Megan Jennaway

Qualitative Methods in Chiropractic Research: One Framework for Future Inquiry

Qualitative research holds potential for helping understand core aspects of chiropractic. Nevertheless, these methods remain underused in the field. This article overviews a qualitative perspective, introduces qualitative methods, and offers one possible framework to develop chiropractic research.

Researching reflexivity: Negotiating identity and ambiguity in a cross-cultural research project

This article examines a multidisciplinary, ethnically diverse team of researchers and their relationship with the research in which they were engaged: a study of overseas trained doctors (OTDs) recruited to work in health services in Aboriginal and Torres Strait Islander communities across four Australian states. The reflexive analysis presented in this article is based on interviews of 13 of the 15 researchers engaged in that project, examining the ways in which the researchers construct their own identities in relation to the research and the commonalities and differences evident within and between clusters of researchers based on their own social and cultural backgrounds and migration histories. The analysis also identifies ways in which discourses emerging from this analysis influence further engagement with the research process itself and the findings of that research by making explicit the assumptions underlying qualitative observations and insights.

Suicide in paradise: aftermath of the Bali bombings

BACKGROUND The relationship between the Bali (Indonesia) bombings of October 2002 and suicide has not previously been investigated, despite anecdotal evidence of the economic and psychological consequences of these attacks. METHOD Suicide rates were calculated over the period 1994-2006 in three Bali regencies to determine whether suicide increased in the period following the first Bali bombings. Poisson regression and time-series models were used to assess the change in suicide rates by sex, age and area in the periods before and after October 2002. RESULTS Suicide rates (age-adjusted) increased in males from an average of 2.84 (per 100 000) in the period pre-2002 to 8.10 in the period post-2002, and for females from 1.51 to 3.68. The greatest increases in suicide in the post-2002 period were in the age groups 20-29 and 60 years, for both males and females. Tourist arrivals fell significantly after the bombings, and addition of tourism to models reduced relative risk estimates of suicide, suggesting that some of the increase may be attributable to the socio-economic effects of declines in tourism. CONCLUSIONS There was an almost fourfold increase in male suicide risk and a threefold increase in female suicide risk in the period following the 2002 bombings in Bali. Trends in tourism did not account for most of the observed increases. Other factors such as indirect socio-economic effects and Balinese notions of collective guilt and anxieties relating to ritual neglect are important in understanding the rise in suicide in the post-2002 period.

Cowboys, cowoks, beachboys and bombs: Matching identity to changing socioeconomic realities in post-2005 North Bali

The collapse of the tourist industry in Bali since late 2002 has had devastating effects on the lives of those who depended on tourism for their livelihood. This sector comprises a vast array of market segments, from those directly employed in hotels, restaurants and retail outlets, or those sustained by an ebullient domestic and export-oriented arts and crafts industry, to the miscellaneous self-employed who predicate their economic strategies on a guaranteed supply of tourists. The present paper examines one such group, the beachboys (cowok), who loiter around the beaches, cafes and bars of Lovina, North Bali, in hope of striking a love match with a foreigner. Such matches are perceived as providing a means of migration to an affluent Western or East Asian country, conceptualised as a place of fantastic wealth and opulence. Although this strategy frequently bore fruit during the prolonged tourism boom of the late 20th century, in the wake of the second series of terrorist bombings, occurring on October 2, 2005, it has foundered. Tourists have deserted the island in droves. The consequent economic and social vacuum so created is not only undermining beachboys’ aspirations for a luxurious life abroad, it may also be transforming the fundamental pattern of foreigner–local interactions in North and even South Bali. The present paper points to the implications of some of these macroeconomic and social changes for the ways in which North Balinese beachboys construct their identity as cowoks, both now and in the future.

Assessment of the burden of human African trypanosomiasis by rapid participatory appraisal in three high-risk villages in Urambo District, Northwest Tanzania

BACKGROUND The public health and socio-economic burden of Human African Trypanosomiasis (HAT) in East Africa is not well documented. Understanding the epidemiology and impact of HAT in such settings is difficult due to a lack of robust surveillance and reporting systems, restricting evidence-based policy development and contributing to the continued neglect of this disease. OBJECTIVE To investigate the burden of HAT in Urambo District, Tanzania in order to inform future public health policy. METHODS A rapid participatory appraisal (RPA) using a combination of qualitative and quantitative methods was conducted, that included key informant interviews, hospital record analysis, and tools adapted from participatory learning and action. RESULTS Three villages adjacent to Ugala Game Reserve appeared to be the most affected. High levels of under-reporting were noted due to a lack of diagnostic tools at peripheral health care facilities and limited access to specialist services. Community stakeholders perceived the health and socio-economic burden of HAT to be similar to that of malaria. CONCLUSION The burden of HAT in remote rural communities is difficult to capture through routine surveillance systems alone. The RPA represents an efficient mechanism for engaging communities in public health action for trypanosomiasis control in northwest Tanzania.

Book review: Healing performances of Bali: between darkness and light

Although the title of this book evokes Laderman and Roseman’s 1996 anthology, The performance of healing, it takes a rather different approach to the study of healing. Most of the essays in the Laderman and Roseman volume concentrate on the performative techniques employed by one healer, and to varying degrees explore his or her social background. Each healer is grounded in a distinct ethnographic context which reinforces the role of the healer and his or her efficacy within their local community. Not so here. Hobart’s account of Balinese healing performances is rich, vivid, and graphic in its rendering of those aspects of Balinese cultural performance relevant to social well-being. However, by emphasizing performance at the expense of illness, Hobart’s account tends to reproduce elite discourses of health and illness rather than demonstrating how these are understood and deployed in the lived experience of ordinary people, the subjects of healing interventions.