Hope in the Most Unlikely Spaces: Thawra and the Contemporary Arabic Novel

In the early to mid-twentieth century, many novelists in the Arab world championed Arab nationalism in their literary reflections on the social and political struggles of their countries, depicting these struggles primarily in terms of spatial binaries that pitted the Arab world against the West, even as they imported Western literary models of progress and modernity into their own work. The intense experience of national awakening that infused their writing often placed these authors at a literary disadvantage, for in their literature, all too often the depth and diversity of Arabic cultures and the complexity of socio-political struggles across the Arab world were undermined by restrictive spatial discourses that tended to focus only on particular versions of Arab history and on a seemingly unifying national predicament. Between the Arab defeat of 1967 and the present day, however, an increasing number of Arab authors have turned to less restrictive forms of spatial discourse in search of a language that might offer alternative narratives of hope beyond the predictable, and seemingly thwarted, trajectories of nationalism. This study traces the ways in which contemporary Arab authors from Egypt and the Sudan have endeavoured to re-think and re-define the Arab identity in ever-changing spaces where elements of the local and the global, the traditional and the modern, interact both competitively and harmoniously. I examine the spatial language and the tropes used in three Arabic novels, viewing them through the lens of thawra (revolution) in both its socio-political and artistic manifestations. Linking the manifestations of thawra in each text to different scenes of revolution in the Arab world today, in Chapter Two, I consider how, at a stage when the Sudan of the sixties was both still dealing with colonial withdrawal and struggling to establish itself as a nation-state, the geographical and textual landscapes of Tayeb Salih‟s Season of Migration to the North depict the ongoing dilemma of the Sudanese identity. In Chapter Three, I examine Alaa iii al-Aswany‟s The Yacoubian Building in the context of a socially diseased and politically corrupt Egypt of the nineties: social, political, modern, historical, local, and global elements intertwine in a dizzyingly complex spatial network of associations that sheds light on the complicated reasons behind today‟s Egyptian thawra. In Chapter Four, the final chapter, Gamal al-Ghitani‟s approach to his Egypt in Pyramid Texts drifts far away from Salih‟s anguished Sudan and al-Aswany‟s chaotic Cairo to a realm where thawra manifests itself artistically in a sophisticated spatial language that challenges all forms of spatial hegemony and, consequently, old and new forms of social, political, and cultural oppression in the Arab world.

Self-Management of Chronic Pain: Interventions, Strategies, Barriers, and Facilitators

Background & Purpose: Chronic pain is a prevalent chronic condition for which the best management options rarely provide complete relief. Individuals with chronic pain with neuropathic characteristics (NC) report more severe pain and experience less relief from interventions. Little is known about current self-management practices. The purpose of this dissertation was to inform self-management of chronic pain with and without NC at the individual, health system, and policy levels using the Innovative Care for Chronic Conditions Framework. Methods: The study included a systematic search and review and cross-sectional survey. The review evaluated the evidence for chronic pain self-management interventions and explored the role of health care providers in supporting self-management. The survey was mailed to 8,000 randomly selected Canadians in November 2011, and non-respondents were followed-up in May 2012. Screening questions were included for both chronic pain and NC. The questionnaire captured pain descriptions, self-management strategies, and self-management barriers, and facilitators. Results: Findings of the review suggested that self-management interventions are effective in improving pain and health outcomes. Health care professionals provided self-management advice and referred individuals to self-management interventions. The questionnaire was completed by 1,520 Canadians. Those with chronic pain (n=710) identified primary care physicians as the most helpful pain management professional. Overall, use of non-pharmaceutical medical self-management strategies was low. While use positive emotional self-management strategies was high, individuals with NC were more likely to use negative emotional self-management strategies compared to those without NC. Multiple self-management barriers and facilitators were identified, however those with NC were more likely than those without NC to experience low self-efficacy, depression and severe pain which may impair the ability to self-management. Conclusions: Health care professionals have the opportunity to improve chronic pain outcomes by providing self-management advice, referring to self-management interventions, and addressing self-management barriers and facilitators. Individuals with NC may require additional health services to address their greater self-management challenges, and further research is needed to identify non-pharmaceutical interventions effective in relieving chronic pain with NC. Public policy is needed to facilitate health systems in providing long-term self-management support for individuals with chronic pain.