Joshua Evans

Theoretical injections: On the therapeutic aesthetics of medical spaces

In this paper we present a dialogue about the seemingly innocuous presence of environmental art in hospital settings as a way of furthering critical perspectives on the therapeutic landscapes concept and its application to medical spaces. We explicitly consider the potential utility of two perspectives, Foucaultian and Lacanian readings, for understanding the relationship between environmental art and the hospital waiting room. We use this paper as a vehicle to demonstrate how such theoretical perspectives can enhance critical scholarship on the therapeutic landscape concept, particularly as it is applied to settings such as health clinics and hospitals. A brief agenda for further critical engagements with the therapeutic nature of health care spaces is put forth in the conclusion.

Re-spacing and re-placing gerontology: relationality and affect

ABSTRACT This paper describes how space and place have been understood in gerontology as phenomenon that are both physical and social in character, yet are relatively bounded and static. The argument is posed as to how, following recent developments in human geography, a relational approach might be adopted. Involving a twist in current thinking, this would instead understand space and place each as highly permeable, fluid and networked at multiple scales. Moreover, it is proposed that the concept of ‘affect’ might also be insightful, recognising space and place as being relationally configured and performed, possessing a somatically registered energy, intensity and momentum that precedes deep cognition. Three vignettes illustrate the relationalities and affects in the lives and circumstances of older people, and how focusing more explicitly on them would allow for a richer understanding of where and how they live their lives. The paper closes with some thoughts on future theoretical, methodological and disciplinary considerations.

Supportive measures, enabling restraint: governing homeless ‘street drinkers’ in Hamilton, Canada

This paper uses a ‘grounded’ governmentality framework to examine the political and personal significance of a novel therapeutic intervention targeting chronically homeless individuals with severe alcohol problems. The paper is based on a qualitative case study of ‘Mountainview,’ a residential facility combining medical care and social services with an ‘alcohol management’ program. Drawing on the experiences of program staff and residents, as well as local policy discourses on homelessness, I explore the significance of this intervention in relation to geographies of inclusion and exclusion in the city. The paper traces how Mountainview encompasses novel forms of visualization, valuation, enclosure, and self-examination that together afford ‘street drinkers’ a new, albeit ambivalent, place in the city.

Questioning context: a set of interdisciplinary questions for investigating contextual factors affecting health decision making

Objective  To combine insights from multiple disciplines into a set of questions that can be used to investigate contextual factors affecting health decision making.

Low-Income Children, Adolescents, and Caregivers Facing Respiratory Problems: Support Needs and Preferences

UNLABELLED Burdens of poverty are often compounded by respiratory problems. This study aimed to identify the support needs and intervention preferences for low-income families facing this challenge. DESIGN AND METHODS Interviews were conducted in two Canadian provinces with low-income children/adolescents (n=32) diagnosed with respiratory health problems and their parents or family caregiver (n=37). RESULTS These vulnerable children and parents described non-supportive interactions with some health service providers and inadequate information. They reported isolation and support deficits, exacerbated by limited resources and health restrictions. Children/adolescents felt isolated and excluded and wanted to connect with peers. Group or dyadic level support, delivered by peers and health professionals, was desired. The importance of logistics to enhance accessibility and appeal of group or dyadic support interventions was clearly identified. CONCLUSIONS The findings of this study reveal that low-income children and their families encounter challenges to accessing support and to utilizing support resources. PRACTICE IMPLICATIONS Partnerships with low-income children/adolescents and family caregivers in provision of education and social support can combat isolation and ignorance. Reducing inequities for this high risk population could be achieved by providing support from experienced peers, in combination with health professional guidance, and knowledge about pulmonary health.

Social enterprises as enabling workplaces for people with psychiatric disabilities

In recent years, western governments influenced by neoliberalism have emphasized paid work as a key route to social inclusion and community participation for people with psychiatric disabilities. Although paid work can offer many rewards, access to mainstream employment for people with psychiatric disabilities is difficult as they continue to encounter discrimination and a lack of workplace accommodation. One response to these challenges has been the creation of social enterprises as ‘alternative spaces’ of employment for people with psychiatric disabilities. On the basis of interviews with key informants from 21 different social enterprises across Ontario, Canada, this paper critically analyzes the strategies used by organizations to create jobs that are both accommodating for people, but also conducive to the ongoing success of the business.

‘You’re In Oil Country’: Moral Tales of Citizen Action against Petroleum Development in Alberta, Canada

The Canadian province of Alberta has experienced phenomenal growth in its oil and gas industry. As the petroleum–industrial complex expands it has sparked a number of community-based conflicts over noxious facilities that are seen by some to be the cause of a number of health problems. The research reported here used two case studies to examine siting conflicts involving natural gas extraction facilities in rural Alberta. We found that the stories shared by citizens involved in these conflicts functioned as ‘moral tales’. These moral tales were political in the way they challenged implicit and institutionalized rationales for redistributing benefits and burdens of oil and gas development. They also created a space for collective action by articulating spatial transgressions and by constructing a type of moral citizenship.

Respiratory Health Inequities Experienced by Low-Income Children and Parents

ABSTRACT As some respiratory conditions are more prevalent among children who are low income, the aim of this study was to describe challenges experienced by children and parents coping with poverty and respiratory health problems and relevant service inequities. Children and parents who are low income (n = 69) were interviewed to identify challenges connected with poverty, compounded by chronic respiratory conditions. Poverty exacerbated challenges linked to respiratory conditions, and respiratory illness increased problems experienced by people living in poverty. Participants reported multiple factors that contributed to poverty and contended that service providers didn’t understand challenges associated with poverty and pulmonary problems. Interviewed service providers (n = 29) reinforced challenge complexities.