Diasporic Identity in Contemporary Sinophone Literature: The Role of Language and Cultural Elements.

Amidst the contemporary diasporic landscape in Sinophone literature, this research critically examines the nexus of language, culture, and identity. The study aims to analyze literary pieces composed in Sinophone languages across diverse diasporic communities and uncover the impact of language and cultural elements on the articulation and comprehension of diasporic identity. This paper used the following. comparative and typological research, an in-depth analysis of three Sinophonic texts, and contextual analysis. The subject of the study was three texts: The Joy Luck Club (Amy Tan), Balzac and the Little Chinese Seamstress (Dai Sijie), and The Woman Warrior (Maxine Hong Kingston). The results showed that In The Joy Luck Club, language and cultural facets unveil the characters' dual identity struggles due to living abroad, exemplified through code-switching's psychological tension. Balzac and the Little Chinese Seamstress utilizes language and cultural details to underscore the significance of preserving heritage within the diaspora, with literary allusions amplifying this endeavor. In The Woman Warrior, language and cultural elements reflect the heroine's inner conflict as she navigates her dual cultural allegiance. This scholarly revelation deepens comprehension of how these aspects influence identity formation in the diaspora. These findings broaden the understanding of Sinophone diasporic literature, spotlighting shared trends in identity portrayal through language and culture. The research has theoretical value for literary, cultural, and anthropological studies and practical significance, potentially informing educational initiatives on diasporic literature and cultural diversity. This study's outcomes hold relevance for students, researchers, and cultural scholars exploring the role of language and culture in diasporic identity expression.

LA COMUNICACIÓN, OBSERVACIÓN Y ÉTICA COMO ESENCIA DEL CUIDADO CULTURAL DE ENFERMERÍA / COMMUNICATION, OBSERVATION AND ETHICS AS THE ESSENCE OF CULTURAL NURSING CARE

En las dos décadas que llevamos del siglo XXI, pareciera que todo cambia de manera casi instantánea, uno de esos cambios, lo es la situación de migración de los seres humanos que se encuentra presente en los cinco continentes que conforman el mundo, esté hecho requiere de profesionales de enfermería preparados para entender el cuidado desde la cultura de la persona a la que se cuida. Durante el siglo XX, la mayoría de los profesionales de enfermería han sido formados bajo el paradigma occidental, las escuelas y facultades, están más preocupadas por la curación que por la prevención, el objetivo del presente artículo es reflexionar sobre la necesidad de profundizar en las habilidades de comunicación, observación y ética que debe tener el profesional de enfermería para otorgar cuidados culturales al ser humano cultural, ante el hecho de que en la mayoría de los países, el profesional de enfermería tiene contacto con diversos seres humanos culturales. El presente artículo de reflexión incluye en la introducción aspectos generales de la cultura y enfermería, en el cuerpo del artículo se habla sobre como la enseñanza de enfermería ha sido permeada por las necesidades de curación más que de los cuidados culturales, se finaliza con la conclusión de que las escuelas y facultades de enfermería deben ser abiertas a aceptar la diversidad cultural que tienen en su país para la enseñanza del cuidado del ser humano, considerando su cultura en combinación con los cuidados occidentales en que han sido formados los profesionales de enfermería, a partir de considerar que enfermería fue una de las primeras profesiones que durante el siglo XX incluyo en su lenguaje el concepto de cultura, por otro lado es conveniente mencionar que durante el tiempo que llevamos del siglo XXI pocos son los países en donde las escuelas de enfermería incluyen cuidados culturales del ser humano, que en este momento son primordiales dadas las características de movilidad nacional e internacional que tiene la población mundial.

In the two decades that we have been in the 21st century it seems that everything changes almost instantaneously. One of those changes involves the migration of human beings in the five continents that make up the world, a phenomenon that requires nursing professionals to provide care that considers the culture of each person being cared for. During the 20th century, most nursing professionals were trained under the western paradigm, when schools and faculties were more concerned with cure than prevention. The objective of this article is to reflect on the need to develop the skills of communication, observation, and ethics that the nursing professional must have to provide effective care for people from other countries and cultures. Following an introduction to general aspects of cultural and nursing, the body of this reflection article discusses how nursing education has been dominated by healing priorities rather than cultural considerations. The article ends with the conclusion that nursing schools and faculties should recognize the cultural diversity in their country when teaching the principles of care, and that they consider cultural factors in combination with the western concept of care in the training of nursing professionals. Considering that nursing was one of the first professions during the 20th century to include the concept of culture in its language, it is worth mentioning that in the 21st century there are few countries where nursing schools teach culturally sensitive care. This is now essential given the national and international mobility of the world population.

[Obstetric violence as epistemic injustice: childbirth trouble.] / La violencia obstétrica como injusticia epistémica: el parto en disputa.

This article theoretically frames the issue of obstetric violence as epistemic injustice, drawing heavily from feminist phenomenological philosophy, within the general framework of narrative bioethics and the fight for sexual-reproductive rights. The first section deals with the concept of obstetric violence, emphasizing Latin America's pioneering role in its coinage and recognition, as well as its empirical-hermeneutical applications. In the second section, consideration is given to how the concept of obstetric violence has been analyzed through the lens of epistemic injustice (in its two versions: testimonial and hermeneutic), which has signified major progress in its systemic understanding and its biopolitical nature. The article's conclusions highlight the full empirical-theoretical relevance of the term, as a thick philosophical concept, despite existing tensions between the biosanitary (especially medical) sector and citizen demands.

Este artículo aborda en términos teóricos la cuestión de la violencia obstétrica como injusticia epistémica, con especial énfasis en las perspectivas que propone la filosofía fenomenológica feminista, desde el encuadre general de la bioética narrativa y la lucha por los derechos sexo-reproductivos. En la primera parte, se aborda el concepto de violencia obstétrica, enfatizando el carácter pionero de América Latina en su acuñe y reconocimiento, así como en su aplicación empírico-hermenéutica. En la segunda parte, se examina cómo el concepto de violencia obstétrica ha sido analizado a través del prisma de la injusticia epistémica (en sus dos versiones: testimonial y hermenéutica), lo que ha supuesto un avance significativo en su comprensión sistémica y en su carácter biopolítico. El artículo concluye sobre la plena pertinencia empírico-teórica del término, en tanto concepto filosófico denso, pese a la controversia existente entre la clase biosanitaria (especialmente médica) y la reclamación ciudadana.

An anthropologist's voice in a veterinarian's noise: gearing up for new cultural realities.

Over the past three decades, the veterinary profession has faced a cultural shift towards postspeciesism that requires a reassessment of the foundations of the existing distinctions between human and non-human animals proclaimed by the speciesism paradigm, which represents institutionalized discrimination against species and recognizes only the subjectivity of humans. Based on ethnographic observations in anthropological fieldwork and using speciesism/postspeciesism distinction, we aimed to explain the main causes of small animal practitioners' work-related stress and apply humanistic knowledge to recommend ways to alleviate the negative effects of the work environment. The explanatory model of disease, illness, and sickness, the example of the concept of family, and the circumstances of the feminization of the veterinary profession are discussed to illustrate the divergence between speciesist naturalistic veterinary knowledge and the postspeciesist cultural framework and its consequences. By failing to accommodate the changing values towards animals and by failing to challenge the anthropocentric hierarchy of values, the speciesist rationale of the veterinary profession contributes to many of the problems faced by practicing veterinarians. The incorporation of a modern moral-philosophical mindset towards animals may not even be possible because veterinary science is subject to a paradigm that is irreversibly tied to institutional discrimination against species and defies reflection on veterinary science itself. However, the veterinary profession has a privileged position in establishing an alternative ontological thinking and an alternative conception of "animal life." Anthropological knowledge was applied to anticipate further intervention of social and cultural sciences in the problems of small animal practitioners. Rather than further diversifying and increasing expectations towards veterinarians by expecting them to acquire additional skills, we propose another practitioner who can support, mediate, and enhance veterinary performance - the cultural anthropologist. With their deep knowledge of cultural differences and social dynamics, they can collaborate with veterinarians to act as a liaison between cultures, paradigms, and species.

La violencia obstétrica como injusticia epistémica: el parto en disputa / Obstetric violence as epistemic injustice: childbirth trouble

RESUMEN Este artículo aborda en términos teóricos la cuestión de la violencia obstétrica como injusticia epistémica, con especial énfasis en las perspectivas que propone la filosofía fenomenológica feminista, desde el encuadre general de la bioética narrativa y la lucha por los derechos sexo-reproductivos. En la primera parte, se aborda el concepto de violencia obstétrica, enfatizando el carácter pionero de América Latina en su acuñe y reconocimiento, así como en su aplicación empírico-hermenéutica. En la segunda parte, se examina cómo el concepto de violencia obstétrica ha sido analizado a través del prisma de la injusticia epistémica (en sus dos versiones: testimonial y hermenéutica), lo que ha supuesto un avance significativo en su comprensión sistémica y en su carácter biopolítico. El artículo concluye sobre la plena pertinencia empírico-teórica del término, en tanto concepto filosófico denso, pese a la controversia existente entre la clase biosanitaria (especialmente médica) y la reclamación ciudadana.

ABSTRACT This article theoretically frames the issue of obstetric violence as epistemic injustice, drawing heavily from feminist phenomenological philosophy, within the general framework of narrative bioethics and the fight for sexual-reproductive rights. The first section deals with the concept of obstetric violence, emphasizing Latin America's pioneering role in its coinage and recognition, as well as its empirical-hermeneutical applications. In the second section, consideration is given to how the concept of obstetric violence has been analyzed through the lens of epistemic injustice (in its two versions: testimonial and hermeneutic), which has signified major progress in its systemic understanding and its biopolitical nature. The article's conclusions highlight the full empirical-theoretical relevance of the term, as a thick philosophical concept, despite existing tensions between the biosanitary (especially medical) sector and citizen demands.

Consumo colectivo de alcohol en jóvenes universitarios en Colombia: análisis desde una perspectiva etnográfica / Collective consumption of alcohol among young university students in Colombia: Analysis from an ethnographical perspective

Objetivo: reconocer los escenarios de consumo de alcohol como fenómeno colectivo, y las interrelaciones que se dan en estos espacios. Metodología: estudio cualitativo con enfoque etnográfico, realizado en dos etapas: cartografía y mapeo de lugares de consumo de alcohol y observación no participante, donde participaron jóvenes universitarios de ciencias de la salud. Se realizó análisis de contenido en ATLAS.Ti. Resultados: Emergieron 8 categorías: 1) Características del lugar de consumo 2) Motivaciones juveniles para beber, 3) Autonomía y autocontrol sobre el consumo, 4) Características del consumo, 5) Efectos del consumo de alcohol en el organismo, 6) Conocimiento de riesgo asociado al consumo, 7) Diferencias basadas en la división sexo-genérica,8) Rupturas por pandemia. Conclusión: Los sitios de consumo de alcohol usan la iluminación, muebles, pantallas, espectáculos, variedad de bebidas alcohólicas, diferentes formas de pago y estrategias de seguridad para atraer a los jóvenes. Las observadoras reportan que los jóvenes reconocen como motivos para consumir alcohol: las rupturas de pareja, desinhibirse, ser aceptados por el grupo, disfrutar con sus pares, eventos deportivos, celebraciones, liberar tensión provocada por responsabilidades académicas, laborales, familiares y sentimentales. Utilizan como mecanismos para enfrentar la presión social en los escenarios de consumo, el autocontrol y autoconocimiento, que les permiten establecer estrategias de cuidado antes, durante y después del consumo.(AU)

Objective: to recognize the scenarios of alcohol consumption as a collective phenomenon, and the interrelationships that occur in these spaces. Methodology: qualitative with an ethnographic approach, carried out in two stages: cartography and mapping of alcohol consumption study sites and non-participant observation, where young health sciences university students participated. A content analysis was performed in ATLAS.Ti. Results: Eight categories emerged: 1) Characteristics of the place of consumption, 2) Youth motivations to drink, 3) Autonomy and self-control over consumption, 4) Characteristics of consumption, 5) Effects of alcohol consumption on the body, 6) Knowledge of risk associated with consumption, 7) Differences based on the gender-sex division, 8) Pandemic ruptures. Conclusion: Consumption sites use lighting, furniture, screens, shows, a variety of alcoholic beverages, different forms of payment, and security strategies to attract young people. Observers report that young people recognize as reasons for consuming alcohol: breakups, loss of inhibition, being accepted by the group, enjoying with their peers, sporting events, celebrations, releasing tension caused by academic, work, family and sentimental responsibilities. They use self-control and self-knowledge as mechanisms to face social pressure in consumption scenarios, which allow them to establish care guidelines before, during and after consumption.(AU)

Creencias y costumbres en la alimentación durante el puerperio mediato de las mujeres nahuas e implicaciones para Enfermería / Beliefs and Customs on Nutrition in Nahua women during the Immediate Postpartum Period and Implications for Nursing

Introducción: La alimentación constituye uno de los saberes ancestrales perpetuados en las comunidades indígenas, con creencias y costumbres peculiares para el puerperio, sobre qué comer y qué no comer. Objetivo: Describir las creencias y costumbres en la alimentación durante el puerperio mediato de las mujeres nahuas y sus implicaciones para Enfermería. Métodos: Estudio cualitativo etnográfico, ejecutado en las comunidades nativas Axtla de Terrazas en San Luis de Potosí, México, entre los meses marzo-julio del 2019. La población la conformaron 50 puérperas de esa comunidad. La muestra, integrada por 14 madres, fue no probabilística por conveniencia y lograda por el criterio de saturación y redundancia de los datos. Para recolectar los datos se usaron la observación participante y la entrevista etnográfica, previo consentimiento informado, luego fueron procesados de manera artesanal según el análisis temático. Resultados: Emergieron tres categorías: a) Alimentos adecuados que contribuyen con la recuperación de la puérpera. b) Alimentos inadecuados que afectan la salud de la puérpera. c) Alimentos que incrementan o disminuyen la producción de leche materna y generan malestar al neonato. Conclusiones: Las mujeres nahuas siguen las indicaciones de abuelas y parteras respecto a los alimentos cuyo consumo es permitido o no durante el puerperio mediato, ya que es importante para su recuperación y la producción láctea. Es necesario realizar más estudios para identificar si las madres reciben los requerimientos nutricionales adecuados, ya que evitan alimentos nutritivos como el huevo, la leche, las carnes rojas, algunas frutas y verduras(AU)

Introduction: Feeding constitutes one of the ancestral knowledge perpetuated in indigenous communities, with peculiar beliefs and customs for the puerperium, about what to eat and what not to eat. Objective: To describe the beliefs and customs of Nahua women during the immediate postpartum period and their implications for Nursing. Methods: Qualitative ethnographic study, carried out in the native communities of Axtla de Terrazas in San Luis de Potosí, Mexico, between March and July 2019. The population consisted of 50 postpartum mothers from that community. The sample, composed of 14 mothers, was non-probabilistic by convenience and achieved by the criteria of saturation and redundancy of the data. The data were collected by participant observation and ethnographic interview, with prior informed consent, and then processed in an artisanal manner according to the thematic analysis. Results: Three categories emerged: a) Adequate foods that contribute to the recovery of the postpartum women. b) Inadequate foods that affect the postpartum women´s health. c) Foods that increase or decrease the production of breast milk and generate discomfort to the neonate. Conclusions: Nahua women follow the indications of grandmothers and midwives regarding the foods whose consumption is allowed or not during the mediate puerperium, since it is important for their recovery and milk production. Further studies are needed to identify whether mothers receive adequate nutritional requirements, as they avoid nutritious foods such as eggs, milk, red meat, some fruits and vegetables(AU)

Experiences of resilience and coping among refugees from civil strife in Kenya / Experiências de resiliência e enfrentamento entre refugiados da Guerra Civil no Quênia / Experiencias de resiliencia y afrontamiento entre refugiados del conflicto civil en Kenia

This study aimed to explore experiences of civil war refugees in Kenya. This qualitative study was conducted with 12 participants in Nairobi, Kenya, from February to March 2016, and the data collection was performed via semi-structured interviews and observation. The analysis was supported by cross-cultural psychology and discourse analysis. The themes emerging from the interviews were grouped into different clusters of discourses of marginalized refugees voices: (1) feelings of insecurity before and after migration, (2) lack of refugee rights, (3) diminished female self-esteem, (4) immigration as a promoter of illness; (5) faith as hope for better days; (6) trauma and suicidal ideation. The immigration status of insecurity, the fear of various types of violence, mainly sexual and physical, the lack of legal rights of citizenship, the disease and, finally, the suicidal ideation, were identified in the group of refugees. The possibilities of hope are scarce and are based on religious groups and social projects.

Este estudo teve como objetivo explorar as experiências de refugiados da Guerra Civil no Quênia. Trata-se de estudo qualitativo realizado com 12 participantes em Nairóbi, Quênia, de fevereiro a março de 2016, e a coleta de dados foi realizada por meio de entrevistas semiestruturadas e observação. A análise foi apoiada pela psicologia transcultural e pela análise do discurso. Os temas emergentes das entrevistas foram agrupados em diferentes grupos de discursos de vozes de refugiados marginalizados: (1) sentimentos de insegurança antes e depois da migração, (2) falta de direitos do refugiado, (3) autoestima feminina diminuída, (4) imigração como promotor de doenças, (5) fé como esperança de dias melhores, (6) trauma e ideação suicida. A situação imigratória de insegurança, o medo de vários tipos de violência, principalmente sexual e física, a falta de direitos legais de cidadania, a doença e, por fim, a ideação suicida foram identificados no grupo de refugiados. As possibilidades de esperança são escassas e fundamentadas em grupos religiosos e projetos sociais.

Este estudio tuvo como objetivo explorar las experiencias de los refugiados de la guerra civil en Kenia. Este es un estudio cualitativo realizado con 12 participantes en Nairobi, Kenia, de febrero a marzo de 2016, y la recolección de datos se realizó a través de entrevistas semiestructuradas y observación. El análisis se apoyó en la psicología transcultural y el análisis del discurso. Los temas que surgieron de las entrevistas se agruparon en diferentes grupos de discursos de las voces de los refugiados marginados: (1) sentimientos de inseguridad antes y después de la migración, (2) falta de derechos de los refugiados, (3) disminución de la autoestima femenina, (4) la inmigración como promotora de enfermedades; (5) la fe como esperanza de días mejores; (6) trauma e ideación suicida. En el grupo de refugiados se identificó situación migratoria insegura, temor a diversos tipos de violencia, principalmente sexual y física, falta de derechos ciudadanos legales, enfermedad y, finalmente, ideación suicida. Las posibilidades de esperanza son escasas y se basan en grupos religiosos y proyectos sociales.

Development of a graphical resilience framework to understand a coupled human-natural system in a remote arid highland of Baja California Sur.

Hydrological systems are important to society as water resources and effective management requires an understanding of how water and humans influence each other. To describe human-water connections it is necessary to bridge social and natural sciences. To this end, we construct an interdisciplinary graphical framework for evaluating potential human-water system resilience, which is a tool to show the spatial and temporal response to system change of both human and natural systems. This helps to identify the ways that human responses to change relate to changing water resources and identifies important thresholds and potential disconnects that would create vulnerability. We further use this tool to describe a dynamic, coupled human-water system present in the arid Sierra de la Giganta region of Baja California Sur, Mexico. In this remote mountain range, there is a community (self-identifying as Choyeros) who rely on spring water for ranching and subsistence. Using mixed methods of hydrogeochemistry and anthropology, we describe spatial connectivity and temporal changes of both hydrologic and social systems. We use these observations to examine the Choyero response to system changes and explore the topology of the various approaches that the community employs to adapt to changing water availability. The framework guides dialogue to constrain the types of policies, strategies, and responses that help to promote the sustainability of water resources. This framework can be used to compare systems across spatio-temporal scales to produce more generalizable and communicable insights of coupled human-natural systems. Supplementary Information: The online version contains supplementary material available at 10.1007/s11625-022-01101-6.

"Using contraceptives is abandoning our culture": A qualitative study of contraceptive use among Somali women in Finland.

OBJECTIVE: Several studies have reported that Somalis have negative attitudes about using modern contraceptives. However, little attention has been paid to the differences in Somali women's attitudes toward contraceptives across generations and the attitude change happening overtime in Somali women's attitudes toward contraception. This study explores attitudes toward contraceptives and factors influencing contraceptive use, among first- and second-generation Somali women living in Finland. METHODS: The study follows a qualitative design with data collection using in-depth interviews. Sixteen women were interviewed regarding their knowledge of, attitude toward, and use of contraceptives. Eight of the study participants were first-generation and eight were second-generation Somali women living in Finland. The data were analyzed using a thematic approach guided by a cultural anthropology framework. RESULTS: Three main themes emerged in the data analysis: (1) Culture influencing Somali women's attitudes toward contraceptives; (2) information sources can work differently within the same cultural group; and (3) Somali women's perspectives on contraceptives change over time. Cultural, religion, taboo, and knowledge resources are used to understand the whole concept of Somali women's attitude toward and use of contraceptives. Hence, the study shows the diverse opinions of Somali women. According to the informants the main underlying factors influencing Somali women's attitudes toward contraceptives were education, culture, misinterpreted religion, and social pressure. CONCLUSIONS: According to the Finish resident women interviewed for this study, Somali culture do not support the use of modern contraceptives. Even though attitudes towards contraceptives are slowly changing, there is a need for SRH education, particularly among first-generation Somalis. Second-generation women are generally more open to the use of modern contraceptives. The study also draws attention to the need to improve the training of health care professionals regarding the handling of culturally sensitive topics such as contraception use.

Cultivating cultural awareness among medical educators by integrating cultural anthropology in faculty development: an action research study.

BACKGROUND: In faculty development, understanding each participant's cultural context is important. However, there is scarce evidence on how to improve cultural understanding in faculty development. Cultural anthropology is a discipline that focuses on developing cultural self-awareness by understanding different cultures. Professionals from this field can be crucial to the goal of cultivating cultural awareness among medical educators. The aims of this study are to 1) develop and modify cultural anthropology sessions in faculty development and 2) evaluate the effectiveness of these sessions, including their long-term impacts. METHODS: The cultural anthropology sessions were organized as part of a longitudinal faculty development program-Foundation Course for Medical Education-at Kyoto University in Japan. The study included 47 medical educators participating in faculty development and three lecturers: two cultural anthropologists and a medical educator. We developed the cultural anthropology sessions and implemented them in the longitudinal faculty development program. In these sessions, cultural anthropologists used inquiry-guided reflection. An action research methodology was employed and repeated in four cycles from 2015 to 2018. Qualitative and quantitative data were collected during the action research cycles. The qualitative data were thematically analyzed. RESULTS: The cultural anthropologists' inquiries fostered learning during the sessions, and three themes-cultural relativism, attention to context, and reframing-were synthesized. As a long-term impact of the sessions, the learners reported becoming more aware of the cultural contexts in their daily educational and clinical activities. CONCLUSIONS: The cultural anthropology sessions in the faculty development program were shown to have enhanced the participants' awareness of cultural contexts. The concept and format of these sessions may be used more widely in faculty development programs.

Os sentidos dos cuidados em saúde mental a partir de encontros e relatos de usuários de um CAPS / The meanings of mental health care from the meetings and reports of CAPS users

Resumo Este artigo apresenta a criação de serviços comunitários em ampla rede e políticas públicas brasileiras no campo da saúde mental, fundamentais para a análise do cuidado nos serviços. O objetivo é analisar a concepção do cuidado em saúde mental por meio da contribuição dos usuários e do entendimento de seus modos de fazer saúde mental. Dessa forma, contribui para o diálogo entre a desinstitucionalização e o panorama atual da saúde mental, com base em experiência de inspiração etnográfica. A metodologia, de natureza qualitativa, teve como componente a observação participante, diários de campo e encontro de grupo focal em um Centro de Atenção Psicossocial (CAPS) III, em Santos, município litorâneo no estado de São Paulo. Os dados foram sistematizados de acordo com a análise temática em três principais eixos: abordagem do cuidado e do acolhimento no CAPS; apontamento das necessidades cotidianas reais dos usuários e a percepção da complexidade no cuidado e nos encontros; e o mandato social dessas instituições, de atribuições inúmeras e complexas no território.

Abstract This study investigates changes in the field of mental health in the Brazilian scenario, analyzing the creation of community services and public policies related to care. With that, it aims to assess the conception of mental health care according to its users, contributing to the dialogue between deinstitutionalization and the field current panorama based on an ethnographic approach. This is a qualitative participant observation research conducted in a Center of Psychosocial Attention (CAPS) III in the city of Santos, Sao Paulo. Data were collected by means of focus groups and field diaries and treated by thematic analysis, resulting in three main discussion axes: care and embracement; real daily needs of users and the perception of complexity in care and meetings; and these institutions social mandate, with numerous and complex roles.

Cuidar al paciente con COVID-19: entre la incertidumbre y el deseo de salir adelante / Caring for the patient with COVID-19: between uncertainty and the desire to get ahead

Introducción: la realidad a la cual la humanidad ha tenido que enfrentarse producto de la pandemia por COVID-19 ha implicado para el personal de la salud, y el de enfermería de manera específica, un gran reto para brindar cuidado a los pacientes, mientras se cuida a sí mismo de un contagio. Objetivo: comprender el significado que tiene para los integrantes de los equipos de enfermería el cuidado de los pacientes infectados por el COVID-19. Método: trabajo cualitativo en el que participaron profesionales y auxiliares de enfermería del Departamento de Antioquia, Colombia; la recolección de datos se realizó mediante entrevistas virtuales y el análisis fue inductivo. Resultados: el equipo de enfermería cuida a los pacientes infectados por el COVID-19 con gran incertidumbre y sin apoyo. Esto los lleva a experimentar sentimientos de miedo, rabia y desconcierto. Su forma de afrontar esta situación es tener una actitud positiva con esperanza, aislarse de los medios de comunicación o pensar en dejar su trabajo. Por ello, sugieren la necesidad de capacitación a ellos y a la comunidad. Por otro lado, piden mejores condiciones laborales y ser escuchados. Conclusiones: el personal de enfermería lleva a cabo el cuidado de los pacientes en medio de incertidumbre y afectación en su salud mental.

Introduction: The reality that humanity has had to face due to the COVID-19 pandemic has implied a great challenge for health personnel, specifically for nurses, to provide care to patients while protecting themselves from getting infected. Objective: Understand what it means for nursing team members to care for patients infected with COVID-19. Methods: Qualitative work in which nurses and nursing assistants from the department of Antioquia, Colombia, participated; data were collected through online interviews, and the analysis was inductive. Results: Nursing teams care for patients with COVID-19 feeling great uncertainty and without support. This leads them to experience feelings of fear, anger, and bewilderment. Their way of dealing with this situation is to have a positive attitude with hope, isolate themselves from media, or think about quitting their jobs. Therefore, they suggest the need for training, both for themselves and the community. They also ask for better working conditions and to be heard. Conclusions: The nurses care for the patients amid uncertainty and mental health conditions.

Introdução: a realidade que a humanidade tem enfrentado em decorrência da pandemia por COVID-19 tem implicado para os profissionais de saúde, e especificamente para os enfermeiros, um grande desafio no cuidado aos pacientes, en quanto cuidam-se a se mesmos do contágio. Objetivo: compreender o significado que tem para os membros da equipe de enfermagem o cuidado aos pacientes infectados pelo COVID-19. Método: trabalho qualitativo, no qual participaram profissionais e auxiliares de enfermagem do Departamento de Antioquia, Colômbia. A coleta de dados foi realizada por meio de entrevistas virtuais e a análise foi indutiva. Resultados: a equipe de enfermagem cuida de pacientes infectados pelo COVID-19 com grande incerteza e sem suporte. Isso os leva a experimentar sentimentos de medo, raiva e perplexidade. A sua forma de lidar com esta situação é ter uma atitude positiva com esperança, isolar-se dos meios de comunicação ou pensar em deixar o emprego. Portanto, sugerem a necessidade de capacitação para eles e para a comunidade. De outro lado, reclamam melhores condições de trabalho e ser escutados. Conclusões: a equipe de enfermagem oferece cuidado aos pacientes em meio de incertezas e afetações em sua saúde mental.

Significado de alteraciones en la salud de niños en situación de calle / Meaning of Health Alterations in Children Living in the Streets

INTRODUCCIÓN: Investigación realizada en la ciudad de Medellín, Colombia. OBJETIVO: Comprender el significado que tienen para los niños en situación de calle las alteraciones en la salud y cómo las tratan. METODOLOGÍA: Estudio cualitativo, etnográfico. Se aplicaron 30 entrevistas a niños en situación de calle y se llevó diario de campo. RESULTADOS: Las alteraciones en la salud las clasifican en enfermedades causadas por Dios y enfermedades o heridas causadas por el hombre; las primeras no pueden prevenirse, las segundas sí. Las causadas por el hombre pueden ser: graves, si están relacionadas con la posibilidad de morir y requieren atención hospitalaria; serias cuando comprometen su libertad requieren ayuda y leves cuando no comprometen su independencia y las solucionan mediante la automedicación o tratamientos culturalmente determinados. Las alteraciones en la salud significan experiencia y las heridas significan venganza, valentía o vergüenza. CONCLUSIÓN: Los niños en situación de calle construyen el significado de alteración de la salud, a partir de sus experiencias, en relación con la muerte y la libertad.

INTRODUCTION: The research was conducted in Medellín, Colombia. OBJECTIVE: The work sought to understand the meaning of diseases and their treatment for homeless children. METHODOLOGY: Ethnographic and qualitative research. Thirty interviews were carried out to homeless children and a field diary was kept. RESULTS: Diseases were classified as those caused by God and diseases or injuries caused by men; the latter can be prevented, but the first one cannot. Diseases caused by men can be severe, if they pose the risk of death and require hospital treatment; serious, when they jeopardize freedom; and mild, when they do not place at risk their independence and are treated through self-medication or culturally determined treatment. Diseases mean experience and injuries mean revenge, courage, and shame. CONCLUSION: Homeless children build the meaning of diseases from their experience, in relation to death and freedom.

Case study: Lesions due to forced ritual scarification in Cameroon - A warning from cultural anthropology to forensic medicine.

Asylum seekers and refugees are constantly increasing worldwide because of human rights' violations and political-related abuses. As a result, some of them show scars due to torture and other forms of maltreatments. In addition, they may also present scars due to ethnical practices, namely ritual scarifications. This case study presents a victim who did not give consent to perform such ethnical practices on her body. The authors aim to enlighten the difficulty to understand the origin and the purpose of these specific injuries and the importance to know how to distinguish them from other forms of abuse. Indeed, it appears that such lesions follow a cultural path, meaning that the lesions are performed methodically and may show macroscopic differences compared to others. The story narrated by the victim can be helpful for the experts' assessment, regardless, they may present memory-loss issues. This represents the value of a correct injuries' diagnosis and the importance of cultural anthropology-related analyses. The cultural and social background are relevant since the injuries have their own signification because of their symbolism. Therefore, a multidisciplinary approach with a cultural anthropologist may have the possibility to help the forensic experts in understanding and interpreting such stories fostering their ability to better assess asylum seekers stories and their reliability.

Understanding the Effect of Electronic Prehospital Medical Records in Ambulances: A Qualitative Observational Study in a Prehospital Setting.

Little is known of ambulance professionals' work practices regarding the use of medical records, their communication with patients, before and during hand over to Emergency Departments (ED). An electronic Prehospital Medical Record (ePMR) has been implemented in all Danish ambulances since 2015. Our aim was to investigate the use of ePMR and whether it affected the ambulance professionals' clinical practice. We performed a qualitative study with observations of ePMR use in ambulance runs in the North Denmark Region. Furthermore, informal interviews with ambulance professionals was performed. Analysis was accomplished with inspiration from grounded theory. Our main findings were: (1) the ePMR is an essential work tool which aided ambulance professionals with overview of data collection and facilitated a checklist for ED hand overs, (2) mobility and flexibility of the ePMR facilitated conversations and relations with the patients, and (3) in acute severe situations, the ePMR could not stand alone in hand over or communication with the ED. The ePMR affected the ambulance professionals' work practice in various ways and utilization of ePMR while simultaneously treating patients in ambulances does not obstruct the relation with the patient. To this end, the ePMR appears feasible in collaboration across the prehospital setting.

'Eating well' in Pacific Islands countries and territories: A qualitative and normative approach to food cultures in New Caledonia.

In recent decades, the food cultures of the Pacific populations have undergone a profound transition, particularly because the increasing trade exchanges with Western countries have facilitated access to a wide range of processed foods. Essentially, a new normative model of eating is now taking the place of the traditional models. The aims of this qualitative study were to explore what 'eating well', 'good food' and 'bad food' now mean in the New Caledonian family context and, more broadly, to categorise the current food practices and representations in adolescents' families. A double qualitative methodology was applied: 59 face-to-face interviews with 30 parents and 29 adolescents in both rural and urban areas and 15 collective structured discussions with middle-school classes (11- to 16-year-olds) of almost 25 students each. The main results showed various normative frames for nutrition, food quantities, local provenance, and personal taste. Food practices were related to food availability (having a home garden or involvement in family farming), socioeconomic status and community. In addition, access to nutritional information, temporal and financial constraints mostly in the urban area, and the role of food socialisation between parents and children had an impact on food practices and perceptions. The permanence of food cultures, mainly observed in families in rural areas, and the social inequalities in urban areas regarding food availability are highlighted. The positive perception of 'local food' as 'cultural', 'organic' and 'healthy' may help policymakers communicate clear messages to reach a sustainable food system.

Divinization, pilgrimage, and social inequality: experiences of women in the access to obstetric assistance / Divinização, peregrinação e desigualdade social: experiências de mulheres no acesso à assistência obstétrica

Abstract Objectives: to understand the experiences of women from Brazilian northeastern semi-arid in accessing obstetric care. Methods: qualitative research conducted by the methodological framework of ethnonursing, carried out with 13 key informants in a public maternity hospital located in the Cariri region of Ceará in the Brazilian Northeast semiarid. The Observation-Participation-Reflection enablers was adopted for data collection, with observations recorded in a field diary and individual interviews, such as "tell me about". The immersion process in the field lasted five months. The empirical material was submitted to procedures of the data analysis guide for ethno-nursing. Results: from the patterns that emerged empirically, three cultural themes became evident: "It has to be delivered in the hands of God": discursive constructions about prenatal care; "We stay in this endless coming and going": antepartum pilgrimage; "If I were rich, I wouldn't be here": attention received in accessing maternity. Conclusions: in the cultural scenario analyzed, women were inserted in the context of clinical and social weaknesses, violation of rights and dignity, resorting to divine designs in the face of difficulties in accessing obstetric services and pilgrimage to guarantee consultations, exams, and hospitalization for childbirth.

Resumo Objetivos: compreender as experiências de mulheres do semiárido nordestino brasileiro no acesso à assistência obstétrica. Métodos: pesquisa qualitativa conduzida pelo referencial metodológico da etnoenfer-magem, realizada com 13 informantes-chave em maternidade pública localizada na região do Cariri cearense no semiárido nordestino brasileiro. Adotou-se para coleta de dados o capacitador Observação-Participação-Reflexão com registro das observações em diário de campo e entrevistas individuais do tipo "conte-me sobre". O processo de imersão no campo durou cinco meses. O material empírico foi submetido aos procedimentos do guia de análise de dados da etnoenfermagem. Resultados: a partir dos padrões que emergiram empiricamente evidenciaram-se três temas culturais: "Tem que entregar nas mãos de Deus": construções discursivas acerca do acompanhamento pré-natal; "A gente fica nesse vai e vem sem fim": peregrinação anteparto; "Se eu fosse rica, não estaria aqui": atenção recebida no acesso à maternidade. Conclusões: no cenário cultural analisado as mulheres encontravam-se inseridas em contexto de fragilidades clínica e social, de violação de direitos e da dignidade, recorrendo aos desígnios divinos diante das dificuldades de acesso aos serviços obstétricos e peregrinação para garantia de consultas, exames e internamento para o parto.

Violencia hacia el profesional de enfermería: una etnografía focalizada

RESUMEN Objetivo: Describir las experiencias del profesional de enfermería sobre la violencia experimentada en su trabajo. Material y Método: Estudio cualitativo con diseño etnográfico focalizado. Los participantes se seleccionaron utilizando un muestreo no-probabilístico por bola de nieve. Los datos se recolectaron a través de 25 entrevistas a profundidad vía telefónica entre enero y junio de 2018, en tres hospitales de Veracruz, México. El Modelo Interactivo de violencia en el lugar de trabajo diseñado por Chappell y Di Martino fue el referente teórico y la técnica de análisis temática fue con el apoyo del software QUIRKOS. Resultados: Las temáticas resultantes fueron: causas y tipos de agresión, reacción de la víctima ante la agresión y agresor. En su mayoría fueron mujeres (72%), del turno matutino (52%), de los servicios de urgencias y medicina interna (28%). El 68% refirió no haber denunciado la agresión a sus superiores e identificaron al médico como el principal agresor (44%), seguido por el familiar del paciente (20%). Conclusión: Es imperativo la implementación de estrategias para evitar la violencia laboral, así como la formación de pautas a seguir en caso de ser violentada/o.

ABSTRACT Objective: To describe the experiences of nursing professionals concerning workplace violence. Material and Method: Qualitative study with a focused ethnographic design. Participants were selected using non-probability snowball sampling. Data were collected through 25 in-depth telephone interviews between January and June 2018 in three hospitals of Veracruz, Mexico. The theoretical framework was based on the Interactive Model of workplace violence designed by Chappell and Di Martino and the QUIRKOS software was used for the thematic analysis. Results: Findings alluded to the causes and types of aggression, the victim's reaction to the aggression and the aggressor. Participants were mostly women (72%), who worked the morning shift (52%), in the emergency and the internal medicine services (28%). 68% indicated not having reported the aggression to their supervisors and identified the physician as the main aggressor (44%), followed by the patient's family members (20%). Conclusion: It is critical that hospitals implement strategies to avoid workplace violence, as well as guidelines that nurses and other healthcare professionals can follow in case of violence in the work setting.

RESUMO Objetivo: Descrever as vivências do profissional de enfermagem sobre a violência vivenciada em seu trabalho. Material e Método: Estudo qualitativo com desenho etnográfico focado. Os participantes foram selecionados por meio de amostragem não probabilística em bola de neve. Os dados foram coletados por meio de 25 entrevistas telefónicas em profundidade entre janeiro e junho de 2018, em três hospitais em Veracruz, México. O referencial teórico foi o Modelo Interativo de violência no trabalho desenhado por Chappell e Di Martino e a técnica de análise temática foi realizada com apoio do software QUIRKOS. Resultados: Os tópicos foram: causas e tipos de agressão, reação da vítima frente a agressão e o agressor. A maioria eram mulheres (72%), do turno da manhã (52%), dos serviços de emergência e clínica médica (28%). O 68% relatou não ter denunciado a agressão a seus superiores e apontaram o médico como o principal agressor (44%), seguido do familiar do paciente (20%). Conclusão: É imprescindível a implementação de estratégias para evitar a violência no trabalho, bem como a formação de diretrizes a serem seguidas em caso de violência.

"Cesárea? Não, Obrigada!": ativismo em uma comunidade online na busca pelo parto normal no Brasil / "C-section? Thanks, But No Thanks!": activism in an online community in quest for normal childbirth in Brazil / "¿Cesárea? ¡No, Gracias!": activismo en una comunidad en línea en la búsqueda de parto natural en Brasil

Resumo: Este artigo visa a compreender a organização de uma comunidade online cujo objetivo é contribuir para a conquista do parto normal e humanizado entre mulheres de camadas médias. Realizou-se uma netnografia na comunidade Cesárea? Não, Obrigada! na rede social Facebook, cujas participantes são de diferentes partes do país. A análise enfoca a troca de saberes, apoio mútuo entre as participantes sobre o que denominam de processo de "empoderamento" e mudanças na relação médico/paciente. Categorizou-se quatro perfis de participantes: não iniciadas, iniciadas, paciente informada e profissional de saúde. Nas razões das usuárias para a busca de informações online alinham-se interesse pela autonomia de decisão, cuidado e humanização da assistência. A comunidade contribui para esse processo ao organizar, educar e fornecer ferramentas para transformar as participantes em pacientes informadas.

Abstract: The aim of this paper is to comprehend the organisation of an online community which supports middle-class women from different parts of Brazil in the process of achieving humanized care in childbirth. A netnography has been performed in the community C-section? Thanks, But No Thanks! on Facebook. The analysis focuses on knowledge exchange, mutual support among participants on what they call empowerment process and changes in physician-patient relationship. Four profiles have been categorized: uninitiated, initiated, informed patient and healthcare professional. The reasons why users search for online information encompass interest in decision-making autonomy, care and humanization of childbirth. The community contributes to this process as it organizes, educates and provides tools for participants transformation into informed patients.

Resumen: El propósito de este artículo es comprender la organización de una comunidad en línea cuyo objetivo es contribuir a la conquista del parto normal y humanizado entre mujeres de clase media. Se realizó una netnografia en la comunidad ¿Cesárea? ¡No, Gracias! en la red social Facebook, cuyas participantes son de distintas partes de Brasil. El análisis enfoca el intercambio de saberes, apoyo mutuo entre las participantes sobre lo que denominan proceso de "empoderamiento" y cambios en la relación médico-paciente. Se categorizó cuatro perfiles de participantes: no iniciadas, iniciadas, paciente informada y profesional de salud. En las razones de las usuarias para la búsqueda de información en línea se incluye el interés por la autonomía de decisión, cuidado y humanización de la asistencia. La comunidad contribuye a ese proceso al organizar, educar y proporcionar herramientas para convertir a las participantes en pacientes informadas.