Assembling the multitude: questions about agency in the urban environment

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.In recent years, urban history has witnessed an expansion of actors. Historians have substantially and continuously extended their perspectives when it comes to examining the forces that drive urban developments. This expansion to an ever-broader range of human and increasingly also non-human actors (e.g. animals, technological systems and resources such as water) has opened up many new venues for investigations. It has also raised new questions about the role of cities in the history of social change. One of the most provocative ideas involves the claim that cities themselves should be considered agents and proprietors of change. Such notions of urban agency are premised on the assumption that, on the whole, cities are more than the sum of their parts. In this context, urbanization is not just viewed as the outcome of other determining societal forces, most notably capitalism. Instead, cities themselves are understood as determining entities and powerful enablers or preventers of material transformations. The investigative potential of such a perspective is tremendous, but the possible pitfalls should also not be underestimated. Exploring the explanatory prospects of urban agency requires, first of all, a critical engagement with both of the terms ‘agency’ and ‘the urban’. In my brief contribution to this roundtable, I would like to offer two points to the discussion: the first centres on the relationship between agency and intentionality/responsibilities, which is ultimately a political concern; the second aims to differentiate between the city as an entity and the urban as a process. Such a distinction, in turn, poses conceptual as well as methodological questions regarding the efficacy of agency as an urban concept

HPV vaccine standing orders and communication in primary care: A qualitative study

BACKGROUND: Standing orders may improve HPV vaccination rates, but clinical staff's readiness to use them has not been well-explored. We sought to explore benefits and challenges to using HPV vaccine standing orders for adolescents ages 9 to 12, understand clinical staff roles in communication about HPV vaccine, and how standing orders can reduce barriers contributing to vaccine disparities among racial and ethnic marginalized groups. METHODS: Participants were a sample of 16 U.S. nurses, medical assistants, and healthcare providers working in primary care, recruited from June to September 2022. Trained staff conducted virtual, semi-structured qualitative interviews. We analyzed the resulting data using reflexive thematic analysis. RESULTS: Themes reflected benefits and challenges to using HPV vaccine standing orders and strategies to address clinic barriers to improve vaccine access and HPV vaccine communication. Benefits included faster and efficient clinic flow; fewer missed vaccine opportunities and promotion of early vaccination; and normalization of HPV vaccination as routine care. Challenges included possible exacerbation of existing HPV vaccine communication and recommendation barriers; and how the complexity of the vaccine administration schedule lessens nurses' and medical assistants' confidence to use standing orders. Strategies to address vaccine access barriers included using nurse-only visits to empower nurse autonomy and catch up on HPV vaccination; engaging clinical staff to follow up with overdue children; and educating parents on HPV vaccine before their child is vaccine eligible. CONCLUSION: Using HPV vaccine standing orders can promote autonomy for nurses and medical assistants and address vaccine access barriers. Clinical staff engagement and clinic support to mitigate existing vaccine communication barriers are needed to empower staff to use of HPV vaccine standing orders

Food Sovereignty in the City: Challenging Historical Barriers to Food Justice

Local food initiatives are steadily becoming a part of contemporary cities around the world and can take on many forms. While some of these initiatives are concerned with providing consumers with farm-fresh produce, a growing portion are concerned with increasing the food sovereignty of marginalized urban communities. This chapter provides an analysis of urban contexts with the aim of identifying conceptual barriers that may act as roadblocks to achieving food sovereignty in cities. Specifically, this paper argues that taken for granted commitments created during the birth of the modern city could act as conceptual barriers for the implementation of food sovereignty programs and that urban food activists and programs that challenge these barriers are helping to achieve the goal of restoring food sovereignty to local communities, no matter their reasons for doing so. At the very least, understanding the complexities of these barriers and how they operate helps to strengthen ties between urban food projects, provides these initiatives with ways to undermine common arguments used to support restrictive ordinances and policies, and illustrates the transformative potential of food sovereignty movements