Locating global health in social medicine

Global health's goal to address health issues across great sociocultural and socioeconomic gradients worldwide requires a sophisticated approach to the social root causes of disease and the social context of interventions. This is especially true today as the focus of global health work is actively broadened from acute to chronic and from infectious to non-communicable diseases. To respond to these complex biosocial problems, we propose the recent expansion of interest in the field of global health should look to the older field of social medicine, a shared domain of social and medical sciences that offers critical analytic and methodological tools to elucidate who gets sick, why and what we can do about it. Social medicine is a rich and relatively untapped resource for understanding the hybrid biological and social basis of global health problems. Global health can learn much from social medicine to help practitioners understand the social behaviour, social structure, social networks, cultural difference and social context of ethical action central to the success or failure of global health's important agendas. This understanding - of global health as global social medicine - can coalesce global health's unclear identity into a coherent framework effective for addressing the world's most pressing health issues

Universal cures for idiosyncratic illnesses: a genealogy of therapeutic reasoning in the mental health field

Over the past decades, there has been a significant increase in prescriptions of psychotropic drugs for mental disorders. So far, most of the explanations of the phenomenon have focused on the process of medicalization, but little attention has been cast towards physicians' day-to-day clinical reasoning, and the way it affects therapeutic decision-making. This article addresses the complex relationship between aetiology, diagnosis and drug treatment by examining the style of reasoning underlying prescribing practices through an historical lens. A genealogy of contemporary prescribing practices is proposed, that draws significant comparisons between 19th-century medicine and modern psychiatry. Tensions between specific, standardized cures and specific, idiosyncratic patients have been historically at play in clinical reasoning - and still are today. This inquiry into the epistemological foundations of contemporary drug prescription reveals an underlying search for scientific legitimacy

Consequences and behaviour problematised : The establishment of alcohol misuse as an object of empirical inquiry in late 18th- and early 19th-century European medicine

Peer reviewe

Disease concepts and treatment by tribal healers of an Amazonian forest culture

<p>Abstract</p> <p>Background</p> <p>The extensive medicinal plant knowledge of Amazonian tribal peoples is widely recognized in the scientific literature and celebrated in popular lore. Despite this broad interest, the ethnomedical systems and knowledge of disease which guide indigenous utilization of botanical diversity for healing remain poorly characterized and understood. No study, to our knowledge, has attempted to directly examine patterns of actual disease recognition and treatment by healers of an Amazonian indigenous culture.</p> <p>Methods</p> <p>The establishment of traditional medicine clinics, operated and directed by elder tribal shamans in two remote Trio villages of the Suriname rainforest, presented a unique investigational opportunity. Quantitative analysis of clinic records from both villages permitted examination of diseases treated over a continuous period of four years. Cross-cultural comparative translations were articulated of recorded disease conditions through ethnographic interviews of elder Trio shamans and a comprehensive atlas of indigenous anatomical nomenclature was developed.</p> <p>Results</p> <p>20,337 patient visits within the period 2000 to 2004 were analyzed. 75 disease conditions and 127 anatomical terms are presented. Trio concepts of disease and medical practices are broadly examined within the present and historical state of their culture.</p> <p>Conclusion</p> <p>The findings of this investigation support the presence of a comprehensive and highly formalized ethnomedical institution within Trio culture with attendant health policy and conservation implications.</p

Investigating trophic ecology and dietary niche overlap among morphs of Lake Trout in Lake Superior

Four morphs of Lake Trout (Salvelinus namaycush, Walbaum 1792) have been identified in Lake Superior: leans, siscowets, humpers, and redfins. In this comprehensive study, the trophic ecology of Lake Trout morphs were characterized using stomach content, fatty acid, and stable isotope data. Stomach content results indicated a predominately piscivorous diet for leans, siscowets, and redfins, whereas humper diets were comprised of 50% fish and 50% Mysis by mass. Humper and siscowets were most similar in their dietary fatty acid profiles, whereas redfins had the most distinct dietary fatty acid profile. Results from stable isotope analysis revealed some among-morph differences along a pelagic-profundal consumption gradient (34S), but there were no significant differences in trophic position (15N) or basal carbon sources among morphs (13C). Using the recently developed nicheROVER software package, 4-dimensional trophic niches for each morph were quantified using stable isotope ratios (δ13C, δ15N, and δ34S) and fatty acid profiles (30 dietary fatty acids, condensed to one axis). Humpers had the largest 4-dimensional niche regions of all four morphs, and redfins had the smallest. Pairwise probability of overlap among morphs in these four-dimensional niche regions was determined to be < 50% in most cases. Overall, stomach content results indicate that humpers diets were more planktivorous than the other morphs, consistent with previous research. Results of the niche overlap analysis suggests some degree of generalist feeding for all morphs. Better characterization of seasonal variation in diet using tracers that reflect more recent feeding (e.g., fatty acids, stomach contents, and/or stable isotope analyses performed on tissues that turnover more quickly than muscle) are needed to further elucidate among-morph differences and similarities in diet and trophic ecology