Thinking About Dementia

Bringing together essays by nineteen respected scholars, this volume approaches dementia from a variety of angles, exploring its historical, psychological, and philosophical implications. The authors employ a cross-cultural perspective that is based on ethnographic fieldwork and focuses on questions of age, mind, voice, self, loss, temporality, memory, and affect. Taken together, the essays make four important and interrelated contributions to our understanding of the mental status of the elderly. First, cross-cultural data show that the aging process, while biologically influenced, is also culturally constructed. Second, ethnographic reports raise questions about the diagnostic criteria used for defining the elderly as demented. Third, case studies show how a diagnosis affects a patient's treatment in both clinical and familial settings. Finally, the collection highlights the gap that separates current biological understandings of aging from its cultural meanings

Thinking About Dementia

Bringing together essays by nineteen respected scholars, this volume approaches dementia from a variety of angles, exploring its historical, psychological, and philosophical implications. The authors employ a cross-cultural perspective that is based on ethnographic fieldwork and focuses on questions of age, mind, voice, self, loss, temporality, memory, and affect. Taken together, the essays make four important and interrelated contributions to our understanding of the mental status of the elderly. First, cross-cultural data show that the aging process, while biologically influenced, is also culturally constructed. Second, ethnographic reports raise questions about the diagnostic criteria used for defining the elderly as demented. Third, case studies show how a diagnosis affects a patient's treatment in both clinical and familial settings. Finally, the collection highlights the gap that separates current biological understandings of aging from its cultural meanings

La verdad de Hermes. Sobre la autoridad en los textos etnográficos

Se analizan cuatro "escuelas" de enfoques cualitativos para la escritura etnográfica sobre la base del rol de autor/escritor: Naturalismo, etnometodología, emocionalismo posmodernismo (si es que tal enfoque existe). En cada uno de estos enfoques el autor se expresa desde posiciones diferentes, explorando así, desde distintos ángulos, la realidad en estudio. Finalmente, se arguye que la combinación de estas cuatro "escuelas", cada una con sus propias limitaciones y revelaciones, podría conducir a un entendimiento más amplio de los demás y de nosotros mismos.Four different "schools" of qualitative approaches to ethnographic writing are analyzed regarding the role of the author/writer: Naturalism, ethnomethodology, emotionalism and posmodernism (if there is such). Each show the author from a different position, exploring different angles of the world under research. It is argued that the combination of these four "schools", each with its own limitations and revelations, would lead to a broader understanding of the other and ourselves

Olhando Para Trás: os dois nascimentos da doença de Alzheimer e a senilidade no Brasil

Resumo: Este artigo tenta mostrar que a doença de Alzheimer é uma categoria médica que define a senilidade diferente das noções populares no Brasil, levantando a questão das conseqüências para as pessoas envolvidas com este mal. Favorecemos um olhar histórico para mostrar como dois momentos na história da doença de Alzheimer - os "dois nascimentos"- resultam do olhar científico de uma determinada época e sua maneira de produzir saberes. Palavras-chave: Alzheimer. Memória. Abstract: This article tries to show that Alzheimer’s disease is a medical category which defines senility in a different way from popular notions in Brazil - raising that question about possible consequences for the persons involved. We favour a historical gaze to show how two moments in the history of Alzheimer’s disease - the "two births"- are the result from the scientific gaze in a certain epoch and its way of producing knowledge. Keywords: Alzheimer. Memory

Participating in clinical trials: masculinity, stem cells and heart disease

One of the ways to understand the many trajectories of aging is to focus on individuals who have, for a variety of reasons, enjoyed privileged access to health care and are therefore able to envisage an aging process that would not otherwise have been possible. This article is based on interviews conducted with men aged 53 to 77, living in a major Canadian city, who suffered serious heart incidents and subsequently took part in a clinical trial program involving the use of stem cells. As a result of their participation in this program, these men have new hope for the future, are able to make concrete plans and can entertain the possibility of aging “in good health.

Consciência da doença na demência

BACKGROUND: Awareness of disease is a concept related to the recognition of deficits, lack of knowledge of cognitive deficits or, also, to the awareness of deficits in activities of daily living in Alzheimer's disease. OBJECTIVE: This review aimed at comparing definitions and etiological hypotheses for awareness of disease in Alzheimer's disease. METHOD: Search of prospective, retrospective, longitudinal, and cross-sectional articles at ISI, Medline, Lilacs and Scielo databases from 1984 to 2004 using the key-words awareness of deficit, awareness of disease, insight and Alzheimer's disease. Articles were examined to evaluate the definition of awareness of disease and divided by areas according to the objective. RESULTS: The concepts of awareness of disease, awareness of deficit, awareness of cognitive deficit, insight, self-awareness and anosognosia were used as synonymous in the 43 articles, regardless of the organic, psychosocial explanations and of the differences of perception between patients and family. CONCLUSION: Awareness of disease may be defined as the ability to notice changes in the self-consciousness and in the daily activities due to the disease. This definition may be operationalized and can help the examination of awareness of disease in dementia.CONTEXTO: A consciência da doença é um conceito relacionado ao conhecimento da presença de comprometimento generalizado, à falta de reconhecimento dos déficits cognitivos ou, também, da percepção dos prejuízos nas atividades de vida diária causados pela doença de Alzheimer. OBJETIVO: Esta revisão comparou as definições e as hipóteses etiológicas para a consciência da doença na doença de Alzheimer. MÉTODO: Busca nas bases de dados ISI, Medline, Lilacs e Scielo de artigos clínicos seccionais, longitudinais, prospectivos, retrospectivos e de caso-controle entre 1984 e 2004 utilizando as palavras-chave "consciência do déficit", "consciência da doença", insight e "doença de Alzheimer". Os artigos foram examinados para avaliar a definição expressa do conceito de "consciência da doença" e divididos por áreas, segundo seus objetivos. RESULTADOS: Os conceitos "consciência da doença", "consciência do déficit", "consciência do déficit cognitivo", insight, "consciência de si" e "anosognosia" foram usados como sinônimos nos 43 artigos selecionados, independentemente de apresentarem explicações orgânicas, psicossociais ou diferença de percepções entre pacientes e familiares. CONCLUSÃO: A consciência da doença pode ser definida como a capacidade de perceber em si e na vida diária alterações causadas por déficits relacionados ao adoecimento. Essa definição é passível de operacionalização e pode auxiliar no exame da consciência da doença na demência

Heterotopia and Illness: Older women and Hypertension in a Brazilian Favela

This article is about older women and the way hypertension is linked to their life in a favela, a “shantytown”, in Rio de Janeiro. Inspired by Foucault, I suggest calling this complex phenomenon ‘heterotopic illness’. By calling attention to the importance of place for understanding certain illnesses, the limited usefulness of some public health prevention campaigns is shown. Since hypertension can be considered a “disease of aging”, it will be argued that some place-related stressors often have a greater impact on seniors than they have on younger adults

Marcinho et Mauricinho : La violence et les « nouveaux » héros de Rio de Janeiro, Brésil

Dans son article sur les sociétés post-traditionnelles, Giddens recommande l’instauration d’une « démocratie dialogique » pour remplir le vide laissé par la disparition des ordres moraux traditionnels. Dans cet article, je suggère qu’au Brésil, une démocratie dialogique factice, fondée sur l’inversion, a pour effet de réduire au silence la voix de nombreux acteurs sociaux impliqués dans le drame de la violence urbaine. On trouve dans les médias, mais aussi dans les débats politiques sur l’identité nationale, des récits publics définissant et fusionnant des valeurs traditionnellement opposées comme le bien et le mal, les riches et les pauvres, les bandits et les héros. Au Brésil se développe actuellement une fascination pour les bandits, redéfinis comme de nouveaux héros. Deux histoires tirées de la presse locale illustrent ce phénomène. La première raconte l’histoire de Mauricinho Botafogo, un bandit issu de la classe moyenne et l’autre, celle de Marcinho VP, un trafiquant de drogue et leader d’une favela (un bidonville) de Rio de Janeiro — Michael Jackson a dû lui demander la permission de tourner un vidéo-clip sur « sa » montagne. VP a aussi reçu une « subvention » de la part d’un membre d’une des plus riches familles de Rio de Janeiro pour écrire un livre sur sa vision du monde ; il s’y présente lui-même comme un Lampião moderne (le Robin des bois brésilien) et la victime d’une société inégalitaire. La fascination pour des bandits comme Marcinho et Mauricinho nourrit la banalisation et l’esthétisation croissantes de la violence, ainsi que l’indifférence à son égard.Giddens in his article on post-traditional societies recommends a ‘‘dialogical democracy’’ to fill in the void left by the disappearance of traditions (moral orders). In this paper we argue that a ’fake dialogical democracy’ or ‘‘inversions’’ end up silencing the voices of many social actors involved in the drama of urban violence. Public narratives on the approximation and fusion of traditionally separated values like good/bad, rich/poor, or bandit/hero can be found in the mass media, but also is part of the national identity politics. Nowadays, a fascination for bandits as the new heroes is taking place in Brazil. Two recent discussions in the local press were chosen for illustration. One is about Mauricinho Botafogo, a bandit coming from the middle class and the other one was initiated by Marcinho VP’s story, a drug boss and leader of a favela (slum) in Rio–Michael Jackson had to ask for his permission in 1996 to film a video clip on the hill. VP received a ‘‘grant’’ by a member of one of the richest families in Rio to write a book on his worldview, in which he presented himself as a modern Lampião (the Brazilian Robin Hood) and victim of an unequal society. The fascination with bandits like Mauricinho and Marcinho is part of the growing banalization, aesthetization and indifference regarding violence

Marcinho et Mauricinho

Dans son article sur les sociétés post-traditionnelles, Giddens recommande l’instauration d’une « démocratie dialogique » pour remplir le vide laissé par la disparition des ordres moraux traditionnels. Dans cet article, je suggère qu’au Brésil, une démocratie dialogique factice, fondée sur l’inversion, a pour effet de réduire au silence la voix de nombreux acteurs sociaux impliqués dans le drame de la violence urbaine. On trouve dans les médias, mais aussi dans les débats politiques sur l’identité nationale, des récits publics définissant et fusionnant des valeurs traditionnellement opposées comme le bien et le mal, les riches et les pauvres, les bandits et les héros. Au Brésil se développe actuellement une fascination pour les bandits, redéfinis comme de nouveaux héros. Deux histoires tirées de la presse locale illustrent ce phénomène. La première raconte l’histoire de Mauricinho Botafogo, un bandit issu de la classe moyenne et l’autre, celle de Marcinho VP, un trafiquant de drogue et leader d’une favela (un bidonville) de Rio de Janeiro — Michael Jackson a dû lui demander la permission de tourner un vidéo-clip sur « sa » montagne. VP a aussi reçu une « subvention » de la part d’un membre d’une des plus riches familles de Rio de Janeiro pour écrire un livre sur sa vision du monde ; il s’y présente lui-même comme un Lampião moderne (le Robin des bois brésilien) et la victime d’une société inégalitaire. La fascination pour des bandits comme Marcinho et Mauricinho nourrit la banalisation et l’esthétisation croissantes de la violence, ainsi que l’indifférence à son égard.Giddens in his article on post-traditional societies recommends a ‘‘dialogical democracy’’ to fill in the void left by the disappearance of traditions (moral orders). In this paper we argue that a ’fake dialogical democracy’ or ‘‘inversions’’ end up silencing the voices of many social actors involved in the drama of urban violence. Public narratives on the approximation and fusion of traditionally separated values like good/bad, rich/poor, or bandit/hero can be found in the mass media, but also is part of the national identity politics. Nowadays, a fascination for bandits as the new heroes is taking place in Brazil. Two recent discussions in the local press were chosen for illustration. One is about Mauricinho Botafogo, a bandit coming from the middle class and the other one was initiated by Marcinho VP’s story, a drug boss and leader of a favela (slum) in Rio–Michael Jackson had to ask for his permission in 1996 to film a video clip on the hill. VP received a ‘‘grant’’ by a member of one of the richest families in Rio to write a book on his worldview, in which he presented himself as a modern Lampião (the Brazilian Robin Hood) and victim of an unequal society. The fascination with bandits like Mauricinho and Marcinho is part of the growing banalization, aesthetization and indifference regarding violence

La verdad de Hermes. Sobre la autoridad en los textos etnográficos

Se analizan cuatro "escuelas" de enfoques cualitativos para la escritura etnográfica sobre la base del rol de autor/escritor: Naturalismo, etnometodología, emocionalismo y posmodernismo (si es que tal enfoque existe). En cada uno de estos enfoques el autor se expresa desde posiciones diferentes, explorando así, desde distintos ángulos, la realidad en estudio. Finalmente, se arguye que la combinación de estas cuatro "escuelas", cada una con sus propias limitaciones y revelaciones, podría conducir a un entendimiento más amplio de los demas y de nosotros mismos