El temps del mal: l’experiència i la gestió de la cronicitat en adults

El temps del mal. L’experiència i la gestió de la cronicitat en adults. El principal objectiu d’aquesta recerca és l’estudi de l’experiència i la gestió diària de la cronicitat, entenent-la com a categoria analítica que engloba els processos de malalties i/o malestars crònics, biomèdicament diagnosticats o no, que perduren en el temps. La recerca es centra en adults entre 30 i 50 anys amb problemes crònics de salut que impliquin algun tipus de discapacitat i/o dependència (a nivell moderat), i s’ubica en l’àmbit urbà i en la comunitat autònoma de Catalunya (dins del context de l’estat Espanyol). L’estudi analitzarà la gestió individual i social de la cronicitat a través dels itineraris terapèutics i pràctiques assistencials dels processos de salut/malaltia/atenció prenent l’autoatenció com a principal categoria analítica. Per altra banda, es descriurà el rol dels serveis assistencials de la sanitat pública i dels serveis socials, per veure com es duu a terme la gestió – polítiques públiques - de la cronicitat en un país amb estat del benestar com Espanya. L’experiència de la cronicitat s’explorarà a través de les narratives de la vivència de la malaltia/malestar tan com a representació cultural – que dóna compte de les relacions, interaccions i respostes socials – i des d’una perspectiva fenomenològica que ens permet comprendre la naturalesa del patiment en l’experiència viscuda del cos malalt. Aquesta recerca espera poder fer aportacions pertinents que contribueixin des de l’antropologia però amb la intenció d’obrir un diàleg públic i interdisciplinar – professionals de la salut, experts en polítiques públiques i públic en general - a la resolució de l’actual problema de salut pública d’increment de cronicitat. El model públic d’atenció a la salut espanyol es va dissenyar per resoldre problemes de salut aguts, malgrat la major part dels usuaris actuals presentes problemes de salut crònics. L’actual crisi econòmica que amenaça aquest pilar de l’estat del benestar és, alhora, una oportunitat per replantejar-ho.

"We do have space in Lausanne. We have a large cemetery": The non-controversy of a non-existent Muslim burial ground

In the context of the administration of spaces assigned by municipalities for the burial of the dead, this article provides a critical analysis of the techniques for the governance of political collectives of citizens implemented by public authorities. More broadly, this article shows how funerary practices (i.e. the social practices surrounding death-the rituals, the legislation, etc.) can be used to develop a critical reading of the social relations that structure the social production of space. To this end, the authors use the conceptual tools provided by critical legal geography to explore the controversy surrounding the development of a 'carré confessionnel' (denominational area) within the Bois-de-Vaux Cemetery in Lausanne, Switzerland. Here, a focus on the techniques that allow 'nomosphere' technicians to convene a subset of the citizens within the public space reveals the administration of cemeteries as a means of governance, a method for mobilising bodies and a paradoxical means of managing flux.

Devenir charrùa dans l'Uruguay de l'après dictature Entre mémoires fragmentées et « sens du collectif ». Une ethnographie audiovisuelle en collaboration.

Dans cette recherche, je me suis intéressée à la genèse des rapports sociaux construisant un collectif, dans l'articulation être nommé et se nommer. En Uruguay, pays construit sur un imaginaire social dit "sans indiens", mon travail a consisté à essayer de comprendre les conditions historiques, sociales et politiques d'émergence de collectifs de personnes réclamant l'appartenance à une identité autochtone précise, l'identité charrùa. J'ai démontré qu'il s'agit d'un processus en cours, individuel et collectif, qui a des temporalités diverses, qui a néanmoins émergé depuis une vingtaine d'années, dans le contexte de la post-dictature et celui géopolitique de l'autochtonie, dans une articulation local/global. L'analyse dévoile que l'identité charrùa est l'enjeu du rapport social qui est la lutte politique contre l'exclusion. Cette identité accompagne l'état-nation depuis sa fondation. Figure duelle, cette identité contient les traces des violences internes dans un continuum de mémoires fragmentées et entrelacées. Elle est aussi promesse de devenir en tant que modèle identitaire parvenu à l'autonomie et conservant le « sens du collectif ». Anthropologue engagée, me situant dans une perspective décoloniale, j'ai proposé aux personnes avec qui j'ai effectué cette recherche, d'élaborer une ethnographie collaborative, la caméra et les films se situant au coeur du terrain, compris comme espace relationnel de construction d'une connaissance partagée. -- My research is based on the genesis of social relations which build up a collective, structured on being named and be named. My work in Uruguay, country built on a social construct called "without Indians", was to try to understand the historical, social and political conditions of emerging collectives. These claim the belonging of a precise indigenous identity, the charrua identity. I showed that the current process, which is individual and collective, with different temporalities, emerged twenty years ago, in the post-dictatorship context as well as the geopolitical context of indigeneity, in a local/global structure. The analysis reveals that the charrua identity is the stake of the social relation which is political fight against exclusion. This identity accompanies the nation state since its foundation. Dategory dual, this identity keeps the traces of the internal in the continuum of the fragmented and intertwined memories. This is also the becoming promise of an identity model, which reaches autonomy and keeps the "sense of collective". As an involved anthropologist, I worked from a decolonization point of view. I suggested that the people who went through the research with me, should work out a collaborative ethnography, the video camera and the movies being set in the middle of the fieldwork. This one is conceived as a relational space of construction of a shared knowledge.

An alternative socio-ecological strategy? International Trade Unions' engagement with climate change

In the context of a global ecological crisis, it is an important move when trade unions turn to environmentalism. Yet, the form that this environmentalism takes is often overlooked. This is especially the case with international trade unions. Based on an empirical study of international trade unions' engagement with the climate change issue, this article argues that international trade unions follow three different (and partially conflicting) strategies. I label these strategies as 'deliberative', 'collaborative growth' and 'socialist', and I examine each in turn. I argue that such analysis is important if we want to identify the potential for transforming the social relations of production that are at the root of the current climate crisis, and for identifying an alternative socio-ecological strategy.

Identity, immigration, and prejudice in Europe: a recognition approach

Social identity is a double-edged sword. On the one hand, identifying with a social group is a prerequisite for the sharing of common norms and values, solidarity, and collective action. On the other hand, in-group identification often goes together with prejudice and discrimination. Today, these two sides of social identification underlie contradictory trends in the way European nations and European nationals relate to immigrants and immigration. Most European countries are becoming increasingly multicultural, and anti-discrimination laws have been adopted throughout the European Union, demonstrating a normative shift towards more social inclusion and tolerance. At the same time, racist and xenophobic attitudes still shape social relations, individual as well as collective behaviour (both informal and institutional), and political positions throughout Europe. The starting point for this chapter is Sanchez-Mazas' (2004) interactionist approach to the study of racism and xenophobia, which in turn builds on Axel Honneth's (1996) philosophical theory of recognition. In this view, the origin of attitudes towards immigrants cannot be located in one or the other group, but in a dynamic of mutual influence. Sanchez-Mazas' approach is used as a general framework into which we integrate social psychological approaches of prejudice and recent empirical findings examining minority-majority relations. We particularly focus on the role of national and European identities as antecedents of anti-immigrant attitudes held by national majorities. Minorities' reactions to denials of recognition are also examined. We conclude by delineating possible social and political responses to prejudice towards immigrants.

Estudi sobre la qualitat de vida de les persones amb demència ateses a la Unitat d'avaluació de deteriorament cognitiu de l'Hospital de la Santa Creu

OBJECTIU: determinar la qualitat de vida de les persones amb demència ateses en una unitat avaluadora de deteriorament cognitiu. MÈTODE: estudi descriptiu transversal amb una mostra consecutiva no probabilística, formada per 42 persones amb demència tipus Alzheimer lleu o moderada i els seus cuidadors. La Qualitat de Vida (QV) es va avaluar amb el qüestionari QoL-AD (Quality of Life Alzheimer’s Disease) en les versions per al pacient (QoL-ADp) i per al cuidador (QoL-ADc). RESULTATS: la mitjana de puntuació del QoL-ADp va ser de 35,38 punts (DE = 5,24) i del QoL-Adc, de 30,60 (DE 5,33). La diferència entre aquests resultats és significativa (p&0,001). Els pacients amb simptomatologia depressiva i els seus cuidadors van puntuar significativament més baix el QoL-AD (p&0,001). En les freqüències per ítems del QoL-ADp s’observa que: més del 75% van valorar com a bona/excel·lent les condicions de vida, família, matrimoni/relació estreta, vida social, situació financera i vida en general; el 61% valoraren bona/excel·lent la capacitat per realitzar tasques a casa; prop del 50% pensava que l’estat d’ànim, l’energia, la salut física, la capacitat per fer coses per diversió i la visió de si mateixos era dolenta/regular, i el 85,7% opinava que la seva memòria era dolenta/regular. CONCLUSIONS: els resultats obtinguts en el QoL-AD no difereixen dels obtinguts en altres investigacions. Suggereixen que les intervencions que genera l’avaluació de la QV en la pràctica clínica inclouen aspectes centrats pròpiament en la malaltia i aspectes vinculats amb les relacions socials.

"Rakas Tarja" ja "hyvä ystävä". Puhuttelu minän ja sosiaalisten suhteiden esittämisen keinoina televisiokeskustelussa

Summary: Terms of address as a means of expressing self and social relations in television debates

Influencia de los medios de comunicación y de los grupos sociales en la percepción de la imagen corporal en pacientes con anorexia neviosa

La anorexia nerviosa es un trastorno de la conducta alimentaria que se caracteriza por unapérdida de peso superior al saludablemente recomendado, conductas para perder peso y evitarel aumento de peso, miedo a la obesidad y distorsión de la imagen corporal. Tanto la incidenciacomo la prevalencia de este tipo de trastornos ha aumentado considerablemente en las últimasdécadas, son varios los estudios que afirman que hay una estrecha relación entre la influencia delos factores socioculturales y el grado de distorsión de la imagen corporal en este tipo depacientes.El objetivo de este estudio es analizar la influencia que ejercen los medios de comunicación ylos grupos sociales en la distorsión de la imagen corporal de pacientes con anorexia nerviosa.Para lograr este objetivo se realizará un estudio fenomenológico con pacientes de 16 a 21 añosque se visiten en un hospital de día de trastornos de la conducta alimentaria. Los datos serecogerán mediante de una entrevista semiestructurada basada en los ítems del cuestionario deinfluencia de los modelos estéticos corporales (CIMEC). El análisis de los datos obtenidos serápor edición, transcribiendo la entrevista, identificando los segmentos significativos paraposteriormente poderlos analizar.En relación con las consideraciones finales, es un estudio que dentro de la subjetividad podríaser realmente útil para conocer desde el punto de vista del paciente cómo influyen los medios decomunicación y las relaciones sociales en la anorexia nerviosa, permitiendo la propuesta deacciones futuras que ayuden a estos adolescentes y adultos jóvenes a hacer frente a la presiónque ejerce la sociedad.

Cambios en los cuidadores informales en cuanto a estilos de vida, relaciones y alteraciones de salud mental

Changes in the informal caregiver life styles, relations and alterations of mental health. Justification.The increase of the population aged 65 years and older in developed countries is generating a proportional increasing of the dependency caused by chronic pathologies. The care of these persons is being carried out by relatives, informal carers, leading to some alterations in diverse areas, among them mental alterations, as a consequence of taking care. Objectives. To develop a profile of the informal carers and to correlate the caregiver burden with the carers disorders. To detect risk factors to allow carrying out premature nursing interventions to diminish the disorders in the informal carers. Design. An observational and cross-sectional study is made in primary care health services area of the city of Girona. Methodology. Random sample of carer of dependent people at their home , assigned to the program of domiciliary attention (ATDOM) of the educational basic areas of health (ABS). A sample size of 269 persons, with a level of precision of 9% was needed. Questionnaire ICUB 97, the test of Barthel, the Philadelphia Geriatric Center scale, and a questionnaire are used as instruments that includes demographic and social variables, and mental and physical carers disorders.Results. A total of 80 participants were interviewed. The most common problems as consequence of taking care were the backache, to feel more tired, to feel impotent and to have less free time. Correlation between the level of dependence of the patient with the number of problems perceived by the caretaker does not exist. Since they are informal carers they eat frequently outside the habitual schedule, took place an increase or loss of weight, experienced more disorders in sexual life and an increasing lack of interest in surroundings. A 33% of the informal carers are being treated for problems related to the mental health.Conclusion. The fact of being informal carer carries important consequences in their health, the lifestyles and the social relations. These can be attenuated if the nursing interventions are able to consider to the well-taken care of subject, and its surroundings in an holistic way. The professionals of infirmary of mental health must contribute to their knowledge and abilities contributing to make an assessment, a diagnosis and an intervention paying special attention to psycho-social aspects mentioned

Cambios en los cuidadores informales en cuanto a estilos de vida, relaciones y alteraciones de salud mental

Changes in the informal caregiver life styles, relations and alterations of mental health. Justification.The increase of the population aged 65 years and older in developed countries is generating a proportional increasing of the dependency caused by chronic pathologies. The care of these persons is being carried out by relatives, informal carers, leading to some alterations in diverse areas, among them mental alterations, as a consequence of taking care. Objectives. To develop a profile of the informal carers and to correlate the caregiver burden with the carers disorders. To detect risk factors to allow carrying out premature nursing interventions to diminish the disorders in the informal carers. Design. An observational and cross-sectional study is made in primary care health services area of the city of Girona. Methodology. Random sample of carer of dependent people at their home , assigned to the program of domiciliary attention (ATDOM) of the educational basic areas of health (ABS). A sample size of 269 persons, with a level of precision of 9% was needed. Questionnaire ICUB 97, the test of Barthel, the Philadelphia Geriatric Center scale, and a questionnaire are used as instruments that includes demographic and social variables, and mental and physical carers disorders.Results. A total of 80 participants were interviewed. The most common problems as consequence of taking care were the backache, to feel more tired, to feel impotent and to have less free time. Correlation between the level of dependence of the patient with the number of problems perceived by the caretaker does not exist. Since they are informal carers they eat frequently outside the habitual schedule, took place an increase or loss of weight, experienced more disorders in sexual life and an increasing lack of interest in surroundings. A 33% of the informal carers are being treated for problems related to the mental health.Conclusion. The fact of being informal carer carries important consequences in their health, the lifestyles and the social relations. These can be attenuated if the nursing interventions are able to consider to the well-taken care of subject, and its surroundings in an holistic way. The professionals of infirmary of mental health must contribute to their knowledge and abilities contributing to make an assessment, a diagnosis and an intervention paying special attention to psycho-social aspects mentioned

Justification du système économique et perception du travail en groupe

L'étude classique des attributions de responsabilité instiguée par Heider en psychologie sociale s'est principalement bornée à aborder ce processus psychosocial dans une perspective individualiste qui se cantonne aux niveaux intra-individuel et interpersonnel (selon la distinction opérée par Doise). Les réflexions et les travaux empiriques présentés dans cette thèse ont deux objectifs. Dans un premier temps, il s?agit d'élargir cette perspective aux autres niveaux sociologique et idéologique (en faisant notamment recours à l'approche des attributions sociales et aux propositions de Fauconnet sur les règles de responsabilité). Deuxièmement, il s?agit d'éprouver la pertinence d'une telle approche dans un contexte particulier : celui du travail en groupe dont la nature des rapports sociaux qui y étaient présentés ont été manipulés à l'aide de scénarii chez des étudiant-e-s de l?Université de Lausanne. L?objectif principal de cette thèse est donc de tester un modèle d?ancrage des attributions de responsabilité qui permette de souligner les dynamiques représentationnelles sous-jacentes en termes de légitimation ou de remise en cause de l?organisation des groupes. Dans l?ensemble les résultats indiquent que si la nature des rapports sociaux (re)présentés dans un groupe sont de puissants déterminants de la manière de légitimer ou de remettre en cause l?organisation des groupes, le niveau individuel d'adhésion à des croyances idéologiques dominantes, comme la justification du système économique, représente un modérateur des prises de position des répondant-e-s interrogé-e-s. De plus, il semble que ces processus évoluent dans le temps, faisant ainsi apparaître l'existence de phénomènes de socialisation relativement plus complexes que ne le laissent entendre les recherches actuellement effectuées dans ce domaine. En effet, si des connaissances idéologiques sur le monde sont acquises dans les filières universitaires et n?interviennent pas toujours dans les processus de formation des représentations du travail en groupe, des connaissances spécifiques aux disciplines et à la politique de sélection universitaire semblent intervenir dans le processus de légitimation des rapports sociaux dans les groupes au niveau des attributions. En tentant une articulation entre les concepts d?ancrage des représentations sociales, d?attribution et de socialisation, cette thèse permet ainsi de souligner la pertinence qu?il y a à insérer une problématique en termes de croyances idéologiques dans l?étude des groupes sociaux.<br/><br/>Heider?s approach of responsibility attributions almost exclusively emphasized on an individualistic point of view ; i.e. focusing at an intraindividual and interpersonnal level of analysis according to Doise?s distinction. The reflexions and empirical studies presented here firstly aim at broaden this perspective by taking socio-structural as well as societal levels of analysis into account. Secondly, it is to test this approach in the particular domain of organized groups. Manipulation of the structure of social relations in work groups on screenplays were undertaken (in a population of students from the Lausanne University). Hence, the main goal of these studies is to test the impact of the social ancoring of social representations in the responsibility processes in terms of legitimation or opposition to the group organization. All in all, the results show that social structures are powerfull predictors of the formation of social representations of a work situation and so forth of the attribution process. Nevertheless hegemonic ideological beliefs, such as Economical System Justification, do play a substantial moderating role in this process. It also proves to be evolving through time. The present findings show that a complexe process of socialization is occuring during the student?s university life. Indeed, the results let us believe that ideological beliefs may not interact anytime in the group?s perception and in the construction of the representation of the situation. In the same time, it seems that more discipline specific oriented knowledge and the impact of selection policy at the Lausanne University also predict the groupe legimation process and interfer with the ideological beliefs. Trying to articulate concepts of fields of research like social representations, attribution and socialization, the present thesis allows to underline the heuristic potential of reabilitating ideological beliefs at a dispositional level in the study of group process.

Capitals, trajectòries i estratègies: la teoria general dels camps de P. Bourdieu

El model de classes de P. Bourdieu articula la dimensió objectiva —l’estructura de classe— i la dimensió subjectiva —l’acció de classe—. Aquesta anàlisi de classe forma part d’un debat al voltant de la naturalesa de la realitat social, en el qual el punt més important és la connexió del camp de la producció i del camp de la reproducció de subjectes. Bourdieu, en enfasitzar la condició relacional de l’àmbit social, defineix l’acció social com a dependent de l’estructura relacional, en existir una connexió lògica necessària entre la localització dels agents en un conjunt de relacions socials i els seus interessos, objectius i estratègies d’acció. Per tant, per a aquest autor, hi ha una eficàcia estructuradora de l’acció dels agents socials per l’estructura de classe, i es constitueix, així, en una matriu d’acció, o millor dit, en una estructura probabilística de l’acció. És, doncs, fonamental, considerar el paper de l’acció en la construcció de les classes en si, ja que les classes teòriques, agrupacions fictícies que només existeixen sobre el paper, estan predisposades a convertir-se en classes en el sentit marxista del terme. I sols es passa de la classe sobre el paper a clase real a costa d’una labor política de movilització. Així, l’existència de classes, tant en la teoria com en la realitat, és una aposta de lluites en existir un espai social, un espai de diferències, en el qual les classes existeixen en estat virtual, no com quelcom donat, sinó com quelcom que es tracta de construir.

Devenir et prise en charge des enfants grands prématurés [Neurodevelopmental outcome of very premature infants].

Very preterm infants are at risk of neurodevelopmental impairments, which may affect motor development, intelligence and behavior. Neurodevelopmental follow-up is offered to these children who represent 1% of Swiss births, and may show abnormal motor tone, which sometimes resolves spontaneously or evolves in cerebral palsy. Standardized tests explore intellectual functioning and may allow the diagnosis of specific learning impediments. Finally, behavior is assessed with standardized questionnaires which can reveal hyperactivity with or without attention deficit, impaired social relations, psychiatric troubles or autism, all more frequent amongst preterm children.