Medical anthropology

  • 文章类型: Journal Article
    语言在维持全球公共卫生和生物医学中的权力不对称方面的作用已成为全球卫生非殖民化运动的核心部分。“在考虑语言如何在全球健康中造成不平等的同时,阻碍干预,并抑制医疗护理,这篇文章认为,殖民地衍生的关于什么语言是自上而下的健康传播努力的理论,这些努力被标记为“非殖民化”,可能会阻碍使后殖民地生物医学护理和公共卫生更加清晰的努力。我们通过概述在坦桑尼亚沿海对癌症术语的语言人类学探索中发现的困境来做到这一点。在Bagamoyo的小镇,saratani-政府在1980年代创建的坦桑尼亚癌症官方翻译,作为非殖民化国家建设的更大努力的一部分-被主要理解为与英文改编的名字kansa不同或明确的疾病。随着saratani一词在语言领域的传播,殖民地衍生的kansa词主要被注册为生物疾病“癌症”,“saratani和kansa之间的这种语言差异不仅给Bagamoyo的肿瘤治疗带来了很多问题,但也阐明了在不平等的全球政治经济中创造更公正的健康交流的危险。通过展示语言的“殖民地”和“本地”的二元概念化如何再现不可沟通性-使种族化的受试者在霸权政权中从根本上无法理解-我们认为,过去为使医学语言非殖民化所做的努力的来世对于“全球健康非殖民化”的当下具有重要的教训。“超越语言的静态概念化,我们主张医学语言学的流动“跨语言”观点,以促进不可沟通性的瓦解和创造它的全球秩序。
    The role of language in maintaining asymmetries of power in global public health and biomedicine has become a central part of the broader movement to \"decolonize Global Health.\" While considering how language engenders inequalities in Global Health, hinders interventions, and inhibits medical care, this article contends that colonially derived theorizations of what language is undergirding top-down health communication efforts labeled as \"decolonial\" can thwart efforts to make biomedical care and public health clearer in postcolonies. We do this through outlining predicaments found in a linguistic anthropological exploration of cancer terminology in Coastal Tanzania. In the small town of Bagamoyo, saratani-the official translation for cancer in Tanzania created by the government in the 1980s as part of a larger effort of decolonial state-building-is dominantly understood as a different or unequivocal disease than kansa-the English-adapted name. As the dissemination of the term saratani into a linguistic arena where colonially derived word kansa is dominantly registered as the biological disease \"cancer,\" this linguistic disjuncture between saratani and kansa has not only created a plethora of problems for oncological care in Bagamoyo, but also illuminates the perils of creating more just health communication in an unequal global political economy. Through showing how binary conceptualizations of language as \"colonial\" and \"local\" can reproduce incommunicability-the rendering of racialized subjects as fundamentally unintelligible in hegemonic regimes-we contend that the afterlives of this past effort to decolonize medical language has important lessons for the present of \"decolonizing Global Health.\" Moving beyond static conceptualizations of language, we argue for a fluid \"translanguaging\" perspective of medical linguistics that facilitates the dismantlement of incommunicability and the global ordering that creates it.
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  • 文章类型: Journal Article
    在这一贡献中,我们讨论了定性研究质量的标准。我们将信度和效度视为“主体间可复制性”综合要求的规范,定性研究应该遵守的。在数据收集阶段,“论证性”可靠性通常必须足够;在数据分析阶段,还必须注意“技术”可靠性。定性研究的验证必须通过三种方法进行:“交流”,\'关键\'或\'经验\'验证。这澄清了定性研究的相对有效性或“真实性”。
    In this contribution, we discuss criteria for the quality of qualitative research. We consider reliability and validity as specifications of the comprehensive requirement for \'intersubjective replicability\', with which qualitative research should comply. In the data collection phase, \'argumentative\' reliability generally must suffice; in the data analysis phase, attention must also be given to \'technical\' reliability. Validation of qualitative research has to take place via three approaches: \'communicative\', \'critical\' or \'empirical\' validation. This clarifies the relative validity or \'authenticity\' of qualitative research.
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  • 文章类型: Journal Article
    目标:由于高质量的防腐和有利的保护条件,法国国王亨利四世(1553-1610年生活,1589-1610年统治)的保存至今。这项研究的目的是使用原始和创新的法医三维分割方法检查亨利四世的上谐振腔和乳突。
    方法:通过将现有的传记信息与临床和柔性内窥镜检查和计算机断层扫描(CT扫描)成像进行交叉参考,研究了法国国王亨利四世的鼻旁窦和乳突细胞。描绘鼻旁窦和乳突细胞,并使用ITK-SNAP4.0软件(开源)评估其体积。使用Fusion360®创建图形表示(AutodeskInc.,圣拉斐尔,CA,美国)和MeshMixer®(AutodeskInc.,圣拉斐尔,CA,美国)。
    结果:鼻旁窦断层密度测定显示形状和数量异常。法国的HenriIV患有鼻窦发育不全。左蝶骨和左额窦都没有明显的对比,右侧翼状突的显着气化延伸到整个右侧翼状突的高度。HenriIV乳突气囊的总体积估计为27和26毫升,分别,对于右侧和左侧,远远超过现代学科的正常平均值和最大值。没有发现慢性耳朵或鼻窦疾病的迹象。
    结论:在法医学中开发了一种创新的方法来建立有关面部生长和呼吸状况的假设。
    OBJECTIVE: The preserved head of King Henri IV of France (life 1553-1610, reign 1589-1610) has survived to the present day thanks to high-quality embalming and favorable conservation conditions. The aim of this study was to examine Henry IV\'s upper resonant cavities and mastoids using an original and innovative forensic three-dimensional segmentation method.
    METHODS: The paranasal sinuses and mastoid cells of King Henri IV of France were studied by cross-referencing available biographical information with clinical and flexible endoscopic examination and computed tomography (CT-scan) imaging. The paranasal sinuses and mastoid cells were delineated and their volumes were assessed using ITK-SNAP 4.0 software (open-source). Graphical representations were created using Fusion 360® (Autodesk Inc., San Rafael, CA, USA) and MeshMixer® (Autodesk Inc., San Rafael, CA, USA).
    RESULTS: Paranasal sinus tomodensitometry revealed abnormalities in shape and number. Henri IV of France suffered from sinus aplasia. Neither the left sphenoid nor left frontal sinus contrasted sharply, and a remarkable pneumatization of the right clinoid processes extended throughout the height of the right pterygoid process. The total volumes of Henri IV\'s mastoid air-cells were estimated at 27 and 26 mL, respectively, for the right and left sides, exceeding the normal mean and the maximum of modern subjects by a wide margin. No sign of chronic ear or sinus condition was found.
    CONCLUSIONS: An innovative method has been developed in forensic medicine to establish hypotheses about the growth and respiratory conditions of the face.
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  • 文章类型: Journal Article
    《黄帝内经》(《黄帝内经》)两千多年来一直是中医药知识和创新的原始文本。尽管有这个关键的相关性,它的许多想法和实践已被证明难以理解和充分实施到临床实践。文化和语言差异可以与这些挑战复杂化,但也可能提供新的机会,进步和洞察力时,由研究人员以外的原始文化。本文介绍了经典文本考古学的方法,并深入研究了作者研究该文本的二十年历程,讨论文化差异和医学奖学金问题。
    Huang Di Nei Jing (《》The Yellow Emperor\'s Inner Classic) has been the source text of Chinese medicine knowledge and innovation for over two thousand years. Despite this key relevance, many of its ideas and practices have proven difficult to understand and implement fully into clinical practice. Cultural and language differences can be compounded with these challenges but may also present new opportunities for advancement and insight when studied by researchers outside of the originating culture. This article introduces the method of Classical-Text Archaeology and delves into the author\'s two-decade journey of researching this text, with a discussion on cultural differences and issues of medical scholarship.
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  • 文章类型: Journal Article
    保留面神经在颞骨手术中非常重要。我们打算研究与在颞骨中进入颈静脉孔和颈内动脉(ICA)的位置相关的放射解剖学因素的测量,这些患者是颞骨高分辨率计算机断层扫描(HRCT)扫描的候选人。
    在这项相关性横断面研究中,样本从AmirAlam医院转诊的患者中选择,这些患者以前是颞叶HRCT的候选人.放射解剖因素在三个轴向进行了评估,冠状和矢状视图。使用描述性统计进行分析,相关分析和因子分析。
    研究了总共173个样品。基于变异系数(CV)的最可靠的放射解剖学因素是矢状视图中第7神经到耳蜗下颌关节(TMJ)的距离(变量名称S2)(CV=8.1%),然后是轴向视图中第7神经到耳蜗下段TMJ的距离(变量名称AI3)(CV=8.4%)。在相关性分析的基础上,再进行验证性因子分析,确定了三个常见的潜在因素(总体R2=0.999).
    这项研究的结果可用于两个目的。首先,在外科手术中直接使用估计的措施,第二个是更高级的建模,以选择外科手术中的方法以及如何实施该方法。对于第一个目标,AI3和S2两个因素是不同人群中最可靠的放射解剖因素。对于第二个目标,对获得的测量结果的三维理解以及对潜在因素的解剖学性质的进一步识别可以帮助选择手术中的方法。
    UNASSIGNED: Preservation of the facial nerve is of great importance in temporal bone surgeries. We intend to investigate the measurements of the radioanatomical factors related to the position of the facial nerve in accessing jugular foramen and internal carotid artery (ICA) in temporal bone of patients who were candidates for temporal high resolution computed tomography (HRCT) scan.
    UNASSIGNED: In this correlation cross-sectional study, samples were selected from patients referred to Amir Alam Hospital who were previously candidates for temporal HRCT. Radioanatomic factors were evaluated in three axial, coronal and sagittal views. Analyzes were performed using descriptive statistics, correlation analysis and factor analysis.
    UNASSIGNED: A total of 173 samples were investigated. The most reliable radioanatomical factor based on coefficient of variation (CV) was the distance of the 7th nerve to the temporomandibular joint (TMJ) in the inferior to the cochlea in the sagittal view (variable name S2) (CV = 8.1%) and then the distance from the 7th nerve to the TMJ in the inferior section of the cochlea in the axial view (variable name AI3) (CV = 8.4%). Based on correlation analysis and then confirmatory factor analysis, three common latent factors were identified (overall R2 = 0.999).
    UNASSIGNED: The results of this study can be used for two purposes. First, the direct use of the estimated measures in surgical operations, and the second is more advanced modeling to choose the approach in the surgical operation and how to implement that approach. For the first aim, the two factors AI3 and S2 were the most reliable radioanatomical factors in different people. For the second aim, the three-dimensional understanding of the obtained measurements and the further identification of the anatomical nature of the latent factors can help in choosing the approach in surgery.
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  • 文章类型: Journal Article
    以前关于医学小丑的研究集中在病人身上,虽然关于小丑本身的研究仍然不足:培训计划和先决条件,小丑方法,道义论和公认的实践。世界各地的非营利组织都在推广补充医学领域的各种方法和范例。根据人种学研究,我们探索了以色列5家医院目前的医疗小丑形式。观察到的小丑来自两个以色列组织,梦想医生和SimchatHalev(希伯来语:心脏的喜悦),由付费专业医疗小丑和志愿者组成,分别。根据调查结果,观察到组织之间存在显着差异。梦想医生被认为是表演艺术专业人士实践的专业知识,需要广泛的培训。这些小丑无人陪伴工作,拿到薪水,被认为是医疗团队的成员,and,鉴于他们的特权地位,可以进入医院的开放和封闭区域。梦想医生认为医疗小丑是一种辅助医疗行为,其中干预措施单独适合每个患者的情况,并获得治疗结果。相比之下,SimchatHalev的医疗小丑是没有先决条件的艺术背景的志愿者,接受的培训时间较短。授予这些小丑的权限,通常成对工作,仅限于开放区域。SimchatHalev提倡医疗小丑作为基于志愿者的公共实践,不分青红皂白地为所有患者提供一般娱乐,他们的贡献是实现基本的娱乐价值。
    Previous studies on medical clowning focused on patients, while research remains inadequate concerning clowning itself: training programmes and prerequisite requirements, clowning methods, deontology and accepted practices. Diverse approaches and paradigms in this field of complementary medicine are promoted by non-profit organisations worldwide. Based on an ethnographic study, we explore the current forms of medical clowning in 5 Israeli hospitals. The observed clowns are from the two Israeli organisations, Dream Doctors and Simchat Halev (in Hebrew: joy of the heart), consisting of paid professional medical clowns and volunteers, respectively. According to the findings, significant differences were observed to exist between the organisations. Dream Doctors is conceived and pursued as an expertise practised by performance art professionals, requiring extensive training. These clowns work unaccompanied, receive a salary, are considered members of the medical team, and, given their privileged status, have access to hospitals\' open and closed areas. The Dream Doctors consider medical clowning as a paramedical practice, in which interventions are individually suited to the circumstances of each patient, and obtain therapeutic results. In contrast, Simchat Halev\'s medical clowns are volunteers with no prerequisite artistic background and undergo shorter periods of training. The access granted to these clowns, usually working in pairs, is restricted to open areas. Simchat Halev promotes medical clowning as a volunteer-based public practice, offering general entertainment to all patients indiscriminately, and their contribution is characterised as achieving basic entertainment value.
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  • 文章类型: Journal Article
    在印度公共卫生政策和实践中,人种学方法如何跟踪结构家系主义的内隐和外显形式?如何批判性地关注普通故事和铸造生活的主观性揭示潜在的婆罗门教道德,对公共卫生的假设和想象,但同样也解开了反种姓的反框架/症状的反理论,苦难,种姓造成的伤害和慢性伤口?怎么做,换句话说,反殖民理论的视野是否可以扩展到将casteism概念化为印度社区健康结果和生活机会的核心决定因素?通过动员“反讲故事”作为来自全球南方的关键医学人类学的概念和方法,以及印度北部纵向人种学的案例研究,本文提供了双重批评:1。与种姓问题有关的公共卫生实践,上瘾,呼吸衰弱,空气污染和结核病。And,2.与“穷人”的健康有关的卫生政策制定的认识论,以及像ASHAs和非制度化卫生行为者这样的社区护理人员的性别化和铸造劳动。
    How can ethnographic methods track implicit & explicit forms of structural casteism in Indian public health policy and praxis? How can a critical attention to ordinary stories and subjectivities of casted lives reveal the underlying Brahmanical moralities, assumptions and imaginations of public health but equally also unravel anti-caste counter-framings/counter-theorizations of symptoms, afflictions, injuries and chronic wounds wrought by caste? How, in other words, can the horizons of anti-colonial theory-making be expanded to capaciously conceptualize casteism as a core determinant of community health outcomes and life-chances in India? By mobilizing \'counter-storytelling\' as a concept and method for critical medical anthropology from the Global South, and case studies from longitudinal ethnography in northern India, this paper provides a dual critique of: 1. Public health praxis in relation to questions of caste, addiction, respiratory debilitation, air pollution and TB. And, 2. Epistemologies of health policy making pertaining to wellness for \'the poor\' and the gendered and casted labour of community care workers like ASHAs and non-institutionalized health actors.
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  • 文章类型: Journal Article
    要求专业人员认为医学上不必要的截肢的患者本身不被视为具有医疗决策能力。这一决定是基于这样的假设,即除了截肢之外,还有一种选择;这种假设在许多情况下溢出到治疗上的固执。对于身体部位生病或受损的人来说,这是一种情况,他们希望避免为挽救肢体而进行的反复和痛苦的医疗治疗,以及受身体完整性烦躁不安(BID)影响的个体。BID是世界卫生组织认可的疾病,并包含在国际疾病分类中。第11版。受影响的个人会产生强烈的身体结构过度完整的感觉,这导致强烈的烦躁不安感的发展,因此需要截肢以消除这种不适的根源。在少数实施截肢的情况下,结果被证明是成功的;个人的生活质量得到了改善,他们没有新的截肢欲望。没有药物治疗,包括医疗截肢,目前适用于受影响的个人。这种情况导致许多BID残害自己。这些事件给医学界带来了具有挑战性的道德困境。本文的重点是BID个人除要求截肢外的能力,以及这对道德责任的影响。建议不能根据截肢请求默认取消患者的自主权,尽管它很奇怪,医生所表现出的任何怀疑都是基于对恶意或无知的错误预感,这导致对请求人的指责态度。
    A patient who requests an amputation deemed medically unnecessary by professionals is disqualified per se from being regarded as having medical decision-making capacity. This decision is based on the assumption that there is an option to pursue something other than amputation; such an assumption in many cases overflows into therapeutic obstinacy. This is the case for individuals who have ill or damaged body parts and who wish to avoid recurrent and painful medical treatment designed to save the limb, as well as for individuals affected by body integrity dysphoria (BID). BID is a condition that is recognised by the WHO and is included in the International Classification of Diseases, 11th edition. Individuals who are affected develop an intense feeling of overcompleteness of their body configuration, which leads to the development of a strong sense of dysphoria and consequently the desire to amputate in order to remove the source of such discomfort. In the few cases in which amputation has been carried out, the results have proved successful; the individual\'s quality of life has improved and they have had no new amputation desires. No medical therapy, including medical amputation, is available currently for individuals affected by the condition. This situation leads many with BID to mutilate themselves. Such events create a challenging ethical dilemma for the medical world.The present paper is focused on the capacity of the individual with BID to do other than request amputation and the implications that this carries regarding moral responsibility. It is proposed that the autonomy of the patient cannot be disqualified by default based on the amputation request, despite its oddity, and that any scepticism demonstrated by the physicians is based on a false preconception of ill will or ignorance, which results in a blaming attitude towards the requesting person.
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  • 文章类型: Journal Article
    Ayahuasca有多种传统用途,然而,全球对其对精神健康状况的潜在治疗益处越来越感兴趣。新的心理治疗方法正在出现,以满足ayahuasca用户的需求,以准备并指导他们“整合”他们强大的迷幻体验,然而,关于可能构成这些治疗过程的伦理框架或影响ayahuasca作为一种药物的分配的社会和文化假设的讨论很少。根据圣马丁和洛雷托的人种学实地调查,秘鲁,我研究了秘鲁素食主义者传统中ayahuasca的各种社会含义和用途,以及库兰德罗斯之间潜在的道德紧张关系,心理健康从业者,和ayahuasca撤退中心。从业者和ayahuasca中心在试图保持对当地治愈本体论的真实性的同时,仍在导航心理健康和道德的全球化概念。care,和安全。
    Ayahuasca has a variety of traditional uses, yet there is a growing global interest in its potential therapeutic benefits for mental health conditions. Novel approaches to psychotherapy are emerging to address the needs of ayahuasca users to prepare as well as to guide them in \'integrating\' their powerful psychedelic experiences, yet there is little discussion on the ethical frameworks that may structure these therapeutic processes or the social and cultural assumptions that influence the assignment of ayahuasca as a medicine. Based on ethnographic fieldwork in San Martín and Loreto, Peru, I examine the varied social meanings and uses of ayahuasca in the Peruvian vegetalista tradition and the potential ethical tensions among curanderos, mental health practitioners, and ayahuasca retreat centers. Practitioners and ayahuasca centers are left with navigating globalized concepts of mental health and ethics while attempting to remain authentic to local ontologies of healing, care, and safety.
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  • 文章类型: Journal Article
    健康科学家声称,与大多数其他职业的工人相比,城市过境工人患压力相关疾病的比率更高。本文研究了由科学家和劳工组织者组成的网络如何将过境工人的压力问题构造为全球现象。根据研究参与者的说法,世界各地的过境工人都面临着类似的与压力相关的风险,这可以作为工人团结的基础。本文分析了如何使用压力概念来识别致病环境,并考虑了人类学的说法,即该概念经常抽象和非政治化有害安排。研究结果表明,科学家和劳工组织者使用压力概念来构造一个普遍处于危险中的过境工人的形象,该形象为跨国劳工组织的目的服务。同时,通过关注旧金山过境工人的案例,这一分析表明,压力和“努力工作”之间的持续联系——无论是在外行还是科学话语中——可能会阻碍人们对被指控懒惰和高薪的过境工人与压力相关的危害的认识。
    Health scientists have claimed that urban transit workers suffer from higher rates of stress-related disease than workers in most other occupations. This paper examines how a network of scientists and labor organizers constructed the problem of transit worker stress as a global phenomenon. According to study participants, transit workers worldwide are subject to a similar set of stress-related risks, which can serve as a basis for worker solidarity. This paper analyzes how the concept of stress has been used to identify pathogenic environments and considers anthropological claims that the concept often abstracts and depoliticizes harmful arrangements. The findings show that scientists and labor organizers use the stress concept to construct a figure of a universally at-risk transit worker that serves the ends of transnational labor organizing. At the same time, by focusing on the case of San Francisco\'s transit workers, this analysis shows that a persistent association between stress and \'hard work\'-in both lay and scientific discourses-may block recognition of stress-related harms for transit workers who are accused of being lazy and overpaid.
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