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In this chapter we introduce the topic and aims of the book and define key terms such as anxiety, corpus linguistics and discourse. We provide the motivation for writing the book and outline other studies which have examined language in healthcare contexts, in particular focusing on studies which have looked at healthcare forums and/or mental health issues, as well as studies which have used corpus linguistics techniques for corpus-assisted discourse analysis. We then outline the research questions which drive the analysis in the book. We introduce the corpus that we worked with and discuss ethical issues in dealing with online data, as well as issues relating to data processing. We also provide a description of the tools and techniques that we used to carry out our analysis. We then reflect on our own position in relationship to the topic we are researching. Finally, we provide an outline of the remaining chapters of the book.
Here, we consider the interactive and online affordances of the forum by looking at the ways that posters respond to each other’s posts. What kind of language use characterises those which receive numerous responses vs those which receive none at all? We also ask, how do posters reach consensus and, considering the range of posts of people from different backgrounds, how is disagreement around understandings of anxiety negotiated? We code a sample of the forum posts using Egbert et al.’s (2021) coding scheme for functional discourse units. This is based on nine codes which indicate the particular purpose of a stretch of interactive text; for example, joking around, engaging in conflict or giving advice. Additionally, we look at uses of computer-mediated communication, including acronyms such as lol and emojis which are often used for affiliative purposes and disambiguation. This chapter uses corpus-based frequency approaches to identify longer stretches of interaction which are then examined qualitatively.
Our analysis begins with a focus on the word anxiety, using the corpus analysis tool Sketch Engine to provide a detailed ‘Word Sketch’ of its use in the forum; for example, looking at its occurrence in different grammatical patterns. This analysis identified four clines in terms of how anxiety is discursively constructed: 1) catastrophisation vs minimisation (e.g., some patients refer to having terrible anxiety while others downplay their condition using phrases such as it’s just anxiety); 2) medicalisation vs non-medicalisation (e.g., use of medical terminology such as anxiety disorder vs colloquial expressions such as anxiety crap); 3) personalisation vs impersonalisation (e.g., some posters represent their anxiety as a conscious being with its own wants and grammatical agency, such as anxiety is playing mind games with them, while others represent anxiety as an abstract concept, such as as an illness); and 4) internalisation vs externalisation (e.g., some people claim their anxiety is part of themselves – my anxiety – while others refer to it as something separate – the anxiety monster).
In this chapter we compare posts from the two countries which most posters identified as residing in. Within the forum, 38.84% of posts were made by people from the UK, 33.94% were made by those from the USA, 17.41% were made by people who did not specify a country and 9.81% consisted of all other countries. While the main language in the UK and USA is English, an analysis of keyword differences indicates numerous differences which point not only to spelling (favorite) and lexical choices (vacation) but also to ways that anxiety is understood. In addition, we consider the extent to which posters are influenced by external cultures; for example, is there evidence that British posters are adopting language and discourses used by American posters, or vice versa? As with the previous chapter, the analysis concludes by considering the role of culture on understandings of anxiety.
The concluding chapter of this monograph summarises the main findings from the preceding chapters and brings those findings together to establish overall patterns and trends in online discourses of anxiety. Concordant with our Critical Discourse Studies approach, these representations are then related to the contexts in which they are situated as well as their implications for understanding mental health in wider society. The chapter also critically reflects on the approach we took, the questions that emerged as a result of engaging with the corpus of forum posts and potential extensions to our study.
In this chapter we delve deeper into forum posters’ descriptions of anxiety by focusing on how they describe what it feels like to experience anxiety, what they believe causes their anxiety and how they best believe that their anxiety can be resolved. We consider also patient narratives around their anxiety. This chapter provides an overview of the linguistic content of the forum by carrying out a keywords analysis of the online corpus to identify words and phrases that are statistically salient in forum posts, comparing first posts with subsequent posts. These words are placed into thematic categories and a representative set are analysed in depth to illustrate different aspects of discussion around anxiety.
In this chapter we make use of the demographically tagged nature of the forum posts by comparing and contrasting posts made by female and male users. Some 52.02% of posts were made by posters who identified as female, 16.71% were made by male posters and 31.20% were made by posters who did not specify their sex. These figures are congruent with data on prevalence of anxiety by sex, which tends to indicate that women are more likely than men to be diagnosed with anxiety. We examine male and female keywords in the corpus, finding that men are more likely to use problem-solving language that focuses on explanations for anxiety and strategies for resolving it. On the other hand, women are more likely to use affiliative language to express empathy, sympathy and encouragement to others. The chapter also examines gendered discourses relating to anxiety by considering representations around words such as man, woman, macho and feminine. Our analysis concludes by linking our findings to consideration of gendered roles and societal stereotypes.
This chapter takes advantage of the fact that our corpus contains posts made over an eight-year period, along with the demographic information we have about patient age. We consider diachronic aspects of the forum in a range of ways. First, we look at how language has changed over the time, focusing on changes in anxiety discourses. We consider the corpus in terms of trends over the eight-year period. We also consider how the age of posters impacts on the ways they write about language, dividing the corpus into age-graded sections. We compare linguistic differences across these age groups, seeking to identify how language use reflects different understandings or representations of anxiety in relationship to age. Finally, we trace how posting behaviour ‘evolves’ over time; for example, early posts involve narrative histories, question seeking and expressions of emotional state whereas later ones involve advice-giving and expressions of affiliation as posters take on the role of ‘expert’. We also consider how participants leave the forum by looking at ‘final posts’. In what ways, if at all, do posters provide a sense of narrative ‘closure’ when they leave the group?
Why is language so important to the ways that we make sense of anxiety? This book uses corpus assisted discourse analysis to examine twenty-three million words of text posted to a forum for people with anxiety. It shows how linguistic techniques like catastrophisation and anthropomorphisation can result in very different conceptualisations of anxiety, as well as how aspects of identity like age, sex and cultural background can impact on understandings of anxiety and how it ought to be managed. It tracks the changing identities of posters, from their first posts to their last, and incorporates a range of corpus-based techniques to examine the language data, enabling consideration of interaction between participants and features associated with online forms of communication like emoji. It ultimately provides a step towards a better understanding of different responses to anxiety and aims to promote further engagement with this topic in the field of applied linguistics.
This study aimed to assess the effectiveness of an ENT simulation course for equipping foundation doctors with core ENT skills in preparation for an ENT senior house officer post.
A total of 41 foundation doctors in the East of England participated in our two-part simulation course. Pre- and post-course surveys, consisting of Likert scales and a Dundee Ready Educational Environment Measure, were sent to assess confidence in core ENT skills and acceptability of course format.
Post-simulation, confidence improved in all core ENT skills taught (p < 0.001), along with confidence and preparedness to work as an ENT senior house officer (p < 0.001). Overall course median Dundee Ready Educational Environment Measure score was 48, and 100 per cent of participants would recommend this course to colleagues.
Simulation improves foundation doctors’ confidence in core ENT skills and increases preparedness for working as an ENT senior house officer. Guidance on core ENT skills requirements should be made available to improve uniformity amongst ENT simulation courses.
High-precision analysis using accelerator mass spectrometry (AMS) was performed upon known-age Holocene and modern, pre-bomb coral samples to generate a marine reservoir age correction value (ΔR) for the Houtman-Abrolhos Archipelago (28.7°S, 113.8°E) off the Western Australian coast. The mean ΔR value calculated for the Abrolhos Islands, 54 ± 30 yr (1 σ) agrees well with regional ΔR values for Leeuwin Current source waters (N-NW Australia-Java) of 60 ± 38 yr. The Abrolhos Islands show little variation with ΔR values of the northwestern and north Australian coast, underlining the dominance of the more equilibrated western Pacific-derived waters of the Leeuwin Current over local upwelling. The Abrolhos Islands ΔR values have remained stable over the last 2896 cal yr BP, being also attributed to the Leeuwin Current and the El Niño Southern Oscillation (ENSO) signal during this period. Expected future trends will be a strengthening of the teleconnection of the Abrolhos Islands to the climatic patterns of the equatorial Pacific via enhanced ENSO and global warming activity strengthening the Leeuwin Current. The possible effect upon the trend of future ΔR values may be to maintain similar values and an increase in stability. However, warming trends of global climate change may cause increasing dissimilarity of ΔR values due to the effects of increasing heat stress upon lower-latitude coral communities.