Over the decade of 2000, the Mexican government defined maternal health as a political priority and put pressure on key stakeholders to institutionalize pregnancy and childbirth in rural communities with indigenous population, through coercive use of poverty relief programs and surveillance policies involving health staff, community leaders, neighbours and families in close maternal control from pregnancy to newborn care. Safe motherhood campaigns addressed pregnant women and recent mothers, making them responsible for their own health and for the health of their unborns and newborns. As a result, most pregnant women went for prenatal chats and check-ups and a growing proportion turned away from homebirth assisted by traditional birth attendants. However, most also kept combining traditional and biomedical care and many felt safer delivering in their homes. This study was nested within a community-led research effort to narrow the distance between biomedically-oriented government policies and indigenous views and practices of maternal and newborn care, aiming to reduce maternal mortality and morbidity among aboriginal populations, without marginalizing indigenous cultures. I explore the connections and interactions between health risk discourse --the dominant paradigm in contemporary public health communication-, safe motherhood discourse, and indigenous discourses about maternal care in Xochistlahuaca, a rural community in Guerrero State, Mexico. I show how institutions and individuals draw from existing discourses, adopt them, reject them, and reshape them to make meaning according to their own needs, circumstances, and aspirations. I discuss how these interactions explain and affect maternal and perinatal care among the majority Amuzgo population. I also analyze the ideological implications of government and indigenous discourses in a context of unequal power relations. In particular, the study reveals how different sources construe the roles of key stakeholders, such as indigenous women and men, and how indigenous women handle and reshape multiple discursive pressures from government and community sources concerning maternal health and their role in society. I analyze data from government health promotion materials and interviews with health officials, government health staff, and men and women in the communities, using a theoretical and methodological framework based on critical discourse analysis, social semiotics, systemic functional linguistics, and multimodal approaches. The findings reveal "discursive synergies" and contradictions between government safe motherhood discourse and traditional orders of discourse. They also shed light on how people make coherent --and rational- construals of risk blending their own experiences and multiple, often conflicting discourses in an unequal multiethnic environment with competing authority claims. These findings should be of interest to a range of stakeholders working to prevent maternal and perinatal death in intercultural contexts.

This dissertation examines the class-, race-, and gender-based conflicts surrounding the 1990s privatization of an African American Public Housing development in New Orleans, Louisiana. The case illuminates how race, class and gender inequality is resisted and reproduced within the context of a post-segregation era, majority Black City. Drawing on Adolph Reed's Black Urban Regime theory, I conceptualize the struggle over privatization of Public Housing as a key expression of the racialized and gendered class relationship that makes up New Orleans' Black Urban Regime. The Black Urban Regime encompasses, on one side, Black officials that control the local State, along with their middle class allies, and the City's White corporate elite. On the other side is the City's Black working class majority, who often times are the electoral base of the Black Mayoral administration. To manage this contradictory relationship the Black political elite must appear to meet the redistributive, progressive agenda of its base, while simultaneously meeting the real neoliberal development needs of White corporate interests. Research for this single case study includes over forty in-depth interviews, a review of news articles, organizational and government documents, and observation of several public meetings dealing with various aspects of the St. Thomas privatization process The study's central finding is that non-profits, an understudied area of Urban Regime-informed works, were central to winning the formerly combative African American Public Housing residents to cooperate, rather than resist, privatization and removal. By engaging residents in a series of planning meetings and insider negotiations, the non-profits removed the female-led Black Public Housing residents from their key terrain and source of power, that of protests and disruption. In the past, disruptive actions won resident's power by undermining the racial, class, and gender legitimacy of the local and national levels of the State. In contrast, non-profits drew residents away from their historic source of power, and thus helped manage, rather than exploit, the Regime's contradictions. Finally, consistent with the extended case study method, the findings of this study are used to contribute and extend theories of urban politics, racism, and the practice of public sociology / acase@tulane.edu

No description available.

No description available.

No description available.

No description available.

No description available.

No description available.

Ce mémoire porte sur les déterminants sociaux de la détresse psychologique des étudiants universitaires canadiens. Nous avons utilisé comme cadre théorique la théorie sociologique du stress (Pearlin et al. 1981). L’objectif de ce mémoire est, en premier lieu, d’examiner si l’expérience de la vie universitaire, en terme de stresseurs et de ressources, a une influence sur la prévalence de la détresse psychologique en tenant compte des différences selon le sexe. En second lieu, nous examinerons si la transition vers l’université augmente le risque du taux de morbidité psychiatrique et si les étudiants québécois qui ont fréquenté le Cégep sont moins vulnérables à cette transition. L’étude a été réalisée à partir des données de l’enquête sur les campus canadiens (2004), menée auprès d’un échantillon représentatif d’étudiants dans 40 universités canadiennes. L’utilisation de données secondaires impose des limites importantes notamment en ce qui concerne les mesures de stresseurs et de ressources. Il ressort de notre étude que les stresseurs liés à l’expérience de la vie universitaire (programme d’études, performance académique, insertion dans la vie para-académique, modalité résidentielle) contribuent de façon marginale à l’explication de la variation des symptômes de détresse psychologique. Les ressources protectrices (sentiment de contrôle et soutien social), pour leur part, expliquent une portion significative de ces variations. La transition vers l’université n’a pas d’effet sur la détresse psychologique sauf dans le cas des femmes québécoises, celles-ci étant plus vulnérables que celles plus avancées dans leur cursus académique. Les résultats soulignent également que certains processus de prolifération du stress sont spécifiques au genre. / In this study we investigate the social mechanics leading to psychological distress in students in canadien universities. We used the stress process model (Pearlin et al. 1981) which shows that the position, the role and the status in the social structure are related to the mental health of individuals.The exposure to stress and resources mobilize resistance. The aim of this study is first, to examine whether the experience of university life (in terms of stressor and resource) has an influence on the prevalence of psychological distress, taking into account gender differences . Second, we examine whether the transition to university increases the risk of the rate of psychiatric morbidity and if students from Quebec who attended Cegep before University are less vulnerable to this transition. The methodology used to perform this study is based on multiple regression model. The data are drawn from the Canadien Campus (2004) Survey conducted on a representative sample of students from 40 canadien universities. The use of secondary data imposes significant limitations especially regarding measures of stressors and resources. Stressors related to the experience of life in university (workload, academic performance, integration into the para-academic, residential modality) contribute marginally to the explanation of the variation in symptoms of psychological distress. Protectives resources (sense of mastery and social support) explain a significant portion of these variations. The transition to university has no effect on mental health except on Quebec women who are more vulnerable than those more advanced in their academic curriculum. Finally, the results also highlight some of the stress proliferation process which are gender specific.

Commentators on U.S. health care policy have noted that the relative weakness of government institutions has left the allocation and financing of health care services to powerful interest groups. Until recently, the actions of state organizations as a major explanation for the organization of the market was seldom used. This dissertation evaluates the efficacy of a state centered approach to explaining Florida's health care politics. / Florida is used as a case study because of the dynamics of its economy, politics, and demography and its effect on the state's health care issues. Four questions guide the research. First, what are the State of Florida's interests in the market? Second, what strategies have state organizations pursued in Florida's interests? Third, to what degree do non-state organizations influence the development of the legislation? Finally, what conditions facilitate the involvement of Florida's state organizations in the health care services market? / Legislation regarding the enactment and continuance of Florida's Medicaid program, Florida's strategy for financing uncompensated hospital care, the financial arrangements for purchasing services, Florida's certificate of need licensing program, and Florida's regulation of hospital budgets is examined over a 28 year period, 1965 to 1993. / The investigation found that the interests of the State, defined by well accepted principles of its appropriate role, were strong enough to enable state agencies to successfully promote legislation authorizing and expanding Florida's Medicaid and indigent hospital care programs. Furthermore, on behalf of Florida's economic interests as a payer in the health care market, state agencies were successful in promoting legislation for alternative financial arrangements than fee for service and legislation regulating the capacity of the industry to produce health care services. / State agencies were successful in promoting these strategies when the interests of influential health care provider organizations were fragmented and, in some circumstances, when these organizations were united in their opposition to legislation promoting state strategies. In these circumstances, state agencies' efforts, influenced by federal monetary incentives, federal policy examples, and other state policy examples, set the agenda for the development of these strategies, not policy initiatives developed in the Legislature. / Source: Dissertation Abstracts International, Volume: 57-03, Section: A, page: 1344. / Major Professor: Allen Imershein. / Thesis (Ph.D.)--The Florida State University, 1996.