Challenges of teaching clinically applied anthropology and cultural psychiatry in India: an evolving partnership between a UK university and an Indian NGO

The current emphasis on Global Mental Health risks losing the focus on the local and the particular and rendering anthropological insight pertinent. A more critical examination of pedagogical methods and curricula, and of the challenges of establishing collaborative, balanced partnerships is required. Since 2006, a group of clinical anthropologists1 based at UCL and members of The Banyan2, have been working together on an innovative series of short, annual courses on social science theory and methods applied to mental health in South Asia. A UCL/BALM3 research unit was also established in 2008 employing local researchers to conduct joint studies into mental health and its related stigma in the Indian context. Following a brief history and outline of the collaboration, this paper discusses specific challenges: institutional issues and local economics; history and power dynamics; teaching versus training; working within mixed disciplinary and “cultural” domains both in the UK and India; and the spatial and temporal challenges of supervising research across continents. The paper concludes by reflecting on the contribution this collaboration has made to knowledge flow, examining localised and culturally specific understandings of pedagogy. These insights offer potential for similar international organisations seeking to establish inclusive and effective partnerships between frequently disparate contexts

How do psychiatrists in India construct their professional identity? A critical literature review

Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical refections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefy in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient–carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfuous critical cultural refexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care

History, Violence and Collective Memory: Implications for Mental Health in Ecuador

National histories of violence shape experiences of suffering and professional responses. In Ecuador, mental health literature addressing this crucial issue is scarce and little debated. In contrast, local psychiatrists and psychologists within the country face contemporary challenges that are deeply rooted in a violent colonial past and the perpetuation of its fundamental ethos. This paper critically reviews relevant literature on collective memory and historical trauma, and focuses on Ecuador as a case study on how to incorporate history into modern mental health challenges. The discussion poses key questions and outlines possible ways for Ecuador to address the link between history and mental health, including insights from countries that have struggled with their violent pasts. This paper contributes to ongoing international debate on the role of cultural history in mental health with implications for social scientists and practising clinicians in former colonised nations

What is pre-criminal space?

Prevent is a UK-wide programme within the government's anti-terrorism strategy aimed at stopping individuals from supporting or taking part in terrorist activities. NHS England's Prevent Training and Competencies Framework requires health professionals to understand the concept of pre-criminal space. This article examines pre-criminal space, a new term which refers to a period of time during which a person is referred to a specific Prevent-related safeguarding panel, Channel. It is unclear what the concept of pre-criminal space adds to the Prevent programme. The term should be either clarified or removed from the Framework

Sensitising mental health professionals to Islam

Based on recent local and global events, and identified local clinical needs of our in-patient Muslim population, this project was conducted on five psychiatric admission wards, at the Huntley Centre, a hospital site in Camden & Islington Mental Health & Social Care Trust. The project aimed to enhance the knowledge base about mental health aspects of Islam among clinicians and administrative staff through an educational intervention, translate this into guidelines for culturally sensitive care for the Islamic population, and revise the general policy on inpatient care across all ethnic groups. Following a literature search and preliminary clinical ethnographic fieldwork, a semi-structured questionnaire was developed to specifically assess staff knowledge on Islam as applied to clinical psychiatric care, before and after a day long targeted intervention workshop. The project resulted in an improvement of staff knowledge on Islam, enhanced care for this group of patients, and the formulation of good practice policy on cultural dimensions of care for Muslim in-patients. The momentum generated by this project led to an established post of a lead cross-cultural nurse, and facilitated the development of a cross-cultural programme on one of the acute clinical units

Generating Toxic Landscapes: Impact on Well-being of Cotton Farmers in Telangana, India

Existing literature demonstrates agro-chemicals result in physical toxicity and damages human health, flora and fauna. However, little is known about how such ‘toxicity’ relates to mental well-being and social suffering. This paper aims to demonstrate how local, national and international vectors are interlinked to shape social distress among cotton farmers in India. Ethnographic interviews and focus group discussions were conducted in a cotton-growing village of the Warangal district, Telangana state, India. The results advance the concept of counter therapeutic spaces and hypothesise that toxic landscapes emerge through a dynamic interaction between dispersed agencies that interact and reconfigure agricultural spaces into socially toxic places. The paper argues that the disciplines of public health and agriculture suffer from a failure of imagination to forge vital interdisciplinary links that could address farmer suffering. Unpacking local ecologies of farmer suffering offer innovative ways for enhancing mental health policy and interventions in India

Research Journal of Pharmaceutical, Biological and Chemical Sciences ANTIOXIDANT AND ANTIHYPERGLYCEMIC POTENTIAL OF METHANOLIC EXTRACT OF BARK OF MIMUSOPS ELENGI L. IN MICE

ABSTRACT Ayurveda refers Mimusops elengi L. for the treatment of the diabetes. Considering the traditional claim of M. elengi in management of diabetes and the possible involvement of oxidative stress in pathogenesis of diabetes, the present study was aimed to evaluate the in vitro antioxidant and in vivo antihyperglycemic property of methanolic extract of bark of M. elengi (MEMeOH). In vitro antioxidant activity of MEMeOH was evaluated using reducing power assay, DPPH and hydroxyl radical scavenging assay. MEMeOH offered significant in vitro reducing power capacity and radical scavenging activity. In acute study in alloxan induced diabetes, MEMeOH exhibited significant (p< 0.001) antihyperglycemic effect. The onset of antihyperglycemic effect was observed at 2 nd hr; peak activity was demonstrated at 6 th hr. The antihyperglycemic effect of MEMeOH 400mg/kg, p.o. was persistent up to 24 th hr after drug administration. MEMeOH produced significant (p < 0.01) reduction in elevated glucose levels in glucose loaded non diabetic animals. The onset of action in non diabetic oral glucose tolerance test was found to be at 60 th min and peak activity was observed at 120 th min after oral glucose load. MEMeOH demonstrated significant (p < 0.01) reduction in elevated glucose levels 2hr before glucose administration and 6 hr after glucose load in oral glucose tolerance test in diabetic animals. MEMeOH has demonstrated antihyperglycemic activity in diabetic as well as non diabetic glucose loaded mice. MEMeOH should be further explored against diabetes and related complications

Floral bud distortion in soybean and incidence in Central India

We describe a peculiar and often harmful budding disorder in soybean, leading to huge yield loss in India. To determine the prevalence of floral distortion in soybean, an extensive random roving survey was undertaken in the soybean-growing regions of Madhya Pradesh, Maharashtra and the adjoining part of Karnataka states during two successive seasons of kharif (monsoon-planted) crops – Oct 2010 and Sept 2011. The average rate of the disorder ranged from 8.0% to 14.6% and severity from 2.0 to 90.0% during 2010 and 2011, respectively. Affected plants were found to have either no or deformed pods and distorted flowers, and they remained green after maturity. All the soybean varieties grown in the surveyed region (i.e. JS 335, JS 93-05, JS 73-23, JS 95-60, AMS-MB-5-19, CO-2, Bragg, JS 10-44, Samrat) were affected by the disorder. The PCR-based diagnosis revealed the absence of phytoplasma in symptomatic soybean samples.Keywords: Glycine max, chlorosis, green stem, thickening and twisting stem, yield loss

Mental illness, poverty and stigma in India: a case-control study

OBJECTIVE: To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. DESIGN: Matching case (hospital)–control (population) study. SETTING: University Hospital (cases) and National Capital Region (controls), India. PARTICIPANTS: A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. MAIN OUTCOME MEASURES: Higher risk of poverty due to stigma among PSMI. RESULTS: 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from ‘lower castes’ were more likely to be poor due to stigma than male controls (p<0.001) or controls from other castes (p<0.001). CONCLUSIONS: Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues

Virulence Characteristics and Genetic Affinities of Multiple Drug Resistant Uropathogenic Escherichia coli from a Semi Urban Locality in India

Extraintestinal pathogenic Escherichia coli (ExPEC) are of significant health concern. The emergence of drug resistant E. coli with high virulence potential is alarming. Lack of sufficient data on transmission dynamics, virulence spectrum and antimicrobial resistance of certain pathogens such as the uropathogenic E. coli (UPEC) from countries with high infection burden, such as India, hinders the infection control and management efforts. In this study, we extensively genotyped and phenotyped a collection of 150 UPEC obtained from patients belonging to a semi-urban, industrialized setting near Pune, India. The isolates representing different clinical categories were analyzed in comparison with 50 commensal E. coli isolates from India as well as 50 ExPEC strains from Germany. Virulent strains were identified based on hemolysis, haemagglutination, cell surface hydrophobicity, serum bactericidal activity as well as with the help of O serotyping. We generated antimicrobial resistance profiles for all the clinical isolates and carried out phylogenetic analysis based on repetitive extragenic palindromic (rep)-PCR. E. coli from urinary tract infection cases expressed higher percentages of type I (45%) and P fimbriae (40%) when compared to fecal isolates (25% and 8% respectively). Hemolytic group comprised of 60% of UPEC and only 2% of E. coli from feces. Additionally, we found that serum resistance and cell surface hydrophobicity were not significantly (p = 0.16/p = 0.51) associated with UPEC from clinical cases. Moreover, clinical isolates exhibited highest resistance against amoxicillin (67.3%) and least against nitrofurantoin (57.3%). We also observed that 31.3% of UPEC were extended-spectrum beta-lactamase (ESBL) producers belonging to serotype O25, of which four were also positive for O25b subgroup that is linked to B2-O25b-ST131-CTX-M-15 virulent/multiresistant type. Furthermore, isolates from India and Germany (as well as global sources) were found to be genetically distinct with no evidence to espouse expansion of E. coli from India to the west or vice-versa