Medicin, rationalitet og erfaring. En antropologisk synsvinkel

Viden udgør såvel indenfor antropologien som medicinen et centralt grundlag for, hvad vi tænker om menneskers forestillinger og om det, mennesker tror. I den videnskabeligeforståelse kan forholdet mellem viden og tro beskrives som hierarkisk, i den forstand at tro synes at skulle omvendes til viden. Ved en kritisk gennemgang af antropologien, hvor klassiske studier indenfor rationalitetsdebaBen sæBes under lup, vises tydeligt, hvordan den normative og empiristiske anvendelse af be-grebet tro også i medicinsk antropologi ganske automatisk involverer dets modsætning: viden. Tro og tilsyneladende irrationelle forestillinger har derfor på et epistemologisk plan indflydelse på tilgangen til teori og empiri. Artiklen påpeger, at der i den medicinske antropologi ligger andre tilgange til forståelser af tro og viden i relation til sygdom og sundhed, end dem der bygger på en rationalistisk og positivistisk arv fra oplysningstide

Au mode subjonctif. La construction narrative des crises d'épilepsie en Turquie

Au mode subjonctifLa construction narrative des crises d'épilepsie en TurquieCet article présente une analyse culturelle des crises en Turquie, à l'aide d'entrevues individuelles et familiales auprès d'un échantillon constitué de personnes diagnostiquées comme souffrant d'épilepsie ou de crises psychogènes. L'article brosse une brève critique des stratégies d'analyse qui juxtaposent « croyances » culturelles et « connaissance » médicale à propos d'une condition biologique et développe une façon spécifique de comprendre la construction narrative de la maladie et de son expérience. L'article s'inspire plus particulièrement des theories de la narrativité et de la réponse du lecteur (Iser, Ricoeur, Bruner) pour analyser les « tactiques de subjonctivisation » présentes dans les récits de maladie.In the Subjunctive ModeThe Narrative Construction of Seizures in TurkeyThis paper provides a cultural analysis of seizures in Turkey, based on individual and family interviews with a community sample of persons diagnosed as suffering epilepsy or psy-chogenic seizures. It outlines a brief critique of analytic stratégies that juxtapose cultural « beliefs » to médical « knowledge » of a biological condition, and develops an alternative understanding of the narrative construction of illness and ils expérience. In particular, it draws on récent theories of narrativity and reader response (Iser, Ricoeur, Bruner) to analyze the « subjunctivizing tactics » présent in illness narratives

Empowerment and the Transition to Housing for Homeless Mentally Ill People: An Anthropological Perspective

Often lacking in scholarly and policy-oriented discussions of homelessness are contextualized understandings of the problems faced, and the values held, by homeless mentally ill people. This article, using an anthropological perspective, examines issues that arise for homeless mentally ill individuals in making the transition from shelter living to permanent residences. The transition occurs as part of a housing initiative driven by the philosophy of consumer empowerment. Project participants are placed in independent apartments or evolving consumer households (ECH) — shared, staffed residences designed to transform themselves into consumer-directed living situations over time. The effects of an empowerment paradigm on the organization of space, the nature of social relations, and the management of economic resources in the ECHs are discussed to show that consumers and staff sometimes have contrasting views of what empowerment entails. It is suggested that anthropological research can help to illuminate the issues at stake in determining policy for homeless people with major mental illness

Da aplicação à implicação na antropologia médica: leituras políticas, históricas e narrativas do mundo do adoecimento e da saúde

Revisa parte da literatura da antropologia médica contemporânea, guiando-se pela orientação/implicação política na escolha de seus objetos de estudo, na análise e na construção de soluções para os problemas investigados. A partir de narrativas de antropólogos, evidenciam-se as bases históricas e sociopolíticas que caracterizaram o campo em seus países de origem ou de migração. No panorama traçado das três principais vertentes contemporâneas – as antropologias médica crítica, do sofrimento e do biopoder –, são caracterizadas escolhas teóricas e temáticas para atender à demanda de “politização” do debate antropológico na saúde, defendendo-se uma antropologia médica “implicada”

Embodied Action, Enacted Bodies. The Example of Hypoglycaemia.

We all know that we have and are our bodies. But might it be possible to leave this common place? In the present article we try to do this by attending to the way we do our bodies. The site where we look for such action is that of handling the hypoglycaemias that sometimes happen to people with diabetes. In this site it appears that the body, active in measuring, feeling and countering hypoglycaemias is not a bounded whole: its boundaries leak. Bits and pieces of the outside get incorporated within the active body; while the centre of some bodily activities is beyond the skin. The body thus enacted is not self-evidently coherent either. There are tensions between the body¿s organs; between the control under which we put our bodies and the erratic character of their behaviour; and between the various needs and desires single bodies somehow try to combine. Thus to say that a body is a whole, or so we conclude, skips over a lot of work. One does not hang together as a matter of course: keeping oneself together is something the embodied person needs to do. The person who fails to do so dies

Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina

BACKGROUND: The results of a qualitative study carried out in four developing countries (Cuba, Thailand, Saudi Arabia and Argentina) are presented. The study was conducted in the context of a randomised controlled trial to test the benefits of a new antenatal care protocol that reduced the number of visits to the doctor, rationalised the application of technology, and improved the provision of information to women in relation to the traditional protocol applied in each country. METHODS: Through focus groups discussions we were able to assess the concepts and expectations underlying women's evaluation of concepts and experiences of the care received in antenatal care clinics. 164 women participated in 24 focus groups discussion in all countries. RESULTS: Three areas are particularly addressed in this paper: a) concepts about pregnancy and health care, b) experience with health services and health providers, and c) opinions about the modified Antenatal Care (ANC) programme. In all three topics similarities were identified as well as particular opinions related to country specific social and cultural values. In general women have a positive view of the new ANC protocol, particularly regarding the information they receive. However, controversial issues emerged such as the reduction in the number of visits, particularly in Cuba where women are used to have 18 ANC visits in one pregnancy period. CONCLUSION: Recommendations to improve ANC services performance are being proposed. Any country interested in the application of a new ANC protocol should regard the opinion and acceptability of women towards changes

The effect of artificial selection on phenotypic plasticity in maize

Remarkable productivity has been achieved in crop species through artificial selection and adaptation to modern agronomic practices. Whether intensive selection has changed the ability of improved cultivars to maintain high productivity across variable environments is unknown. Understanding the genetic control of phenotypic plasticity and genotype by environment (G × E) interaction will enhance crop performance predictions across diverse environments. Here we use data generated from the Genomes to Fields (G2F) Maize G × E project to assess the effect of selection on G × E variation and characterize polymorphisms associated with plasticity. Genomic regions putatively selected during modern temperate maize breeding explain less variability for yield G × E than unselected regions, indicating that improvement by breeding may have reduced G × E of modern temperate cultivars. Trends in genomic position of variants associated with stability reveal fewer genic associations and enrichment of variants 0–5000 base pairs upstream of genes, hypothetically due to control of plasticity by short-range regulatory elements

Is there a divide between local medicinal knowledge and Western medicine? a case study among native Amazonians in Bolivia

Background: Interest in ethnomedicine has grown in the last decades, with much research focusing on how local medicinal knowledge can contribute to Western medicine. Researchers have emphasized the divide between practices used by local medical practitioners and Western doctors. However, researchers have also suggested that merging concepts and practices from local medicinal knowledge and Western science have the potential to improve public health and support medical independence of local people. In this article we study the relations between local and Western medicinal knowledge within a native Amazonian population, the Tsimane'. Methods: We used the following methods: 1) participant observation and semi-structured interviews to gather background information, 2) free-listing and pile-sorting to assess whether Tsimane' integrate local medicinal knowledge and Western medicine at the conceptual level, 3) surveys to assess to what extent Tsimane' combine local medicinal knowledge with Western medicine in actual treatments, and 4) a participatory workshop to assess the willingness of Tsimane' and Western medical specialists to cooperate with each other. Results: We found that when asked about medical treatments, Tsimane' do not include Western treatments in their lists, however on their daily practices, Tsimane' do use Western treatments in combination with ethnomedical treatments. We also found that Tsimane' healers and Western doctors express willingness to cooperate with each other and to promote synergy between local and Western medical systems. Conclusion: Our findings contrast with previous research emphasizing the divide between local medical practitioners and Western doctors and suggests that cooperation between both health systems might be possible