107 research outputs found
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Happiness, Sadness and Government
Full text linkPolicy-making that re-presents – as objects of concern and by means of statistics – the suffering or depression and the happiness of populations indicates an evolving form of governance that examines and reshapes subjectivity itself. Never before have states of subjectivity been acted upon, through surveys, statistical and policy analysis, and scientific disciplines, to the extent seen today. This article: Documents changing epistemic co-ordinates, especially in psychology and economics, that first occluded happiness in the interests of objectivity, but, in recent decades, marked out a renewed ‘science’ of happiness.Examines changes in the discursive formulation of depression, as a counterpart to happiness.Argues that, seen in terms of bio-power, contemporary concerns for happiness and depression are consistent – rather than incompatible – with one another. How can so many claim to be happy when so many, we are told, are depressed, anxious or suffering emotional pain? There is no underlying contradiction here, for two reasons: Happiness and depression are manifestations of the same political discourse (or aspects of a political subjectivity) characterized by dis-inhibition, consumer self-indulgence and performance anxiety. And, just as we needed madness in order to understand ‘sanity,’ or the prison in order to view ourselves as ‘free,’ so we rely upon concerns about depression in order to understand and act upon ourselves as subjects capable of unlimited happiness
What to Do When there is Nothing to Do: The psychotherapeutic value of Meaning Therapy in the treatment of late life depression
Full text linkPsychotherapeutic treatment with the goal of cure, of course, is the standard within the healing professions but when we are dealing with late life depression where there is no hope for longevity, the agenda necessarily must shift from cure to care, from treatment with the goal of renewed healthy living to a focus upon the palliative aspects of a limited prognosis. Here, then, the clinician is faced with the challenge of existential intervention with an emphasis upon the “moment” rather than the future. The encroachment of ennui upon the elderly, particularly and especially those who have been actively engaged in a full life of service such as the clergy, physicians, teachers, and attorneys, can be a traumatic and debilitating experience.When hope for the future is not being sought but rather an effective and celebrative address to the existential realities confronting the elderly patient who is facing decline and death, the quest for those “happy moments” conjured in the patient’s memory constitute a promising field of treatment.Geriatric logotherapy is uniquely constructed to do just that
“I Wish I Had AIDS”: A qualitative study on access to health care services for HIV/AIDS and diabetic patients in Cambodia
Full text linkFinancially stricken Cambodian patients with diabetes and HIV/AIDS typically encounter multiple, serious barriers to effective care. This process may extend over many years and involve numerous rounds of diagnosis and treatment as the disease progresses from initial symptoms to longer term complications. Living with both the impact of the disease and this ongoing struggle for care can severely disrupt the everyday life of both sufferers and their families. Our retrospective study adopted qualitative research methods to collect data from HIV/AIDS and diabetic patients enrolled and not enrolled in treatment programs at varying institutions in urban and rural settings. Using purposive sampling techniques, a total of 25 HIV/AIDS and 45 diabetic patients were recruited. Semi-structured and open-ended interviews were used to collect information on patient experiences of different phases in the on-going process of seeking care and treatment. The findings indicate that both HIV/AIDS and diabetic patients encounter multiple supply- and demand-side barriers to care at different stages of their illness. More strikingly, our research findings suggest that supply-side barriers, for example rationing systems or targeting strategies that limit access to free treatment or social assistance, are substantially higher for diabetic patients. This perceived inequity had a profound impact on diabetic patients to the extent that some “wished they had HIV/AIDS”. These findings suggest that there is an urgent need to widen the focus of health care to address the substantial and increasing burden of disease resulting from diabetes and other serious chronic disorders in Cambodia and many other low/middle income countries.
Contemporary Guarani Shamanisms: “Traditional Medicine” and Discourses of Native Identity in Brazil
Full text linkThe psychoactive substance known as ayahuasca has long been identified with Amazonian shamanism and traditional medicine. Over the last two decades its use has spread outside this region to urban populations in different parts of the world. This paper examines the adoption of the ritual use of the beverage by the Guarani Indians along the southern coast of Brazil. We argue that this process is related to the growing politics of identity of Brazilian indigenous peoples as well as to public policies that promote cultural diversity. In the case analyzed here, the adoption of ayahuasca is articulated with an ongoing cultural revitalization in activities related to shamanism, health and education and with the specific desires and actions of the leading family in one Guarani village
The Implementation of RSBY in Chhattisgarh, India: A study of the Durg district
Full text linkThe Rashtriya Swasthya Bima Yojana (RSBY) scheme is a health insurance model currently being implemented by the Indian government. It is a model, however, still in nascent state, subject to tensions and value testing. Very few studies have hitherto assessed the scheme’s implementation and whether the stated objectives of the government initiative are being fulfilled. This short study undertaken in the Durg district of Chhattisgarh reveals that RSBY fails to cover the population living Below the Poverty Line (BPL). Likewise there is discrepancy in the consistency of information and knowledge regarding the scheme among the beneficiaries who are themselves continuing to incur high out-of-pocket expenses. There are thus severe issues in transparency and accountability within the RSBY scheme. Unless the public health delivery system is strengthened and the private sector regulated and indeed monitored, the scheme will not yield the desired results, and the cost of healthcare will further escalate for the poor. In the absence of regulated health services there needs to be more debate, and indeed greater research, on the implementation and the design of RSBY.
Social Sutra: Yoga, identity, and health in New York’s changing neighborhoods
Full text linkTaking note of the rapid, visible expansion of yoga studios in American cities, this article explores the role of yoga as a social determinant of urban health and yoga’s entanglements with race and class identities. Who are the interpreters of yoga in America, and how has yoga, based on a premise of psychosomatic wholeness, paradoxically served as a prism for refracting social difference? Answers to these questions hold significant implications for the culture of health observed in cities today and possibilities for wellness. Through narrative inquiry, my argument centers on three identities that embody the role of yoga in health: the yoga teacher as healer, the yoga student as seeker of spiritually informed mind-body wellness, and the modern yoga practitioner as consumer of a physically focused, commercialized yoga.A recombination of the identities involved in yoga – healer, seeker, and consumer – can recover the possibilities for yoga to contribute to improved urban health across race and class
The Evolving Relationships Between Hospital, Physician and Patient in Modern American Healthcare
Full text linkThis article explores the ways in which health care has evolved over the past few years for patients, doctors and hospitals in the United States, and the impact these changes have made on modern American health care. As the amount of money the nation spends on health care continues to increase at alarming rates, patients, doctors, and hospitals all appear to have greater struggles than before.This inherent disconnection between the changes in American health care system and the satisfaction of patients and providers leaves much to be desired and considered. Before a solution can be found, however, we must first understand the problem
Cells in the Body Politic: Social identity and hospital construction in Peronist Argentina
Full text linkThis article examines the critical role played by social identity in the construction of hospitals in the Argentine health care sector during the 1940s and 1950s by uncovering the way in which the “jungle” of hospitals withstood attempts by the state to apply some sense of order, purpose, and centralized organization. The first section examines how physicians envisioned the “modern” hospital they hoped to construct. The second section reveals the important antecedents of nationalized hospitalization schemes found in the collaboration between physicians’ unions and the state. In the third section, an analysis of political speeches illuminates how Juan and Evita Perón packaged new hospitals as gifts to the people from their leader. The fourth section outlines specific plans to increase the number of hospital beds. The final section surveys examples of hospital construction to demonstrate how sub-national identities were instrumental to fragmenting both Argentine society and its hospital infrastructure
From Physiology to Prevention: Further remarks on a physiological imperative
Full text linkPhysiology, is the fundamental and functional expression of life. It is the study of all the representative functions of Man in all his capacities, and in particular, his capacity to work. It is very possible to establish a link between a physiological and physiopathological state, the capacity of work and the economy, which can be understood as the articulation between the physiological capacities of Man and the production of work. If these functions are innately acquired by Man they are likewise maintained by regulatory functions throughout life. The stability of these regulatory mechanisms represent the state of good health. The management of this state, constitutes Primary Prevention where both chronic and acute physiopathology defines an alteration in these regulatory mechanisms. We deduce from this reasoning that a tripartite management adapted to the physiological situation is viable and that by choosing parameters specific to individual and collective behavior, it is possible to inject, and combine, at each level and to each demand in order to budget a healthcare system in a more balanced and equitable way.