Generations of women’s health workers, writers, activists, and academics have tended to present midwifery as the opposite of obstetrics; to summon the appealing association of midwifery by advocating ‘tradition and nature’ over ‘modernity and medicalization;’ and to invoke the melodrama of the subordination of female patients by and to male doctors. This thesis suggests that it is much more productive (and historically accurate) to think of the shifting roles and identities of childbirth practitioners and their clients in terms of “boundary work” rather than the oft-touted dichotomy of domination/resistance. The thesis navigates Enlightenment theories of body and nature and moves to explore the example of the Foucaultian “clinic” to illustrate a relatively unstable foundation on which the biomedical clinic appears not as an entity trapped in time and space, but always already subject to change and negotiation. A discussion of maternal health policy and the roles of birthing women in actively shaping the care they receive brings home the central argument that what is crucial to the ever-developing birthing models is not resisting that which appears to dominate, but affirming a practice that more adequately meets the needs of birthing women in BC today.

Generations of women’s health workers, writers, activists, and academics have tended to present midwifery as the opposite of obstetrics; to summon the appealing association of midwifery by advocating ‘tradition and nature’ over ‘modernity and medicalization;’ and to invoke the melodrama of the subordination of female patients by and to male doctors. This thesis suggests that it is much more productive (and historically accurate) to think of the shifting roles and identities of childbirth practitioners and their clients in terms of “boundary work” rather than the oft-touted dichotomy of domination/resistance. The thesis navigates Enlightenment theories of body and nature and moves to explore the example of the Foucaultian “clinic” to illustrate a relatively unstable foundation on which the biomedical clinic appears not as an entity trapped in time and space, but always already subject to change and negotiation. A discussion of maternal health policy and the roles of birthing women in actively shaping the care they receive brings home the central argument that what is crucial to the ever-developing birthing models is not resisting that which appears to dominate, but affirming a practice that more adequately meets the needs of birthing women in BC today.

Abstract This thesis reports on studies of plasmonic nanoparticles and particularly gold nanostars as signal enhancers and contrast agents for biophotonic applications including visualisation, treatment of living cells and chemical sensing. In this thesis, the optical properties of nanoparticles of different size and morphology and their silica composites were compared. Because they are the most suitable plasmonic nanostructures, gold nanostars were utilised for optical imaging modalities such as confocal microscopy and Doppler optical coherence tomography. The ability of gold nanoparticles to enhance the signal in surface-enhanced vibrational spectroscopy, including Raman and Fourier transform infrared spectroscopy was additionally studied. Finally, various gold nanoparticles were applied for cell optoporation to increase the penetration ability of exogeneous substances. In summary, significant advantages of nanostars such as their low-toxicity, high scattering and contrast abilities, in addition to a broad, tunable, plasmon resonance wavelength range, as well as the capability to enhance the signal of analyte molecules in vibrational spectroscopy were demonstrated in this thesis. The results of this study on the effectiveness of nanostars have a broad scope of utility and open a wide perspective for their utilisation in nanobiophotonics and biomedicine. / Tiivistelmä Tämä opinnäytetyö kertoo tutkimuksista, joissa plasmoninanopartikkeleita ja erityisesti kultananotähtiä on käytetty signaalinvahvistimina biofotoniikan sovelluksissa, kuten visualisointi, elävien solujen käsittely ja kemiallinen tunnistus. Tässä työssä verrattiin eri kokoisten ja muotoisten nanopartikkeleiden ja niiden piioksidikomposiittien optisia ominaisuuksia. Sopivimpina plasmoninanorakenteina kultananotähtiä käytettiin optisiin kuvantamismenetelmiin, kuten konfokaalimikroskopiaan ja Doppler-optiseen koherenssitomografiaan. Lisäksi kuvattiin myös kultananopartikkelien kykyä parantaa pinta-aktivoidun värähtelevän spektroskopian signaalia, mukaan lukien Raman- ja Fourier-muunnos-infrapuna-spektroskopia. Lopuksi, eri kultananopartikkeleita käytettiin soluoptoporaatioon eksogeenisten aineiden läpäisevyyden lisäämiseksi. Yhteenvetona, työssä osoitettiin nanotähtien merkittävät edut, kuten matala-myrkyllisyys, suuret sironta- ja kontrastiominaisuudet, laaja plasmoniresonanssin aallonpituusalue ja sen viritettävyys, sekä kyky parantaa analyyttimolekyylien signaalia värähtelyspektroskopiassa. Niinpä tutkimustulokset nanotähtien tehokkuudesta ovat laajasti käyttökelpoisia ja ne avaavat laajan näkökulman niiden hyödyntämiseen nanobiofotoniikassa ja biolääketieteessä.

A tese discute como sujeitos de diferentes inserções socioeconômicas têm vivenciado o projeto de "ter um filho". Partindo da compreensão de que o "desejo" de ser mãe ou pai não é algo dado, mas construído socialmente, a pesquisa buscou mapear como esse desejo tem sido expresso e quais têm sido as alternativas criadas para sua consecução quando do enfrentamento da "dificuldade para ter filho". Considerando que o sofrimento gerado pela "ausência de filhos" só surge na medida da estimulação desse desejo, investigaram-se os processos pelos quais a noção de infertilidade enquanto categoria médica se consolida e o caminho pelo qual se dissemina no processo de medicalização da vida. A partir de investigação etnográfica em um hospital público que oferece serviços de reprodução assistida e em comunidades na periferia de Porto Alegre, pôde-se identificar como não é automática a transformação da "ausência de filhos" em um "problema de saúde". A percepção de formas diferenciadas de encarar a adoção, bem como o tipo de relação estabelecido com os serviços de saúde permite considerar que o acesso a saúde, de uma forma geral, não está desvinculado do acesso às tecnologias reprodutivas, de forma particular. Considerando a desigualdade econômica da sociedade brasileira e a estrutura desigual de acesso a serviços públicos de saúde, a tese problematiza o discurso de garantia de acesso a essas tecnologias por todos e mapeia as diferentes vozes que articulam esse discurso. Nesse processo a vontade das pessoas de terem filhos se mescla com os demais atores envolvidos como médicos, a indústria farmacêutica e o Estado a partir da definição das políticas de assistência à saúde. / This dissertation discusses how persons of different socioeconomic insertions have experienced the project of "having a child". Starting from the comprehension that the "wish" to be a mother or a father is not a given, but a social construct, the research sought to map out how this wish has been expressed and which have been the alternatives created to achieve this wish when one copes with the "difficulty to have a child". Considering that the suffering generated by the "absence of children" only arises when this wish is stimulated, this dissertation investigated the process by which the notion of infertility is consolidated as a medical category and the route through which it is disseminated in the process of medicalization of life. From an ethnographic research in a public hospital that offers assisted reproduction services and in suburban communities in the city of Porto Alegre, in the southern part of Brazil, this dissertation was able to identify how the transformation of the "absence of children" into a "health problem" is not automatic. The different ways to face adoption and also the kind of relationship established with the health services allows one to consider that the access to health, in general, is not unbounded to the access to reproduction technologies, in particular. Considering the economic inequality of the Brazilian society and the unequal structure of access to public health services, this dissertation problematizes the discourse that guarantees access to these technologies by all parts and maps the different voices that articulate this discourse. In this process, people's will to have children blends in with the other actors involved, as doctors, the pharmaceutical industry and the State defining the health assistance policies.

A tese discute como sujeitos de diferentes inserções socioeconômicas têm vivenciado o projeto de "ter um filho". Partindo da compreensão de que o "desejo" de ser mãe ou pai não é algo dado, mas construído socialmente, a pesquisa buscou mapear como esse desejo tem sido expresso e quais têm sido as alternativas criadas para sua consecução quando do enfrentamento da "dificuldade para ter filho". Considerando que o sofrimento gerado pela "ausência de filhos" só surge na medida da estimulação desse desejo, investigaram-se os processos pelos quais a noção de infertilidade enquanto categoria médica se consolida e o caminho pelo qual se dissemina no processo de medicalização da vida. A partir de investigação etnográfica em um hospital público que oferece serviços de reprodução assistida e em comunidades na periferia de Porto Alegre, pôde-se identificar como não é automática a transformação da "ausência de filhos" em um "problema de saúde". A percepção de formas diferenciadas de encarar a adoção, bem como o tipo de relação estabelecido com os serviços de saúde permite considerar que o acesso a saúde, de uma forma geral, não está desvinculado do acesso às tecnologias reprodutivas, de forma particular. Considerando a desigualdade econômica da sociedade brasileira e a estrutura desigual de acesso a serviços públicos de saúde, a tese problematiza o discurso de garantia de acesso a essas tecnologias por todos e mapeia as diferentes vozes que articulam esse discurso. Nesse processo a vontade das pessoas de terem filhos se mescla com os demais atores envolvidos como médicos, a indústria farmacêutica e o Estado a partir da definição das políticas de assistência à saúde. / This dissertation discusses how persons of different socioeconomic insertions have experienced the project of "having a child". Starting from the comprehension that the "wish" to be a mother or a father is not a given, but a social construct, the research sought to map out how this wish has been expressed and which have been the alternatives created to achieve this wish when one copes with the "difficulty to have a child". Considering that the suffering generated by the "absence of children" only arises when this wish is stimulated, this dissertation investigated the process by which the notion of infertility is consolidated as a medical category and the route through which it is disseminated in the process of medicalization of life. From an ethnographic research in a public hospital that offers assisted reproduction services and in suburban communities in the city of Porto Alegre, in the southern part of Brazil, this dissertation was able to identify how the transformation of the "absence of children" into a "health problem" is not automatic. The different ways to face adoption and also the kind of relationship established with the health services allows one to consider that the access to health, in general, is not unbounded to the access to reproduction technologies, in particular. Considering the economic inequality of the Brazilian society and the unequal structure of access to public health services, this dissertation problematizes the discourse that guarantees access to these technologies by all parts and maps the different voices that articulate this discourse. In this process, people's will to have children blends in with the other actors involved, as doctors, the pharmaceutical industry and the State defining the health assistance policies.

A tese discute como sujeitos de diferentes inserções socioeconômicas têm vivenciado o projeto de "ter um filho". Partindo da compreensão de que o "desejo" de ser mãe ou pai não é algo dado, mas construído socialmente, a pesquisa buscou mapear como esse desejo tem sido expresso e quais têm sido as alternativas criadas para sua consecução quando do enfrentamento da "dificuldade para ter filho". Considerando que o sofrimento gerado pela "ausência de filhos" só surge na medida da estimulação desse desejo, investigaram-se os processos pelos quais a noção de infertilidade enquanto categoria médica se consolida e o caminho pelo qual se dissemina no processo de medicalização da vida. A partir de investigação etnográfica em um hospital público que oferece serviços de reprodução assistida e em comunidades na periferia de Porto Alegre, pôde-se identificar como não é automática a transformação da "ausência de filhos" em um "problema de saúde". A percepção de formas diferenciadas de encarar a adoção, bem como o tipo de relação estabelecido com os serviços de saúde permite considerar que o acesso a saúde, de uma forma geral, não está desvinculado do acesso às tecnologias reprodutivas, de forma particular. Considerando a desigualdade econômica da sociedade brasileira e a estrutura desigual de acesso a serviços públicos de saúde, a tese problematiza o discurso de garantia de acesso a essas tecnologias por todos e mapeia as diferentes vozes que articulam esse discurso. Nesse processo a vontade das pessoas de terem filhos se mescla com os demais atores envolvidos como médicos, a indústria farmacêutica e o Estado a partir da definição das políticas de assistência à saúde. / This dissertation discusses how persons of different socioeconomic insertions have experienced the project of "having a child". Starting from the comprehension that the "wish" to be a mother or a father is not a given, but a social construct, the research sought to map out how this wish has been expressed and which have been the alternatives created to achieve this wish when one copes with the "difficulty to have a child". Considering that the suffering generated by the "absence of children" only arises when this wish is stimulated, this dissertation investigated the process by which the notion of infertility is consolidated as a medical category and the route through which it is disseminated in the process of medicalization of life. From an ethnographic research in a public hospital that offers assisted reproduction services and in suburban communities in the city of Porto Alegre, in the southern part of Brazil, this dissertation was able to identify how the transformation of the "absence of children" into a "health problem" is not automatic. The different ways to face adoption and also the kind of relationship established with the health services allows one to consider that the access to health, in general, is not unbounded to the access to reproduction technologies, in particular. Considering the economic inequality of the Brazilian society and the unequal structure of access to public health services, this dissertation problematizes the discourse that guarantees access to these technologies by all parts and maps the different voices that articulate this discourse. In this process, people's will to have children blends in with the other actors involved, as doctors, the pharmaceutical industry and the State defining the health assistance policies.

Made available in DSpace on 2016-12-23T14:36:49Z (GMT). No. of bitstreams: 1 dissertacao marlon bertolani.pdf: 1217798 bytes, checksum: 8ad34118a49d79e31016c94a1d50fa35 (MD5) Previous issue date: 2008-09-25 / O movimento indígena, a partir da década de 80 do século passado, inscreveu definitivamente na agenda nacional o direito a um atendimento específico, capaz de concatenar a melhoria na saúde com o respeito à diversidade cultural. Alicerçado na Teoria das Representações Sociais, este estudo tem por objetivo principal identificar e analisar as relações entre dois diferentes sistemas de saúde a biomedicina e o sistema de saúde indígena , no contexto das ações direcionadas aos Guarani aldeados no município de Aracruz (ES). Busca compreender como as representações sociais que os indígenas e profissionais de saúde constroem acerca de diversos aspectos dessa questão, relativos a si mesmos e aos outros , num cenário marcado por relações interétnicas, impactam ações desenvolvidas em tal área. A complexidade de implementação da referida proposição, aliada à intenção de compreender as representações dos atores em suas conexões com a vida cotidiana, demandou uma abordagem envolvendo diferentes métodos de coleta e análise de dados, quais sejam: pesquisa documental, observação participante, entrevistas na modalidade semi-estruturada e análise de conteúdo. Os resultados apontaram para a existência de relações de poder e disputas pela hegemonia entre os sujeitos ligados aos sistemas de saúde ora analisados. As representações da saúde e da biomedicina expressas pelos Guarani encontram-se em sintonia com as demandas do grupo no campo da saúde e orientam suas reivindicações, dentre as quais assume destaque aquela pelo direito à diferença. Destarte, os especialistas e as lideranças indígenas mobilizam o capital simbólico de que dispõem em estratégias para preservar a hegemonia do sistema de saúde Guarani no interior do próprio grupo, galgando maior controle da agência ocidental, bem como mais espaço na relação com a biomedicina. Por sua vez, nas representações expressas pelos profissionais de saúde, o sistema indígena de saúde aparece como subalterno e portador de eficácia mais simbólica do que propriamente empírica. Essa postura é corroborada pelas ações da Fundação Nacional de Saúde, que ignoram as demandas do grupo. Ademais, as representações existentes entre os profissionais de saúde acerca da cultura do grupo e do comportamento dos indígenas em assuntos relacionados à saúde e/ou aos serviços a eles prestados revelaram a perpetuação de uma postura quinhentista, manifesta na sociedade envolvente e calcada na compreensão do indígena pelo paradigma da falta. Perde-se, assim, a possibilidade de compreendê-lo em sua positividade concreta, ou como o outro é, realmente. Constata-se, portanto, no tocante aos Guarani enfocados neste estudo, que o reconhecimento da eficácia da medicina indígena e do direito desses povos à sua cultura, embora ratificado de um ponto de vista formal pelo Estado brasileiro, mantém-se, na prática, como parte de um enorme alfabeto de letras mortas . / The Brazilian indigenous movement, from the 1980s on, has definitively set in the national agenda the indigenous right to specific service, which should be able to join health improvement and the respect to cultural diversity. Based on the Theory of Social Representations, the main objective of this research is to identify and to analyze the relationships between two different healthcare systems biomedicne and the Indigenous healthcare system , in the context of actions towards the Guarani indians living in settlements in the outskirts of Aracruz (Espírito Santo, Brazil). It tries to understand how much impact on the actions developed in this área was caused by the social representations that indigenous and health professionals have created regarding the various aspects of this issue, concerning themselves and others , in a scenary marked by inter-ethnical relationships. Because of the complexity of implementing this proposition, which intends to understand actors representations in connection with daily life, an approach envolving a pool of different methodologies for collecting and analysing data has been required: document research, participant observation, semi-structured interview and content analysis. The results have shown the existence of power relationship and fight for hegemony between the subjects linked to the two healthcare systems hereby been analysed. The Guarani representations of health and biomedicine are in accordance with the group s health demands and lead their claims, among which the right to difference is of great importance. Thus, the indigenous experts and leaders have mobilized their available symbolical capital in strategies that aim at preserving the Guarani healthcare system within their own group, gaining this way more control over Occidental agency, as well as more space regarding biomedicine. On the other hand, in the representations expressed by health professionals, the indigenous healthcare system is shown as subordinated and as having a more symbolical than really empirical effectiveness. This attitude is reinforced by the actions put into effect by the Fundação Nacional de Saúde (Health National Foundation), which has ignored the indigenous demands. Besides that, the manner in which health professionals represent the indigenous culture and behavior regarding health and/or the provided services has revealed the perpetuation of an ancient position which is expressed by the envolving society and based on the undestanding of the indigenous by the lack paradigm. This way, the possibilty of understanding them in their concrete positiveness or of perceiving how the other really is get lost. So, what can be said about the Guarani focused in this research is that the recognition of the indian medicine and of theese people s right to their culture, although ratified by the Brazilian State under a formal point of view, has in fact been kept as part of an enormous alphabet of dead letters

No description available.

The aim of this dissertation is to examine and analyse the judicial framework with regard to embryonic stem cell research and cloning in South Africa. The examination is conducted within the framework of the South African and United Kingdom's legal systems. Focus is placed on aspects of medical law, human rights law as envisaged in the Constitution of the Republic of South Africa, and the law of persons. The specific focus of this dissertation is to examine the intense debate on the moral and legal status of the embryo and fetus in South Africa. A comparative study is undertaken, with the United Kingdom as a background against which recommendations for the South African framework are made. The study firstly provides a clinical overview of stem cell research and cloning. Secondly, the concept of life, in particular human life; the protection of the embryo and fetus under the constitutional guarantee of the right to life, among other constitutionally protected rights, are examined. In this context, the most important finding is that although the fetus is not a bearer of constitutional rights the state has a constitutional duty to protect fetal life in terms of an objective value system. Thereby, the state is permitted to regulate abortion, fetal tissue research, and embryo research to protect fetal life. In particular, the aim of this dissertation is to present a critical summary of the major debates and policy responses relating to embryonic stem cell research and cloning techniques, drawing attention to some of the challenges posed by conflicting moral values in an era of global scientific endeavour, and to provide an analysis of the key ethical and regulatory implications for stem cell therapy. The most important findings are that current South African legislation remains fragmented and ineffective in the manner in which embryonic stem cell research and cloning are regulated. This finding leads to a summary of recommendations, which attempts to provide specific remedies in order to adapt the current regulatory framework in South Africa. / Dissertation (LLM (Public Law))--University of Pretoria, 2007. / Public Law / LLM / unrestricted

No description available.