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Tesi sul tema "Medical ethnograohy"
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1
Waltz, Margaret. "(Im)Patient Patients: An Ethnography of Medical Waiting Rooms". Case Western Reserve University School of Graduate Studies / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=case1457030358.
Testo completo
2
Flemons, Kristin. "Medical humanitarianism and its mutations: an ethnography of the African Medical and Research Foundation". Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119569.
Testo completoAbstract (sommario):
This thesis examines the ways in which the African Medical and Research Foundation (AMREF) may be considered a 'mutation' of medical humanitarianism, across both time (through the course of the organization's history) and space (from humanitarianism's birthplace in Europe to AMREF's headquarters in East Africa). To this end, the author conducted field research with staff at AMREF's Kenya Country Office between June and September, 2012, involving participant observation, field visits, and archival research. In Chapter 1, the Foundation's commitment to projects of medical, technical and bureaucratic modernity in East Africa is explored, which complicates analyses of humanitarian minimalism. In Chapter 2, the organization's history is discussed as a reference point for understanding its unique characteristics. In Chapter 3, AMREF's research activities are unpacked as additions to, and transgressions of, boundaries between medical humanitarianism and global health.Ce mémoire cherche à montrer que l'African Medical and Research Foundation (AMREF) constitue une « mutation » de l'humanitaire médical, aussi bien dans le temps (à travers l'histoire de l'organisation) que dans l'espace (de l'Europe, lieu d'origine de l'humanitaire jusqu'au siège social d'AMREF en Afrique de l'Est). Dans le cadre de ce projet, l'auteure a entrepris quatre mois de recherches de terrain auprès du personnel des bureaux d'AMREF au Kenya, entre Juin et Septembre 2012, faisant usage de méthodes de recherche telles que l'observation participante, des visites de terrains, et de la recherche d'archives. Le premier chapitre documente l'engagement de la Fondation vis-à- vis de projets de modernité médicale, technique et bureaucratique en Afrique de l'Est, venant ainsi nuancer certaines analyses centrées sur le minimalisme humanitarisme. Dans le deuxième chapitre, une présentation détaillée de l'histoire de l'organisation permet d'en mettre en valeur son caractère particulier et unique. Enfin, dans un troisième chapitre, les activités de recherches d'AMREF sont analysées à la fois comme suppléments et transgressions des frontières entre l'humanitaire médical et la santé mondiale.
3
Wasserkrug, Sue 1960. "The experience of asthma: An illness ethnography". Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/291854.
Testo completoAbstract (sommario):
Thirty patients at a Tucson respiratory clinic were questioned to elicit data to yield an ethnography of asthma. The methodology involved one structured, open-ended interview per patient. The patients ranged in age from 24 to 82; a range of demographic, sociocultural, and medical variables were represented. Two themes, control and limitation, surfaced as the key issues in the construction of meaning attached to the experience of asthma. Asthmatics feel a loss of control over their lives, which they see as being shaped--to some degree--by the limitations that asthma incurs. The sensation of losing control causes fear or panic, a common emotion among asthmatics, according to informants. The need to take medication on a daily basis is seen as an important symbol in the development of patients' conceptions of their illnesses. The influence of dominant cultural values on the expression of asthma is discussed, and an understanding of the effect of asthma on the daily lives of Americans is offered.
4
Moore, David R. "Concepts of disease and their relationship to health-seeking behaviour in Chuquisaca department, south Bolivia". Thesis, University of Oxford, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.308903.
Testo completo
5
Victora, Ceres. "Images of the body : lay and biomedical views of the reproductive system in Britain and Brazil". Thesis, Brunel University, 1996. http://bura.brunel.ac.uk/handle/2438/7299.
Testo completoAbstract (sommario):
This thesis presents an anthropological study of ordinary people's views about the body in general and the reproductive system in particular, based on two case studies carried out in Britain and in Brazil. I discuss the meanings of lay and biomedical images of the body and identify the ways the researched groups reinterpret the biomedical view of the body anatomy and physiology. Through the analysis of ethnographic material on time, space and domestic organisation in four shantytown groups in Porto Alegre, Brazil and in three different groups in London, UK, I point out the dwelling peculiarities of the different groups and suggest there is a relationship between embodied experiences of time/space and knowledge of the reproductive system. These arguments lead to a more general phenomenologically theorised view of gendered and status-framed bodies, consequently situating this work in the interface of Medical Anthropology and a more general socio-cultural Anthropology.
6
Ashencaen, Crabtree Sara. "Sentosa : a feminist ethnography of a psychiatric hospital in Sarawak, East Malaysia". Thesis, University of Hertfordshire, 2002. http://hdl.handle.net/2299/14069.
Testo completoAbstract (sommario):
This doctoral thesis is a feminist ethnographic study of psychiatric patients in the State of Sarawak, East Malaysia. The study took place at a psychiatric hospital located in the capital city of Kuching, commencing in 1997. Although Hospital Sentosa is a small institution it is the only psychiatric institution in the State and therefore constitutes an important mental health resource in this region. This ethnographic study primarily concentrates on the lives of women patients in keeping with my chosen methodological approach and seeks to explore the 'culture' of the hospital setting through facets such as daily interactions, activities and relationships. The feminist approach has not however precluded the accounts of male patients whose experiences are utilised in a comparative exercise with those of women counterparts. In addition the views of staff of both sexes and all ranks are considered in relation to their attitudes towards the care of psychiatric patients and the broader area of work-related concerns including collegial support and occupational hazards. In keeping with an ethnographic approach themes developed in the thesis are drawn through an analysis of findings as noted by observation methods as well as through interviews with participants. Furthermore a self-reflexive approach has been an important aspect of analysis commensurate with feminist methodology, in which my role as a researcher is considered in relation to issues of culture, gender and class as well as some of the difficulties of research in a post-colonial and unfamiliar cultural context. Although some avenues of inquiry in the study have not easily lent themselves to an analysis of gender, this thesis primarily argues that the hospital reproduces oppressive policies and practices that impact with greater severity on women patients. Oppressive practices in relation to gender and ethnicity at the hospital are viewed against a backdrop of contemporary psychiatric care as enacted on wards. It is argued that these practices can be viewed in turn as being, for the most part, historically premised upon imported British models of care replicated through colonialism in Malaya and by extension at a later period in the multicultural State of Sarawak.
7
Lee-Treweek, Geraldine Anne. "Discourse, care and control : an ethnography of residential and nursing home elder care work". Thesis, University of Plymouth, 1994. http://hdl.handle.net/10026.1/362.
Testo completoAbstract (sommario):
This thesis presents the notion that paid elder care work is often more involved with ordering individuals, than caring for them. It discusses this issue via ethnographic data about care assistant and nursing auxiliary work, which was collected in two elder care homes: Hazelford Lodge residential home and Bracken Court nursing home. The thesis uses care, control, and knowledge as the main themes for the discussion of work in both homes. The first chapter sites the thesis within the context of the academic literature on the discourses of the body, the nature of care work and residential care. It focuses especially upon care work as body labour. Chapter two presents the ethnographic methodological approach of the thesis, in two sections. Firstly, the use of the Foucauldian notion of discourse is explained, and secondly, the research process and research relationships are explored through a reflexive account. Chapters two and three present social, structural and spatial aspects of the two settings. They discuss the different ways in which the homes were organised, and that spaces were utilised and had different meanings, within the homes. Chapters four and five are based upon data from Hazelford Lodge residential home, and illustrate the care assistants' work as centred upon created order in the home, based upon the typification of residents and others. Chapters six and seven explore the auxiliaries' work in Bracken Court and present three control issues as central to their jobs. Firstly the overt ordering of patients around spaces in the home. Secondly, the normalisation of individuals into patient, and objects, of body work. Thirdly, the auxiliaries' resistance to heir role and status. Chapter eight compares the work of the assistants and auxiliaries in terms of resident and patient construction, the nature of the two forms of work, their knowledge, and lastly, their constructions of place and status. The thesis argues that both groups of workers are involved in ordering bodies that they perceive to be problematic and degenerating. In Hazelford Lodge order and discipline is practised as care and in Bracken Court the auxiliaries use more overt forms of control, but both 'caring' and controlling are effective methods of creating order. By introducing notions of body labour and ordering, the thesis presents a unique critique of paid care.
8
May, Suepattra Grace. ""Whatever she wants": An ethnography of American women, sex and the internet". Diss., Search in ProQuest Dissertations & Theses. UC Only, 2010. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3398881.
Testo completo
9
Griffiths, Pauline. "Nursing patients in transition : an ethnography of the role of the nurse on an Acute Medical Admissions Unit". Thesis, Swansea University, 2007. https://cronfa.swan.ac.uk/Record/cronfa42820.
Testo completoAbstract (sommario):
This thesis explores the role of the nurse on an Acute Medical Admissions Unit (AMAU). AMAUs provide a dedicated area for the assessment, treatment, and subsequent transfer or discharge of patients who are medical emergencies. Despite increasing numbers of AMAUs across the UK they are an under researched area and, in particular, there is limited research that has explored the role of the nurse in the AMAU setting. Data were generated through the use of ethnography that entailed participant observation over an eighteen-month period, semi-structured interviews with a purposive sample of doctors, nurses, paramedics, and patients (n= 19), and examination of documentary evidence. Drawing on the concept of communities of practice (Wenger 1998) and the demand-control-social support model of occupational stress (Baker et al., 1996) the key themes of the study were identified as: The AMAU nurse's role in co-ordinating patients ' transition; Professional skills and attributes o f the AMAU nurse; 7 love the buzz': the AMAU nurses' work place stresses and balances; and Organisational constraints and practice boundaries for AMA U nursing The findings from the study indicate that a key aspect of the AMAU nurse's role was the facilitation of rapid patient transition. In addition the study has identified the distinctive and locally negotiated working practices developed by the nurses to coordinate this transition. Another important claim arising from this study was the identification of this nursing role as an evolved construction within a community of practice. This study makes a significant contribution to the limited body of knowledge regarding AMAU nursing practice by aiding understanding of the complexity of this nursing role. Additionally, the application of the concept of community of practice provides a unique perspective and insight into this under explored role. Recommendations are offered for practice, education, management and future research.
10
Suhardja, Imelda. "The discourse of 'distortion' and health and medical news reports : a genre analysis perspective". Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/4401.
Testo completoAbstract (sommario):
The advent of medical journalism was initially felt to be an answer to the problem of communicating health and medical information to the public. However, currently, there is a concern among scientists with the way the media, newspapers in particular, communicate health and medical information. The concern of the medical community in particular and of the scientific community in general is that newspapers ‘distort’ health and medical information. In order to deal with this ‘perceived’ problem, scientists adopt a mechanical view and propose to solve it by issuing guidelines for journalists to follow when writing health and medical news. Close investigation of journalistic practice shows that many of the proposed guidelines are already present in journalistic practice, and yet, the concern for ‘distortion’ remains. The overall aim of the thesis is to contribute to this issue. Adopting an Applied Linguistics perspective, more specifically, using the discourse analytic methodology of Genre Analysis, the thesis demonstrates that Health and Medical News Reports are first and foremost news stories and that the proposed guidelines fail to achieve the envisaged changes precisely because they seem to be ignorant of this essential reality. In order to reach this conclusion, Genre Analysis is applied to different types of texts with a view to comparing their structures. Some of the text types used have already been described in the literature, but others are analysed for the first time in this thesis. Thus, comparison is made between Health and Medical Research Articles and Health and Medical News Reports, between Popularised Health and Medical Texts and Health and Medical News Reports, between News Texts and Health and Medical News Reports and between Health and Medical Press Releases and Health and Medical News Reports. Genre Analysis shows that Health and Medical News Reports are first and foremost news stories and, therefore, that the discourse of ‘distortion’ is somewhat ‘misguided’. However, because of its nature as a structural analysis, Genre Analysis leaves one important question unanswered, namely the ‘why’ of the discourse of distortion. Although it is beyond the scope of this thesis to investigate this question, in the thesis, it is indicated that a more context-sensitive analysis, using Critical Discourse Analysis (CDA) for example, could fruitfully be pursued. This thesis draws on four types of data. The main data set consists of Health and Medical News Reports published in The Herald and The Guardian between April and May 2007, where possible, corresponding press releases were collected. Email interviews were conducted with authors whose research was reported in the two newspapers. Finally, ethnographic observation of newsrooms and face-to-face semi-structured interviews were conducted with journalists who wrote the reports over a period of one week.
11
Costanzo, Amy J. "The Culture of Interprofessional Collaborative Practice on Two Adult Acute-Care Medical-Surgical Units". University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1490699191549097.
Testo completo
12
Heslop, Liza. "An ethnography of patient and health care delivery systems : dialectics and (dis)continuity". Monash University, Faculty of Education, 2001. http://arrow.monash.edu.au/hdl/1959.1/8764.
Testo completo
13
Na, Seonsam. "A rebellion in the Korean medicine community : an ethnography of healthcare politics in contemporary South Korea". Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:526e2629-3faf-4d64-9d8d-ce5a3734be98.
Testo completoAbstract (sommario):
This thesis explores South Korean healthcare politics based on a series of inter-generational conflicts that occurred in a medical community in 2012. The conflicts broke out among 'doctors of Korean medicine', a medical profession unique to Korea practicing a form of medicine of East Asian origin that has recently undergone significant 'bio-medicalization'. Doctors of Korean medicine have the same status as doctors of Western medicine in the country's mainstream healthcare system, although the purview of their practice is legally demarcated. Government policies aimed at the industrialization of pharmaceuticals and the promotion of health among Korea's elderly population were the source of the conflicts that escalated into a group of junior doctors leading to what could be considered a 'rebellion' against the community leaders. The thesis investigates first the socioeconomic and political backgrounds of the conflict. It proposes that elements of intra- and inter-professional politics and the aftermath of the country's re-democratization, economic shock and demographic transition were all important factors. Second, it explores the nature of the rebellion itself by focusing on the emergence of a set of norms and values and on the 'ritual-like' interactions observed during the event. The analysis reveals that during the conflicts the actors referenced certain values and ideologies underpinning their everyday lives and, in doing so, were effectively engaged in the strengthening, rather than the weakening, of existing social structures. This thesis contributes to the study of Korean medicine by revealing the features of its integration into the country's healthcare system and the effects of its bio-medicalization. By describing the process by which new online-based agents of a social movement emerged, it also contributes to the study of hyper-connectivity in Korean society. Finally, the ethnography contributes to the anthropological study of East Asian medicine by illustrating the importance of institutional factors such as politics and the economy in capturing the modes of its contemporary presence.
14
Hoy, Janet M. "Outcomes and Incomes: Implementing a Mental Health Recovery Measure in a Medical Model World". online version, 2008. http://rave.ohiolink.edu/etdc/view.cgi?acc%5Fnum=case1207019285.
Testo completo
15
Camfield, Laura. "Measuring quality of life in dystonia : an ethnography of contested representations". Thesis, University of Oxford, 2002. http://ora.ox.ac.uk/objects/uuid:6ac544f6-41a9-4eb6-8dda-9b7325ec1611.
Testo completoAbstract (sommario):
This thesis examines the experiences of people living with dystonia1 and the ways these are represented by people living with dystonia, the Dystonia Society, neurologists, quality of life (QOL) researchers and pharmaceutical companies. Drawing on ethnographic fieldwork conducted within the Dystonia Society and on projects developing a disease-specific QOL measure, and investigating the impact of dystonia on people’s QOL, the thesis explores a series of questions about the conceptual and practical problems inherent in such measures. It asks: • How dystonia is defined and represented and its impact on people’s lives • Whether people’s experiences of living with dystonia can be adequately mapped by generic or disease-specific QOL measures and how the methodology used in their creation might affect such representations • How QOL measures are used to classify and compare and why it is now deemed necessary to represent people’s experiences in this form The thesis is contextualised within a historical account of the origins of QOL measurement and the social and economic context to its rapid expansion, including the pharmaceutical industry’s use of QOL to bring together diverse groups of actors. I address traditional anthropological questions about measuring and creating universal systems of classification and valuation, but go beyond this to link QOL measurement to the classification and hierarchisation of “audit culture”. I describe how attempts to articulate “the patient’s voice” through measures of QOL can silence the voices of people with limiting conditions and suggest we approach their experiences through narratives that embed their conditions in their lives and give them a meaning that is not wholly negative. I argue that even though the phrase “quality of life” promises an empowering and holistic vision of health, there are two main reasons why QOL measurement cannot fulfil this promise. Firstly, it is primarily a tool for audit, and secondly, new measures reproduce the assumptions of existing measures or clinical models and exclude the elements that people consider most important in maintaining quality of life. Paradoxically, the discourse can reduce people’s QOL when it is used to justify rationing in the UK and redirection of resources internationally. However, despite my criticisms of QOL, I conclude that it has benefited people living with dystonia by creating a discursive space for the discussion of health in non-clinical terms and a language to make claims for resources and the acknowledgement of their experiences. 1A chronic neurological condition involving involuntary muscle spasms in one or more body parts.
16
Camfield, Laura Emma Lilian. "Measuring quality of life in dystonia : an ethnography of contested representations". Thesis, Goldsmiths College (University of London), 2003. http://ora.ox.ac.uk/objects/uuid:6ac544f6-41a9-4eb6-8dda-9b7325ec1611.
Testo completoAbstract (sommario):
This thesis examines the experiences of people living with dystonia1 and the ways these are represented by people living with dystonia, the Dystonia Society, neurologists, quality of life (QOL) researchers and pharmaceutical companies. Drawing on ethnographic fieldwork conducted within the Dystonia Society and on projects developing a disease-specific QOL measure, and investigating the impact of dystonia on people’s QOL, the thesis explores a series of questions about the conceptual and practical problems inherent in such measures. It asks: • How dystonia is defined and represented and its impact on people’s lives • Whether people’s experiences of living with dystonia can be adequately mapped by generic or disease-specific QOL measures and how the methodology used in their creation might affect such representations • How QOL measures are used to classify and compare and why it is now deemed necessary to represent people’s experiences in this form The thesis is contextualised within a historical account of the origins of QOL measurement and the social and economic context to its rapid expansion, including the pharmaceutical industry’s use of QOL to bring together diverse groups of actors. I address traditional anthropological questions about measuring and creating universal systems of classification and valuation, but go beyond this to link QOL measurement to the classification and hierarchisation of “audit culture”. I describe how attempts to articulate “the patient’s voice” through measures of QOL can silence the voices of people with limiting conditions and suggest we approach their experiences through narratives that embed their conditions in their lives and give them a meaning that is not wholly negative. I argue that even though the phrase “quality of life” promises an empowering and holistic vision of health, there are two main reasons why QOL measurement cannot fulfil this promise. Firstly, it is primarily a tool for audit, and secondly, new measures reproduce the assumptions of existing measures or clinical models and exclude the elements that people consider most important in maintaining quality of life. Paradoxically, the discourse can reduce people’s QOL when it is used to justify rationing in the UK and redirection of resources internationally. However, despite my criticisms of QOL, I conclude that it has benefited people living with dystonia by creating a discursive space for the discussion of health in non-clinical terms and a language to make claims for resources and the acknowledgement of their experiences. 1A chronic neurological condition involving involuntary muscle spasms in one or more body parts.
17
Brisson, Julien. "Moving beyond Resistance and Medicalization: Challenging Common Representations of Bareback Sex and HIV through Ethnography". Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32991.
Testo completoAbstract (sommario):
Condomless sex between gay men, also known as bareback sex, has been a popular object of research since the beginning of the AIDS epidemic. One of the most common perspectives on studying bareback sex has been through a medicalization approach, as it may be observed notably with public health and psychology. In other instances, the abandonment of condom use is framed as an intentional act of resistance to public health. Through the methodological approach of ethnography, I studied how young gay men in their twenties from Toronto understand bareback sex in relations to popular discourses of the sexual practice. While my informants initially had a certain way of talking of bareback sex, their narratives on the sexual practice changed with time and challenged the common representations of bareback sex as either a site of resistance or medicalization, which I argue was possible because of the methodological approach of ethnography. During fieldwork, other themes also emerged in regards to shaping understandings of bareback sex and HIV as it relates to young gay men, such as the traumatic memories of an older generation who witnessed the earlier days of the AIDS epidemic. From this anthropological research, I seek to invite the opportunity to rethink the relationship between sex, biomedical science, and HIV.
18
Reeser, Douglas Carl. "Medical Pluralism in a Neoliberal State: Health and Deservingness in Southern Belize". Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5295.
Testo completoAbstract (sommario):
This ethnography explores the varied contours of a national health care system and how it is used in conjunction with traditional forms of health care in Toledo District, Belize, focused on the largest town of Punta Gorda (P.G.), In a medically plural environment, a variety of health care options are used based on a wide range of social, economic, and structural factors that shape people's choices and decisions. The convenience of and experience with low-cost home- and self-care options make these the most common first choice during an illness event in P.G., however a deeper exploration of health behavior reveals that people will exhaust all options in their quest for health. In an era when neoliberal trends have a direct effect on people's lives, including a negative impact on health and well-being, Belize stands out as an interesting case. The small Central American/Caribbean nation has taken actions that appear to be contradictory to broader neoliberal policies that encourage privatization of government services, by implementing a national health care system that provides low-cost and free health services to its citizens. While new health facilities have been opened, and health services have become more widely available throughout Belize, an analysis of how and why the health care system functions shows that such programs may actually function as mechanisms of control and surveillance, thus aligning with neoliberal aims such as decentralization and privatization of services. As it has been implemented in southern Belize, the national health care system also replicates and extends an historic trend of marginalization and neglect to the region, showing that from the perspective of the State, and by extension, the powerful and elite of the nation, the citizens of P.G. are seen as less deserving of the quality of health care services that are necessary to lead healthy and productive lives.
19
Schlosser, Allison V. "Subjectivity and Moral Personhood: An Ethnography of Addiction Treatment in the United States". Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1528722783811988.
Testo completo
20
Carrière, Natalie. "It Still Isn't Over: A Mother's Experiences of Healing After Childhood Cancer". Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32862.
Testo completoAbstract (sommario):
This autoethnographic account explores my experiences of healing with my daughter and two sons after childhood cancer. My goal was to understand the disconnect between my experiences of persisting fear, grief and trauma and the contradictory messages we encountered during treatment that urged us to resume our ‘normal lives’ at the end of treatment. In analyzing my story, juxtaposed with other anthropologists’ narratives of their journey through cancer and beyond, I realized that my experiences were mediated by prevalent war metaphors in illness; the pervasive social and medical messages and expectations of restitution; as well as narrow biomedical un- derstandings of illness and healing. I offer up my story with the intention of bridging the divide between patients, their family, and medical professionals.
21
Knopes, Julia. "The Social Construction of Sufficient Knowledge at an American Medical School". Case Western Reserve University School of Graduate Studies / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=case1544043617644668.
Testo completo
22
Burnette, Catherine Elizabeth. "Unraveling the web of intimate partner violence (IPV) with women from one southeastern tribe: a critical ethnography". Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/2449.
Testo completoAbstract (sommario):
Indigenous women experience intimate partner violence (IPV) at a disproportionate and epidemic rate. A common thread among indigenous women's experiences is that of colonization, which has been linked to both IPV and other social ills. Many tools of domination and control used throughout colonization to subjugate and oppress indigenous peoples are consistent with the tactics of power and control used in IPV. Given the distinct history of colonization along with the absence of research on indigenous women from the Southeastern portion of the United States, the purpose of this critical ethnography was to understand the culture and context of IPV for women from a Southeastern tribe across the life course.
Because they complimented and supplemented each other in their ability to increase understanding about indigenous women' experiences with IPV, critical theory, historical trauma, life course theory, and resilience theory guided this qualitative inquiry. Paulo Freire's vision of critical theory was used to conceptualize this dissertation within the specific historical context. Using Carspecken's critical ethnographic method, the relevant data collected for this study included 28 participant observation sessions with indigenous community members and 28 life histories with indigenous women. Data analysis followed Carpsecken's method of reconstructive analysis.
The patterns of power and domination at the societal, community, and interpersonal levels were identified with the broader beliefs that might perpetuate IPV across generations. Results included key factors within the specific historical context of indigenous women that had salient linkage to IPV. The potential symptoms of historical loss and trauma, including alcohol abuse, IPV, and family breakdown, were highlighted. Women's emergent pattern of violence that occurred across the life course was delineated within the culturally specific family structure. Women's perceptions of experiences with the formal and informal support systems were explored. Likewise, the various coping strategies of women who experienced IPV were identified along with the culturally specific protective and risk factors across multiple levels. Women's suggestions for emancipation from oppression were highlighted along with the implications for social work practice and policy.
23
Carlsson-Lalloo, Ewa. "HIV-positive women’s sexual health : A meta-synthesis of how HIV-positive women experience and describe sexual health". Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-17657.
Testo completoAbstract (sommario):
There is no consensus of the concept sexual health in the context of being HIV-positive women. Research in the area tends to focus in different measurable parts of sexual health for HIV-positive women. A meta-synthesis on that research issue can develop a deeper understanding and knowledge of how HIV-positive women in qualitative studies describe and experience sexual health. The purpose with this study is to analyze and synthesize the results about how HIV-positive women describe and experience sexual health. The meta-synthesis follows Noblit and Hare´s method of meta-ethnography and additional use of Walsh and Downe´s checklist to appraise qualitative articles. The result shows that HIV involves changes in the body, sexuality and sexual activity and relationships. The changes lead to feelings of responsibility, fear and hopelessness. Combinations of these feelings lead to actions of avoidance of risks that result in feelings of loss. As a nurse you are expected to promote sexual health as a part of holistic care and with this new knowledge health care workers can help these women to better health and feeling of well-being.Program: Fristående kurs
24
Humphris, Rachel Grace. "New migrants' home encounters : an ethnography of 'Romanian Roma' and the local state in Luton". Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:3af69cfa-2cd7-4972-afb2-14d92238d25a.
Testo completoAbstract (sommario):
This ethnographic study explores how 'Romanian Roma' migrants in the UK, without previous relationships to their place of arrival, negotiate their identity to make place in a diverse urban area. The thesis argues that state forms are (re)produced through embedded social relations. The restructuring of the UK welfare state, coupled with processes of labelling, means that the notion of public and private space is changing. Migrants' encounters with state actors in the home are increasingly important. I lived with three families between January 2013 and March 2014, during a period of shifting labour market regulations and the end of European Union transitional controls in January 2014. Through mapping families' relationships and connections, I identify encounters in the home with state actors regarding children as a defining feature of place-making. The thesis introduces the term 'home encounter' to trace the interplay of discourses and performances between state actors and those they identified as 'Romanian Roma'. Due to the restructuring of UK welfare, various roles assume different 'faces of the state'. These include education officers, health visitors, sub-contracted NGO workers, charismatic pastors and volunteers. The home encounter is presented as a public 'state act' (Bourdieu 2012) where negotiations of values take place in private space determining access to membership and welfare resources. In addition, blurring boundaries between welfare regulations and immigration control mean that these actors' seemingly small decisions have far-reaching consequences. The analysis raises questions of how to understand practices of government in diverse urban areas; the affect of labelling, place and performance on material power inequalities; and processes of discrimination and othering.
25
Lake, Jonathan. "Teaching doctors : the relationship between physicians' clinical and educational practice". Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/8002.
Testo completoAbstract (sommario):
This thesis explores the relationship between physicians’ clinical and educational roles in the context of UK General Practice (GP) education by investigating the experiences of seven GP trainers through an ethnographic approach employing Activity Theory (AT). The Introduction considers the philosophy and structures of GP education and outlines the author’s professional biography to provide context. The Literature Review focusses on the development of medical education as a discrete field and identity formation in medical educators, concluding that: specialist medical educators are a relatively new group; and there is a paucity of knowledge regarding the impact on physicians of occupying dual clinical and educational roles. The thesis then focusses on three Research Questions (RQs), namely: 1. What is the impact of GP trainers’ clinical practice upon their educational work? 2. How does GP trainers’ educational practice influence their clinical work? 3. What are the social contexts for GP trainers’ clinical and educational practice? These questions are addressed within a pragmatic theoretical framework to build up an ethnographic description of the participants’ experiences. Data collection is through semi-structured interviews and observation of video-recorded teaching. Ethical issues associated with the study are discussed in detail, in particular the challenges of “insider” research. Four approaches are used for data analysis: global impressions; word cloud analysis; thematic analysis; and analysis shaped by AT. In answer to RQs 1 and 2, the study finds that GP trainers experience their dual roles as intimately linked, intuitively transferring their skills between their clinical and educational practice. The study also finds that GP trainers reconstruct their professional identities through teaching. With regard to RQ 3, engaging in teaching can lead to internal conflict for GP trainers and tensions with their colleagues, trainees and regulators. These findings are discussed in relation to medical education research methodology and the impact the study on the researcher is explored. The thesis closes by considering the conflicted position the participants occupy, concluding that teaching offers physicians the opportunity to reconstruct their professional identities so they can approach tensions in their practice with a sense of agency and optimism.
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De, Waal Denise. "'We’re All Getting Older You See, and Things Do Change, Don’t They?’ An Ethnographic Study of Disruption and Continuity in the Daily Lives of Couples Living with Dementia and Co-morbidities". Thesis, University of Bradford, 2018. http://hdl.handle.net/10454/17313.
Testo completoAbstract (sommario):
Most people with dementia live in the community with a family member, commonly a spouse. Together they engage in identity redefinition to maintain continuity. Many people living with dementia also have co-morbidities. The aim of this study was to provide a better understanding of the influence of co-morbidities on the lived experience of couples and to provide knowledge to improve services. This had not been researched before.
Drawing on the dialectic relationship between the body, habitus, environment and common sense from Bourdieu’s theory of practice (1977; 1990) combined with identity theory as described by Burke and Stetts (2009) I conducted an ethnographic study with five couples over a six-month period.
The resulting data were analysed using a framework approach and are presented using case studies to illustrate key points. Drawing up on the data I developed an identity perspective which provides a better understanding of these couples’ daily life experiences taking into consideration the contextuality of people’s multiple identities, experiences, care and support needs and their interaction with the environment and community. My findings illustrate how people with dementia and co-morbidities and their spouses negotiate their identity in daily life in order to continue their daily life routine and cope with health conditions. Furthermore, these identity negotiations influence the acceptance of the diagnoses of dementia, the access to care, services and information and the experience of dementia, stigma and co-morbidities in daily life.
Implications include a presentation of the limitations of current concepts of embodied selfhood and the Aging in Place policy for people with dementia. It points to the potential of the identity perspective to shape policy, services and care practice consistent with couples’ lived experience and their needs and preferences.The Alzheimer's Society
27
Santos, Débora Fontenelle dos. "A assistência às pessoas vivendo com HIV/AIDS: aprendendo a cuidar do vírus ou da pessoa?" Universidade do Estado do Rio de Janeiro, 2007. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=3426.
Testo completoAbstract (sommario):
O presente estudo descreve e analisa o aprendizado dos médicos residentes para a prática da assistência às pessoas que vivem com HIV/Aids desenvolvida em um serviço de Doenças Infecciosas e Parasitárias de um Hospital Universitário no Estado do Rio de Janeiro. É uma pesquisa de cunho etnográfico, com a observação do processo de treinamento em consulta em ato da atenção, realizada por médico residente, sob supervisão de staffs do serviço. Os aspectos multicausais da Aids suscitam demandas tanto nos pacientes quanto nos profissionais de saúde envolvidos na assistência a essas pessoas. O processo de ensino/aprendizado na medicina prioriza a doença, relegando a segundo plano, o doente com suas
questões subjetivas, sociais, culturais e econômicas. Entretanto, ao lidarem com estas pessoas, os médicos entram em contato com aspectos objetivos e subjetivos do processo de adoecimento individual. É neste momento, que fica evidente as
lacunas deixadas neste processo de aprendizado. Paulatinamente, os médicos vão aprendendo a cuidar do vírus e seus efeitos. Eventualmente aprendem a cuidar também da pessoa. Para o alcance de uma atenção integral e humanizada ainda é necessário ampliar e aprofundar as reformulações no processo de ensino/aprendizagem dos médicos. Mudanças essas que permitam o aprendizado de cuidar bem tanto da carga viral, do CD4 e dos anti-retrovirais quanto da pessoa que porta o vírus.The purpose of this study is to describe and analyze the learning of resident physicians in their practice to provide medical assistance to the people living with HIV/AIDS. This study was conducted at the Infectious and Parasitary Disease Department of an University Hospital at Rio de Janeiro State. This is an ethnographic research focused in the process of training resident physicians to the act of attention under the supervision of the staff department. The diversity aspects of AIDS epidemic brings up demands coming from patients and from health care professionals involved in the medical assistance to these persons. The proper process of medicine education priories disease instead of individuals singularity (subjectivity, cultural, economic and social aspects). Meanwhile, as long as the physicians have been in touch with these persons, they start facing some aspects (objective and subjective) of the process of becoming sick. In this moment, its clear some blank space in the medicine course curriculum. Slowly, the physicians will elaborate to theirselves how to take care of the virus and its effects. Eventually, they also learn how to take care about the person who is infected. To reach an integral and humanitarian attention, its still necessary to disseminate and intensify reformulation inside the medicine course curriculum. These changes will allow to learn how to take care of some important aspects of the people living with HIV/AIDS and not only the viral load and CD4 count and the quality of ARV treatment
28
Jennings, Peter. "PBL but not as we know it : an ethnography of the practice and facilitation of 'problem-based learning' within a hybrid graduate-entry medical programme in England". Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/14438/.
Testo completoAbstract (sommario):
This thesis lifts the lid' on the educational practices within a medical education programme, which is based upon a Problem-Based learning (PBl) approach. It is an ethnographic case study that sets out to understand the practice and facilitation of PBl situated within a hybrid curriculum at a graduate-entry medical programme in England. Data was collected by audio-visual recording of PBl sessions, audio recording and observing facilitator meetings and through the author's experiences as a participant observer working as a facilitator within the research setting. The study exposes a variety of PBl practices within a single curriculum setting that have not previously been examined in detail within medical education, in particular through use of direct observational methods. The findings pose a challenge to a core educational objective, upon which the 'PBl' programme was founded, that being to develop students' skills as self-directed learners. While this is highlighted within the literature as a central component to the PBl process, the findings raise questions about how these assumptions are reflected in the practice of PBL.
29
Yimmee, Suchawadee. "Implementation of a Clinical Pathway in Thailand: An Ethnograpic Study". [Kent, Ohio] : Kent State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1216759596.
Testo completoAbstract (sommario):
Thesis (Ph.D.)--Kent State University, 2008.Title from PDF t.p. (viewed Oct. 29, 2009). Advisor: Donna S. Martsolf. Keywords: Organizational culture; Clinical pathway; Ethnography; Thailand; Conscientiousness. Includes bibliographical references (p. 133-140).
30
Purdy, Eve Isabelle. "Doing Our Work Better, Together: An Application of Relational Coordination Theory to Explore and Shape Excellence in Trauma Care". Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1538699/.
Testo completoAbstract (sommario):
I conducted a mixed-methods collaborative ethnography using the lens of relational coordination theory. This included a qualitative survey using an established tool to analyze the relational dimensions of multidisciplinary teamwork, participant observation, interviews, and narrative surveys. Findings were presented to clinicians in working groups for further interpretation and to facilitate co-creation of targeted interventions designed to improve team relationships and performance. I engaged a complex multidisciplinary network of ~500 care providers dispersed across seven core interdependent clinical disciplines. Initial findings highlighted the importance of each dimension of relational coordination in trauma care. Narrative survey and ethnographic findings further highlighted the centrality of team briefings and a translational simulation program in contributing positively to team culture and relational ties. A range of 16 interventions – focusing on structural, process and relational dimensions – were co-created with participants after reflecting on findings and are now being implemented and evaluated by various trauma care providers. Relational coordination theory is a valuable way to conceptualize the coordination of trauma care. Collaborative reflection on quantitative and narrative data through this lens can be used as a community-based quality improvement tool.
31
Artz, Matthew. "An Ethnography of Direct-to-Consumer Genomics [DTCG]: Design Anthropology Insights for the Product Management of a Disruptive Innovation". Thesis, University of North Texas, 2018. https://digital.library.unt.edu/ark:/67531/metadc1248393/.
Testo completoAbstract (sommario):
Direct-to-consumer genomics (DTCG) health testing offers great promise to humanity, however to date adoption has lagged as a result of consumer awareness, understanding, and previous government regulations restricting DTCG companies from providing information on an individual's genetic predispositions. But in 2017 the broader DTCG market which also includes genealogical testing demonstrated exponential growth, implying that DTCG is starting to diffuse as an innovation. To better understand the sociocultural forces affecting diffusion, adoption, and satisfaction, qualitative ethnographic research was conducted with DTCG genealogy and health consumers. The data was qualitatively analyzed using thematic analysis to understand the similarities and differences in beliefs, attitudes, intentions, and mediating factors that have influenced consumers. Design anthropology theory and methods were used to produce ethnographically informed insights. The insights were then translated into actionable product management and business strategy recommendations.
32
Thies, Ralf. "Ethnograph des dunklen Berlin : Hans Ostwald und die "Großstadt-Dokumente" (1904-1908) /". Köln [u.a.] : Böhlau, 2006. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=014907255&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
Testo completo
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Zanella, Eduardo Doering. "Práticas, mediações e substâncias : "álcool" e "drogas" nas atividades de um coletivo de pesquisadores". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/102215.
Testo completoAbstract (sommario):
Este trabalho constitui uma pesquisa etnográfica, desenvolvida junto a um coletivo de pesquisadores das ciências médicas, o Centro de Pesquisa em Álcool e Drogas (CPAD), vinculado ao Departamento de Psiquiatria da Universidade Federal do Rio Grande do Sul. Assumindo como ponto de partida que as drogas não constituem entidades pré-existentes, mas substâncias que tomam formas específicas a partir de articulações heterogêneas, objetivo descrever os processos de mediação que envolvem tais substâncias. Trata-se de compreender quais diferenças e transformações são produzidas para estes objetos nos empreendimentos e nas atividades deste centro de pesquisa. Para isto, foco em dois casos: uma parceria estabelecida entre o CPAD e o Departamento Estadual de Trânsito do Rio Grande do Sul (Detran-RS), e uma coleta de dados empreendida com pacientes usuários de drogas, internados para tratamento de dependência química no Hospital de Clínicas de Porto Alegre. Ao final do trabalho, argumento que a transformação ou a diferenciação das drogas “em si” também modifica aquilo que está em seu “entorno”, de tal modo que natureza e sociedade são mutuamente produzidas nestes processos de mediação.This work is an ethnographic research, developed with a collective of researchers of medical sciences, the “Centro de Pesquisa em Álcool e Drogas” (CPAD), linked to the Department of Psychiatry of the “Universidade Federal do Rio Grande do Sul”. Taking as its starting point that drugs are not pre-existing entities, but substances that take a particular shape from heterogeneous articulations, I propose to describe mediation processes involving such substances. I intend to understand the differences and changes that are made to these objects in the projects and activities of CPAD. For this, I focus on two cases: a partnership between the “Departamento Estadual de Trânsito do Rio Grande do Sul” (Detran-RS) and CPAD, and a data collection undertaken with drug users, admitted to chemical dependency treatment at the “Hospital de Clínicas de Porto Alegre”. At the end of this work, I argue that the transformation or differentiation of the drugs "themselves" also modifies what is on their "surroundings", in such a way that nature and society are mutually produced in these processes of mediation.
34
Pizzignacco, Tainá Maués Pelucio. "Escolhas, caminhos e cuidados: o itinerário terapêutico de crianças com Fibrose Cística". Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-06012014-141658/.
Testo completoAbstract (sommario):
A Fibrose Cística (FC) é uma doença genética, até o momento incurável, que junto às demais condições crônicas, exigem cuidados que transcendem a esfera biológica da doença e do cuidado e necessita de estratégias inovadoras para seu manejo. Esse estudo teve por objetivo compreender o itinerário terapêutico de crianças com Fibrose Cística, a partir da perspectiva deles próprios. Para tanto, nos apoiamos no quadro teórico e metodológico conformado pela antropologia médica, etnografia e a hermenêutica interpretativa. Participaram do estudo, 7 crianças entre 8 a 10 anos, em tratamento em um hospital escola do interior do estado de São Paulo e seus familiares. Os dados foram coletados por quatro meses com cada criança partindo-se do referencial da etnografia, mediante observação participante, entrevistas e confecções de materiais que permitiram a participação infantil. Os resultados foram compreendidos em três atos interpretativos que conformam o círculo hermenêutico: As várias facetas da Fibrose Cística; Caminhos e cuidados: avaliações sobre o tratamento e Escolhas, caminhos e cuidados: o itinerário terapêutico de crianças com Fibrose Cística. A partir dos resultados, interpretamos que os modelos explicativos existentes na FC atualmente estão circunscritos em círculos concêntricos dentro dos setores e entre os diferentes atores envolvidos gerando avaliações fragmentadas e diferentes possibilidades de tratamento. As interpretações nos levaram a refletir a respeito da hegemonia do paradigma da saúde pautado no positivismo e suas implicações para o cuidado integral. As possibilidades de mudança aparecem ao considerarmos a etnografia e a hermenêutica enquanto referenciais para a prática bem como a centralidade e a potencialidade da criança como agente da mudança.Cystic Fibrosis (CF) is a genetic disease which, along with other chronic conditions, calls for care that transcends the biological aspects of the disease and requires innovative strategies for its management. The aim of this study was to understand the therapeutic itinerary of children with cystic fibrosis through their point of view. To achieve this, we were supported by theoretical and methodological framework composed by medical anthropology, ethnography and interpretative hermeneutic. The participants were 7 children between the ages of 8 and 10 who were in treatment for CF at a University Hospital in the state of São Paulo and their relatives. Data were obtained during 4 months with each child using the ethnography method through participant observation, interviews and handmade materials that allowed children to participate. The results were understood in 3 interpretative acts that shaped the hermeneutic circle: Plenty faces of Cystic Fibrosis; Paths and care:treatment evaluations and Choices, paths and care: the therapeutic itinerary of children with Cystic Fibrosis. After analyzing the results, we interpreted that the explanatory models currently available in Cystic Fibrosis are limited in circles in the sectors and between the different actors involved what causes fragmented evaluations and different possibilities of treatment. Those interpretations lead us to reflect the hegemony of the health paradigm that is based on positivism and its implication for integral care. The possibilities of change appear when using the ethnography and the hermeneutic theories in the clinical practice and when considering the centrality and the potentiality of the children as transition agents.
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Bisaillon, Laura. "Cordon Sanitaire or Healthy Policy? How Prospective Immigrants with HIV are Organized by Canada’s Mandatory HIV Screening Policy". Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/20643.
Testo completoAbstract (sommario):
Since 2002, the Canadian state has mandatorily tested applicants for permanent residence for HIV (Human immune deficiency virus). The policy and practices associated with this screening have never been critically scrutinized. Authoritative claims about what happens in the conduct of the immigration medical examination are at odds with the experience of immigrant applicants living with HIV. This is the analytic entry point into this inquiry that is organized within the theoretical and methodological frame offered by institutional ethnography and political activist ethnography. Analysis is connected to broader research literatures and the historical record.
The goal of this study is to produce detailed, contextualized understandings of the social and ruling relations that organize the lives of immigrants to Canada living with HIV. These are generated from the material conditions of their lives. An assumption about how organization happens is the social and reflexive production of knowledge in people’s day-to-day lives through which connections between local and extra-local settings are empirically investigable. I investigate the organization of the Canadian immigration process. How is this institutional complex ordered and governed? How is immigration mandatory HIV testing organized, and with what consequences to HIV-positive applicants to Canada? This is a text-mediated organization where all the sites are connected by people’s work and the texts they circulate. The positive result of an immigration HIV test catalyzes the state’s collection of medical data about an applicant. These are entered into state decision-making about the person’s in/admissibility to Canada.
I focus on a key component of the immigration process, which is medical examination and HIV testing with this, along with the HIV test counselling practices that happen (or not) there. The reported absence of the latter form of care causes problems and contradictions for people. This investigation adopts the standpoint of these persons to investigate their problems associated with HIV testing. The main empirically supported argument I make is that the Canadian state’s ideological work related to the HIV policy and mandatory screening ushers in a set of institutional practices that are highly problematic for immigrants with HIV. This argument relies on data collected in interviews, focus groups, observations, and analysis of texts organized under Canada’s Immigration and Refugee Protection Act (S.C., 2001, c. 27) and textually mediated, discursively organized concepts that shape people’s practice. Canadian immigration medical policy makers should make use of these findings, as should civil society activists acting on behalf of immigrants to Canada living with HIV. I make nine specific recommendations for future action on HIV and immigration in Canada.
36
King, Julie Anne. "Weaving yarns : the lived experience of Indigenous Australians with adult-onset disability in Brisbane". Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/34447/1/Julie_King_Thesis.pdf.
Testo completoAbstract (sommario):
Indigenous Australians have lower levels of health than mainstream Australians and (as far as statistics are able to indicate) higher levels of disability, yet there is little information on Indigenous social and cultural constructions of disability or the Indigenous experience of disability. This research seeks to address these gaps by using an ethnographic approach, couched within a critical medical anthropology (CMA) framework and using the “three bodies” approach, to study the lived experience of urban Indigenous people with an adult-onset disability. The research approach takes account of the debate about the legitimacy of research into Indigenous Australians, Foucault‟s governmentality, and the arguments for different models of disability. The possibility of a cultural model of disability is raised. After a series of initial interviews with contacts who were primarily service providers, more detailed ethnographic research was conducted with three Indigenous women in their homes and with four groups of Indigenous women and men at an Indigenous respite centre. The research involved multiple visits over a period extending more than two years, and the establishment of relationships with all participants. An iterative inductive approach utilising constant comparison (i.e. a form of grounded theory) was adopted, enabling the generation and testing of working hypotheses. The findings point to the lack of an Indigenous construct of disability, related to the holistic construction of health among Indigenous Australians. Shame emerges as a factor which affects the way that Indigenous Australians respond to disability, and which operates in apparent contradiction to expectations of community support. Aspects of shame relate to governmentality, suggesting that self-disciplinary mechanisms have been taken up and support the more obvious exertion of government power. A key finding is the strength of Indigenous identity above and beyond other forms of identification, e.g. as a person with a disability, expressed in forms of resistance by individuals and service providers to the categories and procedures of the mainstream. The implications of a holistic construction of health are discussed in relation to the use of CMA, the interpretation of the “three bodies”, governmentality and resistance. The explanatory value of the concept of sympatricity is discussed, as is the potential value of a cultural model of disability which takes into account the cultural politics of a defiant Indigenous identity.
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Baily, Heather Rose. "The Digital Labor Ward: Teleconsultation in Rural Ghana". Case Western Reserve University School of Graduate Studies / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1586514278335033.
Testo completo
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Shapiro, Nicholas Edward. "Spaces of uneventful disaster : tracking emergency housing and domestic chemical exposures from New Orleans to national crises". Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:b42720e6-185b-492b-a83b-aea9de773cd7.
Testo completoAbstract (sommario):
In this thesis, I examine the politics, poetics, and logics of uneventful human harm in the United States by tracking the life and afterlife of a chemically contaminated emergency housing unit. In 2005, the Federal Emergency Management Agency (FEMA) deployed 120,000 trailers to the US Gulf Coast to house those displaced by Hurricanes Katrina and Rita. Chemical testing, spurred by reports of inhabitant illness, revealed elevated levels of formaldehyde emanating from the plywood walls of the trailers. After being reclaimed by the federal government and beginning in 2010, the FEMA trailers were resold at auction to every corner of the country. Resold trailers gravitated to precarious populations at the poles of rural capital accumulation—from oil patches in North Dakota to reservations in Washington. These trailers serve as an exceptional substrate for an investigation into the anatomy of the uneventful as they once approached the apex of eventfulness as a national controversy and now reside in the shadows of the everyday. This thesis apprehends and theorizes these dispersed and ordinary instruments of domestic harm across multiple registers: epistemological, material, spatial, and affective. I examine how failures of matter and meaning shaped and patterned the lives of those who inhabited the FEMA trailers as their lives became framed by chemical off-gassing, architectural insufficiency, material deterioration, and electrical short-circuiting. Crossing scales and venues, I interrogate the modalities of scientific incomprehension that erode the perception, admittance, or substantiation of mass chemical exposure. These technical processes, along with cultural horizons of eventfulness and the chronicity of disaster, foreclosed avenues of toxic harm accountability. These ‘economies of abandonment’ bring into relief the contemporary biopolitical priorities in which the FEMA trailer—an ostensible protection from harm that fosters illness—becomes possible. FEMA trailer residents attend to the minute, gradual, and ongoing symptoms of exposure to discern the reality and magnitude of residential contamination. The body of the exposed becomes both an epistemic instrument and, across time, the means of making low-level, chronic, and cruddy chemical exposures into eventful instances that drive individuals to action.
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Feufel, Markus Alexander. "Bounded Rationality in the Emergency Department". Wright State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=wright1249241698.
Testo completo
40
Mahi, Lara. "La discipline médicale : ethnographie des usages de normes de santé et de savoirs médicaux dans les dispositifs de la pénalité". Thesis, Paris 10, 2018. http://www.theses.fr/2018PA100072/document.
Testo completoAbstract (sommario):
La prison fait l’objet d’un nombre croissant de publications biomédicales depuis les années 1980, en France, comme dans la plupart des pays occidentaux industrialisés, mettant l’accent sur les prévalences élevées de certaines affections chroniques parmi la population carcérale. Comment se fait-il que tant de personnes emprisonnées ont des « problèmes » de « santé » ? Cette thèse entreprend de répondre à cette question en appréhendant la santé non pas comme un état, mais comme une norme. À partir d’une enquête ethnographique associant observations de pratiques judiciaires, monographies des services médicaux d’établissements pénitentiaires, entretiens, statistiques et étude de corpus d’articles scientifiques, elle s’attache à montrer, pas-à-pas, selon une approche processuelle, comment la chaîne pénale produit des « malades » en confrontant les individus saisis par ses dispositifs à des normes de santé et à des savoirs médicaux. À la croisée d’une sociologie des institutions, d’une sociologie de la médecine et d’une sociologie de la connaissance, en étant à la fois attentive à des pratiques bureaucratiques, à la construction de décisions (pénales, gestionnaires et médicales), aux conditions concrètes de réalisation d’études biomédicales en maison d’arrêt et à leurs effets, à des rhétoriques judiciaires et scientifiques, aux activités professionnelles qui constituent le soin en prison et à l’appropriation socialement différenciée de ce travail par les détenus, l’enquête permet de comprendre comment le pouvoir médical se déploie, au présent, de façon discrète et diffuse, dans et par des institutions ne se donnant pas pour première mission de soignerIn France, as in most Western countries, prison has been the subject of a growing number of biomedical publications since the 1980s that emphasize the high prevalence of certain chronic conditions among the prison population. Why do so many prisoners have “health” “problems”? This dissertation undertakes to answer this question by approaching health not as a state, but as a norm. At the intersection of the sociology of institutions, the sociology of medicine and the sociology of knowledge, it draws on an ethnographic study combining observations of judicial practices, monographs of prison medical services, interviews, statistics and analyses of scholarly articles. Through a processual approach, it shows how the penal system produces “ill persons” by confronting the individuals caught by its devices with health norms and medical knowledge. By attending to the bureaucratic practices, to the construction of (criminal, managerial and medical) decisions, to the concrete conditions under which biomedical studies are conducted in prison as well as their effects, to the judicial and scientific discourses, to care activities and to the appropriation of such care by prisoners according to their social background, the present investigation allows for an understanding of how medical power currently unfolds, in a discreet and diffuse fashion, in and by institutions that do not primarily mean to cure
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Deiringer, Sabine A. "Applying anthropology to the situation of the Roma : an ethnography of NET, a project addressing the situation of the Roma of Central and Eastern Europe /". Norderstedt : Books on Demand, 2006. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=016030625&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
Testo completo
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Llort, Suárez Antoniu. ""El pájaro está en el nido". Cocaína, cultura y salud: más allá del modelo de adicción. Una etnografía del consumo de cocaína en Reus". Doctoral thesis, Universitat Rovira i Virgili, 2016. http://hdl.handle.net/10803/399306.
Testo completoAbstract (sommario):
Aquesta investigació es basa en la descripció de les diferents modalitats d'ús de cocaïna i les variables socioculturals que influeixen en la salut de les persones consumidores així com en el manteniment de les seves funcions i relacions socials. S'ha realitzat treball de camp etnogràfic durant 18 mesos a Reus basat en les teories fenomenològiques i de l'interaccionisme simbòlic. També s'han realitzat 32 entrevistes en profunditat a consumidors. Els principals resultats han estat comprendre que la dimensió salut juga un paper molt important en el consum de cocaïna, però principalment pels riscos que implica la il·legalitat i l'estigmatització d'aquesta pràctica. Es proposen dos models d'anàlisi sociocultural del consum de cocaïna, el primer des de la perspectiva fenomenològica i les teories del cos com a objecte social i polític i el segon a partir dels espais de consum identificats, com a llocs que mediatitzen les condicions en què aquests consums es realitzen. Per finalitzar es realitzen propostes concretes de mesures de salut col·lectiva, basades en la formació en matèria de substàncies psicoativas i la creació d'espais d'autoorganització de consumidors i serveis per disminuir riscos i danys mentre es mantingui un mercat il·legal de psicoestimulants.Esta investigación se basa en la descripción de las diferentes modalidades de uso de cocaína y las variables socioculturales que influyen en la salud de las personas consumidoras así como en el mantenimiento de sus funciones y relaciones sociales. Se ha realizado trabajo de campo etnográfico durante un año y medio en Reus basado en las teorías fenomenológicas y del interaccionismo simbólico. También se han realizado 32 entrevistas en profundidad a consumidores. Los principales resultados han sido comprender que la dimensión salud juega un papel muy importante en el consumo de cocaína, pero principalmente por los riesgos que implica la ilegalidad y la estigmatización de esta práctica. Se proponen dos modelos de análisis sociocultural del consumo de cocaína, el primero desde la perspectiva fenomenológica y las teorías del cuerpo como objeto social y político y el segundo a partir de los espacios de consumo identificados, como lugares que mediatizan las condiciones en que estos consumos se realizan. Para finalizar se realizan cinco propuestas concretas de medidas de salud colectiva, basadas en la formación en materia de sustancias psicoativas y la creación de espacios de autoorganización de consumidores y servicios para disminuir riesgos y daños mientras se mantenga un mercado ilegal de psicoestimulantes.
This research is based on a description of the different modes of cocaine use and the socio-cultural variables affecting the health of consumers and their maintenance of roles and relationships. It follows 18 months ethnographic fieldwork, based on the phenomenological theories of symbolic interaction. This field data is augmented by 32 in-depth interviews with cocaine consumers in Reus. Results of the research indicate that the health considerations plays an important role in cocaine use, but mainly in terms of the risks associated with its illegality and the stigmatisation of this practice. Two models of socio-cultural analysis were used in this study. The first, a phenomenological perspective incorporates social and political theory, and the second examines ‘consumer spaces’: identified as sites that mediate conditions in which people use cocaine. Using these two models of analysis, findings suggest specific proposals in the area of public health. Training and education for both consumers and service providers in all psycho-active substances. Developing opportunities for self-organising among consumers. Partnership between consumers and services towards the reduction of risk associated with psycho-stimulant use. To collaboratively seek to develop proposals towards a regulated market for psycho-stimulants.
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Couture, Vincent. "Les vases communicants : une ethnographie des services reproductifs transfrontaliers au Canada". Thèse, Université de Sherbrooke, 2018. http://hdl.handle.net/11143/11862.
Testo completoAbstract (sommario):
Les services reproductifs transfrontaliers (SRT) réfèrent au déplacement d'une juridiction à une autre, de personnes ou de matériel reproductif dans le cadre d'un projet de procréation assistée (PA). Ce phénomène a été observé dans de nombreux pays, mais le système de PA mondialisé canadien, ou reproscape, demeure sous-étudié. Ce manque de connaissances nuit au développement normatif en matière de PA. En adoptant un cadre conceptuel issu de l'anthropologie médicale, l'objectif général de cette thèse était de décrire et comprendre le reproscape canadien. Pour alimenter la réflexion éthique et juridique et la prestation des services de PA, nous avons réalisé une enquête ethnographique clinique multisite combinant : (1) une revue de la littérature, (2) l'observation participante et non participante de deux cliniques de fertilité (Québec et Ontario), d'une agence d'importation de gamètes et d'une dizaine de congrès scientifiques, ainsi que (3) des entrevues semi-dirigées avec 45 actrices et acteurs des SRT : personnes utilisatrices, personnel médical et intermédiaires. Les données ont fait l'objet d'une analyse qualitative inductive, assistée du logiciel NVivo 11.
Trois dimensions émergent de nos résultats. (1) Le Canada se caractérise par une mosaïque de lois et de règlements locaux, fédéraux et provinciaux qui influencent de façon paradoxale les SRT. L'obligation de don altruiste, établie par la Loi sur la procréation assistée (LPA), joue un rôle prédominant sur le reproscape canadien. (2) Au niveau de l'expérience des SRT, la simplicité de certains SRT intégrés à la pratique clinique, comme l'importation de sperme ou d'ovocytes, contraste avec la complexité des voyages vers l'étranger auxquels les personnes utilisatrices se sentent souvent contraintes. (3) Interrogées sur leurs perspectives éthiques, quatre positions principales ressortent des entrevues: (a) le respect de leur autonomie reproductive, (b) les risques individuels et (c) sociaux des SRT, dont celui d'exploitation des gestatrices et des donneuses d'ovules, ainsi que (d) les incohérences de la LPA quant à sa capacité d'atténuer ces risques. En conclusion, le reproscape canadien se caractérise, entre autres, par une situation de " sous-traitance reproductive " : une reconnaissance institutionnelle des SRT, combinée à une délocalisation des risques moraux et médicaux hors des frontières nationales. Les conclusions de notre étude mettent en évidence le caractère inextricable du local et du global en PA et comment le reproscape mondial fonctionne par vases communicants.Abstract : Cross-border reproductive care (CBRC) refers to the movement from one jurisdiction to another of persons or reproductive material as part of assisted reproductive technology (ART) treatment. This phenomenon has been observed in many countries, but the Canadian globalized ART system (or "reproscape") remains understudied empirically. This lack of data undermines the normative development in terms of ART. The aim of this dissertation is to describe and understand the Canadian reproscape in order to support ethical and legal reflection. To achieve this goal, we conducted a multi-site clinical ethnography combining (1) literature reviews, (2) participant and non-participant observation in two fertility clinics (Quebec and Ontario), a gamete importation and distribution agency and a dozen scientific congresses, (3) as well as semi-directed interviews with 45 actors of CBRC: users, medical professionals and intermediaries. The data were analyzed by inductive qualitative analysis assisted by NVivo 11 software. Three dimensions emerge from our results. (1) Regarding the legal and clinical contexts of ART, Canada is characterized by a local mosaic of laws and regulations that paradoxically influence CBRC. The altruistic obligation established by the Assisted Human Reproduction Act (AHRA) plays a predominant role on the reproscape. (2) In terms of the experience of the main actors, the simplicity of CBRC integrated to the clinic, such as the import of semen or oocytes, contrasts with the complexity of journeys abroad for which users often feel constrained. (3) When asked about their ethical perspectives, the actors mentioned four main positions: (a) the respect for their reproductive autonomy, (b) the individual and (c) social risks of CBRC, including the exploitation of egg donors as well as gestational surrogates, and (d) AHRA inconsistencies in its ability to mitigate these risks. Our conclusion is that the Canadian reproscape is characterized, inter alia, by a situation of "reproductive outsourcing." This concept is characterized by an institutional recognition of CBRC combined with a relocation of moral and medical risks outside national borders. The results of our study underline the inextricable local and global nature of ART and how CBRC works as communicating vessels.
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McLennan, Amy Kathleen. "An ethnographic investigation of lifestyle change, living for the moment, and obesity emergence in Nauru". Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:bd001d98-7648-4d2b-9d92-8130f022b34b.
Testo completoAbstract (sommario):
The Republic of Nauru, a small Pacific island nation, has one of the highest obesity rates in the world. Obesity emerged rapidly in Nauru during the 1970s, a period characterised by political independence and unprecedented economic growth resulting from lucrative phosphate mining. In the mid-1970s, the Nauruan population was one of the first in the world in which obesity, diabetes mellitus and cardiovascular disease – co-morbidities associated with obesity – were identified as significant public health concerns. Such ‘lifestyle diseases’ continue to have debilitating effects on the Nauruan community. Obesity is generally understood to result from an energy imbalance; that is, people eat and drink more calories over time than they expend. This biomedical paradigm is implicit in the majority of research relating to obesity, such that the lifestyle to which obesity is attributed is limited to diet and activity. Yet in practice, lifestyle is much more than this. The lifestyle of a particular group is related to political, legal, religious, economic and value systems, modes of education, communication, transport and healthcare, and styles of art, music and entertainment. In this thesis I draw on ethnographic participant observation carried out in the Republic of Nauru during 2010-11, life history interviews, and diverse historical materials to answer three questions. First, what characterises the Nauruan lifestyle? Second, in what ways did the Nauruan lifestyle change over the second half of the twentieth century, the time period during which obesity and diabetes rapidly escalated? Finally, how might these changes be linked to the emergence and persistence of ‘lifestyle diseases’ in Nauru? I focus on one characteristic that stood out prominently in many different aspects of Nauruan life: ‘island time’, or the suggestion that there is ‘No Action Unless Really Urgent’. In theorisation of obesity, such living for the moment has been interpreted as laziness, pleasure-seeking or lack of self-control. However, a deeper analysis reveals that island time emerged gradually in the latter half of the twentieth century as Nauruans incorporated market-derived moral values into their everyday lives. This has led to profound changes in the way people feel when engaged in social exchanges, and is linked to temporally-shorter and more spatially dispersed social networks. I thus recast living for the moment as representative of a social trend rather than individual self-interest, and obesity as a phenomenon associated with the space between bodies rather than within each one. This leads me to consider more closely the links between social relationships and health. In Nauru, as in many societies, it is difficult to disentangle the biological and the social; the same feeling of unhealthiness, for example, is associated with being clinically ill and having a fight with a loved one. Yet many activities that are associated with tightening social networks, and which are prominent in the lifestyle characterised by island time – eating, drinking, or sitting and gossiping, for example – are also associated with obesity emergence. As a result, being biomedically healthy and feeling healthy are now somewhat incompatible in Nauru. In concluding, I argue that the adoption of economic rhetoric into everyday life has re-shaped moral values, everyday social relationships, and the demographic health profile on Nauru.
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Dahlbom, Gro. "The art of saving life : Interaction of the initial trauma care system from a cognitive science persepctive". Thesis, Linköpings universitet, Institutionen för datavetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-70704.
Testo completoAbstract (sommario):
Trauma care is the treatment of patients with injuries caused by external forces, for instance car crashes, assaults or fall accidents. These urgent patients typically arrive at the hospital’s Emergency Department, where they are treated by an interdisciplinary team of physicians and nurses, who collaborate to identify and address life-threatening injuries. In this thesis, the urgent phase of trauma care has been explored through observations of trauma calls and interviews with trauma care professionals, with the purpose of mapping the workflow and providing a basis for a discussion of IT systems within trauma radiology. The professionals, procedures and tools involved are collectively described as the initial trauma care system. There has been a focus on interaction between the units of this system, as well as on how decisions regarding treatment are made, often with the help of medical imaging. The initial trauma care system functions under significant time pressure, striving towards the well-defined objective of saving the life of the patient. To a great extent the system relies on standardized procedures, aiming for screening life-threatening injuries. The trauma team features a clear hierarchy and distinct roles, where the team leader role is considered vital for the team’s performance. Experience is valued and important for everyone, especially since the team often makes decisions, that may affect the future of the patient, based on incomplete information about the situation. Therefore, CT (computed tomography) images offer valuable decision-making support. The respondents are fairly satisfied with the current tools for viewing and manipulating radiological images. Little support for the need of improved or novel IT systems in trauma radiology is found, as is the use for 3D visualization of radiological images in this domain. Informants recognize communication failures and lacking teamwork as the major problems in trauma care. Difficulties like this may be decreased by education and training regarding these issues.
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Agic, Haris. "Hope Rites : An Ethnographic Study of Mechanical Help-Heart Implantation Treatment". Doctoral thesis, Linköpings universitet, Hälsa och samhälle, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-76158.
Testo completoAbstract (sommario):
This thesis is about cultural aspects of advanced medical technology for treating end-stage heart failure. New medical technologies like mechanical help-hearts save lives, but they also bring new uncertainties, risks, and challenges. Based on nine months of ethnographic field work in a Swedish academic hospital, this study examines the ways of managing uncertainties of end-stage heart failure and of high-tech treatment, and also how these practices tie into the shared understandings of life-threatening chronic illness, the body, and medical technology’s role. This study draws on anthropological discussions of healing rituals as an analytical tool to make sense of social and cultural dimensions of mechanical help-heart implantation treatment. Viewed as a ritual, this treatment creates and maintains hope as a virtue through which possibilities of new medical technology are justified as culturally approved ways of handling the uncertainties of severe heart failure and mechanical help-heart treatment. Ultimately, even when treatment is regarded as successful, the patients may be saved but are never really ‘cured’ and remain, thus, permanently tied to the world of medicine. This new mode of existence is characterized by paradoxical permanent transit between uncertainty and hope.Avhandlingen fokuserar på de kulturella aspekterna av den medicinska teknologin som används vid behandling av svår hjärtsvikt. Samtidigt som ny medicinsk teknologi som mekaniska hjälphjärtan räddar liv för den även med sig ovisshet och nya utmaningar som ofta är svåra att förutse. Baserat på nio månaders etnografiskt fältarbete vid ett universitetssjukhus i Sverige undersöks hur denna ovisshet och dessa utmaningar hanteras av medicinskt personal och patienter. I avhandlingen behandlas också sambanden mellan medicinska praktiker och de lokalt delade uppfattningarna om livshotande kroniska sjukdomar, den mänskliga kroppen och teknologins roll. Utifrån diskussioner inom antropologin om ’helande ritualer’ analyseras i avhandlingen de sociala och kulturella aspekterna av behandling med mekaniskt hjälphjärta. Studien visar att genom de rituella aspekterna av denna behandling, genereras och upprätthålls hoppet som en dygd. Den nya medicinska teknologins möjligheter rättfärdigas på så sätt som ett kulturellt accepterat sätt att hantera ovissheten vid svår hjärtsvikt och behandling med mekaniskt hjälphjärta. Även vid lyckade behandlingar, då patienternas liv räddas, blir de trots allt inte riktigt ’botade’ utan förblir bundna till den medicinska världen. Detta nya levnadssätt karakteriseras av en paradoxal och livslång balansgång mellan ovisshet och hopp.
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Yajahuanca, Rosario Del Socorro Avellaneda. "Sem kutipa: concepções sobre saúde reprodutiva e sexualidade entre os descendentes Kukamas Kukamirias, Peru". Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-13042009-151633/.
Testo completoAbstract (sommario):
A Amazônia peruana ocupa 62% do território do país. Ali existem 42 grupos etnolinguísticos, que apresentam características culturais, econômicas e políticas diferentes de outras populações do território nacional. Existe uma grande dívida histórica de reivindicação dos direitos destas populações, o que pressupõe elaborar formas de entender a dinâmica entre culturas diferentes, e projetando novas formas de relação que propiciem o encontro intercultural. Isso é importante para que a atenção à concepção, gravidez, parto e pós-parto se torne mais satisfatória e efetiva, e também para que sejam implementados serviços de saúde culturalmente adequados, com mais respeito aos direitos sexuais e reprodutivos no período gestacional. Objetivo: Conhecer as concepções sobre as necessidades específicas de saúde sexual e reprodutiva, com foco na saúde materna, no grupo étnico kukama kukamiria da comunidade de San Regis. Metodologia: Trata-se de um estudo qualitativo de base etnográfico, utilizando os instrumentos de entrevista aberta, observação participante e diário de campo. No total, foram realizadas 25 entrevistas individuais, com mulheres grávidas e puérperas, parteiras, médicos herbalistas, parceiros e servidores de saúde. A identidade dos participantes foi protegida com a utilização de nomes fictícios. Resultados: As mulheres grávidas costumam preferir os serviços das parteiras/ parteiros da comunidade de San Regis pelo vínculo emocional e afetivo entre as duas partes, que resulta numa atenção mais calorosa. As plantas e ervas medicinais são muito utilizadas para curar moléstias ou favorecer um melhor estado de saúde na gravidez, durante e depois do parto, além de serem usadas no cuidado do recém-nascido. Os serviços de saúde são menos procurados, por freqüentemente desrespeitos as tradições deste grupo kukama kukamiria e pelas técnicas inapropriadas que utilizam. Conclusão: As parteiras/parteiros são procuradas pela sua proximidade cultural e afetiva; nos serviços de saúde, freqüentemente a população se sente ameaçada pelo contato rude e procedimentos invasivos.The Peruvian Amazon occupies 62% of the territory of the country. In such area there are 42 ethnolinguistic groups each presenting its own cultural, economic and political features, different from other groups within the national territory. A great historical debt exists in terms of the claims of these people, what calls for the construction of ways to understand the dynamics relations among the different cultures and for the proposal of new forms of relations allowing intercultural encounter. This is important so that the assistance given during conception, pregnancy, labor and the post-partum period may be more satisfactory and effective, and also for the implementation of culturally adequate health services which pay due respect to sexual and reproductive rights during the pregnant period. Objective: To know the representations of the specific sexual and reproductive health needs with a focus on maternal health, in the ethnic group Kukama Kukamiria, in the community called San Regis. Methodology: This is a qualitative ethnographic study, using the instruments of open interview, participating observation and field diaries. Altogether 25 individual interviews were made, with pregnant women and women in labor, birth attendants, herbal doctors, partners and health personnel. The identity of the participants has been protected by the use of fictitious names. Results: The pregnant women customarily prefer the services of male or female birth attendants of the San Regis community because of the emotional and affective links between the two sides which results in more humanized assistance. Medicinal plants and herbs are very used to cure ailments or produce a better state of health during pregnancy and during and after labor as well being used in the care of the new-born. The health services are less preterably sought after because of their frequent disrespect to the traditions of th-is kukama kukamiria group and because of the inappropriate techniques used. Conclusion: The male or female birth attendants are sought after due to their cultural and affective proximity; conversely, in the health services, people frequently feel threatened by the rude approach and invasive procedures.
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Klein, Robert R. "Toward a Good Life in Later Life: Perspectives, Problems, and Responses". The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1364341896.
Testo completo
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Tria, Parareda Núria. "Cursant Concerta. Una aproximació etnogràfica a nens, adolescents i joves diagnosticats de TDAH". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/434476.
Testo completoAbstract (sommario):
La diagnosi de TDAH i la medicació amb metilfenidat o atomoxetina, junt (o no) a reeducacions cognitivo-conductuals, ha esdevingut en les darreres dècades una solució habitual que els dispositius educatiu i sanitari han ofert als nens que es considera que no progressen a l’escola adequadament. Aquesta “solució” ha generat abundant debat i controvertida literatura des de la inclusió del TDAH als anys ’80 del segle passat als manuals diagnòstics psiquiàtrics de referència, especialment als EEUU, pioner en la medicalització d’aquest àmbit de la vida dels nens i les seves famílies. Mentre uns afirmen que es tracta d’una malaltia “inventada” d’altres defensen “l’evidència científica” de la seva ubicació cerebral i el pes de la genètica en la seva aparició.
A la present recerca pretenc explorar per mitjà del treball de camp etnogràfic el fenomen social del TDAH estudiant-lo a un context local format per dues unitats d’anàlisi: un Centre de Salut Mental infanto-juvenil (CSMIJ) i el meu propi centre de treball, un Institut d’Ensenyaments Secundaris (IES), ambdós ubicats a Barcelona.
La recerca l’he plantejat en dos temps, i des de dos angles diferents, reflectits a les dues parts de que consta l’etnografia. A la primera part i amb l’objectiu de copçar el fenomen del TDAH en conjunt, l’he considerat un “fet social total” i he utilitzat les nocions de “joc” i “institució” per a preguntar-me i descriure, tant al CSMIJ (capítol I) com a l’IES (capítol II) els processos de construcció i institucionalització de la nosologia mèdica TDAH i la seva administració a nens, adolescents i joves. A la segona part (capítol III) m’he apropat a l’experiència particular d’alguns nois que han estat, en algun moment de la seva vida, designats com a TDAH i medicats. He escoltat la seva veu i m’he preguntat què significa “esdevenir TDAH”, posant el focus en els processos de subjectivació, d’internalització, de la taxonomia biomèdica així com del que anomenarem “lògica del diagnòstic”.
La reflexió final gira entorn la configuració de la persona, de la identitat, d’aquests nens, adolescents i joves que han estat diagnosticats de TDAH i medicats, entenent aquesta identitat com una construcció en procés i en diàleg permanent, al frec del joc institucional i les particularitats biogràfiques individuals. Em pregunto si podem parlar d’identitats medicalitzades i, finalment, procuro explicar què significa per a mi, “cursar Concerta”, una expressió que, sobre el terreny, sentia plena de significatA diagnosis of ADHD and treatment with methylphenidate (Ritalin) or atomoxetine (Strattera), combined with cognitive-behavioral therapies (though not always), has emerged in recent decades as the solution that education and health professionals customarily provide to children who are considered not to make adequate progress at school. This “solution” has generated intense debate and produced controversial literature ever since the 1980s when ADHD was included in clinical psychiatric diagnostic manuals, especially in the US, a pioneer in pathologizing this area of children’s and families’ lives. While some maintain that ADHD is an “invented” disease, others point to the “scientific evidence” of its location in the brain and the genetics involved in its presentation. In this study, I aim to explore the social phenomenon of ADHD through ethnographic field- work, specifically by studying a local context comprised by two sites of analysis, both located in Barcelona: a Childhood & Juvenile Mental Health Center (CSMIJ, in Catalan) and my own workplace, a Secondary Education Institute, (IES, in Catalan). I have planned the research to take place in two periods, from two different angles, reflected in the two parts that make up the ethnography. In the first part, in order to better grasp the phenomenon of ADHD in its totality, I approach it as a “global social fact,” using the concepts of “interplay” and “institution” to inquire and describe the processes of construction and institutionalization of the medical classification of ADHD and its management in children, adolescents and young adults at both the CSMIJ (Chapter 1) and the IES (Chapter 2). In the second part (Chapter 3), I approach the personal experience of certains youths who at some point in their lives have been diagnosed with ADHD and medicated. I have listened to their voices and considered what it means to “develop ADHD” by focusing on the processes of subjectivation and internalization of the biomedical taxonomy, as well as what I call the “logics of diagnosis.” The final reflection centers on the configuration of the personhood and identity of these children, adolescents and young adults who have been diagnosed with ADHD and medicated. I understand “identity” as a construction-in-process and in constant dialogue, between institutional interplay[1] and individual biographical particularities. I venture to ask if we could be dealing with “medicalized identities,” and finally, I attempt to explain what the expression “cursant Concerta[2]” (one that I felt charged with meaning on the ground) means to me.
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Patel, Raakhee Navin. "An Ethnographic Study of Doctor-Patient Communication within Biomedicine and Its Indian Variant in Mumbai". Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1619705858186443.
Testo completo