Esta pesquisa tem por objetivo estudar o processo de medicalização e patologização da educação através de entrevistas com psicólogos da rede pública de saúde e coordenadores pedagógicos de escolas públicas focalizando a intervenção desses profissionais nas dificuldades apresentadas no processo ensino-aprendizagem. Medicalização e Patologização entendidas como um processo ideológico que transforma problemas sociais em doenças de indivíduos. Trabalhamos com a região norte do município de São Paulo. Os psicólogos entrevistados atuam em Unidades Básicas de Saúde e os coordenadores pedagógicos em escolas públicas de ensino infantil, fundamental e médio. O método utilizado foi o qualitativo, sendo as entrevistas conduzidas de acordo com o preconizado por José Bleger. A análise desenvolvida utiliza o referencial teórico de Grupos Operativos, tal qual formulado por Enrique Pichon-Rivière. Os resultados apresentados desvelam as dificuldades enfrentadas pelos profissionais no cotidiano de trabalho, principalmente no que tange à estrutura e dinâmica institucional e à formação acadêmica. Como consequência identificam-se processos de medicalização e patologização da educação. Aponta-se para a necessidade de revisão das políticas públicas e melhor instrumentalização teórica e técnica dos profissionais. Indica existir um pacto denegativo entre as instituições que garante a preservação da ordem estabelecida, evitando a crise que toda mudança carrega e, com isso, impedindo a transformação / This research aims to study the process of medicalization and pathologizing of education through interviews with psychologists in public health and coordinators of public schools focusing on the intervention of such professionals in the difficulties encountered in the teaching-learning process. Medicalization and pathologizing understood as an ideological process that transforms social problems in diseases of individuals. We work with the north region of the city of São Paulo. Psychologists interviewed worked in Basic Health Units and coordinators in public schools kindergarten, elementary and secondary. The method used was qualitative interviews were conducted in accordance with the recommendations by José Bleger. The analysis uses the theoretical Operational Group, as it formulated by Enrique Pichon-Rivière. The results presented reveal the difficulties faced by professionals in daily work, especially with regard to the structure and dynamics of institutional and academic. Consequently it identifies processes medicalization and pathologizing of education. Points to the need for revision of public policies and better exploitation of theoretical and technical professionals. Indicates there is a pact between denegativo institutions that guarantees the preservation of the established order, avoiding the crisis that all change loads and thereby preventing the transformation

Orientador: Gustavo Tenório Cunha / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T05:54:05Z (GMT). No. of bitstreams: 1 Cardoso_RaquelVaz_M.pdf: 1911463 bytes, checksum: e8a59f3e73bfbaa288183dfb27d6b863 (MD5) Previous issue date: 2014 / Resumo: A medicalização é um processo social surgido com o advento da medicina moderna e que hoje encontra-se profundamente arraigado nas concepções e práticas de saúdedoença em todo o mundo, bem como em todos os níveis de atenção à saúde. Ela é um fenômeno complexo e possui múltiplos sentidos, sendo exploradas, neste estudo, a sua característica polissêmica e a sua rede de coprodução no âmbito da atenção primária à saúde. Foi realizado estudo qualitativo por meio de revisão narrativa da literatura e de um estudo de caso, para o qual foi utilizada a estratégia de observação participante (agregando técnicas de entrevistas e grupos de discussão na coleta de dados). Objetivou-se, com esta pesquisa, encontrar elementos que deem visibilidade ao processo de Medicalização, às práticas na Estratégia de Saúde da Família consoantes com este processo e, portanto: verificar aspectos do processo de trabalho da equipe de saúde da família, do contexto local das práticas clínicas e de gestão, bem como das diretrizes da Estratégia de Saúde da Família, que possam ser considerados como fatores contribuintes, efeitos ou mesmo expressões de práticas de saúde medicalizantes; analisar as divergências e as aproximações entre o cuidado produtor de saúde e autonomia e as práticas geradoras de heteronomia e iatrogenia no âmbito da atenção primária. Os resultados deste estudo estão apresentados em quatro capítulos. No primeiro, é realizado um relato da implicação da pesquisadora com o tema e de como se construiu esta questão de pesquisa. No segundo capítulo, é conceituada a medicalização, apresentando sua polissemia e complexidade, bem como são discutidos os seus efeitos, as iatrogenias. No terceiro, aborda-se como a organização da Atenção Primária à Saúde e da Estratégia de Saúde da Família pode favorecer ou dificultar o processo de medicalização, além de algumas estratégias que propõem um enfrentamento deste. Por fim, no quarto capítulo, apresenta-se a metodologia do estudo de caso, é delimitado o trabalho de campo, bem como são discutidos os resultados deste. Com este estudo, pode-se observar que a medicalização é um fenômeno universal - porém com manifestações muito singulares que necessitam de contextualização - sobre o qual seria possível apontar algumas características em comum, entre elas as decorrentes do modelo biomédico como orientador do saber-fazer hegemônico em saúde, o reducionismo biológico, a cientificização da experiência humana, o conhecimento ancorado em abstrações universalizantes acerca do processo saúde-doença e a prevalência da heteronomia nas relações profissional-usuário e sistema de saúde-usuário. A medicalização foi observada nas práticas da equipe de saúde da família, perpassando todos os núcleos profissionais e as diferentes ações de saúde, sejam práticas preventivas ou curativas, de vigilância, educação em saúde, administrativas ou clínico-assistenciais. Foram identificados como importantes atores e fatores neste processo: os profissionais e usuários do serviço, a gestão e a organização locais e da rede de saúde, a mídia, o contexto político-econômico municipal. O estudo deste fenômeno, suas particularidades e rede de determinações, pode fornecer subsídios para a reorientação das políticas sociais e de saúde e das práticas e saberes dos profissionais que o vivenciam no cotidiano / Abstract: Medicalization is a social process emerged with the advent of modern medicine, biomedicine, which today is deeply rooted in the concepts and practices of health and disease throughout the world, as well as all levels of health care. It is a complex phenomenon and has multiple meanings, being explored in this study, its polysemic feature and its network of coproduction in primary health care. Qualitative study was conducted through a narrative review of the literature and a case study, for which the methodology of participant observation was used (aggregating techniques of interviews and discussion groups to collect data). The objective of this research was to find elements that give visibility to the process of medicalization, to practices in Family Health Strategy would be consonant with this process and therefore: verify aspects of the work process of the family healthcare team, local context of clinical practice and the management, as well as the guidelines of the Family Health Strategy, which might be considered as contributing factors, effects or even expressions of medicalized health practices; analyze differences and similarities between the practices in primary health care that produce autonomy or heteronomy and iatrogenics. The results of this study are presented in four chapters: the first one is about an account of the implication of the researcher with the theme and how this research question was performed; in the second chapter, it is conceptualized medicalization, with its polysemy and complexity, as well as a discussion of its effects, iatrogenic complications; the third chapter presents how the organization of the Primary Health Care and the Health Family Strategy may promote or hinder the process of medicalization in everyday professional practice, as well as some strategies that propose a confrontation of this; the fourth chapter presents the methodology of the study, which is delimited field work as well as its results are discussed. It is observed that the medicalization is a universal phenomenon - but with very singular manifestations that require contextualization - on which it would be possible to point out some features in common, including those arising from the biomedical model as a guiding know-how hegemonic health, biological reductionism, the scientifization of human experience, knowledge anchored in universalizing abstractions about the health-disease process and the prevalence of heteronomy in the professionaluser and user - health system relationships. The medicalization was observed in family health team practices, traversing all the different nuclei and professional programs in health, whether preventive or curative practices, surveillance, health education, administrative or clinical care. There were identified as important actors and factors in this process: professionals and service users, local management and health network organization, the mass media, the municipal political-economic context. The study of this phenomenon, its peculiarities and determinations network, can provide support for the reorientation of social and health policies and practices and knowledge of the professionals who experience it in everyday life / Mestrado / Política, Planejamento e Gestão em Saúde / Mestra em Saúde Coletiva

Considérée comme l’avenir de la pratique médicale, la nanomédecine est l’application des nanotechnologies aux soins de santé. Plus qu’un nouveau domaine d’application technologique, la nanomédecine est porteuse d’un nouveau paradigme biomédical qui promeut une conception technoscientifique de la santé. Ce nouveau paradigme regroupe sous le préfixe nano l’ensemble des grandes tendances actuelles de la recherche en santé : la médecine prédictive, la médecine personnalisée et la médecine régénératrice. Centré sur le développement d’innovations visant au contrôle technique des éléments et des processus biologiques fondamentaux, ce nouveau paradigme se développe largement grâce au soutien des gouvernements et aux promesses économiques qu’il soulève. Il se construit à la croisée du scientifique, du politique et de l’économique. Interroger la nanomédecine revient alors à examiner plus largement la forme et les conditions du sens des innovations biomédicales et à soulever de la sorte les implications de la « technoscientifisation » des soins de santé.L’objectif de cette thèse est ainsi de rendre compte de la spécificité et des enjeux sociaux, culturels et politico-économiques caractéristiques du modèle biomédical technoscientifique porté par la nanomédecine à partir de sa conceptualisation sous la forme d’un idéaltype : la nanosanté. Si la nanomédecine renvoie de manière générale aux applications techniques de la nanotechnologie au domaine biomédical, la nanosanté renvoie aux diverses dimensions sociologiques constitutives de ces technologies et à leurs effets sur la santé et la société. Notre modèle de la nanosanté s’organise autour de trois dimensions : la transversalité, l’amélioration et la globalisation. Compte tenu de sa nature synthétique, ce modèle tridimensionnel permet d’aborder de front plusieurs questionnements cruciaux soulevés par le développement de la nanomédecine. Il permet d’éclairer le rapport contemporain à la santé et ses implications sur l’identité ; de mettre en lumière la centralité des technosciences dans la conception du progrès médical et social ; de mieux saisir les nouvelles formes globales de pouvoir sur la vie et les nouvelles formes d’inégalité et d’exploitation caractéristiques d’une société qui accorde une valeur grandissante à l’adaptabilité technique de l’humain et à l’économisation de la santé et du corps ; mais aussi de mieux comprendre le sens et les répercussions de l’engagement scientifique, politique et économique dans les innovations moléculaires et cellulaires. / Nanomedicine – the application of nanotechnology to medicine – is seen as the medicine of the future. Thus, nanomedicine is not just a new biomedical field. It carries a new biomedical paradigm promoting a technoscientific conception of healthcare. This new paradigm grows from and brings together the three current tendencies of healthcare research: predictive medicine, personalized medicine and regenerative medicine. Its focus is on the technical control of the molecular mechanisms underlying the biological development of the body. The growing of this new biomedical paradigm is largely the result of government supports and economic potentials. It is both a scientific and a politico-economic construction. In that sense, analysing nanomedicine means analysing the form and the conditions of the current biomedical progress. In other words, nanomedicine helps us to grasp and understand the issues and implications of the ‘‘technoscientifization’’ of healthcare. This thesis aims to highlight the socio-cultural nature of the technoscientific model of healthcare promoted by the nanomedicine. To do so, I propose the construction of an ideal-type of this technoscientific model, which I call nanohealth. If nanomedicine refers to the different technological applications of nanotechnology to medicine, nanohealth refers to the different sociological dimensions and impacts of these applications on health and society. The nanohealth ideal-type is constructed around three dimensions: transversality, enhancement and globalization. The synthetic nature of this tridimensional ideal-type helps us to tackle the crucial issues surrounding the development of the nanomedicine. It helps us to understand the meaning and impacts of the scientific, political and economic engagement in nanomedicine; to highlight the centrality of technoscience in the cultural conception of medical and social progress; to grasp the new forms of power upon life and identity, and the new forms of inequality and exploitation, which are characteristics of a society focusing on the technical adaptability of human being and the economization of health and body.

The term medicalization refers to the process through which a previously nonmedical issue newly becomes conceived of as a medical one. The aim of this thesis is to show how the utilization of this concept can help lead to a better understanding of the contemporary phenomenon of mass antidepressant consumption. I attempt to demonstrate here that the rise in antidepressant use, which has been occurring worldwide in the last few decades, must be understood as the result of a host of factors, among which a key role is played by changes in the conception of certain emotional states, previously understood as normal, as symptoms of mental illness. Aside from a general analysis of the factors that contribute to the consumption of these medications, the thesis also contains my own case study of one of them, namely the ways in which antidepressants are portrayed by the media. I focus on articles, published between the years 1996 and 2016 in Czech national newspapers and attempt to show how discussions about antidepressants, despite their relative neutrality, by accenting a medicalized frame of understanding mental problems help to create an environment, which supports their consumption.

The aim of this work was to develop knowledge about and awareness of fatness stigmatization from a systemic perspective. The stigmatization of fat people was located as a social problem in a second-order reality in which human fatness is observed and responded to, in turn providing it with negative meaning. Four separate studies of processes involved in this systemic stigmatization were performed. In study I, the association between weight and psychological distress was investigated. When controlling for an age-gender variable, this association was almost erased, questioning the certainty by which a higher weight in general is approached as a medical issue. In study II, the focus was on stigma internalization where negative and positive responses combined were connected to fat individuals’ distress. We found that both responses seemed to have a larger impact on fat individuals, suggesting that the embodied stigma of being fat sensitizes them to responses in general. In study III, justifications of fatness stigmatization was explored by a content analysis of a reality TV weight-loss show. The analysis showed how explicit bullying of a fat partner could be justified by animating the thin Self as violated by the fat Other, thus downplaying the evils of the bullying act in favor of highlighting the ideological value of thinness. The implications of these studies were related and seated in a context comprising a historical aversion toward the fat body, a declared obesity epidemic, a new public health ideology, a documented failure to reverse this obesity epidemic, and a market of weight-loss stakeholders who thrive on keeping the negative meanings of being fat alive. The stigmatization of fat people was intelligible from a systemic perspective, where processes of structural ignorance, internalized self-discrimination, and applied prejudice reinforce each other to form a larger stigmatizing process. In paper IV, it was argued that viewing fatness stigmatization as oppression rather than misrecognition could hold transformative keys to social change. / There are social groups in society that are categorically connected, for example by their physical, cultural or psychological markers. For political, or moral, reasons, some of these groups seem to trigger special attention in form of forceful response processes at several societal levels. This is the case with the contemporary ‘obesity epidemic’ phenomenon; postulated by the World Health Organization as one of the most severe threats to the health of future mankind. One of the downsides with such special attention is that the fat individuals find themselves caught up in seemingly unavoidable processes of devaluation. Instead of investigating the catastrophic (well-known) psycho-social consequences of these individuals, this work focuses on connecting the devaluing processes that form a systemic stigmatization of fat individuals. From this critical perspective, it is argued that the pervasive stigmatization of fat people is not an unfortunate consequence of structural norms that passively exclude its ‘non-fits’, but an intelligible outcome of a highly active set of processes that continuously construct and re-construct a historical aversion towards fat people.

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This essay is a study about how Carl Ulrik Sondén, a Swedish doctor during the 19th century, described and with his descriptions medicalized religious ecstasy in his thesis from 1842. The essay uses Vera Syrakvash theoretical model of medicalization to analyse how Sondén medicalized religious ecstasy, Chorea s:t Viti, to show how his thesis plays a part in the medicalization of Chorea s:t Viti. Sondéns medicalization, and how it is a part of the secularization that took place in Sweden during the 19th century is also discussed. To analyse this, Thorleif Pettersson’s work about secularization is used, and Sondéns thesis is applied to Petterssons theory of the three levels of secularization. The essay shows how Sondéns thesis fills all three of Syrakvash’s levels of medicalization and therefore fully medicalizes Chorea s:t Viti. This medicalization is then applied in to Pettersson’s theoretic model, and it fulfils the first level of secularization.

Tremendously popular in American society, the breast cancer movement functions through a rhetoric of risk to persuade women to monitor their breasts and thus medicalize their bodies. The vast majority of breast cancer literature available is specifically aimed at women with breast cancer, while the research here examines the way the breast cancer literature actually includes women without breast cancer in its audience, expecting these women to see breast cancer as an eventual experience. The rhetoric of risk focuses on lifestyle choices, the body, genes, and the environment in order to encourage women to engage in body projects to prevent breast cancer. The attention to risk factors without reliable facts produces fear of the body. Prevention of breast cancer, really impossible, becomes synonymous with early detection, thus displacing responsibility for the disease from society to the individual. Through the rhetoric of risk, the breast cancer movement promotes the ideology of femininity by manipulating women to become complicit subjects in their subordination. Furthermore, the directives, as yet unproven, to prevent breast cancer are the same directives to attain the white heterosexist ideal of beauty. The woman is thus reinscribed into the traditional feminine role of caretaker (of her body) and femininity is not only preserved but produced despite a disease that physically threatens a woman's most visible marker of her femininity, the breast. / Master of Arts

This thesis purpose is to highlight young adults with perceived mental illnesses, and who have experiences of being or not being included by Swedish welfare through a phenomenological perspective. The empirical material of the study is built upon six interviews with women who experience psychological problems and have been on sick leave for some time. In order to contextualize the narratives of the informant’s observations have been made in two Facebook groups. The empirical chapters are built on the following main questions: In what ways do the informants experience their psychological problems that have been confirmed by the health care system? In what ways do the informants communicate their illnesses? And how are the informant’s everyday lives shaped by their psychological problems? The main conclusion of the study is that medicalization has made it more complex when trying to understand human health, since the labels that are provided by medical sciences are insufficient when trying to evaluate an individual's actual well-being.

Recent developments have seen a rise in empirical attempts to challenge the persistently negative sociocultural attitudes toward menstruation. The thesis proposes a Foucauldian feminist conception, as well as the identification of the three elements stigmatization, medicalization and commercialization, to provide a comprehensive theoretical framework conceptualizing dominant menstrual discourse and its effects, based on which the empirical contemporary UN human rights agenda on the topic is approached. The findings, methodologically arrived at through the means of Directed Content Analysis, thereby generate both, an understanding of strengths and weaknesses in contemporary empirical attempts to challenge the effects of dominant menstrual discourse on women, and an exemplification of the utility of social science theory for human rights research in the realm of menstruation. Most importantly, the theoretical framework on dominant menstrual discourse indicates the need of holistically addressing all three formative elements, in order not to risk a perpetuation of its effects.