Landscape architecture and health

Swedes are living increasingly longer lives, but the number of years lived in good health is decreasing. The present doctoral dissertation is focused on the threat to Swedish public health that is constituted by aches and pain and various types of mental illnesses, of which fatigue reactions, often called ”burnout syndromes,” are increasing most rapidly. Besides the personal suffering involved, the costs of increased ill health constitute a threat to the welfare of Swedish society. According to the Swedish government, good health has become a resource – perhaps even the country’s most important resource for sustainable development. Today, several scientific disciplines consider health to be a positive and holistic state encompassing the individual’s entire life situation: biological, cultural, social and not least environmental aspects. With the Swedish Parliament’s adoption of the public health bill Public Health Objectives, public health work in Sweden is to be based on the idea of finding different societal factors that promote good health on equal terms for the entire population. The present doctoral dissertation focuses on a health factor represented by different types of natural environments. The dissertation is based on two studies of two different types of health-promoting natural environments: Healing gardens – Improvement of ill health Urban green spaces – Maintenance and fortification of good health Healing gardens are gardens that are purposely designed to promote health among a certain group of patients. The dissertation focuses on the type of healing garden that is specially intended for patients suffering from fatigue reactions or burnout syndromes. Interest in healing gardens is spreading rapidly throughout the world. However, both in Sweden and in other countries, ”healing gardens” are being laid out that do not actually possess health-promoting qualities. In order for health to actually be improved, purposeful design based on the patient group’s special needs is required. There is a great need for scientific knowledge concerning how these gardens should be designed. For a long time past in our history, the importance of city greenery for city dwellers’ health and wellbeing has been pointed out. In the present dissertation, urban green spaces – i.e. greenery in the city such as parks, green areas, schoolyards and gardens belonging to a house – are viewed as healthpromoting elements of city planning. Interest in how urban green spaces can maintain and fortify human health is spreading among scientists, architects, politicians and the public. Despite this interest, the problem remains of how urban green spaces should be planned and designed so as to attract the urban population. The dissertation has an applied perspective and is aimed at both scientists and practitioners. It presents findings from two different studies, one on how healing gardens may be designed for people with burnout syndromes and the other on how urban green spaces may be planned from a health-promoting perspective. The overall purpose is, thus, that the dissertation should contribute to the evidence-based design and planning of health-promoting outdoor environments

The Nurse, the Veteran, and the Female Scientist: Dependency and Separation

The discourse that emerged around the female nurses who served in American Civil War hospitals has been a major topic in the debate about nineteenth-century gender relations. What remains obscure, however, is the genesis of this figure during the postwar period and its influence on late nineteenth-century gender relations. Focusing on the post-1865 period as a time of emotional crisis and mental adaptation (Leslie Butler), this article seeks to analyze and assess the gendered tensions that emerged when the process of “binding up the nation’s wounds” (Abraham Lincoln) became a more permanent occupation than was commonly anticipated. By reading Louisa May Alcott’s Hospital Sketches, Silas Weir Mitchell’s “The Case of George Dedlow,” Alonzo F. Hill’s John Smith’s Funny Adventures on a Crutch, and Mary Bradley Lane’s Mizora as contributions to and critical interventions into official veteran memorial culture, this article sheds light on the gendered dimension of the Reconstruction adaptation and negotiation process, and explains why the concept of the female nurse played a crucial role in this development

Dying for Leave: How Societal Views on End-of-Life Care Pushed Ballard to Expand the Meaning of Care Under the Family and Medical Leave Act

The Seventh Circuit’s recent decision in Ballard v. Chicago Park District shook employers and employment law attorneys to their core, forcing reevaluation of what it means to care for a family member with a serious medical condition under the Family and Medical Leave Act (FMLA). Ballard, a former employee of the Chicago Park District, requested FMLA leave to take her terminally-ill mother on vacation to Las Vegas as part of her mother’s end-of-life plan, constructed by her mother and her mother’s hospice team. The Seventh Circuit agreed with Ballard that her employer should have granted FMLA leave for the trip. In fact, Ballard created a circuit split on the issue,6 placing the Seventh Circuit at odds with the First and Ninth on the meaning of care in the context of traveling. By holding that an employer improperly denied FMLA leave to an employee accompanying her dying mother on a Las Vegas vacation, the Seventh Circuit stretched the FMLA’s meaning of care when applied to a seriously ill family member. Ballard expanded the meaning of care by finding aspects of end-of-life care acceptable as caregiving activities. The unique facts of this case and the court’s emphasis on the nature of the mother’s terminal illness introduce the subtle notion that the meaning of care loosens when applied to a dying family member. This case creates a lower threshold that was likely not intended by Congress and will frustrate employers, but is very much in line with American values and societal norms regarding end-of-life care. This Note analyzes the Seventh Circuit’s interpretation of FMLA care in Ballard. Part II provides an overview of the FMLA, focusing on the family-member-care provision, and various judicial interpretations of this provision. Part III explains the facts and judicial rationale in Ballard. Then, Part IV analyzes societal and congressional views of end-of-life care. Finally, Part V of this Note explores the significance of the Ballard decision and the risk of employee abuse. While the FMLA does not distinguish or discriminate on its face between a seriously ill family member and a dying one, this Note explores how the definition of care likely becomes more flexible if the employee requests FMLA leave to tend to a terminally ill family member. This flexibility will have a huge impact as the largest generation begins to depart while under the care of employed, younger family members. While Congress likely did not intend the FMLA’s meaning of care to be taken so far, Ballard’s expansion of the meaning of care is well in line with other legislative actions addressing elderly care and societal views that the dying deserve the best care, even beyond what medicine can provide

Unintelligibility as discourse accessibility in a Senegalese ethnomedical encounter

‘Unintelligibility’ is not an on–o¢¥ phenomenon, but rather a processual, bydegrees, and phase-relative phenomenon, as recent literature has demonstrated. With these facts in mind, this article approaches ‘unintelligibility’ in terms of discourse ‘accessibility’, emphasizing especially how ‘access’ is regulated in multiple ways (not only through language), and how it centrally involves changes in participation structure. Using a Senegalese ethnomedical encounter as my focus, I examine how the verbal and nonverbal regulation of accessibility helps bring into play forms of mediation, where the interactant conferring access o¢¥ers to the patient both expert knowledge and contact with incorporeal beings. During a divination phase, a phase of maximum inaccessibility, contact with these beings comes to be presupposed in the healer’s discourse as he positions himself as a mediator who stands between the patient and the unseen sources of advice and curative power. By making the inaccessible accessible over phases of the encounter, the healer both invokes expert knowledge and constructs an interdiscursive figure, a virtual ‘speech-chain’ structure, in which his verbal (and nonverbal) contributions become links designed to convey curative power and blessings from incorporeal beings to the patient in the immediate speech event

Escaping the Shadow of Malpractice Law

Abinovich-Einy addresses several constituencies operating at the meeting point of alternative dispute resolution (ADR), communication theory, healthcare policy, and medical-malpractice doctrine. From an ADR perspective, the need for, and barriers to, addressing non-litigable disputes, for which the alternative route is the only one, is explored. It is shown that ADR mechanisms may not take root when introduced into an environment that is resistant to collaborative and open discourse without additional incentives and measures being adopted

Escaping the Shadow of Malpractice Law

Abinovich-Einy addresses several constituencies operating at the meeting point of alternative dispute resolution (ADR), communication theory, healthcare policy, and medical-malpractice doctrine. From an ADR perspective, the need for, and barriers to, addressing non-litigable disputes, for which the alternative route is the only one, is explored. It is shown that ADR mechanisms may not take root when introduced into an environment that is resistant to collaborative and open discourse without additional incentives and measures being adopted