Regime Of Care Research Articles

INTERNATIONAL PATRONAGE DURING CONFLICTS AND WAR

The article examines the latest challenges to the system of collective security associated with political instability and economic turbulence. Their key prerequisites, factors and features of a global nature are determined. The origins of international conflicts are shown, with an emphasis on armed conflicts that turn into wars according to the logic of their progression and the practice of response. Examples of the international reaction to the actions of the aggressor in the form of political and economic, sectoral and individual sanctions and multi-channel internationally consolidated and bilateral aid to the country suffering from the war are given. The role of international patronage in the system of measures and tools to help countries that have become objects of military aggression is shown. The essential features of international patronage are defined as the establishment of a voluntarily initiated regime of care for objects in force majeure circumstances to eliminate or neutralize internal and external threats to their existence and development. Its types (political, economic, financial, social), types (internal, external), objects (state, regions, cities, sectors, enterprises, infrastructure, projects), subjects (foreign countries, international organizations, corporations, public organizations, political parties, individuals) and forms (direct aid, grants, consulting, mass media support, lobbying, monitoring) are distinguished and identified. Using the example of Ukraine, projects of international political, economic and military patronage over cities and regions that have undergone significant destruction are illustrated.

Intimacy, Anonymity, and "Care with Nothing in the Way" on an Abortion Hotline.

This essay is an ethnographic account of a volunteer, anonymous hotline of physicians and advanced practice providers who offer medical advice and guidance to those who are taking medications on their own to end their pregnancies. Attending to the phenomenology of caring on the Hotline reveals a new form of medical expertise at play, which we call "care with nothing in the way." By operating outside the State's scrutiny of abortion provision, the Hotline offers its volunteers a way to practice abortion care that aligns with their professional and political commitments andthat distances them from the directharm they see caused by thepolitical, financial, and bureaucratic constraints of their clinical work. Bydelineating the structure of this new regime of care, these providers call into question the notion of the "good doctor." Theyradically re-frame widely shared assumptions about the tenets of the ideal patient-doctor relationship and engender anew form of intimacy-one based, ironically, out of anonymity and not the familiarity that is often idealized in the caregiving relationship. We suggest the implications of "care with nothing in the way" are urgent, not only in the context of increasing hostility to abortion rights, but also for a culture of medicine plagued by physician burnout.

Under the Press(ure)? The Role of Media in Organisation and Provision of Municipal Elderly Care

What is the role of media(tisation) in organisation and provision of elderly care? By looking at how planning, organising and execution of elderly care is understood in two Swedish municipalities this paper seeks to contribute to discussions of the ways in which values, preferences and working practices of news media play out in shaping conditions for provision of municipal welfare services. Our findings suggest that we can see the role of media values and preferences as embedded – although in different ways and to varying extent – in three distinct but inter-related processes that influence how actors connected to organisation and provision of municipal welfare services understand and relate to each other. These are: 1) setting the aims, aspirations and priorities in the provision of welfare services (i.e., the what); 2) translating these aims, aspirations and priorities into necessary means, resources and activities (i.e., the how); and 3) explaining and justifying the what and the how to different constituencies (i.e., the why). The paper concludes that commonly held values and beliefs about media reinforce the ongoing changes in the governing regime of elderly care in a direction where the role of municipal administrative bodies is more explicitly articulated, especially in terms of accountability and responsibility.

Life after trafficking: reintegration experiences of human trafficking survivors in Nigeria

Purpose Reintegration programs have emerged as part of the regimes of care for survivors of human trafficking. However, empirical analysis of the reintegration outcomes for survivors remains limited in the African context. Hence, this paper aims to examine the challenges and opportunities of reintegration assistance programs for survivors of human trafficking in Nigeria. Design/methodology/approach Drawing on qualitative methods of data collection and analysis, this study conducted semi-structured interviews with repatriated women who have accessed reintegration assistance in Nigeria, and data was analyzed using thematic analysis. Findings The findings suggest that while the reintegration programs might address the procedural aspect of reintegration, the achievement of substantive reintegration remains incomplete. This is because of the structural conditions of the context within which reintegration is supposed to occur. Practical implications There is a need to take seriously the distinction between the reintegration of survivors into a new community or a former community in the design of a regime of care for survivors of human trafficking in Africa. Crucially, the focus on procedural reintegration should not also divert attention away from the structural conditions and reforms needed to ensure survivors achieve substantive reintegration. Originality/value This paper contributes to the limited literature on life after trafficking and demonstrates the strengths and limitations of reintegration programs as a regime of care for survivors of human trafficking. In addition, this study empirically grounded the theoretical distinction between different aspects of the process of reintegration.

Worlding a Mbya-Guarani heritage: from dissonant heritage to ontological conflicts

ABSTRACT The article analyses the ontological conflicts implicit but not addressed during the process that registered the ruins of the Jesuit-Guarani Mission in São Miguel (Brazil) as intangible cultural heritage: ‘Tava, Place of Reference for the Guarani People’. The process can be understood as an appropriation of the tools of modernity that provides an indigenous and dissonant narrative of the missions, counters discrimination and affirms the Mbya-Guarani when they negotiate with the state. However, the research also revealed that the conceptualisation of tava is based on a different ontology from modernity – on which the category of heritage is still based – that is related to the importance for the Mbya-Guarani of building good and beautiful bodies and social relations by wandering through the land left to them by the gods and following the precepts and signs of the latter. Instead of perpetuating the hierarchies between ontologies, the article brings to light the ontological conflicts with the objectives of overcoming the limitations of the policies of recognition and enhancing the perspective of heritage as a regime of care not only for objects, places and practices, but also for the people and worlds for whom these things are heritage.

Non-compassionate care: a view from an Islamic charity organization

Drawing on fieldwork at a large charity organization in Cairo, this article describes a bureaucratized Islamic ethics of care. Founded in 1975, the Mustafa Mahmoud Association today offers free and discounted medical services, funds micro-projects, and provides financial support to about 10,000 families each year. The bulk of that financial support comes from donors’ private donations in the form of obligatory and voluntary alms (zakāt and sadaqa). By taking a close look at three offices—the donation, intake, and disbursement office—I untangle the regime of care that shapes the daily transactions at this Islamic charity organization. In particular I highlight a significant gap between “caring for” and “caring about.” Donors view caring for those in need as a duty and frequently frame their donations in calculative terms, as a way of “trading with God.” Less central is a language of empathy or compassion. While this seemingly careless care-less? Careless means not careful, sloppy. form of caremight seem cold and heartless, I suggest that it offers a powerful alternative to the liberal illusion of “compassion.”

Experience with laparoscopic common bile duct exploration in failed endoscopic retrograde cholangiopancreatography cases at a tertiary care hospital

Background: Minimally invasive techniques for stone removal in common bile duct (CBD) are endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) or laparoscopic CBD exploration with LC (laparoscopic common bile duct exploration (LCBDE) and LC). Failed, multiple attempted or complications of ERCP leads to other surgical approaches where LCBDE is a preferable option by experts due to its added benefits.Methods: We did LCBDE and LC in 40 cases of failed ERCP. Standard investigation protocol was followed in all cases and CBD were explored laparoscopically and stones were retrieved. Post retrieval choledochoscopy was done and sphincter of oddi was dilated by the dilators.Results: With careful selection of cases, stone calculi were retrieved successfully in 38 cases by laparoscopically and 2 cases by open method after conversion. Postoperative choledochoscopy were found normal. Bile leak seen in 3 cases, which were managed conservatively. Standard regime of postoperative care was taken followed by T-tube removal after cholangiogram on day 10-14. All patients survived the operation.Conclusion: We advocate that LCBDE is the most viable alternative for open surgery in failed ERCP cases for retrieval of CBD stones. This results in early recovery, better cosmetic scar, least complications with early resumption of routine life. Needs cautious patient selection and expertise in laparoscopic surgery.

Migrants into Humanitarians: Ethnic Solidarity and Private Aid-Giving during Romania’s Historic Flood of 1970

This article studies the involvement of Western diaspora communities of Transylvanian Saxons in the humanitarian campaign for Romania during the flood disaster in 1970. It shows how the Saxons’ private relief campaigns established new forms of connectivity and exchange across the Iron Curtain through a transnational regime of care, ethnic solidarity, and charitable work. The article argues that the contingent and precarious situation of such spatially divided ethnic communities refashioned a generation of World War II refugees and migrants from “speechless” objects of humanitarian intervention into passionate advocates, effective mediators, and surprising champions of private aid giving in postwar Europe.

Geriatrics and humanism: Dementia and fallacies of care

Based on fieldwork in a specialized geriatric outpatient clinic in Brazil, this article shows how a humanistic discourse that ‘means well’ can do good, but can also produce a regime of care that ultimately results in care that is contrary to stated values. These values – such as holistic care, multidisciplinarity, and empathy - that have been at the heart of geriatrics since its more official founding in the 1940s and 1950s, cannot be conceived as only local. The Brazilian data mirrors international geriatric values and norms, which, however, are being applied here in a specific context, in a country perceived as ‘young’ and with limited resources for elder care. Fallacies of care in this context result preliminary from a translation of more structural factors as individualized (self-)care and from the abstraction and generalization of aging individuals as ‘older people’.

Take-home naloxone and the politics of care.

'Take-home naloxone' refers to a life-saving intervention in which a drug (naloxone) is made available to nonmedically trained people for administration to other people experiencing an opioid overdose. In Australia, it has not been taken up as widely as would be expected, given its life-saving potential. We consider the actions of take-home naloxone, focusing on how care relations shape its uses and effects. Mobilising Science and Technology Studies insights, we suggest that the uses and effects of naloxone are co-produced within social relations and, therefore, this initiative 'affords' multiple outcomes. We argue that these affordances are shaped by a politics of care, and that these politics relate to uptake. We analyse two complementary case studies, drawn from an interview-based project, in which opioid consumers discussed take-home naloxone and its uses. Our analysis maps the ways take-home naloxone can afford (i) a regime of care within an intimate partnership (allowing a terminally ill man to more safely consume opioids) and (ii) a political process of care (in which a consumer takes care of others treated with the medication by administering it 'gently'). We conclude by exploring the political affordances of a politics of care approach for the uptake of take-home naloxone.

Protecting the Interests of Vulnerable Defendants in the Criminal Justice System: The New Zealand Experience

Approaches to the management of people with intellectual disabilities (IDs) vary across jurisdictions. However, the inconsistent development and implementation of official policy has often resulted in a significant over-representation of persons with developmental difficulties in criminal justice systems worldwide. This reality led the New Zealand government in 2003 to introduce dedicated legislation recognising the special needs of offenders with an ID. The article examines the New Zealand legislative response to the challenges presented by this cohort of offenders, in the light of emerging international data of the incidence of, and official responses to, offenders with special needs. In New Zealand, the emerging problem of how to manage intellectually disabled offenders who commit serious crimes, and the legislative response to it, was driven by changes in mental health legislation in the early 1990s that had effectively disenfranchised persons with ID with challenging behaviours from regimes of supervisory care and treatment. The Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 has provided for a separate regime of compulsory care and rehabilitation that may be accessed either directly as a criminal justice disposition, following a finding of unfitness to plead or legal insanity, or as a result of transfer from the mental health or penal systems. The compulsory care regime has proven effective in addressing the needs of intellectually disabled offenders, increasing numbers of whom are young people, who would have great difficulty coping in a prison environment. The New Zealand experience contrasts with experience in other jurisdictions where offenders with an ID are often over-represented in prison statistics and subject to victimisation and abuse. The article suggests that change is clearly required as a matter of urgency to ensure that offenders with an ID are able to benefit from the positive rights guaranteed under the UN Convention for the Rights of Persons with Disabilities and other rights instruments.

Learning from deep brain stimulation: the fallacy of techno-solutionism and the need for 'regimes of care'.

Deep brain stimulation (DBS) is an effective treatment for the debilitating motor symptoms of Parkinson's disease and other neurological disorders. However, clinicians and commentators have noted that DBS recipients have not necessarily experienced the improvements in quality of life that would be expected, due in large part to what have been described as the 'psychosocial' impacts of DBS. The premise of this paper is that, in order to realise the full potential of DBS and similar interventions, clinical services need to be arranged in such a way that these psychosocial dimensions are recognised and managed. Our starting point is that the psychosocial effects of DBS 'in the field' present us with analytically-useful disruptions: they disturb and foreground deeply held assumptions relating to the individual, health and its treatment, and which in a crude form manifest as the myth of technological solutionism within health care. Drawing on scholarship in medical sociology and science and technology studies (STS), we argue that DBS brings to the fore the relational dimensions of personhood, and demonstrates the emotional and social turmoil that can result if the relational dimensions of personhood are ignored by clinical services. In light of this, we argue that DBS should be implemented within a regime of care. Drawing on ethnographic research of a paediatric DBS clinical service, we provide an example of a regime of care, and conclude by reflecting on what other DBS services might learn from this paediatric service.

Ethical living: relinking ethics and consumption through care in Chile and Brazil.

Mainstream conceptualizations of 'ethical consumption' equate the notion with conscious, individual, market-mediated choices motivated by ethical or political aims that transcend ordinary concerns. Drawing on recent sociology and anthropology of consumption literature on the links between ordinary ethics and ethical consumption, this article discusses some of the limitations of this conceptualization. Using data from 32 focus groups conducted in Chile and Brazil, we propose a conceptualization of ethical consumption that does not centre on individual, market-mediated choices but understands it at the level of practical outcomes, which we refer to as different forms of 'ethical living'. To do that, we argue, we need to depart from the deontological understanding of ethics that underpins mainstream approaches to ethical consumption and adopt a more consequentialist view focusing on ethical outcomes. We develop these points through describing one particular ordinary moral regime that seemed to be predominant in participants' accounts of ethics and consumption in both Chile and Brazil: one that links consumption and ethics through care. We show that the moral regime of care leads to 'ethical outcomes', such as energy saving or limiting overconsumption, yet contrary to the mainstream view of ethical consumption emphasizing politicized choice expressed through markets, these result from following ordinary ethics, often through routines of practices.

KO IMA PRAVO DA IGRA? OMETENOST I ESTETIKA EGZISTENCIJE

Članak istražuje odnos između osoba s ometenošću i pozorišta polazeći od rada Udruženja Per-Art. U prvom delu rada autor naglašava da moderno sazrevanje društvene solidarnosti s osobama s ometenošću nije imalo za rezultat njihovu veću, nego manju prisutnost u likovnim umetnostima. Nakon pokazivanja da se prisustvo osoba s ometenošću na platnu vekovima svodilo na mehanizam zahvaljujući kojem se osnaživala svakidašnja svest o »zajedničkom«, i uvežbavala se da s lakoćom odbacuje sve što odstupa od društveno usvojenih normi, autor analizira posebnosti inkluzivnih gestova na savremenoj pozornišnoj sceni. Za razliku od uvođenja pojedinačnih likova s ometenošću u konvencionalne predstave, autor ističe da svakidašnji režim brige osobe s ometenošću prepoznaje kao objekte o kojima se moraju pobrinuti drugi, dok im uslovi grupnog umetničkog rada omogućavaju da iskroje vlastiti lik tako da se, što je najvažnije, ne oslanjaju na predstave i očekivanja drugih. U drugom delu rada autor sučeljava Fukoov pojam estetika egzistencije sa pozorišnim radom osoba s ometenošću. Grupno pojavljivanje takvih osoba na sceni omogućava moralnu konverziju zahvaljujući tome što se značenja scenskog pokreta preobražavaju u samosvojni moralni zahtev. Susret s drugošću ometenih za publiku postaje sinonim za iskorak iz egoističnog traženja sebe u drugima, a za same aktere na sceni označava šansu za nadmašivanje društvene separacije.

Health advisor facilitated mouth care regime for patients with head and neck cancers undergoing intensity-modulated radiotherapy

AbstractAimTo develop a regime of care for patients with head and neck cancers undergoing intensity-modulated radiotherapy (IMRT), with the support of a health advisor (HA) and temporary access to the mouth care product Caphosol™.Materials and methodsA HA was temporarily employed to assess, monitor and refer patients as appropriate and ensure patients received and utilised supplies of Caphosol™. A retrospective audit was undertaken to provide a gap analysis of current service. The data were used to develop a pro forma for documenting assessments and monitoring lifestyle factors for IMRT patients. Assessments referrals and compliance, plus hospital admissions owing to treatment-related issues, were documented during the baseline audit and the temporary HA service and provision of Caphosol™.ResultsThe presence of a HA facilitated 100% compliance with appropriate assessments, referrals and adherence to treatment. The data suggests that the additional provision of Caphosol™ may have reduced levels of mucositis and associated pain.ConclusionIt is recommended that a HA role be established within radiotherapy departments to facilitate lifestyle assessments, referrals and compliance with positive behaviour changes (e.g., stopping smoking). The use of Caphosol™ as a routine part of mouth care regime for IMRT patients also warrants further investigation.

A Foucauldian Reading of Mothers' Views on the Paternalism/Autonomy Debate in Relation to the Sexual Practices of Their Intellectually Disabled Adult Sons and Daughters

The obstacles preventing intellectually disabled adults living in Ireland from enjoying a more optimal quality of life take multiple forms. This article focuses on the issues of sexual relations and autonomy in relation to a specific population subsumed under the intellectual disability umbrella term; namely adults with Down syndrome living in the parental home. The obstacle under examination is the contention that the paternalistic regime of care that many parents of adults with Down syndrome deploy is a principal factor in explaining why many of their sons and daughters have failed to find the boyfriends/girlfriends they seek. To explore this conjecture a series of semi-structured interviews were carried out with ten mothers of adults with Down syndrome. The main findings are that while all of the respondents acknowledged that they subjected their sons and daughters to a paternalistic regime of care, they denied any causal connection between this form of surveillance and the fact that, with one exception, none of their mainly thirty-something charges have yet embarked on a sexual relationship. To offer a sociological interpretation as to why this data takes the form it does, the Foucauldian framework is employed to theorise the accounts proffered by the respondents.

Patient-reported recovery after enhanced colorectal cancer surgery: a longitudinal six-month follow-up study

The concept of enhanced recovery after surgery (ERAS) is a modern regime of care, and numerous studies have proved its beneficial impact on recovery after colorectal surgery. However, little is known about patients' continuing recovery after discharge. Therefore, the purpose of this study was to describe patient-reported recovery after colorectal cancer surgery in the context of ERAS from the day of discharge until 1 and 6 months after surgery. Assessments were made at discharge, at 1 month and at 6 months after surgery using the questionnaire Postoperative Recovery Profile (PRP). In all, 119 patients recovering from abdominoperineal resection, rectal resection, or colonic resection completed all three assessments. The global score of recovery showed that no patient experienced being fully recovered at discharge. After rectal resection, patients frequently reported being not at all recovered. One month after surgery, patients recovering from colonic resection reported significant improvements regarding 11 of 17 questionnaire items, whereas abdominoperineal resection patients reported no significant improvements regarding any item. Instead, significantly higher levels of problems were reported in the items fatigue, muscle weakness and feeling down. Rectal resection patients reported significant improvements between 1 and 6 months after surgery regarding 7 of 19 items. However, the item gastrointestinal function distinguished, as patients reported significant deterioration towards higher levels of problems 6 months after surgery. This study elucidates the difference between groups of colorectal patients and the diverse patterns of their recovery, implying different needs in terms of prolonged support after discharge.

The Advocate's Compromise: Strategies and Tactics to Improve the Well-Being of People with Diminished Status

In this paper, I examine how advocates seek to improve the well-being of recipients who reside in organizations or systems of care in which factors influencing risk and jeopardy prevail. I use data from multiple action research projects to frame what I call ‘the advocate's compromise’: in systems and organizations regulating people who are considered vulnerable or dependent the advocate must advance collaborative relationships with care providers and supervisors so they become allies in advancing the well being of their charges. I place the advocate's compromise in context by amplifying a theory of diminished status, which offers a rationale for advocacy in social work. By identifying variation in its forms I illuminate the richness of advocacy practice in which the compromise is readily observable. In considering the context influencing the practice of advocacy in social work, I elaborate central aspects of the compromise, and reveal some of its ethical demands. Finally, I delineate principal strategies and tactics I have observed advocates employ to make the compromise a useful tool, particularly in total institutions, so incremental and limited advancements can make marginal improvements to a recipient's well-being without threatening the regulatory regime of care or supervision.

Queer Youth Resilience: Critiquing the Discourse of Hope and Hopelessness in LGBT Suicide Representation

Queer Youth Resilience: Critiquing the Discourse of Hope and Hopelessness in LGBT Suicide Representation

The Pornography of AddictionThe Pastoral Clinic: Addiction and Dispossession along the Rio Grande. By Angela Garcia. Berkeley: University of California Press, 2010.

ulation.” The final chapter centers on how the women are assessed by clinic personnel. This is a counterpoint to the earlier discussion of the role that physicians’ views play in designating the pregnant Medicaid patient’s body as polluted, for nonmedical personnel view them as “wily cheats and welfare queens.” This ethnography does almost everything that a compelling ethnography should do, yet it would have been useful to consider the neoliberal context in which racialization and surveillance of the pregnant body occurs. Consideration of neoliberalism would have broadened Bridges’s analytic frame to interrogate race and reproduction in this context and to cast a net over yet another way in which citizenship is compromised. Additionally, the issue of choice is provoked in this text, not only by virtue of the fact that the women seem to have little of it but also in terms of the meaning of choice in a neoliberal context. But Reproducing Race does an excellent job of exploring the profound incoherence of a poor pregnant woman’s experience at Alpha Hospital. It reveals the ways in which the uninsured are constructed as unruly and consequently receive a regime of medical care that medicalizes poverty. The institutional entanglements, that is, the circumstance of being controlled through state-sanctioned service provision, result in both monitoring performance and assessing deficits. While Bridges’ ethnography represents a major contribution to Black Critical Theory, this groundbreaking work should be widely read in anthropology, medical training, public health, social work, gender studies, African American studies, and critical medical studies, and by policymakers.