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FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 1 1.Introduction Lecture Listed as Course Content Item (i) Questions #1-3 * 3 questions only* Slides 1-9 Introductory to Course/Course Expectations Health Studies could involve many disciplines,including Clinical Health Studies. This would include: • Occupational categories (types of jobs)- medicine,nursing,occupational therapy,pharmacy,veterinary medicine, management and administration • Medical categories and‘basic sciences’:anesthesiology,toxicology,genetics,immunology,microbiology- focused around the body • Clinical specialties:geriatrics,pediatrics,family practice,critical care,mental healthcare -focused around the type of services In this course,Health Studies will be studied across Social Sciences - including social,cultural,political,and economic issues - broad questions : healthcare socially and culturally construct? principles? challenges facing gov & ppl? Using a critical perspective touching on: • challenges conventions,norms,philosophies,theories in policy and practice, • special attention to diversity,difference,rights and social justice • goal:transforming a change where needed • critiques many methods and theories Sub-disciplines allied to health including: - medical sociology,health geography,anthropology,health psychology/economics - in the absence of these sub-disciplines,work is conducted from“parent”social science disciplines: political science,religious studies,social work,sociology Health Studies also draws on a range of interdisciplinary fields:women studies,cultural studies,aboriginal studies, gerontology,labour studies Sociology Perspective:interested in relationships between: • health beliefs and culture • health behaviours and edu. • Health needs and health care • Economic structures and health care services • Political structures and health care services • Technological innovations and health care services • Sub-discipline themes: - Perspective based:Feminist,historical,socioeconomic,sociopolitical - Places based:rural,urban,third world - Issue based:family violence,education,prejudice,and discrimination Health sciences discipline: • public health research • health studies research • nursing research • population health Humanities: • classics • history • philosophy • English- and other languages • Music-and other arts Methods used in Health Studies: Quantitative-statistically:(statistics,number crunching) health records and statistics,census data,surveys Qualitative-“soft methods”:(soft methods) interviews,focus groups,participant observations,document analysis (journals,letters etc) FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 2 BrainTickler Exercise related to Jackson :Article“Key MethodologicalApproaches” Listed as Course Content Item (iii) Question #4 *1 question* For Medical Consideration 1. Five year old child with a cleft palate ($5,000) 2. Teenager (15 years old) with a fatal cancer that has an expensive treatment ($10,000 minimum) 3. An eighty year old farmer requires a hip replacement ($5000) 4. A twenty five year old prostitute needs a liver transplant ($10,000) Text in green is article 5. A middle aged teacher has cataracts on both eyes to be removed ($5000) information from the iClicker votes:teenager,five year old,teacher,farmer,liver patient courseware for better Total Budget:20 thousands understanding! Discussion: desire vs deserving,longevity,seriousness of medical condition,importance based on service output to community Prostitute may have been by profession to support a family and children?Why is she put last? Liver transplant far more important that hip replacement of old farmer! But why did we all vote the farmer before the prostitute? Relating thisTickler to what we learned previous day: We are responsible for the process of decision making: 1. Equity or Moral Relativity:“who gets what,when how” 2. Efficiency /Cost effectiveness: “ getting the most out of a given input”/“ cost vs resulting benefits” 3. Security/Social Capital:“need carries more weight than desire or deservingness” 4. Liberty/Individual vs Collect Rights:Belief of inclusive and collective rights - do the best we can for all people 3.JacksonArticle“Key MethodologicalApproaches Listed as Course Content Item (iii) Questions #5-6 (* 2 questions*) We can identify three important (contemporary) approaches in the social sciences: 1. The Positive Approach (The Structural Functionalist Approach) 2. The InterpretiveApproach (ConflictTheorists) 3. The CriticalApproach (Symbolic Interactionist Perspective) These three approaches make assumptions about science,human behavior and values and their pros/cons 1. The PositiveApproach /Structural Functionalist • Approach used in physical sciences • French scholarsAuguste Comte (1798 -1857) and Emile Durkheim (1858 -1917) were leaders in encouraging positive approaches to understanding social behaviors. • August Compte proposed:societies go through three stages in their development ✓ Theological Stage ✓ Metaphysical Stage ✓ Positive Stage / Structural Functional:where society is organized according to scientific observations & experiments.Comte proposed hierarchy of sciences - social science at the top b/c of complexity. • Emile Durkheim asserted that“sociologists should study social facts” • need to look at social facts objectively {Social facts need to analyzed objectively,and these facts are expressed through patterns} • observe patterns:Durkheim argued that social facts are expressed in society by way of patterns • patterns of regularity can be studied statistically (ie.suicide rates - to understand why a person committed suicide may not help in understanding the pattern of suicide should we find that all canadian provinces males are four times more likely to commit suicide then females) FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 3 Orange Heading: • you are entitled to your own opinion but what are the statisticalNotes taken in class, you methods) * delete if you like! From the Slides: • Sociologists began studying“medicine” around the 1950’s-60 • the dominant paradigm or model was structural functionalist (positivist) • “this perspective viewed society as consisting of a number of social institutions (social structures) that are interdependent and when functioning properly ensure social order and stability • there were five institutions included in the original paradigm/model and we can add a sixth • the original paradigm / model was star shaped – refer to the one presented in class and that you should have noted here • the sixth institution we can add is health care • from an institutions and roles perspective -health and illness can be understood as social roles (e.g.the sick role – Parsons and non medical sick role – others build on Parsons’ work) health concept evolves – illness care,health promotion,lay beliefs,formal care, health behaviors • • discussion of all six elements • discussion of the university as a wee society that reflects this model • now you as a part of the McMaster society have decided on our five patients • what were our thoughts and why? • we addressed the physical condition but did we look at the mental,emotional and psychological aspects directly • did we focus on compliance with medical institution as it dictates and not question Mehnoor Notes continuation from * Dominant paradigm (model) - Beliefs: • that all behavior is naturally determined where each outcome is produced by an external cause • humans are part of the natural world,and therefore their behavior can be studied • nature is orderly and regular- so if an event appears to be‘random’ it reflects our inability to understand natural forces all objective phenomena (nature or human behavior) is knowable • nothing is self evident,which is why we need to prove behavior objectively • • truth is constantly changing,as our knowledge increases • knowledge comes from experience,primarily gained through senses ➡ positivists test theories of human behavior by deriving hypotheses,where research should be value-free (researchers should not incline towards one outcome,but should proceed with the experiment systematically-no favoritism) ➡ Viewed society as consisting of many social institutions (social structures) that are interdependent (dependent on one another) and ensure social order and stability ➡ 5 institutions involved with a 6 addition ❖ original paradigm:model star- family,religion,edu.,politics and economics,with the 6 addition: health ❖ an institutions and roles perspective believes that health and illness can be understood as social roles - Parsons claimed that a sick individual should be exempt from responsibility due to their illness (individuals become sick by chance).He adds on that,an sick individual has rights to exempt themselves from their daily responsibilities.Individuals have a duty to try to get well asap and resume responsibility which requires them to seek medical attention from physicians or medical practitioners Individuals are expected to protect their health-ie flu shots (well informed citizen) - - Medico-centric approach:the physician is in power to define illness (biomedical) where patients only complies ✤ Health concept evolves-illness care,health promotion,lay beliefs,formal care,health behaviors 2)The CriticalApproach/ ConflictTheorists (more justice oriented) • Claims that health and illness are professional constructs that result from power struggles between competing interest groups (Deals with power and conflict) FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 4 One group tries to improve their status at the expense of the less powerful (exploitation) • Researchers feel the need to advocate for social justice on the behalf of those less fortunate • Want to impose moral and ethical absolute-deal with inequities (reason for socialized medicine) • • Conflict theorists want us to be sensitized to the social injustice and the social problems in the world • Conflict theorists want to empower people and to create a more egalitarian society • Conflict theorists would like to impose moral absolutes in order to deal with inequities • Centralized around dealing with justice nationally and globally • Conflict health sociologists question how organized medicine is attained and maintained in its position of dominance in the health care field • Conflict health sociologists question how physicians acquired exclusive rights to diagnose and treat disease, prescribe medication,do surgery,etc-> these rights were made legal by legislation • Medical profession pre-empted competitors such as midwives,homeopaths,chiropractors • Grew out of fashion as the significance of doctors grew • Medical ideology convinced the pop. that they were the ultimate authorities on health as in“you are the doctor” • Doctors accumulate a lot of power within western society-politically well organized • Linked to a medical-industrial complex ➡ The conflict theorists are focused on inequality and conflict loose sight of the prevention aspect of contemporary medical practice (AIDS issue) ➡ Uses quantitative and qualitative data 3)The InterpretiveApproach/ Symbolic Interactionist Perspective,GroundedTheory (policy making) • Symbolic interactionists understand health and illness as interpersonal meanings since people socially construct their reality given their lived experiences and interactions with others • This is a more microscopic look at the individual and their“human agency”-ability to determine their lives, define their situation and define themselves in relation to others • Emphasis on human behavior,and their motives including their thinking and feelings • We look at the vocabulary of motive-what are people saying that tells us how they see themselves and others • How do we influence others and how they influence us (humans are constantly developing) • Role modeling:where the individual is willingly choosing to copy another’s attitudes and behaviors • How do we consult,negotiate order,build consensus in a meaningful way • Collect information via qualitative methods • How did it or how did not apply to our exercise of prioritizing patients FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 5 4.StoneArticle“Excerpts from Policy Paradox Listed as Course Content Item (ii) Question #7 (1 question*) For Consideration:Decision Making,Approach,Paradigms of Understanding and the Social Construction of Reality Decision Making:Stone and others - variables we might consider when making decisions 1. Equity or Moral Relativity - defined as“who gets what,when,how”- we see distribution -“alternate definitions of what is equitable” ‣ This chapter describes issues of distributive conflicts in which EQUITY is the main goal - keep in mind that the conflicts come from the issue of how things are distributed ( distribution in terms of goods and service, wealth and income,health and illness,opportunity and disadvantage) ‣ There are alternate definitions of what is equitable as shown in this example : ‣ YUMMY CAKE - should distribute according to the number of people in class and divide slices equally ‣ challenges of this solution:some will say solution is unfair because... 1. Equal slices but unequal Unfair to people left out of class (decided to skip,would have invitation enrolled had they known cake was going to be served etc.) 2. Unequal slices for unequal Political Science Department ;cake should be shared ranks, but equal slices for equal according to department structure ---> All Undergraduates ranks = crumbs,Graduates= mouthful,Associate profs = wedges Men complain that baking = “ GIRLTHING” -> Female 3. Unequal slices but equal instructors more likely to bring cake,To be fair cake:should blocks be divided in halves for each gender,regardless of the ration of boys to girls.(1/3 males ,2/3 females) 4. Unequal Slice but equal Class attends luncheon,those who ate less of the main meals course should get more desert (bigger slice of cake) to equalize and vice versa 5. Unequal Slices but equal Some students allergic,don’t like chocolate so will have small value to recipients piece to be polite and will give bigger pieces to those who can truly appreciate the cake. 6. Unequal slices but equal Some will say solutions so complicated just give everyone a starting sources fork and blow whistle to start attacking the cake! 7. Unequal slices but equal Could only make a cupcake - draw a name for who gets to statistical chances eat it 8. Unequal slices but equal Student GovernmentActivists will say ,in a democracy the votes only fair way to decided who gets the cupcake is to vote & hold election Lecture Example/Topic of Discussion: American Health Care example - best health care system - average person lives up 78.1 - 17 on the list Canadian Health Care- 5th for spending on healthcare - life expectancy 80.6,6th on the longevity (better than the americans! woot!) Canada - healthcare for all, Americans - the rich pay what they can,preference, Stone found 8 ways: the cake - how we morally share the cake equally between individuals (model of issue of medical care and wellness)Are we doing the best morally relative job in regard to decision towards the health care? - FIRST CONCERN! FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 6 2. Efficiency/Cost Effectiveness simplest definitions of the goal of efficiency include: -“getting the most out of a given input” -“cost vs.resulting benefits” Efficiency is a comparative idea that dominates contemporaryAmerican discourse about public policy. ‣ ‣ Efficient organizations are ones that get things done with minimum waste,duplication and expenditure of resources ‣ Efficient people are one who get a lot dine in a little time ‣ Efficient allocations of resources are ones that yield the most total value for society from existing resources ‣ Efficient choices are ones that result in the largest benefit for the same cost,or the least cost given the benefit. ‣ Basically everyone would like to attain something of value is the least costly way.Conflict arise over three questions : 1. Who gets the benefits and bears the burdens of a policy? 2. How should we measure the values and costs of a policy 3. What mode of organizing human activity is like to yield the most efficient results? Lecture Side Notes input = output - biggest anticipation related to efficiency Innovation at MAC - (example of efficiency) - evidence based medicine ->The OttawaAnkle Rule Security/Social Capital - how do we look at one another in terms of supporting one another for health and well being - need carries more weight than desire or deservingness (people who pay taxes vs people who work underground - should the tax receipt be taken to the doctors office for preference?) what are we doing,how are we doing are we getting what we banged for? should we care for others? 3. Security/Social Capital “need carries more weight than desire or deservingness” Belief of inclusive and collective rights - do the best we can for all people “objective need and objective programs ‣ The conflicts we face over security include:What kind of security should gov. attempt to provide?What needs should it attempt to meet? How will the burdens of making security be collective responsibility and distributed equally? ‣ Just as people are all for equality and efficiency ,most people believe that society should help individual and families when they are in dire need. ‣ But how do we distinguish between needs and desires? Not everything is a need. Objective need + Object programs (policies with certain criteria) = a way of putting programs beyond ‣ political dispute. 4. Liberty/Individual vs Collect Rights “when should community or social purpose trump individual choice” John Stunder what circumstances should public policy ever limit individual privacy and autonomy? ‣ John Stuart Mills believed that deliberation and the exercise of choice are essence of what it means to be human and that therefore gov.should interfere with individual choice as little as possible. Lecture Side Notes: -given the information we have,weather or not this appropriate or not - collective and individual policies - these distinctions are made - bungee jumping - your freedom sign a wavier and go about it - don’t want to wear a seatbelt - consequences if caught /fined (collective) - as a society we have the variable of liberty - collective and individual rights are both taken in to perspective Cartoon - Real LifeAdventures (Wise andAldrich) - What are you doing? - Reply:SearchingAngie’s List for a good,yet chubby cardiologist in our area.I want one that cant give me anyguff about my weight Discussion: - perspective of society - negative towards over weight people - we stigmatize people who may not look healthy - he’s looking for a cardiologist who will do something for him but he’s not looking to change his lifestyle - his individual right his he wants to get better - collective right is there is ONE way,a certain way (socialized medicine) FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 7 5.KleinmanArticles a)“ Health Care Systems as Forms of Social and Symbolic Reality” and b)“The Inner Structure Of Health Care Systems” plusArt Duerksen profile Listed as Course Content Item (iv) and (v) Questions #8-14 (7 questions*) Powerpoint:Kleinman’s FigureThree Discussion:Popular Sector,Professional Sector,and Folk Sector Social Construction of Reality: • Health care systems are socially and culturally connected • Universal health care is part of our social reality as Canadians • Does it play a part in our being one of the best places in the world to live ? • The social reality of universal health care an ingrained value in our society • It becomes our Social reality based on 2 levels: • The external interpersonal environment we are situated in (norms,communication with other norms) • Our own internal intra psychic space Kleinman’s two diagrams Figure #3 on page 8 of the courseware and Figure #2 on page 5 of the courseware become the focus of our discussion • Fig 3:depicts 3 sectors- popular,professional and folk (3 alternatives are not seen as equally viable) Figure #3 :Local Health Care System: Three Sectors - Popular,Professional and Folk 1.Popular Sector: • Largest • Least studied and most poorly understood because previous work was proven to be irrelevant to practical issues in health care • May be subdivided into levels:individual,family,social network,and community beliefs, • Participants are lay persons and non professionals,non specialists • Illness is first defined here and health care activities are initiated here • 70-90% of illnesses episodes managed here • Other choices available:this sector decides whether it will participate in the other 2 sectors:folk and professional practitioners,which are based on cognitive and value orientations of popular culture (popular sector interacts with other sectors) • Popular sector decides if it is going to participate in either of the two sectors Researchers have been slow to examine the popular sector -most widely active and used yet understudied - • Family based health care and self treatment-these are the first agencies of therapeutic intervention • Popular Sector Steps:steps involved when illness is first encountered in a family: 1. perceiving experiencing the symptoms 2. identifying the disease (label and evaluating) 3. sanctioning a specific sick role 4. determining what to do and engaging in specific healthcare -seeking health care 5. applying treatment and therapy from other sectors of the health care system  family needs to interpret the illness by possibly disregarding it as ordinary or they can label the sick individual with their sick role.Once the sick role is established,family can consult peers on illness or move beyond this sector by entering the professional or folk sectors,within which they can choose from a wide range of treatments  preoccupied with health maintenance and not illness  sector is diffused- multiple opinions on what you may have and what you need to do,defining you as a sick member of family • Preoccupied with health maintenance not illness • Perhaps why“sick role” may be quickly referred to or employed –“better stay at home from school for a few days • Folk or professional sectors lay out a different set of beliefs or values in the cognitive structures • The individual does not see these three alternatives as equally viable • sick • self evaluate symptoms and choose to ignore or address their concerns • popular sector can diffuse into any of the other sector,largest sector,most illness originate here. FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 8 Slide Continuations: • The Popular Sector is diffused – multiple opinions on what you might have and what you should do – here you are defined as a sick family member • The Professional sector is the most powerful – it is institutionalized and social power is in large part a function of institutionalization – in the professional sector you are defined as a patient – doctor patient confidentiality • The Folk Sector is where you are referred to as a client - • Special form of care is applied in each of the sectors • Different sectors lead to different languages • Communication across the sectors is a problem • Each sector is like a separate“culture” • Popular culture is concerned with health and health maintenance • patient 2.Professional (Sector of Health Care): most powerful • Organized healing professionals present-doctors • Modern scientific medicine • Also some professional indigenous medicine systems • Friedson describes how allopathic medicine (modern medical profession) gained dominance by restricting other healing traditions,proving that professional organization became a means of social order • Ref to the Flexner report 1910 where by the empowerment was achieved by driving out“non professional” practices • Recent rise of new technology,medical sub specialization and establishment of para-professionals,all of which have been licensed by subsidiary have generated many jobs Increasing clinical responsibilities assumed by nurse practitioners and medical assistants • • Indigenization= the cultural re-patterning of professional clinical care to a greater or lesser degree ie delivery methods • Popularization=certain aspects of professional care (scientific health concepts) are altered and diffused after they enter the popular health sector (washing hands,singing happy birthday) • Professional sector = most powerful & dominant • Research by physicians and public health personnel is systematically limited to problem frames defined by biomedicine,where the solutions fit professionally sanctioned frames and are evaluated from that standpoint • Professional dominance a self fulfilling prophecy – they embrace data/ research which supports their professional orientation • Medical/professional ideology – blind conviction • Professional sector devalues the popular culture and folk culture • Biological aspects first order,psycho,social and cultural aspects second order • Professional sector persons see themselves as experts thus patients (families) ignorant • Dr.s tell,order and the patient listens passively and complies • Failure of the patient to comply with the professional – a moral offense • Consumers begin to speak about a loss of autonomy • The locus of responsibility for health decisions shifts from patients/families to health professionals • Professional insensitivity is systematically fostered in both undergraduate and postgraduate medical education • In reality one needs to look at the“whole” patient – beliefs,values,feelings about illness and treatments • Professional sector is not the“only” or“true” view but one among a range • client 3.FOLK CULTURE (of Healthcare): • Folk medicine shades into 2 other sectors • Folk sector both sacred and secular (in 2 parts) • Sacred=shamen-ritual curing • More practiced • Secular=herbalism,special systems of exercise (yoga) This sector is expanding to the broader health care system • • Efficacy of folk healing presents a problem as no or little follow up research is available to compare the status of patients before or after the treatment • Specialist,non-professional • Mixture of many diff.components,mostly related to popular • Primarily observed in developing societies FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 9 • Sick person :client POWERPOINT B: Kleinman FigureTwo andArt Duerksen Discussion: Health Care Systems as Forms of Social and Symbolic Reality- Case study:Art Duerksen: To understand the paradigm and this particular article,we will look at a specific person and his story that was in the news A 55 year old man,who was not really involved in running and swimming (athletic activities).He paid to join in an ironman triathlon to raise money for charity,but just before Christmas he started experience significant symptoms,some of which included:slurred speech lispy,lose of strength in left side,blurred vision and imbalance. After seeking medical attention,he discovered he had suffered brain damage(main artery blocked,leaked blood), with a second stroke experienced leaving him blind in his right eye.Doctors began mentally preparing Duerksen for a different lifestyle.Through the progression of his treatment,the medications began to make him more ill, restricting his movement.Throughout this period,Duerksen maintained a positive outlook on the situation. Durksen revealed his plans of doing a triathlon to the doctors,who laughed at him in disbelief and gave him instructions to relax.A month late,he walked on a treadmill for 5 minutes very slowly.A few weeks late,we went swimming with a snorkel.He noticed that his symptoms began to fade,where his vision returned-improving his speech,and he completed a half-ironman.He completed his triathlon. A little over a month ago he swam 3.9km, biked 180km,ran 26km in 14hours and 33 minutes. Paradigm:  The way we decide to incorporate folk,popular and professional options in our lives as we effect our well being  Every person differs in their conscious understanding and acceptance of social norms,which affects the degree to which we choose to follow these norms through practice  The distinctiveness of each person determine the ability of each one of us to make decisions about our illness and actions/measures we should take (and what we might do about it) Social reality is made of the way we,our families,our practitioners view the illness and how they respond to  it.(how we think about our illness,how our families /practitioners respond to us and our illness) Kleiman distinguishes between two aspects of social reality:  1. The social cultural world is social reality per say 2. The link between the Social cultural world and the psychological,biological and physical reality is called symbolic reality Symbolic Reality: Symbolic reality tries to understand the inner experience - Shapes personal identity in compliance with social cultural norms - Influence psychological processes (ie:attention,consciousness,perception,memory and motivation) - Unclear link between social environment and psychological process (inner experience -flip the switch) This introduces the need to speak toAlternativeTherapies such a touch,music,art,imagery,religious/spiritual etc. How do they relate? FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 10 6.Women healers and Patients (Lecture) Listed as Course Content Item (vi) * no article for this! Questions #15-18 (4 questions*) Women Healers & Patients • Health and health care position of leadership • Both in Europe andWestern society,women the original“healers” or“doctors” • Men exercise a well thought out plan to to suppress women healers • Men wanted to be the dominant professionals in the health care field’ • Executed an“active takeover” NOTE:the text in green is made based on the LECTURE • Mens dream in why they initiated the takeover: Men saw it as a professionalism,prestige,power,profit - advantageous position • The dream of the women healers - to help people,share their knowledge with other women (no formal institute of health care),the more women knew the healthier the society - encouraged them to share the information. Women saw medicine has“labour of love” - benefit others not for profit,not for prestige,just to make others well • MotherTeresa - example of women of the above category (women healers).Someone of Nobility - Princess Diana - a more recent example of someone who reached out to the aids patients.(raised a lot of money) (women healers) • Is this gender specific? No ...we sawTommy Douglas • Women healers had great respect in the way they could make you well - middle ages - documentation and recognition of health providers.14th hundreds to 16th hundred is when these men come with the manipulative dream and figure how to take over the care giving profession • The men used people in political positions,religious clergy and they worked in tantrum to secure health care for themselves - to prove they are better or the women are unworthy of care givers - refer to women as “contaminated” - dirty,tricky,voodoo - destabilized the image bringing on the stream ofWITCH CRAZE! If you are a women practicing the care giving with herbs and what not then you are aWITCH Why did this happen? - Men’s dream of controlling“healing” (medicine) and related institutional organizations - Men’s view and women’s views differ regarding health and health care – extrinsic vs.intrinsic Subservience ofWomen - Historically women healers formally recognized as early as 476A.D.– 1450A.D. So what happened next? • 1300’s -1600’s men initiated and carried out the manipulated suppression of women healers • Ruling class:both political and religious elements create an aura of contamination around women – better known as the“witch craze” • Women healers seen as a threat: • Politically • Religiously • Sexually/(sexism) NOTE:the text in green is made based on the LECTURE ‣ Politically women healers are an element that makes the people in power shudder ‣ They have a record of all the people that have trusted them ‣ Feared that women would rise with the poor peasant class against the rich class ‣ Politically,women healers were items that frightened the people in power ‣ Religious order of that time established that what men said was stone hard,and always went. Women healers dared to experiment (what worked- what didn't work) ,dared to question (herbs),go above and beyond put the religious heads at feeling threatened for going over. Religious leaders :your sick because you sinned Women healers:there is a cure! ‣ ‣ Women leaders were a threat to the religious leaders FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 11 ‣ Sexuality & Sexism:women were not seen as equals,assigned a“second class” status,the women healers would not stay within the box - were confident individuals that didn't always do what the church told them to do - this did not fit well ‣ woman healers were so confident that societies remarks about not meeting the norm expectations did not stop them from continuing to what they were doing - in retaliation - the church labels these women as“female aggressive” - labelled as“bad girls - miss using magical powers! -” when women think alone they think evil!” - this ignited the witch craze - result -> many women killed (burned under the pretense that they were witched) TheWitch Craze • calculated ruling class campaign of terror Western Society and the Displacement ofWomen Healers • New Jersey experience: Majority of healers were woman healers and were referred as“ socialized medicine” : by1818 - benefit of ‣ all - once men realized that this could be put into a profitable situation for them,they systematically destroyed the woman healers system ‣ Men start initiating the mentality that the women healers were helpers of a lower level - this pointing towards the female nurses and doctors.Healing men were often“killing” more people than helping - women healers were leagues ahead of them in terms of healing practices - these women were using herbs - out in nature remedies to help cure and make people feel better ‣ These amateur men were trying to establish them over women - they really want this profession - what do they do?They build a strong association with the american market - how systematically was the market takeover? Male healers cozy up to the upper class people who have legislative leverage - in 1830 ,13 states in the US had passed the medical practicing law outlawing women to practice without formal education (irregular practices) - immediately women healers are differentiated by healers - regular doctors (mostly men) - seen as the only legal healers in the 13 states • People’s medicine and women healers • Rise of the regular doctor • Medical methods of male“regular doctors” and“irregular female healers” • Role of the risingAmerican business establishment – the Foundations ‣ Do women put up with this? NO!The popular health movement lead by women healers and work sector.the regular doctors came up with a countermovement putting together the first national club“american medical association” circling around themselves,regulating membership keeping women out.They let a few women like (Elizabeth Blackwell - not as good as women healers) in the club just so people who knew women healers could not support healers in any further complaint of being isolated and secluded purposely.ElizabethTaylor was no good either,she goes out and says midwifery and what not is also irregular! SoWhat Happened Next? • 1830 – Licensing Laws • The opposition of the Popular Health Movement • Counter movement of the“regular doctors” • Foundations conditions for funding • Abraham Flexner and the 1910 report ‣ 6/8 black medical schools closed ‣ Medicine in United States at the turn of 19 - 20th century a white middle -upper class profession.There were women who continued their services of midwifery to poor,and in healing and grouped together to forming a professional service (charging) ‣ Men described these women as “ignorant,incompetent” ‣ Cree women build a pile of fresh moss - stands over it,a cree women behind and in front of her gradually pressing their hands down pushing the baby gently working with gravity - MEN were the ones who got pregnant women to lie down in labour - when the other method works smoothly or has been! ‣ Partnership of church and regular doctors - from the 5th century to 13th century - the church actually stood in the way of development of medicine - church believed it had control over peoples bodys and souls ‣ Arabs moved ahead in the production of mathematics,musics and medicine • Medicine becomes a white male middle and upper class profession • Last holdouts were the midwives FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 12 • The church in partnership with the“regular doctors” • 5 – 13 century anti medical stance • 13 century revival of learning medicine • Church sets Catholic Doctrine as guideline to practicing medicine • “Regular doctors” and clergy work together:to share mind body spirit health of the individual,doctors didn't work without the permission of the Church - tooth ache prescribed medicine - writing on the jaw patient on part of the clergy who is working with the Doctor in the name of Father,the Son -Amen.And then doctor touch the needle to the patients tooth! Control Mechanisms to Subjugate women to the Role of Patient - Theories and Myths: 1. The Conservation of EnergyTheory 2. Myth of Female Frailty - Women disqualified as healers and made highly qualified as patients ‣ Men had to work hard at discredited the female healers:so that the man have the power and authority of medicine ‣Conservation of EnergyTheory:individuals have a set quantity of energy directing the energy from one organ to another - developing one organ at the expense of another.Women's primary purpose: reproduction.If women focus on intellectual purpose at the expense of reproduction organs. ‣CofET creates stereotypes,myths and stigmatizes women making medicine males only ‣Women who believe they can have children and can study or join the professional sector seen as “UNRULY” - problems attributed to reproductive organs ‣There is a myth attributed to the psychology ovaries that some women that are to upidy or aggressive or assertive when it comes to their reproductive organs - you remove their organs and will make women orderly,cleanly -THIS ISA MYTH ‣Women to sexual?They preforms female genital mutalation so women cant feel any pleasure in sex “quieting” them down. We see this today,if a female is grumpy ,putting her foot down we all say“she's on her period,she’s ‣ pmsing” If a man gets assertive,grouchy - we say he’s strong,he’s hungry,macho, 7.Davis-FloydArticle“Gender and Ritual” Listed as Course Content Item (vii) Questions #19-24 (5 questions*) Davis Floyd- Gender Ritual • The way society treats pregnancy and childbirth,reveals the way society treats women • Major life transitions are ritualized - Childbirth being one of them • This occurs in a social cultural context • The method of labor is standardized in the U.S.,where most women are hooked to an electronic fetal monitor,an IV,given pain-relieving drugs,receive an episiotomy (widening of vagina)- all of which is done while the mother is lying on her back. In low technological cultures:birth is given in sitting or squatting position with the help of experienced • midwives • The deepest belief in modernized societies centre around science,technology,patriarchy (male dominance), and institutions that control and distribute them- it is believed that this is the best method-> hospital procedures are the best* • Sexist gender lens:these procedures tell western women (in visible and in invisible ways) that their bodies are defective machines of giving birth without the assistance of these male machines • Ritual:is a patterned,repetitive and symbolic enactment of a cultural belief or value,where the intention is to align the belief system of individual with society’s. • Rituals transform societies perception of individual and individuals perception of themselves • a rite of passage is a series of rituals that move individuals from one social stage to another (ex:girlhood-> womanhood) • Rites of passage transform societies perception of individuals and the individual’s perception of themselves • Rite passage consist of 3 stages (Ritual Stages): • separation:of individual from their previous social state (ex:when woman discovers she is pregnant) FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 13 • transition:an intermediary state,where the individual is not the preceding thing or the following state (they are neither one thing or the other) (duration of pregnancy till several days after childbirth) • integration:individual is absorbed into a new social stage (woman becomes a mother and takes up a new lifestyle) • Cognitive restructuring of ritual is the process of childbirth that is transformed to a cultural rite of passage allowing society to ensure its basic values are transmitted to 3 new members (the new baby,woman who enters her new social role of a mother,and the man is reborn as a father).The greatest responsibility is upon the mother,who is responsible for teaching her children- the bearer of society’s values tomorrow • the symbolic message is felt through the body - this cultural rite of passage is most noticeably to cement or build the male-controlled (patriarchal) status quo - characteristic of ritual - symbolism: routine obstetric procedures are mainly symbolic o symbol:an object,idea or action with cultural significance,which are decoded by the right side of the brain o symbol’s message is felt through body and emotions o ex:the hospital is an alien territory,made of brick,cement,cold and where no personal authority rules.In this environment,the wheelchair sends a symbolic message that you are disabled,a bed symbolized you are sick,intravenous drips are umbilical cords to the hospital (making the woman dependant on the hospital for life denoting that we are all dependent on institutions for life) o even thought the mother is the real giver of life,where society and institutions cannot exist without her,the hospital/institution/patriarchal group is shown to be the giver of life Routine Obstetric ProceduresAre Highly Symbolic • Hospital,alien territory,brick,cement,cold,no personal authority here,wheel chair a symbolic message you are disabled or not well,bed a symbol you are sick,intravenous drip is symbolic of biomedical model = umbilical cord to hospital • Now the hospital,the institution,the patriarchal edifice is the life giving force and not the mother Cognitive Matrix Ritual not arbitrary,they transmit a belief system into emotions,minds and bodies,lead to a profound • understanding of a belief system The hospital sets a technocratic model of reality which forms the philosophical bases for biomedicine and • Western society • Technocratic Paradigm = the model of reality forms the philosophical basis of bothWestern bio-medicine and Western society • Technology is a hierarchical bureaucratic society driven by an ideology technological progress • It is believed that nature is being improved upon by controlling it through technology • Philosophically,it is assumed that 1) the universe is mechanistic,2) follows predictable laws,3) one can discover this through science and manipulate it through technology • The model sees the body as a machine with a body mind and soul separation – the body is left to scientific investigation • Dominant religious belief in early times was that women were inferior ,their bodies defective • Males the prototype of normal and led to their rise as obstetricians,they mechanized obstetrics with tools and technology to manipulate and improve the inherently defective mothers • Mechanization of obstetrics = assembly line,production of goods (baby),mother’s body a birthing machine, doctors to meet production and quality control,hospital a technocratic factory,mother secondary,For doctors and nurses convenience is the consideration • Repetition and redundancy = need to reinforce the dependency of the labouring woman,the“ritual” is repeated in different forms, gown,ID bracelet,IV line an umbilical cord (life line) to managing hospital sustaining her,electronic monitoring,frequent manual examinations by other professionals, administration of drugs • Cognitive reduction = this lower level of thinking encouraged where mothers are concerned do not allow her to consider other options or considerations with regard to her birthing process • Four techniques employed to achieve cognitive reduction = 1) repetition,2) hazing,3) strange making,4) symbolic inversion FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 14 • Cognitive Stabilization = the“ritual” mediates between cognition and chaos,the ritual restores order to the world,mothers generally satisfied with the outcome,ritual in a frame of inevitability,locked into a set of cosmic“gears,” a correct performance of a now standardized procedure,compliance and confidence on part of mother,intervention expected • CognitiveTransformation = symbolic message fused with the individuals emotion and belief,aligning rituals with desired perceptions of the patient,map the technocratic model of birth on to the mother,mother subordinate to all • Affectivity and Intensification = Rituals are emotionally charged and ensure long term learning Preservation of the status quo = perpetuates the power structure,legitimizes the doctors position,legitimizes • cultural privilege of patriarchy (doctor are boss) • Positions dictate power relationship = woman laying down,doctor standing up,delivery is toward doctor 8.Dr.Raz (Lecture) Listed as Course Content Item (vii) Questions #25-27 (3 questions**) This section is a continuation of the Davis - Floyd/ Gender Ritual & Birth | Dr.Raz Moda/ Strategies and Solutions Powerpoint SLIDE 10 • Episiotomies and caesarian sections serve both to legitimize and to raise the status of obstetrics as a profession by ensuring that childbirth is not a natural but a surgical procedure • Effecting Social Change = women are empowered by their personally directing their child’s birth • Alternative Paradigms = a holistic model,home births,other practical and healthy ways to give birth • The discussion of the situation in B.C.with Dr.Raz Moda = DreamTeamApproach to Birthing • Choices = deliveries 1/3 by midwives,1/3 by doctors,1/3 by obstetrics/ gynecologist specialist ‣Doctor are the individuals that are making the important decisions about the child,about the machinery. ‣Both the mother and father will recognize that the specialist is the boss,has al-mighty power ‣Doctors take all the decisions (have the power/authority) - tell you if you will do a natural birth or C-section where you are cut up and stitched up - don't really ask if your comfortable with it,just make the decision Gone from the a natural process to a surgical procedure - practice of using technology in birth process ‣ ‣Some women deliver babies at home - rejection of this method by specialist ‣alternative models of birthing - home birth - social context - suppose to make it much more comfortable & less hectic - what happens in case of complications?can midwife handle it? what is the solution? ‣ SLIDE 11 • Dream team does not compete for clients/patients,work in co-operation and respect,specialist called in only if there are complications • Normalization is the goal of the Dream team,mother is listened to and she has input,may ask for a birthing tub,relationship between all is to be fluid and respectful,a consensus of approach is nurtured,a comfortable relationship between the mother and the delivery entourage,deconstruction of patriarchal practice ‣Dr.Raz Moda wants to normalize the birthing process - normalize it for the mother He believes it has to be cooperative,and well defined in terms of a process and that all participants,health care ‣ professions,mother,father and child are suppose to help facilitate this ‣This process is referred to as the dream team for women:this practice is practiced in a way beneficial to society ‣historical recap:midwives stigmatized, look around the world,mid wives are still alive and well - 7/10 births in UK,9/10 in Netherlands.Canada:midwifery is being reintroduced ‣In Dr.Raz’s hospital in BC deliveries are turn 1/3 each by midwives,doctors and specialist - do not compete for patient,they work together - specialist only called if complication,the midwife is the first person to help the mother if bought upon request.If the midwife feels if something might arise,the doctor who has following the women's health and well being for 9 months is called in ‣mother and midwife come to hospital together;birth place selectable - birthing tub,chair - idea is to make it as homely as possible ‣here in the hospital they try to make it as homely as possible FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 15 ‣Toronto Mount Sinai Hospital - 80% deliveries - specialist ,20% = midwives +doctors ‣Dr.Raz questions :how much is this costing the medical system and is the obstetric.gyne specialist really necessary - He really doesn’t think so ‣His rational:we have first world problems,we just want bigger and better all the time ‣Dr.Raz goes to Zimbabwee ,senior doctor only doctor for 250 people,division of tasks,Raz in charge of all deliveries,Raz learns for midwife to do C-section systematically in a 3rd world country - learned a lot from midwives and brings the same approach to BC - sharing information between doctors,midwives ‣Dr.Raz says back up in the hospital if things gone wrong in addition normalized birth 9.Armstrong andArmstrongArticle“Contradictions at work:” Listed as Course Content Item (viii) Questions #28-31 (4 questions**) Armstrong andArmstrong (2 Canadian researchers) Contradictions at work: • CMA (Canadian medical association)established (mid 1800’s with monopoly),state support for admission, acquisition,autonomous practice,regulation • Male dominated medical profession Nuns and other women defined as unskilled workers-> they are pushed to a secondary status • Women do not rebel • Florence Nightingale reassures nurses that“graduate in late 1800s-handmaidens to doctors,expectation” • Doctors shed unwanted jobs to nurses (who are seeking for responsibilities) • WW2 expanded the need for health care in Canada • During 1960’s,Sask initiated new thought about health care=results in universal health care with provincial and federal government taking responsibility • Nursing expands and attempt to unionize as they were trying to raise their significance • Nurses repeatedly try to gain recognition,and are viewed threatening by doctors.To decrease the competition doctors place restrictions on them. • Women could only be nurses if they were unmarried,because family was her primary obligation-> many nurses were single as they sacrificed marriage to establish a career • Medial work (inexpensive work) is pushed onto nurses • Doctors are mainly white,upper-class males,while nurses are middle or working class white females while workers (below nurses) are minority groups or recent immigrant groups • Nurses are trying to improve their status • Short term stay of patients in hospitals to cut costs in hospitals with the goal of efficiency (nurse practitioners begin to prescribe some drugs,and pharmacists can renew prescriptions,to avoid time waste and money) • Rising costs for doctors and nurses= necessities shedding aspects of their jobs to others to save money= new workers on board (dieticians,housekeepers,homecare workers,clerical workers,laundresses) • The ancillary labour is racialized,immigrants,vulnerable • Doctors continue to gain power and control,protecting patients from unskilled workers as they as the only ones qualified as physicians • Nurses try to care out a skills area and improve their statues • Due to cuts doctors are forced to accommodate their practices to scarce resources,held accountable for decisions as management protocols set down for all to follow • Evidence Based Medicine developed at McMaster University hospital to improve care and save money i.e. OttawaAnkle rule • Evidence based medicine uses rigorous evaluation of evidence to develop and practice guidelines and protocols as well as performance indicators that would allow doctors to make informed decisions for specific patients • New protocols reduce the power of individual doctors and transfers some nurses to lower paid jobs • Nurses suffer in the management re-evaluation • Nurses are shifted to become a part of the part time casual labour • Nurses had failed to recognize that the superiority of doctors came from their class and gender more so than their science degree FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 16 • There are many obstacles between nurses to be degreed for greater status recognition because education takes time and money- which becomes more difficult to obtain a profession especially after they become wives and mothers • Nurses may become temporary works,as they are mainly seen as homecare providers • Social construction of health determined by gender,class,race • Health care now to promote health and disease prevetion • Myths and stereotypes persist from earlier times to allow governments to shift work from paid employees to unpaid mainly females workers at home and health care workers with altruism with in the paid sector • Response = Ontario health coalition’s grass roots movement mobilized through city hall assemblies and popular referenda in communities right across Ontario-to protest the exploitation and manipulation of nurses and ancillary workers • Technology increases precision when it comes to health care but restricts independent judgement of doctors and decreases care 10.Boddy Article“……Trance and Possession Disorder” WardArticle“Excerpts from aWorld Full ofWomen” Listed as Course Content Item (ix) and (x) Questions #32-38 (7 questions*) DSM by Boddy Powerpoint: SLIDE 1:Diagnostic and Statistical Manual of Mental Disorders ( J.Boddy) • DSM – defines what is considered normal and what is not – Certain smells are idiomatic of spirit intrusion (spirits despise some smells and are attracted by others bringing wrath and attachment respectively) • DSM states that in many societies trance and possession trance are integral parts of everyday life,considered normal and/or expected within culturally specific contexts,yet not confined to communal or ritual events • Possession take total command over ones life,it is a learned behavior - whose manifestation is bound by implicit rules • Lends self knowledge,self confidence -The Haitians attribute the growth of self-knowledge and self confidence in various endeavors (goals) as influenced by the presences of certain spirits,Iwa. • Possession by a male spirit who is now in control of the woman’s body,speaks about her with her husband “man to man” dispensing advise and imparting information that would otherwise impossible for them to discuss • Requires an analysis of power relations,usually imbedded in relations of gender,age,rage & economic advantage • Questions about possession and the trance,seen as“disorders” - disorders to whom? who decides that the trance or possession trance is dysfunctional? - to answer these we need to look at power relations SLIDE 2 • Trance to be authorized as a normal part of the collective cultural or religious practice,to normalize its presence,it has to be authorized,could well be dealing with a subtle compartmentalization of self:the protesting and resistance self versus the compliant self • Religious,economic cultural and political reasons not to authorize,leaves issues important to women unaddressed • Possessions can be considered a highly creative and politically informed response = quite normal World,Women byWard Powerpoint: SLIDE 1 • Possession cults are a means for women to seek health • Represents the subjective life of the individual/inner self • Possession is a form of communication,speaks to the psychological,social,biological realities • Reflects anxiety,conflict,illness and recovery • Self advocacy for wellness,self assertion,realignment • Theoretically a vehicle for • 1) powerless women, FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 17 • 2) cults of affliction ( women who feel their aspirations and intelligence are not being met or utilized - In these cults of affliction women find release from and alternatives to male dominated societies and husband dominated marriages. • 3) a connection to the motherline and others for support as the dramatization of conflicts are presented given the possessions • A therapy,an expressive and aesthetic form,ritual dramatization of conflicts • The cults are ways in which powerless people (predominantly women) work out their anger of and fears about more powerful people - people afflicted by spirits receive extra attention + sympathy. • Women become adept (experts) in trances or possession states - by calling on their female ancestors to help them conceive or carry a living baby to term. • Why are women so strongly associated with possession states?Why is it so frequent and spontaneous? - If men and babies can enter of inhabit women’s bodies - then spirits can to! • Susan Sered says“ Could it be that possession trance is normal and healthy part of human experience,but men have trouble with it because they have a problem with relations?” SLIDE 2 • Korean housewives feel suffocated under domestic role leading to what we call a nervous breakdown,cycles of these breakdowns label the person from being“ill” to “caught by the descending spirits” or Shaman (a pyschic healer) • Becoming possessed = becoming a Shaman,is empowering,it neutralizes the negative situations((abussive husband,cruel MIL) that provoke the breakdown -As a Shaman women were getting income,independence and a new status as“healers” • Zar therapy works by convincing the woman to recognize her dissociated feelings as separate from herself in the first place -A women is not infertile,but merely the spirits have seen fit to unsurp her capacities • Western psychotherapy – patient to accept and integrate previously dissociated feelings as part of herself – take ownership and work through it • Important to note that it is not about a male conspiracy or dominance,the central problem is the over- socialization of women,the over-determination of women,women have a moral self image more narrow than their life experience of life offers them i.e.onerous codes of modesty,chastity • Being possessed is not a cure;it doesn't make a women fertile,pregnant or reunited with lost loved ones.But it may give her a life,an identify,and explanation and a healing validation beyond that SLIDE 3: • Possession tries to liberate women and demand they treat themselves • Possession = cultural resistance • All points to a variety and resiliency of women’s healing work within the establishment • Gives women a life,an identity,an explanation and a healing validation 11.Andrew et al.Celebrity Places,Sites and Settings (Lecture) Listed as Course Content Item (xi) Questions #39-42 (4 questions*) POWERPOINT:Music andWellness: Celebrity Places,Sites,and Settings • Places,meanings,and identities shape over time,which may also include the shaping of health care institutions (ie.Betty Ford Clinic) How musical celebrities factor into health and wellbeing?: • - Celebrities promote the health of individuals,populations and places - Celebrities can address issues of poverty,clean water and disease - Convey personal,population and global messages • Music can affect emotional well-being (music as well as art,poetry literature,touch religion can also achieve this) Music and It’s Interrelated Strands FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 18 • Music can be political (speak social justice or civil rights) • Music can integrated into the lives of people emotionally and geographically (ie.engagement place and song playing) • Music may define designs of cities which affects how music is produced and marketed Music may define how urban subcultures interrelate and identify within city spaces • • Music may be popular enough to become a movement! Globalization of Music andWellbeing: • Music became transcultural • Music (deteriorates?) place and identity • Music reflects traditions of dominant nations • There is a consideration that there is an emotional internalization of music by listeners • Music creates a soundscape- an atmosphere and environment where the individual is mentally occupied within “the moment” Music helps people to move on from current situations by making them feel better • MusicTherapy • The good (pro): - Music can decrease depression,stress,pain,blood pressure,increase confidence,attention and relaxation • The bad (con) - Music can be associated with poor health - There has been a relationship between music and drug use,urban violence,and negative self perception even Bono & U2:PossessionTrance?Andres et al.2010 • Bono was the lead singer of U2 (band) • Advocates (promotes) for health,welfare and justice by offering an idealism and optimism • Socially and politically aware • Rebellious and defiant • Spoke about the physical,emotional and social consequences of military conflict • Comments on displacement resulting from conflict • Presented politically inspired works/anthems/songs about inspirational people like Martin Luther King • Spoke to political stances about violence and neglect • Sang about capitalism in urban spaces • Raised concern for the information age,new technology,and emerging Europe Sang about the peace process in Northern Ireland • • Articulated a stance on living fast and self neglect • Presented songs of feeling,journeying • Took a stance against poverty • Stated that one should not die alone • Presented music about personal development,attachment and pilgrimage • Recap:Bono possessed firm religious beliefs which were underpinned in U2’s social and health activism,but however has not been a spokeperson for a specific religion.Their music related to faith,hope,love,peace in midst world of doubt,despair,and violence.He emphasized the coexistence of religion and transcendence.As well as,recognized a need for harmony and humanitarianism.He also mentions commitment to social justice by assisting others. Celebrity Diplomacy and Politics: • Goal:to raise awareness of health inequities (FarmAid,BandAid,LiveAid) by encouraging fund raising and organizing boycotts. • Influenced funding for health related initiatives (product red- products and credit cards contributed money to global fund for foreign aid fightingAIDS,TB,and malaria - Developed (debt,aids,trade,Africa) Results: • Generated over $400 million for debt relief in the developing world • Saved 5 million lives in 8 yrs • Created an internationalAIDs program FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 19 • Doubled the non-loan international financial assistance toAfrica The health messages in songs included: • Health geography:focusing on the opportunity for health and access to health care (speaks to location and distance) on macro scale • References made to individuals and settings (engaging with the personal situations and feelings and sense of place) on micro scale Medicinal Music-Rosalie Rebollo 2004 • Wellbeing can result from the consumption of music • Lyrics can take on many meanings given our personal interpretations • Soundscapes are as complex as the human mind is perceived to be • Music therapy treatment for brain injuries,which was purposed to re-stimulate basic communication abilities • Musical interventions used to reach patients in comatose state (coma) • Children who have attention deficit disorder and receive neurofeedback training reduces behaviors linked to inattentiveness • Biofeedback and music can affect heart rate,bp,and stress hormone production • Music therapy is used in pain management and stress reduction Music can lead to higher patient empathy • • Music played throughout the postanesthesia stage can positively affect the pain experience and improve the comfort level during surgery • Music also was used to reduce postoperative pain in abdominal surgery • Rhythmic auditory cues can cause walk-like performance in patients who have suffered a stroke (Musculoskeletal injuries) • Music therapy soothes premature infants,promotes language development,and enhances neurological maturation in at-risk babies • Infinite motivations,forms,possibilities • Music promotes emotional wellbeing,in everyday lives - possible collective sense of healing Controversy Mixes music and politics • • Oversimplifies the issue,when in reality it is more complex • Unable to understand complex issues • Provides a short term solution only 12.KinselyArticle“Healing in Contemporary NorthAmerican Christianity” Listed as Course Content Item (xii) Questions #43-47 (5 questions*) Healing andTouch • KinselyArticle -Thoughts and perspectives • Religious stance – God heals or teaches one something they need to learn via their illness • Healing is something that needs to be awaken or cultivated within us – a kind of acceptance of God’s will and our need to deal with it • So in a general sense how might this translate in our lives? Theological stance – religious framework to understand illness and how it fits a larger biological or social • pattern • How it helps us find healing and combat fear and anxiety • To be understood that illness has a purpose or significance – illness leads to the potential possibility of healing thus acknowledging a divine purpose RelatedTheologicalAssertions • Christianity relates illness to human beings sinfulness,sinful nature or to specific thoughts or actions = sin causes illness directly,cause or effect way,or is a punishment from God i.e.original sin • Patterns of sin suggest that we are not being disciplined enough to be in tune with or hear God • So individuals are expected to take responsibility for illness – thought is they brought it upon themselves FINAL EXAM REVIEW NOTES Reda Siddiqui & Noor Meh 20 • Can we think of an example to challenge this assumption? AnotherAssertion • Healing is admitting one’s sin – healing is renewal • The illness is Satan or evil spirits seeking to undermine the human commitment to God • This assertion disassociates God from the sickness and relieves the individual of the blame for their illness • THE PERSON ISAVICTIM • The assertion is that the individual can avoid being victimized by joining a prayer group or healing group Group structures and Practices: Small Healing Groups • Private settings • Low key • Lay people who do not claim healing power • Democratization
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