in environmental management. These conflicts do not necessarily resist resolution but need to be fundamentally transformed in order to reach agreement. Reframing, a process that allows disputants to create new alternative understandings of the problem, is one way of transforming these conflicts. Cognitive and interactional reframing are the two major approaches to conflict transformation. These approaches have some drawbacks. Cognitive reframing does not guarantee commensurate consideration of all disputants' views about the problem. Interactional reframing is prone to inter-disputant influences that interfere with presenting the problems as accurately as they exist in disputants' minds. Inadequate consideration of other disputants' views and inter-disputant influences often lead to inaccurate problem identification and definition. This in turn leads to solving the wrong problem, enabling intractability to persist. Proper problem identification and definition requires commensurate consideration of all sides of the conflict while minimizing inter-disputant influences. From a problem diagnosis perspective, we show how Q methodology is used to reframe environmental problems, rendering them more tractable to analysis while minimizing the influence of who disputants are talking with, and without ignoring the perspectives of other disputants. Using a case of contentious All-Terrain Vehicle (ATV) use in a state-administered public land, conflicting parties reframed the problem by prioritizing issues, outlining areas and levels of consensus and disagreement, and revealing inherent unrecognized and/or unspoken agendas. The reframing process surprisingly revealed several areas of common ground in disputants' diagnosis of the problem, including lack of emphasis on environmental protection and uncoordinated management factions. Emergent frames were misaligned on some issues, such as the behaviors of ATV riders and the role of management, including political and economic influences on decision making. We discuss how the reframing process enhances tractability of multiparty environmental problems. We point to some limitations of Q methodology as a tool for the diagnostic reframing of such problems.

Framing transformation: the counter-hegemonic potential of food sovereignty in the US context

Originally created by the international peasant movement La Via Campesina, the concept of “food sovereignty” is being used with increasing frequency by agrifood activists and others in the Global North. Using the analytical lens of framing, I explore the effects of this diffusion on the transformative potential of food sovereignty. US agrifood initiatives have recently been the subject of criticism for their lack of transformative potential, whether because they offer market-based solutions rather than demanding political ones or because they fail to adequately address existing social injustice. In this paper, I consider how food sovereignty measures up to this critique both as it was originally framed by Via Campesina and as it is being reframed for the US context. First I briefly compare food sovereignty to community food security (CFS), which was developed more explicitly for the North American context and has been criticized for its lack of transformative potential. I then explore how the potential of food sovereignty has been affected as it is reframed to resonate with US audiences through an examination of its use on the web sites of US-based organizations. I find that, while some reframing of the concept to highlight consumer choice does seem to be occurring, it remains a primarily political concept. It may not, however, be fulfilling its potential for addressing social injustice in the US agrifood system because it tends to be used either in reference to international issues or, when applied to the US context, treated as a rough synonym for local control. I conclude that, if advocates can successfully guide the reframing process, food sovereignty could serve as a valuable counter-hegemonic vision to complement the more pragmatic and locally-grounded work of CFS advocates.

Facilitating capabilities through reflection: from welfare to appreciative well‐being

During the laboratories of the Reflect‐OR project, the guidance counseling practitioners told some stories of success regarding their professional practice. From these stories a leitmotif emerges. In many cases the success is not solving the difficulty of a person (especially finding a new job, entering into a program of training etc.) but it is about facilitating a reframing process. Also, this success isn’t the result of direct action but of giving the clients the opportunity and the experience necessary to understand their sustainable and real exigencies and to act appropriately. In this article I link the evidence of the changes in the professional practice of the guidance practitioners with the emergence of the concept of capability in a debate about justice and welfare. The guidance practitioners that were the protagonists of our laboratories in the Reflect‐OR project became skilled in a very difficult tightrope walk. Born as professionals inside the welfare state institutions, they were shifting to a more counseling oriented mission. This is a radical change in the meaning and culture of their service, their profession and their relationship with clients, institutions and colleagues. The Reflect‐OR project, with its participative appreciative action and reflection (PAAR) approach, has not only been able to detect such a shift, but it has also been able to give positive suggestions to increase the quality of the service and of the professional life.

Framing land use changes in the expansion of Brazilian ethanol production

Internationally land use change for the expansion of ethanol production in Brazil has been associated with deforestation and CO2 emissions. This association has been denied by important Brazilian actors. To clarify the diverging opinions, a study was made of the expansion of sugarcane plantations. Frame analysis was the tool selected. The conflicting frames identified were named ‘ethanol as destructive for nature’ and ‘ethanol as green fuel’. The analysis suggested that the frames are mostly economically orientated, environmental orientation being secondary and that a reframing process is underway. International actors started to recognise the peculiarities of land use in Brazil. Brazilian actors started to understand that acceptance of Brazilian ethanol on the international market depends not only on price and energy balance competitiveness, but also on product traceability and certification. However, a serious environmental threat remains to the Cerrado biome. This is a challenge that Brazilians actors will have to tackle to ensure the sustainability of ethanol production.

Mediating Relationships across Research, Policy, and Practice in Teacher Education

This self-study explores my mediation as a literacy teacher educator in the context of a professional development undertaking that involved developing and leading an early school years literacy course. I examine the tensions that arose in the light of my own professional history and explore ways that the tensions led me to reconcile conflicting messages through processes of reframing. I describe how I put my reframings into action in the way I designed and presented the professional development course. This self-study advances knowledge about teacher education in terms of its role in mediating connections between research, policy and practice, identifying some of the tensions that occur in this mediation and illustrating how, as teacher educators, we can use these tensions to reframe our mediation.

Schizophrenia: Cognitive Theory, Research, and Therapyby BeckAaron T. , RectorNeil A. , StolarNeal , and GrantPaul . New York, Guilford Press, 2008, 420pp., $45.00

Schizophrenia: Cognitive Theory, Research, and Therapyby BeckAaron T. , RectorNeil A. , StolarNeal , and GrantPaul . New York, Guilford Press, 2008, 420pp., $45.00

The educative practice of professional caregivers at shelters: coping with violence lived by female adolescents

This study aimed to identify strategies caregiving professionals at shelters discuss and use in care delivery to violence situations lived by female adolescents; and to discuss educative practice as a care technology for coping with violence. Based on qualitative research, the data were produced through interviews with caregivers at a municipal adolescent shelter and were interpreted according to content analysis. The results evidenced individual and institutional strategies for care delivery to the adolescents. In conclusion, educative actions are care technologies in the reframing process of life's value by female adolescents living on the streets or in shelters, considering the cultural diversity - a dialogical action systemized and institutionalized for coping with the violence they experience.

The problem of human trafficking in the U.S.: Public frames and policy responses

Nine years after the passage of federal anti-trafficking legislation in the United States, fewer incidents of trafficking have been identified than original estimates of the problem predicted. Some scholars and commentators suggest that changes in the public framing of the trafficking problem aimed at advancing particular agendas are to blame. Yet no studies to date had measured such a reframing process and its attendant consequences. Using a natural history of social problems model (Spector & Kitsuse, 1973) as the theoretical framework to examine the framing of trafficking, this study analyzed text from U.S. newspaper articles about human trafficking from 1990 to 2006. Findings suggest the public framing of human trafficking has changed over time corresponding with the adoption of policies focused on national security and the identification, apprehension, and criminal prosecution of trafficking perpetrators. Challenges following such definitional shifts are discussed.

From Temples to Organizations: The Introduction and Packaging of Spirituality

This article is based on a research of Israeli spiritual consultants and their interaction with local organizations. The incorporation of ideas of spirituality into the world of efficient management and organizations seem on the outset to be `unnatural'. We show that while this inherent contradiction does not disappear, spiritual consultants employ various ways to overcome the anticipated resistance and to make an impact. These ways include not only attentive processes of selection and reframing of ideas before introducing them to the new setting, but often enough also methods of concealing and lack of transparency in the consultants' interactions with managers and or employees. We use domestication, as a key analytical concept. In spite all the familiarization and disguising techniques, spiritual consultants do bring new ideas into the organizational context. Unlike conventional consultants, they set an emphasis on the individual's awareness of his or her body, thoughts and feelings at the moment and by that challenge management expectation that employees would conform to their jobs and roles. Finally, we argue that consultants create `noise' in terms of the ideas that they promote but most of them `keep order' in terms of the way they choose to deliver these ideas.

Re-Framing Questions: Assessing the Significance of Leisure

Leisure research has received scant attention from researchers in other disciplines and has had relatively little impact on social policy to date. It is argued in this paper that re-framing the questions posed by leisure scholars could help to increase the visibility of the field, as well as increase awareness of the relevancy and significance of leisure for individuals, communities and societies. The re-framing process suggested would involve examination of the complex inter-connections between leisure and the major social, economic, political and cultural systems that dominate our lives, as well as the implications of leisure for human rights and justice. Further, the concept of re-framing suggests the need to adopt an outward looking perspective, the need for better theoretical understanding of negative as well as positive leisure practices, and the need to address societal and global issues. The potential exists not only for a broader and more contextualized understanding of leisure, but also for leisure and leisure research to play an enhanced role in social policy development, advocacy and activism.

Organisational active learning: implications for innovation adoption and implementation

Drawing on the education and training literature, this paper defines organisational active learning and proposes a conceptual model that specifies organisational-level processes of active learning. In this framework, organisations are presumed to learn through a cyclic process of priming, practising, and reframing. The present theoretical framework articulates the collective processes of active learning in organisations, which enhances our understanding of the process of innovation, adoption and implementation.

Decision making at the end of life: shifting sands

Two decades ago, when patient groups expressed dissatisfaction with the endpoints of clinical trials in advanced disease, trialists began to supplement conventional indices such as survival time with measurements of 'quality of life'. Sometimes, however, they encountered the paradox that quality of life was unchanged or even improved despite manifestly worsening symptoms. The explanation lies in 'response shift'—the process whereby, in the face of severe disease or impending death, individuals abandon their usual roadmap of values and adopt new perspectives.1 These response shifts have implications for how patients experience illness and how they make decisions about treatments. They may also influence how health professionals or health researchers understand their experience and, accordingly, how well we help people cope with decisions in serious illness. Let us suppose that, as disease becomes rapidly worse, the patient is forced to stop work? If work is part of the scaffolding of life, this event itself may prompt basic existential questions such as who am I without my work? If I can no longer take care of this and that responsibility, how do I function as a parent or provide care to my own parent or spouse? What is my role in the community now that I can no longer do what I did (so well) for so long? This fundamental reconsideration may cause the individual to recognize what is truly important or essential to his or her being and legacy—an insight that transcends the 'temporary' roles that occupy much of our energy when we are healthy. To the clinical researcher, response shifts might at first seem unlikely to influence the tide of scientific quests. We are coming to see, however, that these 'private pertubations' are deeply relevant not only to the way we measure the effects of treatments and psychosocial interventions but also to perceptions of health as they change with the passage of time.2 In the research context, take a Swiss trial reported by Bernhard and colleagues.3 These workers looked at patients randomized to three postoperative strategies after resection of colon cancers—observation, 5-fluorouracil/levamisole, 5-fluorouracil. In all three groups, quality-of-life measures pointed to reframing of perceptions, and the degree to which this happened was related to measured effects on appetite, functional performance and nausea/vomiting. In several trials the quality-of-life indices have run counter to conventional endpoints.4-6 A meta-analysis indicates that response shifts are particularly notable in relation to fatigue and global quality of life, with effect sizes of an order that most trialists would deem clinically important.7 For those patients who return to normal health, any process of reframing (re-evaluation, reappraisal) is likely to be truncated by resumption of workaday life, where there is little time or room for such reflection. For patients whose disease trajectory worsens, however, the 'shifting sands' take them progressively further from former reference points and may assume great relevance when palliative care or life-sustaining treatment come into discussion. A patient who experiences the reality of some unpleasant late effect of disease may decide, despite earlier opposition, to request life-sustaining treatment.8 Palliative care clinicians are particularly well aware of this phenomenon—hence their somewhat negative attitude to recording patients' wishes and to long-term planning of specific care.9-11 So, where does this leave us with advance planning? We know that, in certain patients, the application of life-sustaining treatment at the end of life does little but sustain suffering.12 The challenge is to devise 'advance directives' (living wills) that allow for the possibility of response shifts. One way, of course, is to revisit the document again and again with the patient, as health worsens.13 But how often? What event or indicator should catalyse a return to this discussion? How do patients feel about repeated discussion of these difficult topics? These questions are worthy of qualitative and quantitative research. Another approach relies on a distinction promoted by Fins14—namely, 'contract' versus 'covenant'. Fins notes that, in the process of advance care planning, some individuals expect their wishes to be acted upon strictly as specified by them (i.e. 'contract'); others to have their core values understood and acted upon whether or not the action runs counter to a specific statement or preference expressed in their living will (i.e. covenant). Clearly, we need to discover the usefulness of these constructs in practical terms. For planning purposes one would wish to discover, well in advance, the preferences of patient and proxies for contract or covenant, and whether they agree. Further, it would be helpful to know whether, in general, the expressed preference for contract or covenant bears on the likelihood that a patient will change his or her mind about life-sustaining treatment having discovered that advanced disease is more bearable than expected?15 A deep exploration in these terms might help us to narrow the difference between patients' wishes and what actually happens at the end of their lives.

`When the Hand that Holds the Trowel is Black...'

This article uses images from the archive of John Goodwin, one of the first professional archaeologists in sub-Saharan Africa, to open up a set of questions around relations of work in archaeology - in particular, practices involving the use of `native' labour. It seeks to tell the story of those men who dug, sieved, sorted, located sites and finds, fetched and carried, pitched camp, cooked and served food, negotiated with local chiefs and suppliers, and assisted in the interpretation of artefacts and events, yet who remain unacknowledged in official accounts of the discipline. Restoring to such men the dignity of a name and the lineaments of a biography is a first step in a process of redress involving archaeology in colonial and former-colonial contexts. Used in this way, photographs provide an opportunity to imagine a process of editing or reframing, so that the figure on the margins of the scene steps into the foreground, or steps behind the camera to become the framing consciousness.