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Electronic communication between patients and general practitioners (GPs), known as e-consultations, was introduced in Denmark as a cost-effective and convenient means for patients to access their GP and receive test results as well as answers to quick questions. Research on e-consultations internationally has found that patients are generally very positive, while doctors are more hesitant. Most studies of e-consultations have involved survey or interview methodologies, while studies of their content, form or language are limited. In this study, we address this gap by proposing that genre may be a productive concept for comprehending textual aspects of e-consultations. We explore the following two questions: (1) what are the generic characteristics of the e-consultation?; and (2) do e-consultations belong to the email genre? Based on an analysis of two Danish corpora of patients’ first turns in e-consultations with their GPs, we identify an underlying move structure: subject, opening, update, problem presentation, request, argumentation, closing. We argue that the e-consultation is an example of an email genre with identifiable conventions, which are both specific to the communicative function of e-consultations and aligned with generic features of emails.

Pregnant women, particularly first-time mothers-to-be, often experience anxiety about the forthcoming birth, as well as feelings of vulnerability and loneliness (McLeish & Redshaw, 2017). There is, at the same time, growing understanding of the importance of wellbeing in healthy pregnancies (WHO, 2016), and that professionals can assist with the psychosocial challenges of transitioning to motherhood (Midwives, 2012). In Denmark, midwife-led group antenatal consultations are used to help pregnant women exchange ideas and create social networks (Brot & Poulsen, 2013). Although the learning that occurs in such settings has previously been investigated (Nisbeth Jensen & Fage-Butler, 2016), we know little about their emotional aspects. The aim of this paper is to explore women’s experiences of interpersonal aspects of encountering other pregnant women in antenatal group consultations. Using a phenomenological interpretative methodology (Smith et al., 2009), I analysed 16 semi-structured interviews of women who had experienced antenatal group consultations in Aarhus, Denmark. Findings reflected two overarching themes: the mainly positive emotional impact of encountering others, as concerns were normalised and fears were assuaged; identification with others where the pregnant body and a common approximate due date generated feelings of solidarity. The findings are discussed in relation to the centrality of corporality to human experience (Merleau-Ponty, 2014 [1974]), responsibility for the other (Levinas, 2006), and the I-Thou basis for relationships (Buber, 1984). This study highlights the emotional value of breaking with the clinical dyad for certain patient groups. References Brot, C., & Poulsen, A. (2013). Anbefalinger for Svangreomsorgen [Recommendations for antenatal care] Retrieved from https://www.sst.dk/da/udgivelser/2015/~/media/C18BD8F183104A8384F80B73B155826D.ashx Buber, M. (1984). I and Thou (R. Gregor-Smith, Trans.). New York: Scribner. Levinas, E. (2006). Humanism of the Other. Chicago, IL: University of Illinois Press. McLeish, J., & Redshaw, M. (2017). Mothers’ accounts of the impact on emotional wellbeing of organised peer support in pregnancy and early parenthood: A qualitative study. BMC Pregnancy and Childbirth, 17(28), 1-14. doi:10.1186/s12884-017-1220-0 Merleau-Ponty, M. (2014 [1974]). Phenomenology of perception (D. A. Landes, Trans.). Abingdon: Routledge. Midwives, R. C. o. (2012). Maternal emotional wellbeing and infant development: A good practice guide for midwives Retrieved from https://www.rcm.org.uk/sites/default/files/Emotional Wellbeing_Guide_WEB.pdf Nisbeth Jensen, M., & Fage-Butler, A. (2016). Antenatal group consultations: Facilitating patient-patient education. Patient Education and Counseling. doi:10.1016/j.pec.2016.07.032 WHO. (2016). WHO recommendations on antenatal care for a positive pregnancy experience Retrieved from http://apps.who.int/iris/bitstream/10665/250796/1/9789241549912-eng.pdf

Lack of sufficient sleep is associated with a range of health consequences (Hillman & Lack, 2013), and is considered a significant public health issue (WHO, 2004). In response to the problem of poor sleep hygiene (Irish, Kline, Gunn, Buysse, & Hall, 2015), some doctors are now prescribing sleep apps to their patients (So, 2014). Given the rapid pace of citizens’ entanglement with these technologies, there is a need for greater focus on the sociocultural implications of these developments, for example, in relation to issues of identity, subjectivity and power (Lupton, 2014, 2015). In this paper, I employ Foucauldian discourse analysis (Foucault, 1972) to analyse the discursive construction of sleep app-users, using as data the “Bedtime” app (iOS 10) for iPhones, pop-up information about using the app on the iPhone, and the app’s promotional video. The main findings are that potential “Bedtime” app-users are constructed as self-determining in some areas yet lacking self-control in others, as needing help, as victims in their life circumstances, as sensitive to stimuli and as quantifiable. I argue that the construction of the m-patient evident in the data has more in common with the biomedical patient than the e-patient (Fage-Butler & Anesa, 2016).

Online health forums provide patients with important, relatively secure spaces for sharing narratives, raising concerns, asking questions, and advising and supporting one another (Sillence 2013), where both “experiential knowledge” (Caron-Flinterman et al. 2005) and shared scientific knowledge are considered valuable informational currency. An aspect raised on online patient forums where knowledge and support are very valuable relates to pregnant women’s decisions regarding the choice of homebirth as opposed to hospital birth, particularly due to women’s concerns that homebirths, while preferable for many personal reasons, may result in greater health risks to both self and baby. This paper contributes to current research into online patient communication by exploring the question: “How do pregnant women discuss the potential risks and benefits associated with homebirths on online patient forums?” It uses a combination of Foucauldian discourse analysis (Willig 2013) and Luhmannian semantic analysis (Andersen 2003) to explore the discursive construction of the risks and gains of homebirth on two open access online forums. Whilst the findings reflect women’s acknowledgement of ongoing political debates regarding health and safety, medicalization and patient empowerment, risks have also intensely personal meanings for women, amongst other things as they relate to the potentially serious impact of personal decisions and attendant culpability. This paper sheds important light on sociocultural debates which also reflect seasoned tensions in professional midwifery - the tensions between the natural and the scientific/medicalized, the normal and the abnormal, and the institutional and the private. It also provides important insights into women’s priorities which can support midwives counselling women, and can be considered an important study of how online forums provide discussion spaces where politically and personally sensitive issues are debated by the decision-makers themselves.

Introduction and objectives: The doctor-patient dyad has constituted the main paradigmatic relationship in Western medicine, and provided a central focus for health communication research and clinical teaching endeavors. With new technologies, other constellations are enabled, such as patient-patient communication, which is increasingly taking place in online patient communities. One novel offline setting which can support patient-patient communication is the group consultation where an individual healthcare professional and a group of patients engage. The purpose of this study is to investigate how patient-patient communication unfolds in a group consultation with a midwife in order to identify its communicative strengths and weaknesses. Methods: Using a sequential multi-methods design, we performed eight individual interviews with pregnant women from a Danish antenatal clinic about their experiences of two group consultations, followed by an observation study of group consultations at the same clinic. Results: Analysis identified the value of placing patients together, as it helped to normalize pregnancy which otherwise can be medicalized in the healthcare setting. The sharing of personal experiences had a reassuring effect, and the power of experiential knowledge became clear when second-time pregnant women shared their experiences with women who were pregnant with their first baby, prompting new sets of questions and answers. Interviewees highlighted the fact that group composition affected their experiences of this consultation mode, and stated that further patient-patient communication could be facilitated in group consultations.Discussion/Implications: Group consultations offer new possibilities in terms of patient engagement, where pregnant women not only participate in their own health and wellbeing, but also in that of others. Further research is necessary to investigate the exciting communicative potential of group consultations and to establish how they can be improved in order to facilitate greater patient involvement. Introduction and objectives: The doctor-patient dyad has constituted the main paradigmatic relationship in Western medicine, and provided a central focus for health communication research and clinical teaching endeavors. With new technologies, other constellations are enabled, such as patient-patient communication, which is increasingly taking place in online patient communities. One novel offline setting which can support patient-patient communication is the group consultation where an individual healthcare professional and a group of patients engage. The purpose of this study is to investigate how patient-patient communication unfolds in a group consultation with a midwife in order to identify its communicative strengths and weaknesses. Methods: Using a sequential multi-methods design, we performed eight individual interviews with pregnant women from a Danish antenatal clinic about their experiences of two group consultations, followed by an observation study of group consultations at the same clinic. Results: Analysis identified the value of placing patients together, as it helped to normalize pregnancy which otherwise can be medicalized in the healthcare setting. The sharing of personal experiences had a reassuring effect, and the power of experiential knowledge became clear when second-time pregnant women shared their experiences with women who were pregnant with their first baby, prompting new sets of questions and answers. Interviewees highlighted the fact that group composition affected their experiences of this consultation mode, and stated that further patient-patient communication could be facilitated in group consultations.Discussion/Implications: Group consultations offer new possibilities in terms of patient engagement, where pregnant women not only participate in their own health and wellbeing, but also in that of others. Further research is necessary to investigate the exciting communicative potential of group consultations and to establish how they can be improved in order to facilitate greater patient involvement.

Critical genre analysis (CGA) investigates the impact of context on genres by analyzing interdiscursivity (the integration of discourses in genres), but there has been a shortage of discussion of specifi c methods. This paper demonstrates that Foucauldian discourse analysis (FDA) - specifi cally, statement function analysis - constitutes a very useful approach with which to analyze interdiscursivity in CGA. Analysis of the move of "priorities/goals" (Cornut et al. 2012) in three strategic plans produced by British hospitals using FDA reveals three main discourses: strategic management, public service accountability, and patient centeredness. As interdiscursive analysis reveals the discursive foundations of organizational practices, CGA is well-positioned to make many valuable contributions to organizational research.

Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically sustainable way of transferring health information than the individual consultation and 2) that it can deliver positive patient education outcomes such as new opportunities for learning. Whilst the clinical dyad has been the subject of considerable research, there are many empirical and theoretical gaps in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis of the written materials found the juxtaposition of biomedical and patient empowerment discourses; these findings form the backdrop to the interviews, which are currently being undertaken. Conclusions: This study not only presents empirical findings on a relatively new, but increasingly used, setting for client-professional encounters where expertise is distributed among professionals and clients, it also discusses the implications for practice, theory and ethics.

In the extant literature, there is no shortage of different appreciations of what communication ‘is’ and what communication ‘does’. From a functionalistic perspective, we have the transmission model of communication (e.g., Shannon & Weaver, 1949), from a hermeneutical perspective, we have the interaction model of communication (e.g., Schramm, 1954), and from a social constructivist / social constructionist perspective we have different versions of the transactional model of communication (e.g., Barnlund, 1970; Rogers & Kincaid, 1981). The most recent offspring of the social constructivist / social constructionist take on communication is to view “communication-as-constitutive” (Cooren et al., 2011: 1149). Typically, communication-as-constitutive it is epitomized in the so-called CCO principle. The CCO principle stands for “communication constitutes organization” (e.g. Putnam et al. 2009; Schöneborn, Blaschke 2014). Without delving deeper into the matter at this point, let it suffice to say that – for various reasons – for the CCO principle, ‘social reality’ is subsumed under “organization”. In my paper, I will take my point of departure in the CCO principle, as it is undoubtedly the current capstone of communication theory, I will, however, do so from a critical perspective. My point of departure will be a critical reading of formative papers from within the three schools of thought that currently dominate the CCO conversation. That is, the school of thought that propagates elements of speech act theory, primarily of a Searlean persuasion (e.g., Coreen, 2000), the school that builds on Giddens’ structuration theory (e.g., McPhee & Zaug, 2000), and the school that adheres to a Luhmannian legacy (e.g., Blaschke et al., 2012). Using my critical remarks as stepping stones, I will go on to present a radical constructivist (von Glasersfeld, 2015[1995]) view on communication that takes into consideration what communication ‘is’ and what it ‘does´ as seen from the perspective of Knowledge Communication. The paper ends with this appreciation of communication being modelled under the caption of co-actional communication. Barnlund DC 1970. A transactional model of communication. In: Sereno KK and Mortensen, CD (eds.) Foundations of Communication Theory. New York: Harper, 83-102.Blaschke, S.; Schöneborn, D.; Seid, D. 2012. Organizations as networks of communication episodes: Turning the network perspective inside out. Organization Studies, 33, 879-906.Coreen, Francois 2000. The Organizing Property of Communication. John Benjamins. Coreen, Francois; Kuhn, Timothy; Cornelissen, Joep P.; Clark, Timothy 2011. Communicating, Organizing and Organization: An Overview and Introduction to the Special Issue. Organization Studies, 32(9), 1149-1170.McPhee, Robert D.; Zaug, Pamela 2000. The Communicative Constitution of Organizations: A Framework for Explanation. The Electronic Journal of Communication, 10(1 and 2), 1-13.Rogers, Everett M.; Kincaid, Lawrence D. 1981. Communication networks: toward a new paradigm for research. University of Michigan: Free Press. Shannon, Claude; Weaver, Warren 1949. The mathematical theory of communication. Urbana: University of Illinois Press. Schramm, Wilbur L. 1954. The process and effects of mass communication. Urbana: University of Illinois Press.Putnam, Linda L.; Nicotera, Anne M.; McPhee, Robert D. 2009. Communication Constitutes Organizations. In: Putnam, L. L. & Nicotera, Anne M. (eds.) Building Theories of Organizations: The Constitutive Role of Communication. New York: Routledge, 1-20.Schöneborn, Dennis; Blaschke, Steffen 2014. The Three schools of CCO thinking: interactive dialogue and systematic comparison. Management Communication Quarterly 28(2): 285-316.von Glasersfeld, Ernst 2015[1995]. Radikaler Konstruktivismus : Ideen, Ergebnisse, Probleme. Frankfurt am Main: Suhrkamp.