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The paper is aimed at contributing to an empirically grounded understanding of the psychosocial dynamics that underlie the relation between heteronormative images of masculinity, internalized heterosexism and health behavior of gay men in the global North. It is based on a qualitative interview study that focuses on the consequences of the internalization of dominant images of masculinity for the identity constructions of gay men and their HIV-related sexual risk behavior in Germany. In the paper it will be argued that 1) the tension between the authoritative image of masculinity that is determined by heteronormative discourses one the one hand and the gendered self-image that is shaped and threatened by connotations of a non-masculine homosexuality on the other constitutes a decisive issue of gay identity constructions, 2) a higher sexual risk behavior can be understood as a possible consequence of the internalization of masculine images and its impact on the self-esteem, if the self-image does not match the male ideal, and 3) this may include a paradoxical desire for the imagined masculinity that is experienced as violent with regard to one’s own psychodynamics. Finally, perspectives on gay masculinities that may transgress dominant heteronormative modes of subjectification are discussed.
"A manager in the minds of doctors" : a comparison of new modes of control in European hospitals
(2013)
Background: Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals.
Methods: The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources.
Results: The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) ‘integrated’ control with high levels of coordination and coherent patterns for cost and quality controls; (2) ‘partly integrated’ control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) ‘fragmented’ control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management.
Conclusions: Our comparison highlights how organisations matter and brings the crucial relevance of ‘coordination’ of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective.
"A groundbreaking decision"
(2018)
Canada’s geographic centre lies in the Territory Nunavut. From here the distance to the geographic North Pole is as far as to the US border. Nunavut takes up about 1/5 of the Canadian land mass but has by far the smallest population with currently about 38,000 residents. 85% of its population are Inuit whose culture dramatically changed within the last 70 years.
As a result, the territory is dealing with several generations of Inuit that are traumatized or at least severely affected by cultural and economic changes that started after World War 2 with the resettlement from the land into permanent communities. No matter if we are talking about the actual elders, mid-age adults or pre-teenagers, each of this generation experienced and still experiences various personal and cultural challenges of identity, financial and housing insecurity, food insecurity, substance abuse education, change of social values ranging from inter-generational and gender relationships to the introduction of a foreign political and legal system.
On the other side, a lot of the traditional societal values are still being practiced in Inuit families. Despite all the tragedies that several generations of Inuit have experienced by now, the society keeps generating the strength and cultural pride that allows many Inuit both, as individuals and as a collective under the umbrella of either Inuit Land Claims or not for profit organizations to advocate on behalf of Inuit culture, to fight for more acknowledgement of Inuit culture and to enhance pride in the historic and present day cultural achievements of Nunavut’s indigenous population.
The social issues, inter- and intra-cultural processes described in my thesis are not exclusive to the situation in Nunavut or to Inuit. Studies from other regions, in Canada or from around the world (LaPrairie 1987; Jensen 1986; Nunatsiaq News 6/30/2010) reveal similar challenges.
Though many structural similarities can be identified by comparing these studies with each other, e.g. marginalization of the indigenous local population, colonization, paternalism and resulting issues like personal and cultural identity loss, it is important to have a more in depth look into the single cases to determine which individual events and developments causes and maybe still cause such a devastating social situation as it is found among many indigenous peoples across the world. From my perspective effective improvements of the situation of a group, a respective community or region can only happen when particularities of socialization, communication and philosophy in the single cultural entities are being considered.
That is why my thesis will exclusively focus on developments in Nunavut and use various case studies of communities. The case studies shall help to identify local differences in historic and recent developments and thus provide starting points for explanations of different developments in different Nunavut communities.
The thesis is looking at both, historic and recent root causes for the many issues in Nunavut.
The data that my my thesis is based on are a combination of literature and about 60 formal and informal interviews that I conducted in three Nunavut communities (Iqaluit, Whale Cove, Kugluktuk) during my 18 months of field work between October 2008 and March 2010. Many more spontaneous unstructured conversations between me and community members added to the pool of first-hand information that I gathered.
Since my field work is limited to those three communities it has a very strong qualitative character. The quantitative side, which allows me to confidently apply my research analyses to entire Nunavut, comes from literature research as well as many informal conversations and a few formal interviews that I conducted with people who had some experience in other communities than Iqaluit, Kugluktuk and Whale Cove.
Furthermore, while I was living at the old residence of the Nunavut Arctic College in Iqaluit, I spend time with college students from across Nunavut. Through them, I obtained „case studies “from following communities: Iqaluit, Qikiqtarjuaq, Kimmirut, Pangnirtung, Clyde River, Pond Inlet, Igloolik, Repulse Bay, Cape Dorset, Chesterfield Inlet, Baker Lake, Rankin Inlet, Whale Cove, Arviat, Taloyoak, Kugluktuk.
My general categorization of “early contact period”, “contact”, “1st generation” and “2nd generation” is very similar to Damas’ terms of “early contact phase”, “contact – traditional”, “resettlement” that he uses to create a timeline that describes the major phases of impact for Inuit society (Damas 2002: 7, 17).
Chapters 2 is meant to provide an inventory of the key aspects of current social issues in Nunavut. In this context I am looking at the four major aspects that in my opinion shape Nunavut’s society:
1) violence and other forms of social dysfunctions
2) the associated services and delivering agencies that try to address those matters
3) Education
4) Inuit cultural particularities in communication and socialization
Those four areas are forming the foundation for the rest of my work. The following chapters will guide the reader through the historic transformation process of Inuit pre-colonial semi-nomadic society to a society that is living in permanent settlements, strongly influenced if not in many ways dominated by Euro-Canadian culture. Each of those chapters will be referring to the social and cultural changes that happened in the different time periods that I labeled with “Pre-settlement, First, Second, and Third Generation”. The relevance of violence and other social dysfunctions, their context and strategies how each generation dealt with those matters will be analyzed while I will be also referring to the impacts that non-Inuit, primarily Euro-Canadians and Euro-Americans had and have on Inuit society.
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“WAR IS PEACE, FREEDOM IS SLAVERY, AND IGNORANCE IS STRENGTH”. The slogan from George Orwell’s “1984” dystopia appears to capture the state of Russia’s 2014 official discourse quite accurately. This has not gone unnoticed by public and academic spectators in and outside Russia: while Bild magazine is counting Putin’s lies in his recent ARD interview, a Zeit article declares Russia itself to be a post-modern “lie”...