Vivir con Chagas en Madrid: estructuras temporales de la vivencia de un grupo de pacientes bolivianos con el diagnóstico y la atención médica a la enfermedad de Chagas en un hospital metropolitano español

How can a chronic disease determine the life of a group of people diagnosed as seropositive away from their home country? And how do we account for that lived experience. Some diseases contemplated a few decades ago as strictly rural or of poor countries, are an urban reality now and are part of the epidemiological setting in wealthy developed countries. That is the case of Chagas disease in Spain. A disease linked for a long time to rural poverty, until migratory movements occurred nationwide from the country side to the city, and recently with international migration have turned pathology into a global public health issue. Chagas disease is a chronic parasitic infection, endemic in all Latin America and can be transmitted by triatomine or “kissing bug” (Triatoma Infestans), which lives and reproduces in straw houses of rural regions. According to the Pan American Health Organization (PAHO, 2006), the disease affects approximately eight million people. It is recognized by the WHO as a “neglected tropical disease”...

Movement and figurality: The circulation diagram and the history of the architectural plan

Knowledge of the plan competes with self-consciousness of experience. The less we are able to understand our spatio-visual experience by the abstract coordinates of the plan, the more we are thrust back into a lived experience of the building in duration. This formula, frequently unacknowledged, has been one of the main precepts of the experientialist modernism which arises out of the picturesque and which stands in critique of classical idealism. One of the paths to critique this formula is by showing that the attention to the experience of the spaces in duration is predicated on obscuring, complicating and weakening the apprehension of the plan as a figure. Another development in the practice of modern planning has been architects using a kind of over-drawing where human circulation diagrams or 'movement lines' are drawn expressively across the orthographic plane; thus representing the lived experience of buildings. We will show that these two issues are linked; the plan's weak figure and the privilege this supposes for durational experience has a corollary - experience itself demands to be visible in the plan, and this is one origin of the present fascination with 'diagramming'. In this paper we explore the practice of architectural planning and its theoretical underpinnings in an attempt to show the viability of a history of architectural planning methods.

O CORPO COMO UM TEXTO VIVO A Festa e a Dança no Candomblé

Este trabalho é um estudo sobre o papel e a construção do corpo, a partir dos rituais públicos do candomblé. Durante esses rituais, dei-me conta de que o corpo, para essa cultura ágrafa, assumia o papel de um texto, no qual se podiam ler, por meio dos gestos e da dança, as histórias e os valores desse grupo social. Todo esse processo só é possível porque a noção de pessoa no candomblé é pensada como um todo, resultado de todas as partes do corpo, diferentemente da noção disjuntiva presente no ocidente. Todos os sentidos do corpo: olfato, tato, visão, audição e paladar, são onsiderados centros de força, e o processo de iniciação coloca em equilíbrio esses centros. Do mesmo modo que a pessoa é múltipla e construída ao longo do processo iniciático, o corpo manifesta suas múltiplas forças e é construído esteticamente, tornando um texto para ser lido pela sociedade. Dessa forma, o corpo se constrói, nos rituais do candomblé, graças à aprendizagem de valores sociais, culturais e religiosos, que se dá por meio da oralidade, dos atos, gestos e da experiência vivida no quotidiano do terreiro. Nos rituais públicos, através da dança de transe, o iniciado mostrará ao grupo seu estágio espiritual, a visão de mundo do grupo e o ethos de seu povo. A pesquisa de campo foi realizada na Casa de Candomblé Ilé Dara Àse Òsun Eyin, comandada pelo Pai Cido de Òsun Eyin, durante os anos de 2001, 2002 e 2003.(AU)

A INSTITUIÇÃO ESCOLAR ESPECIAL E SEUS CONFLITOS ESTUDO DE CASO

O presente estudo realiza uma análise dos conflitos entre profissionais especialistas na organização escolar especial privada, segundo a percepção e análise dos registros da pesquisadora como docente e coordenadora na área de Educação Especial. Há algum tempo, a organização escolar especial é composta de diversos especialistas para atender às necessidades dos seus alunos. Tais profissionais possuem formações e desempenho de papéis distintos que são combustíveis para conflitos. A pesquisa trata do assunto por meio das teorias: clássica, das relações humanas e teoria estruturalista, da sociologia e psicologia das organizações. Por meio da união dos registros da experiência vivida pela pesquisadora com os estudos bibliográficos confirmou as hipóteses de que os conflitos na organização escolar especial ocorrem por disputa, por legitimidade, por desempenho de papéis, pelas especialidades e por mudanças.

Women, anger, and aggression an interpretative phenomenological analysis

This study reports a qualitative phenomenological investigation of anger and anger-related aggression in the context of the lives of individual women. Semistructured interviews with five women are analyzed using interpretative phenomenological analysis. This inductive approach aims to capture the richness and complexity of the lived experience of emotional life. In particular, it draws attention to the context-dependent and relational dimension of angry feelings and aggressive behavior. Three analytic themes are presented here: the subjective experience of anger, which includes the perceptual confusion and bodily change felt by the women when angry, crying, and the presence of multiple emotions; the forms and contexts of aggression, paying particular attention to the range of aggressive strategies used; and anger as moral judgment, in particular perceptions of injustice and unfairness. The authors conclude by examining the analytic observations in light of phenomenological thinking.

Ethnicities and values in a changing world

Recent debates about national identity, belonging and community cohesion can appear to suggest that ethnicity is a static entity and that ethnic difference is a source of conflict in itself. "Ethnicities and Values in a Changing World" presents an alternative account of ethnicity and calls into question models of community cohesion that present ethnicity as the source of antagonisms and differences that must be overcome. It suggests instead that ethnicity is itself multiple and changing and is unlikely to be a basis for articulating shared values. This volume brings together an international team of leading scholars in the field of ethnic studies in order to examine innovative articulations of ethnicity and challenge the contention that ethnicity is static or that it necessarily represents traditional values and cultures. Asserting that ethnicity is deployed in part as an expression of values and a model of ethical practice, this book examines displays of ethnicity as assertions of identity and statements about way of life, sense of entitlement and manner of connection to others. "Ethnicities and Values in a Changing World" draws together debates about the articulation of ethnic identity, the nature of our relation to each other and discussions of everyday ethics, thus engaging with discussions of racism, multiculturalism and community cohesion. As such, it will appeal not only to sociologists, but to anyone working in the fields of cultural studies, race and ethnicity, globalization, migration and anthropology. Table of Contents: Introduction: ethnicities, values and old-fashioned racism, Gargi Bhattacharyya; Teaching race and racism in the 21st century: thematic considerations, Howard Winant; Diaspora conversations: ethics, ethicality, work and life; Migrant women's networking: new articulations of transnational ethnicity, Ronit Lentin; 'The people do what the political class isn't able to do': antigypsyism, ethnicity denial and the politics of racism without racism, Robbie McVeigh; Violent urban protest - identities, ethics and Islamism, Max Farrar; Beliefs, boundaries and belonging: African Pentecostals in Ireland, Abel Ugba; On being a 'good' refugee, John Gabriel and Jenny Harding; Narrating lived experience in a binational community in Costa Rica, Carlos Sandoval Garcia; Conclusion: ethnicity and ethicality in an unequal world, Gargi Bhattacharyya; Index.

Patients’ and physicians’ experiences of atrial fibrillation and anticoagulation therapy:a qualitative journey

Background: Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF) however it is often underutilized and sometimes refused by patients. This programme of work included a meta-synthesis and two inter-linking studies aiming to explore patients’ and physicians’ experiences of AF and OAC. Methods: A meta-synthesis of qualitative evidence was conducted which informed the empirical work. Semi-structured individual interviews were utilised. Study 1: Three AF patient sub-groups were interviewed; accepted (n=4), refused (n=4), or discontinued (n=3) warfarin. Study 2: Four physician sub-groups (n=4 each group) prescribing OAC to AF patients were interviewed: consultant cardiologists, consultant general physicians, general practitioners and cardiology registrars. Data was analysed using interpretative phenomenological analysis. Results: Study 1: Three over-arching themes comprised patients’ experiences: (1) the initial consultation, (2) life after the consultation, and (3) patients’ reflections. Patients commented on the relief and reassurance experienced during the consultation but they perceived the decision making process mostly led by the physician. Lack of education and take-home materials distributed during the initial consultation was highlighted. Patients who had experienced stroke themselves or were caregivers, were more receptive to education aimed towards stroke risk reduction rather than bleeding risk. Warfarin monitoring was challenging for patients, however some patients perceived it as beneficial as it served to enhance patient-physician relationship. Study 2: Two over-arching themes emerged from physicians’ experiences: (1) communicating information and (2) challenges with OAC prescription for AF. Physicians’ approach to the consultation style shifted through a continuum of compliance-adherence-concordance during the consultation. They aimed for concordance, however challenges such as time and the perceived patient trust in them as the expert, led to physicians adopting a paternalistic approach. Physicians also pointed out challenges associated with guideline adherence and the need to adopt a multi-disciplinary approach, where other health professionals could provide on-going education. Conclusion: This programme of work has illustrated the benefit of taking an in depth phenomenological approach to understanding the lived experience of the physician-patient consultation. Together with the meta-synthesis, this work has strengthened the evidence base and demonstrated that there is a need to target patients' and physicians' ability to communicate with each other in a comprehensible way.

Patient involvement in primary care mental health:a focus group study

Background: Patient involvement in health care is a strong political driver in the NHS. However in spite of policy prominence, there has been only limited previous work exploring patient involvement for people with serious mental illness. Aim: To describe the views on, potential for, and types of patient involvement in primary care from the perspectives of primary care health professionals and patients with serious mental illness. Design of study: Qualitative study consisting of six patient, six health professional and six combined focus groups between May 2002 and January 2003. Setting: Six primary care trusts in the West Midlands, England. Method: Forty-five patients with serious mental illness, 39 GPs, and eight practice nurses participated in a series of 18 focus groups. All focus groups were audiotaped and fully transcribed. Nvivo was used to manage data more effectively. Results: Most patients felt that only other people with lived experience of mental illness could understand what they were going through. This experience could be used to help others navigate the health- and social-care systems, give advice about medication, and offer support at times of crisis. Many patients also saw paid employment within primary care as a way of addressing issues of poverty and social exclusion. Health professionals were, however, more reluctant to see patients as partners, be it in the consultation or in service delivery. Conclusions: Meaningful change in patient involvement requires commitment and belief from primary care practitioners that the views and experiences of people with serious mental illness are valid and valuable.

"I'm a better manager":A biographic narrative study of the impact of personal trauma on the professional lives of managers in the UK

This doctoral study aims to understand how experiences of critical illness or bereavement affect the way managers view and approach their work and their relationships at work. This is an interpretative phenomenological study examining the subjective meanings of personal experience and is underpinned by biographic narratives from four participants and interviews with their nominated workplace witnesses (i.e. colleagues who worked alongside the individual at the time of their trauma). As a consequence of the findings that have emerged across this study, three contributions to theory are presented. All four participants described their traumas as a professional growth experience for themselves as managers, which resulted in self-reported and observed behaviour change at work. Consequently, the first area of theoretical contribution is a suggested extension to the post-traumatic growth (PTG) framework (Calhoun & Tedeschi, 2006) with the addition of a new behavioural dimension called ‘managerial growth’, when applied to the context of ‘ordinary’ organizations. The second area of theoretical contribution arose through the reflexive process that was created during data collection where participants and their witnesses remembered episodes of compassion interaction at work. The second area of contribution thus seeks to extend the existing model of compassion at work (Dutton, Worline, Frost and Lilius, 2006), by conceptualising compassion as a dyadic process between a compassion ‘giver’ and a compassion ‘receiver’ in which the compassion receiver ‘trusts or ‘mistrusts’; ‘discloses’ or ‘withholds’; ‘connects’ or ‘disconnects’ with the compassion giver. The third area of contribution is a new conceptualisation of reflexivity, ‘three-dimensional reflexivity’ (3DR) (Armstrong, Butler and Shaw, 2013). 3DR brings together three of the elements that have been missing from critically reflexive management research; by working with multiple variants of reflexivity in the same study; surfacing different reflexive voices to guard against the researcher’s (potentially) solipsistic own; and remaining sensitive to the concept of reflexive time. In doing so, 3DR not only provides a deeper understanding of individual lived experience; it is also a vehicle in which self-insight is gained. Furthermore, by engaging in its practice, those involved in this study have developed both personally and professionally as a result.

The experiences of con sultations on oral anticoagula-tion for AF:the importance of qualitative research incardiovascular sciences

Objectives: Multiple-perspective qualitative designs can aid researchersto develop a more multifaceted account of a phenomenon and as aform of triangulation of data. Two interlinking studies aimed toexplore patients’ and physicians’ experiences of atrial fibrillation (AF)and warfarin.Methods: Audio-recorded semistructured individual interviews wereused. Study 1: Three AF patient subgroups were interviewed (n = 11);accepted, refused, or discontinued warfarin. Study 2: Four physiciansubgroups (n = 16): consultant cardiologists, consultant general physi-cians, general practitioners, and cardiology registrars. Data was ana-lyzed using interpretative phenomenological analysis, a qualitativemethodology.Results: Study 1: Three overarching themes comprised patients’ experi-ences: the initial consultation, life after the consultation, and patients’reflections. Patients commented on the reassurance experienced duringthe consultation, but they perceived the decision-making processmostly led by the physician. Lack of education and take-home materi-als during the initial consultation were highlighted. Patients’ uptake ofinformation was influenced by past experiences and knowledge ofstroke and/or bleeding. Study 2: Two overarching themes covered phy-sicians’ experiences: communicating information and challenges withwarfarin prescription for AF. Physicians’ approach to the consultationstyle shifted through a continuum of compliance-adherence-concor-dance during the consultation. Time and the perceived patient trust inthem as the expert led to physicians to adopt a paternalistic approach.Guideline adherence and the need to adopt a multidisciplinaryapproach were pointed out as current challenges.Conclusion: There is a need to target patients’ and physicians’ abilityto communicate with each other in a comprehensible way. This projecthas illustrated the benefit of using a qualitative approach to under-stand the lived experience of the physician–patient consultation.Disclosure of Interest: None declare

Living well to the end:a phenomenological analysis of life in extra care housing

OBJECTIVES: To understand older adults' experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. DESIGN: A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. METHODS: Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential-phenomenological theory of well-being. RESULTS: Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. CONCLUSIONS: An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents' quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling-empathic imagination-in caregiving may help staff and residents relate better to each other, thus helping individuals to become ontologically secure and live well to the end.

Learning to live with Parkinson’s disease in the family unit:an interpretative phenomenological analysis of well-being

We investigated family members’ lived experience of Parkinson’s disease (PD) aiming to investigate opportunities for well-being. A lifeworld-led approach to healthcare was adopted. Interpretative phenomenological analysis was used to explore in-depth interviews with people living with PD and their partners. The analysis generated four themes: It’s more than just an illness revealed the existential challenge of diagnosis; Like a bird with a broken wing emphasizing the need to adapt to increasing immobility through embodied agency; Being together with PD exploring the kinship within couples and belonging experienced through support groups; and Carpe diem! illuminated the significance of time and fractured future orientation created by diagnosis. Findings were interpreted using an existential-phenomenological theory of well-being. We highlighted how partners shared the impact of PD in their own ontological challenges. Further research with different types of families and in different situations is required to identify services required to facilitate the process of learning to live with PD. Care and support for the family unit needs to provide emotional support to manage threats to identity and agency alongside problem-solving for bodily changes. Adopting a lifeworld-led healthcare approach would increase opportunities for well-being within the PD illness journey.

Transcultural experiences: A literature bridge to English for ESOL students from Cuba

This qualitative study is concerned with exploring the transcultural experiences of ESOL students and connecting their lived experiences to literature in the classroom. The purpose of this study was to describe and explain the transcultural perspectives of six high school and community college students: four Cuban born students and two American born/raised students of Cuban-American culture. The participants were from Barbara Goleman Senior High School and Miami-Dade Community College. The six phenomenological portraits were explored in the form of lived experience pieces, representing the students' transcultural experiences. The data was collected in the form of student interviews, researcher's journal, and document reviews. The following exploratory questions guided this study: (1) From the perspective of four Cuban-born, non-native English-speaking students (NNS), what are the essential structures of their transcultural identities? (2) What are the underlying themes that account for the Cuban NNS students' transcultural experiences? (3) What are the universal transcultural structures among the Cuban NNS students' transcultural experiences and the Cuban-American, native English/Spanish speaking (NESS) students' experiences? (4) What are the possible structural meanings of the Cuban NNS students' interests in relation to their transcultural experiences? (5) What are some connections between the structural themes inherent in the Cuban NNS students' transcultural experiences and teaching literature in ESOL? ^ A phenomenological approach was used to investigate the participants' transcultural experiences, focused on the students' lived experiences. The study consisted of three interview sessions for each of the six participants. The analysis of the data was conducted following the principles of qualitative research, which included participant interviews, thematic analysis, researcher's journal, document reviews, and triangulation. The researcher created portraits representing students' transcultural experiences. Subsequently, the participants' transcultural experiences were used to respond to the exploratory questions, including comparing and contrasting themes and drawing connections among teaching literature in the ESOL classroom. ^ The results of this study show some relevant specific statements and themes that emerged from the students' transcultural data. The results serve as a better understanding of these students' transcultural experiences and the potentiality of connecting their perspectives to literature in the classroom. In addition, this study shows the need for a better understanding of the connection between transcultural experiences and literature in ESOL. ^

Heteronormativity and teaching: A phenomenological study of lesbian teachers

The purpose of this phenomenological study was to understand what impact “heteronormativity” has on a lesbian teacher's perception of her instructional style, content, and context of curriculum taught. Through taped interviews with lesbian educators, this research examined the lived experience of the lesbian teacher. The framework for this study included theories related to historical, sociocultural, and psychosocial development while the methodology included a qualitative design using primary elements of a phenomenological study outlined without ignoring the influence associated with contextualism. Due to the sensitive nature of the study nine women who were the focus of this research were volunteers with the first serving as a “gatekeeper” to assist in the pilot study. The subsequent group evolved as a result of “snowballing” to gain more participants. ^ The data in the form of narrative derived from the interviews was transcribed, color-coded, and organized into four themes and associated sub-themes, based upon the perceptions of these educators. These themes characterized the coming out process of a lesbian, which directly paralleled the personal and professional development of the lesbian educator, emerged as a result of the analysis. They included: (a) self-acknowledgement; (b) self-indentification; (c) coming out to other lesbians by overcoming fear and establishing relationships; (d) coming out to others by overcoming heteronormativity by using support groups in defining a lesbian's role as a teacher. ^ The results of this study showed that the acceptance of the lesbian culture, shared with the acknowledgement, rather than compliance or defiance, of cultural hegemony can allow the lesbian educator to develop a curriculum and a classroom climate that will foster understanding and even generate social change among colleagues, parents, and students, one person at a time. ^

A hermeneutic phenomenology of graduate education students' understandings of instructor power in a higher education classroom

Higher education is a distribution center of knowledge and economic, social, and cultural power (Cervero & Wilson, 2001). A critical approach to understanding a higher education classroom begins with recognizing the instructor's position of power and authority (Tisdell, Hanley, & Taylor, 2000). The power instructors wield exists mostly unquestioned, allowing for teaching practices that reproduce the existing societal patterns of inequity in the classroom (Brookfield, 2000). ^ The purpose of this hermeneutic phenomenological study was to explore students' experiences with the power of their instructors in a higher education classroom. A hermeneutic phenomenological study intertwines the interpretations of both the participants and the researcher about a lived experience to uncover layers of meaning because the meanings of lived experiences are usually not readily apparent (van Manen, 1990). Fifteen participants were selected using criterion, convenience, and snowball sampling. The primary data gathering method were semi-structured interviews guided by an interview protocol (Creswell, 2003). Data were interpreted using thematic reflection (van Manen, 1990). ^ Three themes emerged from data interpretation: (a) structuring of instructor-student relationships, (b) connecting power to instructor personality, and (c) learning to navigate the terrains of higher education. How interpersonal relationships were structured in a higher education classroom shaped how students perceived power in that higher education classroom. Positive relationships were described using the metaphor of family and a perceived ethic of caring and nurturing by the instructor. As participants were consistently exposed to exercises of instructor power in a higher education classroom, they attributed those exercises of power to particular instructor traits rather than systemic exercises of power. As participants progressed from undergraduate to graduate studies, they perceived the benefits of expertise in content or knowledge development as secondary to expertise in successfully navigating the social, cultural, political, and interpersonal terrains of higher education. Ultimately, participants expressed that higher education is not about what you know; it is about learning how to play the game. Implications for teaching in higher education and considerations for future research conclude the study.^