El cuerpo cotidiano: itinerarios corporales de mujeres / The everyday body: women's body itineraries

Resumen El objetivo de este trabajo es estudiar los itinerarios corporales de mujeres de nivel socioeconómico (NSE) alto y bajo que viven en Santiago de Chile. A través de una investigación cualitativa se indaga en las prácticas de alimentación, ejercicio y cuidado estético. Se realizaron entrevistas reflexivas a cuatro mujeres y se hizo un análisis temático reflexivo. Los análisis muestran que las mujeres de nivel socioeconómico alto refieren a las prácticas corporales cotidianas desde una alta sensación/conciencia corporal, mientras que para las de nivel socioeconómico bajo el cuerpo se vive como un lugar de control sobre el que hay escaso registro. A la descripción de las prácticas se agrega el carácter moral y afectivo con que son descriptas. Como resultado emergente, el cuidado de hijos/as surge como una variable relevante dentro de los itinerarios corporales, específicamente respecto de las prácticas de alimentación y ejercicio. Se concluye que las diferencias en las prácticas de alimentación, ejercicio y cuidado estético entre mujeres de NSE alto y bajo son consistentes con disparidades presentadas en encuestas. Trabajar desde la noción de itinerarios corporales permitió mostrar el modo en que se articula una diversidad de asuntos cotidianos que tradicionalmente se han estudiado de manera desagregada. Se sugiere para futuras investigaciones trabajar con muestras que incluyan otro tipo de participantes (hombres y/o sujetos de NSE medio) e integrar el rol de cuidadora como una variable a considerar.

Abstract This work aims to study women's body itineraries, through the interviews of women from high and low socioeconomic status (SES) who live in Santiago de Chile. The project inquiries bodies' itineraries as a set of nutrition, exercise, and aesthetics care actions as everyday practices. This concept allowed reflecting on the body as a continuous becoming, a movement or action, and not a fixed entity. The project had a qualitative research design. Data was collected using reflexive interviews. Participants were asked to describe a typical day using magazine images. Every interview started with the question: "If your body could talk with images, how would it tell its day?". Four women were interviewed, two of high SES and two of low SES. The data analysis was conducted the reflexive thematic analysis guidelines. The results compared high and low SES bodies itineraries organized by type of practice. Women of high SES describe their nutrition practices in terms of body awareness; how food affects their bodies. Low SES women instead talk about their nutrition from a self-control perspective. These women describe their food intake as something that must be at all times regulated. For them, nutrition becomes a constant failure because they usually lack self-control. Women of high SES describe the exercise as a pleasant activity, it is related to wellbeing. The interviewed women from this group reported exercising regularly. Women of Low SES described their lack of exercising in terms of laziness. Women of low SES report makeup as a daily aesthetic care practice. Women describe that they start applying makeup at their house, continue in the subway or bus on the way to work, and finish at the workplace. Makeup doesn't have a delimited space or place. Women of high SES describe aesthetic care practices in terms of skincare. They emphasize that good-looking skin and body image reflect a healthy body. A significant difference between low and high SES women is that the first consider aesthetic care practices as superficial, while for the latter is an inner state that reflects exteriorly. In general terms, women of high SES refer to body itineraries in terms of awareness. Women regularly refer to how the practices of nutrition, exercise, and aesthetic care affect their bodies. Women of low SES instead describe their body itineraries as control practices that regularly fail. They don't report body sensations. The analysis shows that the description of nutrition, exercise, and aesthetic care have moral (good/bad) and affective dimensions (how a body shall be affected in these practices). Being a caregiver emerged as a relevant issue when accounting for body itineraries. Two of the four women we interviewed were mothers, one from each SES. Caregiving was significant in nutrition and exercise practices. Women with children tend to eat when and what their children are eating. Eating tends to be a practice distributed in the routine. For example, a woman had a sandwich with her son before school and then a coffee after dropping him at school. Likewise, exercise is in function to the children's routine. For example, a woman walks fast from the school to her house. Being a caregiver structures time and, as an effect, it is very significant in body itineraries. Finally, in the discussion the analysis was compared with other data. The different practices of women of high and low SES derive into different outcomes. Women of low SES are more obese and sedentary than women from high SES. The notion of body itineraries is an integrative concept to study nutrition, exercise, and aesthetic care.

Decisiones médicas en enfermedades raras: de su definición estadística a su comprensión social / Medical decisions in rare diseases: from their statistical definition to their social understanding

Resumen Este ensayo teórico pretende analizar las decisiones médicas en el caso de las enfermedades raras. Una decisión médica es un proceso que orienta la producción de un diagnóstico o un tratamiento de salud, utilizando la información y evidencia disponible, en el cual muchas veces se incorporan las preferencias de los pacientes. En el caso de las enfermedades comunes o frecuentes, existe información clara y disponible sobre las distintas alternativas frente a un problema de salud. En el caso de las enfermedades raras, que están estadísticamente definidas como aquellas patologías que tienen prevalencia inferior a 1:2000, no suelen existir tales alternativas. Por la cronicidad y gravedad que este tipo de patologías suelen revestir, la ausencia de posibilidades se convierte en un problema que tiene dimensiones sanitarias y sociales. En este sentido, este artículo propone una transición de una definición estadística de las enfermedades a una definición social, que permita a futuras investigaciones conocer y profundizar en los procesos y efectos sanitarios, psicológicos y sociales sobre las enfermedades raras y su padecimiento.

Abstract The following article is a theoretical work on medical decisions in the case of rare diseases. A medical decision is a process that guides the production of a health diagnosis or treatment, using the available information and evidence, where the preferences of the patients are often incorporated. In the case of common or frequent illnesses, patients usually have clear and available information on the different alternatives to a health problem. In the case of rare diseases, which are statistically defined as those pathologies with a prevalence of less than 1:2000, usually there are no such alternatives. Due to the chronicity and severity that these types of pathologies have, the absence of possibilities becomes a problem that has health and social dimensions. In this sense, the article below proposes a transition from a statistical definition of diseases to a social definition that allows future research to learn about and deepen the health, psychological and social processes and effects on rare diseases and their condition.