Lek och empowerment : de alternativa rummens roll i sociala rörelser

Play and empowerment: the role of alternative spaces in social movements The article examines the role played by alternative space in social movements and argues that it plays a crucial role in counter-acting feelings of powerlessness and facilitating the empowerment of subaltern groups. Alternative space is defined – using Benjamin’s notions ofshock, nature and history – as constituted by forms of interaction in which society is made to appear as history. To facilitate empowerment, alternative space must, firstly, provide a place for subaltern groups in which they are no longer subordinated; secondly, instill hope that social change is possible and encourage such change; and, thirdly, expand or consolidate alternative space itself. These tasks can easily enter into conflict with each other, since they sometimes appear to require alternative space to adopt more ”abstract” forms of interaction in which aspects of the social situation are bracketed and sometimes more ”concrete”ones in which such aspects are again given attention. In order to study how movements may relate to this difficulty, the article looks at three contemporary Japanese social movements with NAM, New Start / New Start Kansai and the General Freeter Union as central organizations. Only the third successfully combines the three tasks, in large measure through its skillful use of the play-element.

Existential issues in surgical care : Nurses’ experiences and attitudes in caring for patients with cancer

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

Parent’s experiences of feeding their preterm infant in Neonatal Units in Sweden. : Ethnographic design

Introduction: Studies have shown that having a preterm infant may cause stress and powerlessness for parents. It is important to support parents around the feeding situation, and that the Neonatal Intensive Care Unit (NICU) has appropriate space and place to help the family to bond to each other. For the healthcare professionals it is important to promote skin-to-skin contact and breastfeeding; particularly for preterm infants. There are many studies on parent’s experiences of NICUs and a few studies on parent’s experiences of feeding their infant in the NICU. Objective: The objective of this study was to explore parents experiences of feeding their infant in the NICU. Design: The study was conducted using an ethnographic design. Results: A global theme of ‘The journey in feeding’ was developed from four organising themes: ‘Ways of infant feeding’; ‘Environmental influences’; ‘Relationships’ and ‘Emotional factors’. These themes illustrate the challenges mothers reported with different methods of feeding. The environment had a big impact on parent’s experiences of infant feeding. Some mothers felt that breastfeeding seemed unnatural because their infant was so tiny but breastfeeding and skin-to-skin contact helped them to bond to their infant. The mothers thought it was difficult to keep up with the milk production by only pumping. Routines were not inviting parents to find their own rhythm. They also felt stressed about the weighing. Healthcare professionals had positive and negative influences on the parents. Conclusions: This study demonstrates that while all parents expressed the wish to breastfeed, their ‘journey in feeding’ was highly influenced by method of feeding, environmental, relational and emotional factors. The general focus upon routines and assessing milk intake generated anxiety and reduced relationality. Midwives and neonatal nurses need to ensure that they emphasise and support the relational aspects of parenting and avoid over-emphasising milk intake and associated progress of the infant

The influence of materialism on consumption indebtedness in the context of low income consumers from the city of São Paulo

This research is in the domains of materialism, consumer vulnerability and consumption indebtedness, concepts frequently approached in the literature on consumer behavior, macro-marketing and economic psychology. The influence of materialism on consumer indebtedness is investigated within a context that is characterized by poverty and by factors that cause vulnerability, such as high interest rates, limited access to credit and to quality affordable goods. The objectives of this research are: to produce a materialism scale that is well adapted to its environment, characterizing materialism adequately for the population studied; to compare results obtained with results of other studies; and to measure the relationship between materialism, socio-demographic variables, attitude to debt and consumption indebtedness. The primary data used in the analyses were collected from field research carried out in August, 2005 that relied on a probabilistic household sample of 450 low income individuals who live in poor regions of the city of Sao Paulo. The materialism scale, adapted and translated into Portuguese from Richins (2004), proved to be very successful and encourages new work in the area. It was noted that younger adults tend to be more materialistic than older ones; that illiterate adults tend to be less materialistic than those who did literacy courses when they were already adults; and that gender, income and race are not associated with the materialism construct. Among the other results, a logistic regression model was developed in order to distinguish those individuals who have an installment plan payment booklet from those who do not, based on materialism, socio-demographic variables and purchasing and consumer habits. The proposed model confirms materialism as a behavioral variable useful for forecasting the probability of an individual getting into debt in order to consume, in some cases almost doubling the chance of occurrence of this event. Findings confirm the thesis that it is not only adverse economic factors that lead people to get into debt; and that the study of demand for credit for consumption purposes must, of necessity, include variables of a psychological nature. It is suggested that the low income materialistic consumer experiences feelings of powerlessness and exclusion because of the gap that exists between their possessions and their desires. Lines of conduct to combat this marginalization from the consumer society are drawn targeting marketing professionals, public policy makers and vulnerability researchers. Finally, the possibility of new studies involving the materialism construct, which is central to literature on consumer behavior, albeit little used in empirical studies in Brazil, are discussed.

O difícil enfrentamento do processo de morrer vivenciado pelo enfermeiro em unidade pediatríca

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Entre a potência e a impotência do exercício profissional de médico perito no Intituto Nacional do Seguro Social (INSS): a importância do Estado como componente dilemático e paradoxal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Significados atribuídos por graduandos de enfermagem aos cuidados paliativos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Redes de atenção à saúde para gestantes usuárias de álcool e/ou outras drogas

Pós-graduação em Saúde Coletiva - FMB

Women's subjective and objective health over time : the role of psychosocial conditions and physiological stress responses

Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work.

Social Work, Social Politics and Justice

"The disaster does not primarily lie in people and in the way that they perceive the circumstances, rather in the circumstances that doom people to powerlessness and apathy - circumstances which they could, however, change" (Adorno, 1966, p. 189). When Karl Marx writes to Friedrich Sorge in his letter of the 19.10.1877, regarding his critique of the opinion of his opponents Dühring & Co., that one must deal with "a whole crowd of immature students and pompous doctors who claim to give socialism a 'higher, ideal' turn, that is to say, to replace the materialistic basis (that demands serious, objective study if one wants to operate on it)… with modern mythology by means of their goddesses of justice, freedom, equality and fraternité" (Marx, 1973, p. 303; cf. Schiller, 1993, p. 199 onwards), this thus refers to fundamental problems with the concept of "justice" up until today. As the debate shows, it concerns the contextualization of the term "justice", its meaning in historically concrete as well as socio-political circumstances, and therefore a social analysis that is both representation and critique. Essentially it also concerns the question of the relationship between ideas and reality and the development of standards of historical systematic 'nature' out of social frameworks (see Frey, 1978; Theunissen, 1989).

Contested Control: Irregular Transit Migrants in Europe

This presentation is about young migrants’ journeys with low chances of receiving asylum or any other type of residence in Europe. These migrants exhibit a highly complex migration pattern. First, these migrants are frequently in durable “transit” across Europe, moving back and forth between different states. Second, transit migrants must exhibit a high degree of flexibility, as they have to respond to suddenly changing conditions, such as work opportunities, rejection of asylum claims, detention or deportation. Third, transit migrants often switch between different legal statuses, such as asylum seeker, rejected asylum seeker, illegal worker or detainee. This throws them into a general state of uncertainty and psychological distress. The experience of these young adults shows a deep ambivalence between a sense of autonomy, on the one hand, and of profound hope- and powerlessness, on the other. This presentation explores the “fragmented journeys” of these migrants, by way of a multi-sited ethnographic approach and biographical interviews. It focuses on the lived experiences and the strategies of irregular migrants to find a way to reside in Europe in the context of an increasingly restrictive migration management.

Stuck in Mobility? Fragmented Journeys of Migrants without Chances of Admission in Europe

This paper is about young migrants without chance of being granted legal residence status in the Schengen zone. Previous observations suggest that some migrants, whose country of origin leaves them with low chances of receiving asylum or in fact any type of residence permit, exhibit a highly complex migration pattern that is characterised by 1) durable “transit” across Europe, which is a multi-linear movement according to opportunities that open up along the journey; 2) a high degree of flexibility, as they have to respond to suddenly changing conditions, such as work opportunities, rejection of asylum claims, detention or deportation, and 3) switching between different legal statuses, such as asylum seeker, sans papiers or detainee. The experiences of these young adults thus show a deep ambivalence between a sense of autonomy, on the one hand, and of profound hope and powerlessness, on the other. The Dublin Convention intends to limit such a hypermobility of migrants but seems to fail in many cases. Simultaneously it provokes some of the movements by sending asylum seekers and irregular migrants back to their first country of arrivals. Given the fact that little is known about these fragmented journeys inside of the Schengen area, this ethnographic study produces novel data on a highly pertinent migration pattern, the impact of the European migration management on individual migrants as well as the inter-relatedness of the asylum regime and irregular migration in Europe. At the same time these fragmented journeys are an excellent example to discuss mobility as a resource on the one hand (since it enables this specific migrant group to extend their presence in Europe) and as a handicap on the other (since it impedes the building of stable social networks, the planning of the future, etc.).

Redes para las nuevas formas de clientelismo político

La descentralización de políticas sociales hacia los municipios es planteada como una alternativa de desarrollo a partir de las relaciones micro sociales. Los municipios deben asumir una nueva responsabilidad y plantearse una nueva función: definir y ejecutar políticas sociales locales o regionales. Esta nueva relación del municipio con su población ha sido uno de los elementos, en un proceso que tiene múltiples explicaciones, que ha favorecido nuevas prácticas clientelares denominadas Clientelismo fino o institucional. Este clientelismo favorece una situación de sometimiento y de asistencialismo, dificultando nuevas formas de relación que permitan el desarrollo humano y el ejercicio de derechos.

Hurt feelings in couple relationships: Towards integrative models of the negative effects of hurtful events

Previous research suggests that hurt feelings can have powerful effects on individual and relational outcomes. This study examined a typology of hurtful events in couple relationships, together with integrative models predicting ongoing effects on victims and relationships. Participants were 224 students from introductory and third-year psychology classes, who completed open-ended and structured measures concerning an event in which a partner had hurt their feelings. By tailoring Leary et al.'s (1998) typology to the context of romantic relationships, five categories of hurtful events were proposed: active disassociation, passive disassociation, criticism, infidelity, and deception. Analyses assessing similarities and differences among the categories confirmed the utility of the typology. Structural equation modeling showed that longer-term effects on the victim were predicted by relationship anxiety and by the victim's immediate reactions to the event (negative emotions and self-perceptions; feelings of rejection and powerlessness). In contrast, ongoing effects on the relationship were predicted by avoidance, the victim's attributions and perceptions of offender remorse, and the victim's own behavior. The results highlight the utility of an integrated approach to hurt, incorporating emotional, cognitive, and behavioral responses, and dimensions of attachment security.

OHS in the nursing workplace: accountability and the management of stress

There has been growing interest in occupational stress in the nursing context, both in New Zealand and internationally. This article takes a critical approach to the literature on nursing stress by examining the implications of a body of research largely informed by a theoretical approach which highlights the individual. In spite of evidence that the main sources of stress for nurses are related to workplace conditions, the focus is on the individual nurse and his/her personal response to stress. This approach encourages the development of interventions where the objectives are the individual management of stress, and thereby consolidates nurses' perceptions of powerlessness. Alternatives to these palliative measures, such as highlighting the legal obligations for employers to provide a safe workplace or collective industrial action for change, are glaringly absent in the literature. The importance of such an approach is supported by recent findings from the United States on the advantages of hospitals which promote nurses' autonomy and control.