A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

The research we present here forms part of a two-phase project - one quantitative and the other qualitative - assessing the use of primary health care services. This paper presents the qualitative phase of said research, which is aimed at ascertaining the needs, beliefs, barriers to access and health practices of the immigrant population in comparison with the native population, as well as the perceptions of healthcare professionals. Moroccan and sub-Saharan were the immigrants to who the qualitative phase was specifically addressed. The aims of this paper are as follows: to analyse any possible implications of family organisation in the health practices of the immigrant population; to ascertain social practices relating to illness; to understand the significances of sexual and reproductive health practices; and to ascertain the ideas and perceptions of immigrants, local people and professionals regarding health and the health system. Methods: qualitative research based on discursive analysis. Data gathering techniques consisted of discussion groups with health system users and semi-structured individual interviews with healthcare professionals. The sample was taken from the Basic Healthcare Areas of Salt and Banyoles (belonging to the Girona Healthcare Region), the discussion groups being comprised of (a) 6 immigrant Moroccan women, (b) 7 immigrant sub-Saharan African women and (c) 6 immigrant and native population men (2 native men, 2 Moroccan men and 2 sub-Saharan men); and the semi-structured interviews being conducted with the following healthcare professionals: (a) 3 gynaecologists, (b) 3 nurses and 1 administrative staff. Results: use of the healthcare system is linked to the perception of not being well, knowledge of the healthcare system, length of time resident in Spain and interiorization of traditional Western medicine as a cure mechanism. The divergences found among the groups of immigrants, local people and healthcare professionals with regard to healthcare education, use of the healthcare service, sexual and reproductive healthcare and reticence with regard to being attended by healthcare personnel of the opposite sex demonstrate a need to work with the immigrant population as a heterogeneous group. Conclusions: the results we have obtained support the idea that feeling unwell is a psycho-social process, as it takes place within a specific socio-cultural situation and spans a range of beliefs, perceptions and ideas regarding symptomology and how to treat it

Procedural Meaning Explicatures in the Development of New Subordination Strategies in Romance

The sociocultural changes that led to the genesis of Romance languages widened the gap between oral and written patterns, which display different discoursive and linguistic devices. In early documents, discoursive implicatures connecting propositions were not generally codified, so that the reader should furnish the correct interpretation according to his own perception of real facts; which can still be attested in current oral utterances. Once Romance languages had undergone several levelling processes which concluded in the first standardizations, implicatures became explicatures and were syntactically codified by means of univocal new complex conjunctions. As a consequence of the emergence of these new subordination strategies, a freer distribution of the information conveyed by the utterances is allowed. The success of complex structural patterns ran alongside of the genesis of new narrative genres and the generalization of a learned rhetoric. Both facts are a spontaneous effect of new approaches to the act of reading. Ancient texts were written to be read to a wide audience, whereas those printed by the end of the XV th century were conceived to be read quietly, in a low voice, by a private reader. The goal of this paper is twofold, since we will show that: a) The development of new complex conjunctions through the history of Romance languages accommodates to four structural patterns that range from parataxis to hypotaxis. b) This development is a reflex of the well known grammaticalization path from discourse to syntax that implies the codification of discoursive strategies (Givón 2 1979, Sperber and Wilson 1986, Carston 1988, Grice 1989, Bach 1994, Blackemore 2002, among others]