Engaging in the disablement process over space and time: narratives of persons with multiple sclerosis in Ottawa, Canada

This article presents an interpretive analysis of the narratives of 15 men and women who have been diagnosed with multiple sclerosis (MS) living in the city of Ottawa, Ontario, Canada. Relatively little is known about how people who are affected by MS cope with the challenges posed by social and physical barriers in their environment. Our research investigates two objectives: (1) to explore how those who have developed MS cope with their disease and resulting impairments, both in terms of the bodily experiences of becoming a chronically ill person and in terms of how they cope with changing relationships, changing identities and challenges in their physical environment; and (2) how they engage in the process of disablement over time and space as a result of these changing social and spatial relationships. We argue that the physical body and its social placings in public and private spaces are intertwined and both affect experiences of health, ability, impairment, disability and chronic illness. We further argue that these relationships are experienced across time and space, and in place, as people who have developed a chronic illness, such as MS, engage in, with and through the process of disablement. This article demonstrates the need for researchers to pay more attention to the role and significance of the simultaneity of space, place and time in shaping the experiences of people with disabilities and chronic illnesses, as it has been shown that these variables played a significant role in regulating the everyday experiences of this study's respondents.     

复杂理论视角下城市健康地理学探析

城市公共健康问题是根植于所依托的地域空间背景下的复杂问题,因而,目前学界主要以还原论的模型假设来分析影响城市健康的复杂多因子关系时存在一定局限。本文在分析城市健康地理问题的"地方"复杂性基础上,提出用复杂理论认识城市的健康问题,将城市健康地理系统看作为具有开放性、组分的知识局限性、自组织性、路径依赖、涌现性、正反馈和锁定特征的复杂系统。从复杂理论视角探讨了当前城市健康地理学研究的三个主要议题,进而提出复杂理论视角下城市健康地理学研究框架及未来研究展望。     

对城市社会-生活空间的本体解构

根据国外著名学者的观点与权威性文献总结国外地理学社会论(学派)形成与发展的思维观,重点探讨城市社会-生活空间理论的思想与方法论,并力图用概念化结构模式(图)表示出来,作为理解城市社会-生活空间本体构成,以及进一步对其研究的解构理念。全文从地理学社会论创立解剖社会空间的思想观逻辑,预示城市社会-生活空间规律的研究代表了当今人文地理学前沿理论水平的重要方面。     

General Geographic Concepts

Following are fragments of a book devoted to theoretical geography on which Professor Smirnov, head of the Department of Economic Geography of Odessa University, was working at the time of his death in July, 1969. An attempt is made to formulate a system of general geographic concepts that would constitute the axiomatic foundation of geography. Several types of fundamental concepts are distinguished: spatial concepts; concepts of the structure and functions of geographical formations; concepts of simple and complex formations, etc. The present paper is limited to an examination of spatial concepts associated with geographical space, which is viewed as one of the general properties of geographical formations. Three basic spatial concepts are discussed: (a) the concept of group space, meaning the space occupied by a set of interrelated objects, as opposed to the individual space of a single object; (b) the concept of spatial integration of phenomena, implying causal relationships; (c) the concept of geographical commonality of phenomena, as opposed to the theory of uniqueness or local exclusiveness. The interplay of general laws and purely local relationships gives rise to a spatial field of interaction known as the geographical field. A geographical formation and its field of interaction may be centered, as in urban settlement, industry and other nodal phenomena, or they may be noncentered, as in rural settlement, agriculture and other spatially continuous phenomena. Other concepts are the area, shape, orientation and spatial dynamics of development of geographical formations.     

国外对城市康体保护空间的研究

对城市康体保护空间的研究涉及医学地理学、健康地理学(或保健地理学)。前者重在探讨如地方病、癌症等的地理生态、地理流行特点、环境病因和疾病制图等领域。中国在此方面的研究已处于世界前列,特别是地理化学因素与地方病和癌症等的病因研究更为突出[2]。后者探讨社群总体健康水平与环境的关系。城市社会地理学出于对城市生活空间质量的探源,研究城市不同区位(或社区)康体保护的水平以及对社区的管制。国外对此方面的研究也可称为城市保健地理。由于国外发达国家已进入高消费阶段,对城市空间的康体性有了很高的期望,因此,在此方面的研究处于领先地位。其创新之处在于,摆脱了传统的与健康有关的城市宏观物资条件的分析,综合与康体有关的社群、行为、管理与社会经济因素的研究,引发了对城市保健地理方面的全面审视。本文在总结国外最新的文献和资料的基础上,从探讨城市生活空间质量水平的角度,全面对城市康体保护空间研究的内容进行总结,并力图用模式的形式表述出来。     

Structural boundaries that effect the representation of gender and disability in works of fiction from the United States and United Kingdom

Abstract

Discussions of intellectual disability are found in medical journals, published biographies, and disability research. However, outside the realm of medicine or personal reminiscence intellectual disability struggles for spaces of social, historical, cultural and imaginative representation. This article addresses these struggles for space and specifically focuses on the imagined space of narrative fiction. Being imagined spaces they should easily be able to accommodate people with disability, and yet, very few characters with intellectual disability are represented or more importantly have agency in narrative fiction. Drawing on work from feminist geographies and literary geographies this article addresses the limiting narrative structures that have been used against fictional characters who have a disability and ways authors may move beyond these limitations. Reconciling feminist geographies and literary geographies allows new critical spatial knowledge around disability to emerge. It is not enough to write characters with disabilities into narrative fiction if the structures surrounding them remain limiting and prejudiced. This article discusses the three main limiting structures in narrative fiction: character representation, narrative voice and genre. Looking at narrative fiction through feminist and literary geographies reveals how these limiting structures function as power hierarchies, and importantly, shows how these imposed structures can be subverted and changed.     

Book Reviews

Books reviewed in this article:
Unsettling cities: movement/settlement. John Allen, Doreen Massey and Micheal Pryke (eds)
From colonization to democracy: a new historical geography of South Africa : Alan Lester
Leisure/tourism geographies: practises and geographical knowledge : David Crouch (ed)
Mind and body spaces: geographies of illness, impairment and disability : Ruth Butler and Hester Parr (eds)     

‘I am also doing research’: Engaging mental illness and precarity in Ouagadougou

Narratives about mental health in Africa often present people with mental illness in situations of extreme precarity, such as in chains or on the street. In this article, the author argues that such representations should not become the only story regarding mental illness in Africa. The article focuses on the story of Joseph, a man who is an outpatient of a psychiatric ward in Ouagadougou, Burkina Faso, and reflects upon his experience of mental illness in relation to the ongoing story of his life. His confident statement ‘I am also doing research’ provides an entry point for understanding his engagements with life and mental illness as acts of experimentation that are not necessarily rooted in precarity. His story shows how precarity and possibility can evolve alongside each other. It also shows the role that psychiatry already plays in (some of) the lives of people with mental illness in an African context, interacting with other narratives of mental troubles and healing.     

A New Application of the Bioarchaeology of Care Approach: A Case Study from the Metal Period,the Philippines

A case of disability in the Metal Period of the Philippines, likely requiring healthcare from others, is presented to explore aspects of group dynamics in this period of antiquity. B243, a middle‐aged man excavated from the Napa site in the central Philippines, suffered severe trauma to the right leg resulting in considerable restrictions to mobility and self‐maintenance of survival‐related behaviours such as food provision and hygiene. It is likely that B243 required assistance from others to survive for some period of time prior to eventual death. The bioarchaeology of care method was applied to assess the types of healthcare that B243 likely required and to consider potential social and biological impacts to both B243 and his community. Provision of healthcare practice in this case suggests that B243's community had access to health‐related resources, knowledge on the treatment of his injuries and underlying values in the group for sustaining human life in the case of injury and disability. Copyright © 2017 John Wiley & Sons, Ltd.     

Sik Bilong Ples: an Exploration of Meanings of Illness and Well-Being Amongst the Wosera Abelam of Papua New Guinea

This paper examines indigenous concepts of health and well-being amongst the Wosera Abelam, East Sepik Province, Papua New Guinea. Indigenous conceptual frameworks for understanding human well-being are remarkably resilient despite the use of western medical services and nutritional advice from health clinics. Their resilience is probably attributable to their embeddedness within a wider worldview that emphasises the social context of health and well-being and thus makes them resistant to change. Whilst the Wosera Abelam are open and receptive to modern health services, their response to these services remains considerably influenced by indigenous concepts of health and illness.     

FOUCAULT'S ‘HALL OF MIRRORS’: AN INVESTIGATION INTO GEO‐EPISTEMOLOGY

In this article we aim to single out a part of Foucault's trihedrals of spatialization – discourses and practices, that is, technologies of power that have their spatialized frames. In order to analyse them we use the concept of a trihedral, not a triangle, because we noticed that several lines can be drawn from any angle and can form new spaces. In such a manner we are able to see their multiplication, separation and parallelisms. Using the trihedrals of spatialization we detect in Foucault's work, besides the demands for a certain (spatialized) ontology, the existence of no less significant geo‐epistemology as knowledge and discourses that are formed in spaces and as the space formed through knowledge/power/discourses. We face a polyvalent character of the angles of the trihedrals and try to avoid the labyrinth into which their multiplication pulls us. The article pays special attention to Foucault's elementary trihedral, life–work–language, in which man came to life as a being who works, speaks and reproduces in a new shape – as population. In this trihedral the angles/concepts are only seemingly separated: they overlap, mix, collide and intertwine in a game that cannot end. That is why this is only a snapshot of the many trihedrals; a possible aggregate of combinations, yet in no case coherent and homogenous. In that sense this article is not an attempt to systematize Foucault's thought but to identify one of the many possible models/matrices for understanding the meaning of his spatial turn and his analysis of power.     

Reimagining GIScience for relational spaces

A mismatch between largely absolute Newtonian models of space in GIScience and the relational spaces of critical human geography has contributed to mutual disinterest between the fields. Critical GIS has offered an intellectual critique of GIScience without substantially altering how particular key geographical concepts are expressed in data structures. Although keystone ideas in GIScience such as Tobler's “First Law” and the modifiable areal unit problem speak to enduring concerns of human geography, they have drawn little interest from that field. Here, we suggest one way to reformulate the computational approach to the region for relational space, so that regions emerge not through proximity in an absolute space or similarities in intensive properties, but according to their similarities in relations. We show how this might operate theoretically and empirically, working through three illustrative examples. Our approach gestures toward reformulating key terms in GIScience like distance, proximity, networks, and spatial building blocks such as the polygon. Re‐engaging the challenges of representing geographical concepts computationally can yield new kinds of GIS and GIScience resonant with theoretical ideas in human geography, and also lead to critical human geographic practices less antagonistic to computation.     

Constructing subjective spiritual geographies in everyday mobilities: the practice of prayer and meditation in corporeal travel

This paper contributes to contemporary geographies of religion by exploring how everyday spaces of mobility and flows can be transformed through specific practices such as prayer and meditation that contribute to personal spirituality. The work challenges traditionally held assumptions that sacred space or codified religious spaces requires stillness and calmness by drawing on the New Mobilities Paradigm to explore how spiritual practices are conducted within the flows and movement that characterise contemporary everyday life. Using questionnaires and diary-interview methods, everyday journeys of participants captured how prayer, meditation and encounters with others and the environment facilitated by movement can transform and be transformed by mobility and the mode of travel. Participant’s accounts of their everyday mundane journeys reveal personalised associations of the everyday spaces that they travel through and the different routines they enact on a daily basis that incorporate religious objects, practices or ideas. These journeys and time-spaces form what I term a ‘subjective spiritual geography’, a network of the interrelated time-spaces threaded together by the individual’s schedule and routine that create, maintain and reinforce personal and informal religious meaning in everyday life.     

The influence of the 'spaces of everyday life' on pregnancy health

Given the recent focus of medical geography on the social influences of health and illness, this paper draws upon a socio‐theoretical framework to show the link between pregnancy health and the spaces of everyday life. The health of pregnant women is becoming increasingly important given that 85 percent of women work during their pregnancy. Employment during pregnancy is consistently linked with good health for infants; however, large discrepancies exist on the effects for employed mothers. This study estimates the health effect of women's employment during pregnancy with data from the National Longitudinal Survey of Children and Youth. Findings show that women's involvement in paid employment has a beneficial impact for infants compared to women not involved in paid labour. Women who work one job or more per week experience more health problems than women who work less than one job per week. Finally, women who work in male‐dominated and gender‐neutral workspaces experience significantly more prenatal problems than women in female‐dominated workspaces. In conclusion, there is evidence to support that differences in employment status, number of workplaces involved in and gendered workspaces influence the experience of health and illness that are negotiated in the spaces of everyday life.     

‘You have to make a new way of life’: women's drug treatment programmes as therapeutic landscapes in Canada

The concept of the ‘therapeutic landscape’ has been widely applied by health geographers over the past decade and a half. Despite its broad application, the concept has been criticized. Some scholars, for example, have argued that it adopts an overly positive view of the health effects of therapeutics settings. Others have noted a lack of attention to gender. In this article we respond to these limitations by engaging with feminist research on women and drug use to critically examine women's experiences of the therapeutic space of drug treatment programmes. Drawing on in-depth interviews and participant observation conducted at two sites in southern Ontario, we examine the ways in which programmes' organizational logics, daily routines and social spaces are shaped by gendered assumptions about the nature of, and solutions to, women's drug use. In so doing, we contribute to a more nuanced and critically informed understanding of such landscapes.     

段义孚的地方空间思想研究

地方与空间思想是段义孚人文主义地理学的核心,以人的生存为旨归,从人的感官、感情、美学的多重维度,揭示人与地方、空间两种地理环境的本质联系,呈现了人类认识地方、认识空间、重构地方的崭新视角。本文从思想内涵、历史渊源、学界评价及影响、当代价值方面对段义孚的地方空间思想进行了体系性与初步理论建构式研究,认为段义孚地方空间理论以人为本,地方是具有既定价值的安全中心,代表着真实与安定;空间跟时间一样,构成人类生活的基本坐标,代表着向往与自由。二者对立统一,在人的生存中相辅相成、缺一不可,人类生活就是穿梭于地方与空间的辩证运动,揭示了人与生存环境的本质关系,蕴含深厚的人文关怀。有助于人们进一步探讨人与地方和空间的内在联系,改善人的生存环境,为缓解身份危机和环境危机、维护精神生态和环境生态提供新的理念。     

Taking Space: Moments of Rupture and Everyday Life in Occupy London

Taking space has been a common feature of recent social movements worldwide, and was a defining act of the Occupy movement. This article examines the taking of two spaces by Occupy London in October 2011, and argues that there was a tension between taking space as a moment of rupture, lived space‐times of intensity that provide an opening to new possibilities, and everyday life, the routines and rhythms through which social life is reproduced. My argument builds on the work of Lefebvre, bringing together his conceptualisation of “moments” and everyday life, and his radical theory of the production of space. I argue that examining the tensions over taking space provides a useful angle to explore some of the challenges faced by the Occupy movement, such as an unequal division of labour on camp, and may help in negotiating them.     

‘You just have to be smart’: spatial practices and subjectivity among women in sex work in London,Ontario

Social science research on the relationship between space and sex work, specifically among women in street-based settings, demonstrates the spatialized nature of risk and how different forms of civic and legal governance contribute to their socio-economic marginalization. However, these studies rarely consider the women’s spatial practices and gendered subjectivities beyond the sex trade, which is problematic because sex work is not their singular life activity or the only impetus for their spatial movements through the urban landscape. Using social mapping and interview data from 33 women in sex work in London, Ontario, this article explores how our participants navigate the spaces where they work and live alongside those regarding health care, social services, violence and places they avoid. Findings reveal that the women traverse diverse spaces as they access health services, especially for crisis issues that necessitate travel to hospitals located beyond the inner city. The spaces used to access social services and those they avoid (i.e. to not be emotionally triggered or under police surveillance) overlap significantly, which presents unique challenges for our participants who depend upon these services for their socio-economic survival. The theoretical contributions these data make to the feminist geography literature on gender and space are discussed, particularly with respect to the issues of nomadic subjectivity and the relationality between city spaces and marginalized bodies.