The aim of this study is to contribute to a better understanding about how discourse fragmentation is affecting the way doctors perceive the patient's role and expectations that are being redefined under the influence of media and other information sources. The diabetes case provides the empirical evidence to support the fragmentation thesis. This condition offers a unique mix of complexity, scope, and controversy to understand the dialectics of discourse fragmentation. Through a combined analysis of media discourse and experts' discourse (researchers and clinicians), this article describes the connections between the macro (the realm of the public sphere) and the micro (the localized medical practice) in the context of health care delivery. The study concludes that a fragmented media discourse tends at the same time to nourish the public perception about the “diabetes complexities” (a multifaceted and growing epidemic), and to normalize some emerging concepts such as “prediabetes” and metabolic syndrome. This fragmentation seems to have a double-edged sword effect on doctor–patient relationships; in some occasions the atomized discourse about diabetes has a clear disruptive impact on their medical practice, adding an “extra burden” to the disease management, while in other opportunities it has a more convergent effect facilitating the dialogue and the interaction between the actors.

The main objective of this article is to lay the foundations of a theory of grotesque transparency that looks into the aesthetics of ‘ocular politics’. Inspired by Ramón del Valle-Inclán’s definition of the esperpento – a grotesque representation of the hero – this interpretative schema uncovers the rhetorical, narrative and iconic mechanisms that constitute a form of political communication that creates the illusion of total affective disclosure. We tested the premises of this theory by studying a public performance of the now-deceased Venezuela President Hugo Chávez where discursive genres overlap (presidential speech, comic soundbites and preacher’s homily), dissolving the ‘truth’ in an ‘excess of transparency’, and also performing a function of social criticism through desecration of institutional formalities.

Background: We discuss the aesthetics of grotesque transparency in public health communication campaigns and health-related social marketing initiatives, and its strategic and ethical implications. Methods: Some emblematic cases are discussed illustrating the relevance of the grotesque transparency strategy. Results: These case studies show aesthetical and emotional considerations that public health scholars and professionals should carefully consider in the context of an expansive visual culture driven by digital communications. They also indicate that with the advent of technologies that expand the capabilities of manipulating and diffusing images the role of the transparently grotesque is more prevalent in public health and social marketing initiatives. Discussion: The study of grotesque transparency is particularly important when facing emerging global public health challenges, such as pandemics and climate change-related health issues, in a disruptive communication ecosystem.

Background: To counter the effects of radicalization, we should first understand the persuasion mechanisms used by fundamentalist organizations to reach and engage with potential candidates to religious radicalization, particularly in Western societies. Focus of the Article: The paper analyzes ISIS and Al-Qeada (AQ) propaganda as grotesque transparency strategy, with particular attention to the so-called “Islamic State.” Research Questions: The main research question guiding this case study is: how the “grotesque transparency” strategy is articulated in the context of radicalization propaganda by Islamist terrorist organizations? The secondary research question is: how the understanding of the “grotesque transparency” strategy could inform social marketing and policy initiatives to counter the effects of such propaganda? Importance to the Social Marketing Field: The novelty of grotesque transparency in the context of digital networks lies in the ease with which potentially everyone can be a propagandist, transforming the strategic prescriptions of the organized terrorist into an individual “creative” tactic or action. In this context of media fragmentation, the notion of social marketing as mainly a strategic endeavor to favor general change of attitudes and behaviors may be reconsidered as a more dialogic and individualized interaction to understand the expectations, needs and ideas of the “tribal groups.” Methods: By applying the “aquarium metaphor”, the author describes the narrative of such radical groups, including the visual elements that are key in the case of grotesque transparency in the digital media ecosystem. Results: The visually grotesque gives meaning to events in a world of excess, fragmentation, and disenchantment. The language of the ocular reduces ambiguity, privileges the concrete, and facilitates moral judgments. It has become a way of “knowing” based on emotion. Recommendations for Practice: Social marketing experts and officers might reconsider the very notion of strategy when trying to counter the effects of grotesque transparency radical propaganda among certain groups of the population, moving beyond the more traditional approach of control-command to a more open and interactive process to engage in a dialogue and connect with individuals, their families and peers through strategizing. Limitations: The analysis presented here of the Islamist terrorist propaganda is based on a literature review and some empirical research. The question of reception and tactical appropriation by some groups remains an important area to be explored in future research.