Carlos Barradas

In April 2011, Portugal called on
the European Union for a  nancial bailout due to its debt crisis, and counterbalanced this rescue with
various austerity measures. Within the Portuguese public health system (Serviço Nacional de Saúde, SNS) these measures were swiftly applied on a large scale,
and in turn led to increasing dif culties among the health professionals within the SNS with regard to the use of diagnostics, treatments, and medications for patients, as well as growing obstacles to regular clinical consultations. Through media analysis of Portuguese health policy related to cancer and statements from professionals in the SNS, this article expresses the concerns of these health providers and explores how this situation is negatively impacting the lives of those who deal with this disease every day.

The paper analyses illness experiences of breast cancer in women undergoing treatment at the Hospital of Cancer III of the National Institute of Cancer. It argues that part of the interviewed women's experience was constructed from the interaction between family coexistence and the mobilisation of different cultural meanings of the disease and femininity, negotiating senses for biomedical entities. The study results from a qualitative research of ethnographic inspiration that interviewed women undergoing treatment from breast cancer during 2015. It draws on the accounts to discuss the interaction of society with biomedical entities for the significance of cancer in Brazil between the 1990s and 2010s.

The paper analyses illness experiences of breast cancer in women undergoing treatment at the Hospital of Cancer III of the National Institute of Cancer. It argues that part of the interviewed women's experience was constructed from the interaction between family coexistence and the mobilisation of different cultural meanings of the disease and femininity, negotiating senses for biomedical entities. The study results from a qualitative research of ethnographic inspiration that interviewed women undergoing treatment from breast cancer during 2015. It draws on the accounts to discuss the interaction of society with biomedical entities for the significance of cancer in Brazil between the 1990s and 2010s.

In April 2011, Portugal called on the European Union for a financial bailout due to its debt crisis, and counterbalanced this rescue with various austerity measures. Within the Portuguese public health system (Serviço Nacional de Saúde, SNS) these measures were swiftly applied on a large scale, and in turn led to increasing difficulties among the health professionals within the SNS with regard to the use of diagnostics, treatments, and medications for patients, as well as growing obstacles to regular clinical consultations. Through media analysis of Portuguese health policy related to cancer and statements from professionals in the SNS, this article expresses the concerns of these health providers and explores how this situation is negatively impacting the lives of those who deal with this disease every day.

This paper explores the way those commonly described as “lay persons”, “the public” or “patients” appropriate biomedical and biological knowledge and make it part of their repertoires of experience, including embodied experience, as well as the specific apparatuses or dispositifs associated with health promotion or education. The paper draws on an extenexperimentalinitiative in health promotion in Brazil. This initiative raises intriguing challenges to current approaches to what counts as knowledge and how it is associated with the empowerment of citizens in relation to health.

On April 2011, the Portuguese Socialist Party asked the European Comission for a financial bailout, as a response to its sovereign-­‐debt crisis. This led to a political standoff, concluding with the election of a government constituted exclusively by right-­‐wing parties. With the bailout, a package of externally defined austerity measures (namely by the European Comission, The European Central Bank and the International Monetary Fund – the Troika) was regarded as a priority to minimize the debt. Concerning the field of health -­‐ specifically the National Health Service (NHS) -­‐ several measures were taken swiftly and, according to several media, far beyond what had been imposed by the Troika. Thus health professionals working in the NHS started feeling growing difficulties in using means of diagnosis, treatments and medication for patients, as well as increasing obstacles to patients’ attendance of appointments with physicians. This paper intends to display such anxieties and explore how this is affecting breast cancer patients’ lives through the testimonies of health professionals.

O presente artigo pretende, recorrendo a uma diversidade de fontes empíricas e um quadro teórico focalizado, aferir da conjugação de atores e momentos que desencadearam uma nova constelação de instituições nos quadrantes legislativo, executivo e judicial e que levaram à aplicação de um quadro normativo referente ao consumo e venda de tabaco em Portugal, alterando assim os discursos sobre direitos e deveres dos indivíduos e, em última instância, os hábitos e crenças enraizadas sobre um aspeto da vida social. A pesquisa foi realizada com recurso a variados materiais legislativos e decorrentes da mídia com ênfase na lei anti-tabaco em portugal. A pergunta de partida era avaliar de que modo a nova economia institucional e o pragmatismo volitivo constituiriam instrumentos teóricos e metodológicos adequados para a análise e interpretação do percurso da lei anti-tabaco em Portugal. O novo institucionalismo, o pragmatismo volitivo e a epistemologia que advoga fornecem ferramentas metodológicas e conceptuais úteis para a análise de fenómenos económicos que não podem ser examinados tomando o mercado ou a racionalidade dos indivíduos como únicos referenciais, como num modelo mecanicista Paretiano, que indica aquilo que é “socialmente preferido”, particularmente porque aquilo que é o “social” tem diferentes sentidos e apropriações. No caso das políticas públicas, a lei antitabaco é um óptimo exemplo, dada a rapidez e extensão da sua aplicação. Através do recurso aos conceitos de um enquadramento teórico restrito da economia institucional, procurou-se uma caraterização breve dos mesmos, mas aferindo simultaneamente da sua aplicabilidade num caso que possui o mesmo princípio, em dois países. Confere mais consistência teórica aos modelos não dominantes que até agora têm procurado explicar o fenómeno da emergência da lei anti-tabaco e provoca novas pistas de investigação que podem ser pertinentes do ponto de vista teórico. Por fim, dizer que aqueles modelos teóricos e metodológicos contêm capacidade explicativa, motivada pela sua aplicação noutro contexto empírico.

Abstract (English): Using a variety of empirical sources and a specific theoretical framework, this article attempts to assess the combination of actors and moments that triggered a new "constellation of institutions in the legislative, executive and judicial branches" (Bromley, 2006:47) and led to the implementation of a regulatory structure for the tobacco sale and consumption in Portugal, thus changing the discourse on rights and duties of individuals and, ultimately, habits and beliefs rooted in social life. The research was conducted using a variety of legislative and media materials with the focus on the anti-tobacco law in Portugal . The initial question was to assess how the new institutional economics and volitional pragmatism constitute adequate theoretical and methodological tools for the analysis and interpretation of the development and establishment of the anti-tobacco law in Portugal .

The new institutionalism, the volitional pragmatism and the epistemology it advocates provide useful conceptual and methodological tools for the analysis of economic phenomena that can not be examined by taking the market or individual's rationality as unique references, in a mechanistic model like the Paretian, which indicates what is "socially preferred" ( Bromley , 2006 : 216 ), particularly because what is "social" has different meanings and appropriations. In the case of public policy , the anti-tobacco law is a great example, given the swiftness and extent of its application. Making use of and briefly describing the main concepts deriving from a restricted theoretical framework of institutional economics,  its applicability to other empirical contexts was sought.

This article attributes further consistency to the non-dominant theoretical models based on institutional economics that satisfactorily explain the emergence of anti-tobacco laws and provokes new research leading to the consolidation and validity of a non-dominant theoretical and methodological standpoint. Finally, it is needed to say that such theoretical and methodological models contain explanatory capacity, motivated by its application in another empirical context.

This article provides an overview of the process that led to the adoption of a methodological strategy that privileges personal narratives on illness, in the frame of an ongoing research project. To this project, which focuses on three types of pathologies (cancer, respiratory diseases and child obesity), qualitative methodologies were considered as the most suitable, on the one hand because of the richness of the information they elicit, on the other by their adequateness concerning conjectured goals and work hypotheses. Hence, the use of MINI (McGill Illness Narrative Interview) (Groleau et al., 2006), was privileged, considering its appropriateness to the field. A preliminary approach to the methodological and conceptual choices is presented, as well as an account of the importance of personal illness narratives in the objectives of the project.

A IVG tem, um pouco por todo o mundo, sido alvo de inúmeros estudos centrados na questão da saúde pública, dos direitos humanos, dos direitos das mulheres, do direito à integridade corporal e do direito à vida, entre outros. Comum a estas análises é uma retórica socio-jurídica assente na lei e nos direitos. Neste artigo avaliamos as representações em torno da lei do aborto por parte dos/as diversos/as agentes envolvidos/as, como as mulheres, operadores/as judiciários/as, parteiras, profissionais de saúde, activistas e representantes de partidos políticos.

Os estudos feministas sobre o direito têm vindo a demonstrar que aquele é guiado por um paradigma eminentemente patriarcal, razão pela qual a lei, baseada numa hierarquia de género, tende a negligenciar diversos tipos de violência exercidos sobre as mulheres. Como exemplos paradigmáticos  são apontados os regimes jurídicos que proclamam uma igualdade formal entre homens e mulheres, mas persistem em penalizar a interrupção voluntária da gravidez. Nesse sentido, as teorias feministas alertam que o direito não é necessariamente sinónimo de justiça, pelo que as práticas e representações sobre uma verdadeira justiça sexual podem não ser coincidentes com a lei nos livros. Neste artigo, recorrendo ao caso português, avaliamos as representações em torno da lei do aborto por parte dos/as diversos/as agentes envolvidos/as, como as mulheres, operadores/as judiciários/as, parteiras, profissionais de saúde, activistas e representantes de partidos políticos.

A heavy heritage hovers upon photography. Its use as an instrument involved in a strategy of inferiority production and maintenance of unequal power relations motivated by the colonial domain had formerly transformed it into a metaphor of imperialism. With the subsequent disappearance of colonial administrations and their political-juridical borders, we have entered the period commonly assumed as post-colonialism. However, the fading of those boundaries did not render invisible some of the distinguishable characteristics of colonialism, namely the undervaluation of the “Other” from the point of view of the once colonizing countries’ gaze. In that sense, photography’s role itself has been distorted, not only based on the current existence of oppressions deriving from the colonial period, but also in relation to the new approaches and photographic productions from both the “central” countries as well as from the traditionally “inferiorised” places. This article will explore the symbolic power that photography held in the past and advocates in the present, drawing from its double side, simultaneously regulatory and challenging, simultaneously oppressive and liberating,

As narrativas de experiência de doença constituem uma das formas mais eficazes de aceder ao mundo individual e
profundamente subjetivo da experiência de doença e, por inerência, de saúde. Estas têm constituído uma das principais
fontes de informação na área da antropologia médica e estudos sociais da medicina e da saúde. Têm a capacidade de
revelar o modo como os indivíduos desenvolvem modelos explicativos e protótipos salientes (Kleinman, 1989) que
relacionam as suas experiências ao conhecimento biomédico. Por outro lado, o estudo das narrativas da experiência de
saúde e doença expõe os contextos sociais e discursivos dentro dos quais lhes é atribuído sentido, bem como os
quadros culturais nos quais as pessoas interpretam certas experiÍncias (Groleau et al., 2006).
No âmbito de dois projetos de investigação em curso, foi selecionada uma abordagem metodológica que privilegia a
informação decorrente das narrativas de experiÍncia de doença e de saúde através do uso de um guião semiestruturado designado MINI (McGill Illness Narrative Interview). Com esta opção, e usando resultados preliminares, pretende-se contribuir, por um lado, para um reforço da importância do uso das narrativas pessoais de doença no
estudo dos determinantes sociais de saúde e, por outro, para o entendimento do modo como as experiências de doença e saúde traduzem a importância que os quadros sociais e culturais desempenham nas concepções destes fenómenos.

Narratives of experience provide unique materials for exploring the ways in which subjects make sense of illness whilst building
a link between their experiences and medical knowledge. The
project "Evaluating the State of Public Knowledge on Health and
Health Information in Portugal” within the Harvard Medical
School-Portugal Program on Translational Research and Health
Information, funded by Portuguese Foundation for Science and
Technology, seeks to explore new approaches to the experience
of asthma patients as they are articulated in narratives, through an
adaptation of the McGill Illness Narrative Interview (MINI)
schedule as its main tool. This presentation aims at discussing the
preliminary findings drawn from narrative interview analysis
conducted in Portugal – Hospital São João of Porto, with patients
of the Immunoallergology service. This component of fieldwork
allowed us to identify and characterize: in detail, (i) what counts
as health knowledge; (ii) what are the different patterns of
description and explanation; (iii) different experiences of living
with the condition and the engagements with health care services
and health professionals; and (iv) the different forms and
strategies for managing the disease. Self-management is
particularly relevant if we take into account the existence of a
‘chronic disease paradigm’ associated with asthma that, to some
extent, allows the individual control and management of this
disease and results from different forms of combine medical
knowledge with the personal experiences of the asthma.

Medical information made available for patients in medical settings is, generally, produced without their feedback on its content and vocabulary. In the context of an ongoing doctoral project, in association with the Harvard Medical School – Portugal Program on Translational Research, breast and colorectal cancer patients were interviewed using the McGill Illness Narrative Interview (MINI) (Groleau et al., 2006) in oncology units from public hospitals and the Portuguese Oncology Institute. Among other goals, one objective was to assess patient’s views on the best ways to promote, disseminate and understand this medical information. These interviews were conducted two weeks after the appointment with the physician ‐ in which the diagnosis of their condition was given as well as medical information, such as flyers and guidelines. Drawing from this “delivery” of information and its conceptual grounds, according to which individuals are social and cultural void receptacles in which information and knowledge are poured and uncritically interpreted, preliminary results of this project contradict this very principle. In fact, the generally conveyed idea that the mere provision of medical information leads to its consultation is wrong. This notion is challenged based on the fact that it is the illness experience itself (either from the individual or from the individual’s social network) the catalyst for the search and assimilation of medical information. This paper intends to demonstrate that in the field of production of medical information, the experience of patients provides a wide array of socially, culturally and politically relevant resources and ultimately facilitates political strategies on health information.