Drawing on ethnographic fieldwork in Ghana, and the growing number of studies on “sanism” (or psychiatric oppression), this paper revisits outstanding methodological concerns around privilege and power, body and space, language and the liminality of social categories, as a platform to reconsider the insider/outsider debate. It ponders openly, and hopefully collectively, the implications of expanding research interests, so, too, the very circulation of ideas, against what the author is analytically describing as the experience of becoming “White.” The article focuses on questions that fieldwork exposed about researcher identity and “belonging,” not least the risk of essentialism. In effect, it seeks to demonstrate the ethical and epistemological dilemmas that arise from giving account, toward a more sensitive way in academia, relationship building, and solidarity work—where, when, how, or whether, critical ethnography can relinquish, reimagine, or altogether transform its dialectical tensions without undermining ends of resistance?
The question I asked in this essay was, “Is it possible that language is systematically structured in ways that people did not intend or have not been aware?” I used dashes and underlines to indicate that an unusual interaction exists between words, and I used arrows when the order of the words is important, as in a conceptual transformation, or when one idea appears to derive from another. The relationships between the words and concepts probably started out as accidental, but became non-accidental over time through some type of organizational process, which may or may not have been conscious. For example, “Trick-onometry” may be similar to a rock that I excavated that happened by chance weathering to have the shape of a stone tool, so I recorded it to be sure. That “evolution” contains the words “love” and “evil” is similar to a stone tool that was manufactured by a conscious person, or it may be derived from a non-conscious non-random organizational process that has given it the appearance of conscious design, similar to the way natural selection has given the appearance of design to species of animals. The odds that the combinations could have come about by chance may not be statistically high. Rather the associations are barely noticeable. The hypothesis is empirical, and the dataset is abstract.
This paper explores how scholars continuing within, or expanding on, Goffmanian tradition have, to varying degrees, given grit to the praxis and study of (new?) social movements today. Particular emphasis is put on the politics of madness, including the writings of anti-psychiatrists, as well as the recent emergence of Mad Pride, and how these might relate to human rights advocacy projects in Ghana. The discussion draws on semi-structured and qualitative interviews with “mad” activists, and is interspersed with personal anecdotes as an effort to map the author’s sinuous – yet continuous – path to an “engaged sociology.”
Scholarship in feminism, anticolonialism, Disability and Mad studies, have repositioned storytelling as instructive to the present and to the ethics of care. Emplotted with time and space, like the acts and lives of others, stories make discernible those everyday encounters, sites of practices, and material conditions that usher power and pain. They destabilize essentialism, so, too, the asymmetries that ensue, and are therefore pivotal in the politics toward self-definition. It has even been argued that the concept of the story garners much of the attention once assigned to that of identity. But here, I juxtapose, I entwine, no, I exbody competing multivalent social scripts, each a verse in itself, to nuance—albeit creatively—the story in this current age of governmentality and concomitant surveillance technologies. Paying homage to Patricia Hill Collins, I evoke intersectionality and endeavour to bring us back to identity politics … analytically.
The goal of the study was to assess perceived level of satisfaction with end-of-life care, focusing on the last 48 hours of life.
A previously validated instrument was used in a telephone survey with bereaved family members (n=90) of patients who died within an organization in British Columbia.
Bereaved family members had many unmet needs for information about the patient’s changing condition, the process of dying, how symptoms would be managed and what to do at the time of death. In addition, many bereaved relatives felt that the patient or resident had an unmet need for emotional support and that their own emotional needs were not addressed adequately. The last place of care had the most significant effect on all of these variables, with acute care and residential care having the most unmet needs. Hospice had the fewest unmet needs, followed by the palliative and the intensive care units.
We discuss these findings in relation to overall satisfaction with care, focus on individual, ethno-cultural and diversity issues, information and decision-making, symptom management and attending to the family. We conclude by offering possible practices address the end-of-life needs of patients and family members.
BACKGROUND:Recognition of the global economic and epidemiological burden of chronic non-communicable diseases has increased in recent years. However, much of the research on this issue remains focused on individual-level risk factors and neglects the underlying social patterning of risk factors and disease outcomes.METHODS:Secondary analysis of Argentina's 2005 Encuesta Nacional de Factores de Riesgo (National Risk Factor Survey, N = 41,392) using a novel analytical strategy first proposed by the United Nations Development Programme (UNDP), which we here refer to as the Average/Deprivation/Inequality (ADI) framework. The analysis focuses on two risk factors (unhealthy diet and obesity) and one related disease outcome (diabetes), a notable health concern in Latin America. Logistic regression is used to examine the interplay between socioeconomic and demographic factors. The ADI analysis then uses the results from the logistic regression to identify the most deprived, the best-off, and the difference between the two ideal types.RESULTS:Overall, 19.9% of the sample reported being in poor/fair health, 35.3% reported not eating any fruits or vegetables in five days of the week preceding the interview, 14.7% had a BMI of 30 or greater, and 8.5% indicated that a health professional had told them that they have diabetes or high blood pressure. However, significant variation is hidden by these summary measures. Educational attainment displayed the strongest explanatory power throughout the models, followed by household income, with both factors highlighting the social patterning of risk factors and disease outcomes. As educational attainment and household income increase, the probability of poor health, unhealthy diet, obesity, and diabetes decrease. The analyses also point toward important provincial effects and reinforce the notion that both compositional factors (i.e., characteristics of individuals) and contextual factors (i.e., characteristics of places) are important in understanding the social patterning of chronic diseases.CONCLUSION:The application of the ADI framework enables identification of the regions or groups worst-off for each outcome measure under study. This can be used to highlight the variation embedded within national averages; as such, it encourages a social perspective on population health indicators that is particularly attuned to issues of inequity. The ADI framework is an important tool in the evaluation of policies aiming to prevent or control chronic non-communicable diseases.
This review investigates the health of immigrants to Canada by critically examining differences in health statusbetween immigrants and the native-born population and by tracing how the health of immigrants changes aftersettling in the country. Fifty-one published empirical studies met the inclusion criteria for this review. The analysisfocuses on four inter-related questions: (1) Which health conditions show transition effects and which do not? (2)Do health transitions vary by ethnicity/racialized identity? (3) How are health transitions influenced by socioeconomicstatus? and (4) How do compositional and contextual factors interact to affect the health of immigrants?Theoretical and methodological challenges facing this area of research are discussed and future directions areidentified. This area of research has the potential to develop into a complex, nuanced, and useful account of thesocial determinants of health as experienced by different groups in different places.