Global Health Interventions:The Military, the Magic Bullet, the Deterministic Model—and Intervention Otherwise

“Intervention” is central to global health, but the significance and effects of how intervention is practiced are often taken for granted. This review takes interventions into health and medicine as subjects for ethnographic inquiry. We highlight three lines of anthropological contributions: studies of global health interventions that serve imperial and military objectives, studies of “magic bullet” interventions arising from laboratory science, and studies of interventions based on deterministic modeling techniques. We then outline examples of “intervention otherwise,” in which people build relations of solidarity and care through global health programming, design interventions to be interactive and adaptable, and use data and modeling to support health justice. Whereas many global health interventions reproduce Western power hierarchies, intervention otherwise draws attention to alternative forms of knowledge, action, and expertise. Our analysis of lively and multivalent practices of intervention has implications for debates about the im/possibility of decolonizing global health.<br/

Integrating climate change mitigation and adaptation in agriculture and forestry: opportunities and trade-offs

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.International audienceAlthough many activities can jointly contribute to the climate change strategies of adaptation and mitigation, climate policies have generally treated these strategies separately. In recent years, there has been a growing interest shown by practitioners in agriculture, forestry, and landscape management in the links between the two strategies. This review explores the opportunities and trade-offs when managing landscapes for both climate change mitigation and adaptation; different conceptua-lizations of the links between adaptation and mitigation are highlighted. Under a first conceptualization of 'joint outcomes,' several reviewed studies analyze how activities without climatic objectives deliver joint adaptation and mitigation outcomes. In a second conceptualization of 'unintended side effects,' the focus is on how activities aimed at only one climate objective—either adaptation or mitigation—can deliver outcomes for the other objective. A third conceptualization of 'joint objectives' highlights that associating both adaptation and mitigation objectives in a climate-related activity can influence its outcomes because of multiple possible interactions. The review reveals a diversity of reasons for mainstreaming adaptation and mitigation separately or jointly in landscape management. The three broad conceptualizations of the links between adaptation and mitigation suggest different implications for climate policy mainstreaming and integration

Homosexual Women Have Less Grey Matter in Perirhinal Cortex than Heterosexual Women

Is sexual orientation associated with structural differences in the brain? To address this question, 80 homosexual and heterosexual men and women (16 homosexual men and 15 homosexual women) underwent structural MRI. We used voxel-based morphometry to test for differences in grey matter concentration associated with gender and sexual orientation. Compared with heterosexual women, homosexual women displayed less grey matter bilaterally in the temporo-basal cortex, ventral cerebellum, and left ventral premotor cortex. The relative decrease in grey matter was most prominent in the left perirhinal cortex. The left perirhinal area also showed less grey matter in heterosexual men than in heterosexual women. Thus, in homosexual women, the perirhinal cortex grey matter displayed a more male-like structural pattern. This is in accordance with previous research that revealed signs of sex-atypical prenatal androgenization in homosexual women, but not in homosexual men. The relevance of the perirhinal area for high order multimodal (olfactory and visual) object, social, and sexual processing is discussed

Large avian frugivores in the Philippines show linear responses to improvements in forest quality

Large avian frugivores are important in ecosystem function, but are seriously threatened across the tropics. To conserve them we must understand their habitat needs and the effects of improved forest management on individual species and the community as a whole. We recorded the presence/absence of 18 parrot, pigeon and hornbill species along nearly 500 km of transects at 24 sites in Luzon, Philippines, and used logistic GLMMs to identify bird-habitat associations based on topographical, forest structure and floristic data taken at 1227 habitat plots. We then searched for more complex relationships and thresholds in species responses along forest quality/restoration gradients using GAMMs. Frugivore species richness was highest in forest with large-girthed trees, although some small-scale agricultural disturbance was tolerated or even favoured. Importantly, richness was highest in forests on flat ground, areas which are usually the first to be converted to agriculture. Individual species were positively associated with large trees but responses to floristic gradients were more variable. Very few species had complex relationships with forest quality; for the great majority, the probability of occurrence increased linearly along the forest quality/restoration gradient. While the precise benefits in terms of seed dispersal, and costs of management, at different points along the quality/restoration gradient are likely to be themselves complex, avian frugivores benefit proportionately from step improvements right along the gradient. Thus, any actions to improve forest quality on Luzon, from reforesting the most degraded lands to preventing degradation of relatively healthy forests, are likely to benefit frugivores

Is Homosexuality a Paraphilia? The Evidence For and Against

Whether homosexuality should be described as one among many paraphilic sexual interests or an altogether different dimension of sexual interest has long been discussed in terms of its political and social implications. The present article examined the question instead by comparing the major correlates and other features of homosexuality and of the paraphilias, including prevalence, sex ratio, onset and course, fraternal birth order, physical height, handedness, IQ and cognitive neuropsychological profile, and neuroanatomy. Although those literatures remain underdeveloped, the existing findings thus far suggest that homosexuality has a pattern of correlates largely, but not entirely, distinct from that identified among the paraphilias. At least, if homosexuality were deemed a paraphilia, it would be relatively unique among them, taxonometrically speaking

The human rights implications of virginity testing in South Africa

This article examines the historical context of virginity testing in Southern Africa with a focus on South Africa. It then examines the arguments often adduced in justifying the introduction of this practice. The two major arguments to support the reintroduction of virginity testing, namely, that it helps in reducing the spread of HIV and in preserving societal moral values are critically examined. Thereafter, the article discusses how the ever contentious debate between universalists and relativists applies to virginity testing. The last part of the article then considers the human rights implications of virginity testing

Incorporation of a Dietary Omega 3 Fatty Acid Impairs Murine Macrophage Responses to Mycobacterium tuberculosis

by creating an immunosuppressive environment. We hypothesized that incorporation of n-3 PUFA suppresses activation of macrophage antimycobacterial responses and favors bacterial growth, in part, by modulating the IFNγ-mediated signaling pathway.. The fatty acid composition of macrophage membranes was modified significantly by DHA treatment. DHA-treated macrophages were less effective in controlling intracellular mycobacteria and showed impaired oxidative metabolism and reduced phagolysosome maturation. Incorporation of DHA resulted in defective macrophage activation, as characterized by reduced production of pro-inflammatory cytokines (TNFα, IL-6 and MCP-1), and lower expression of co-stimulatory molecules (CD40 and CD86). DHA treatment impaired STAT1 phosphorylation and colocalization of the IFNγ receptor with lipid rafts, without affecting surface expression of IFNγ receptor. in response to activation by IFNγ, by modulation of IFNγ receptor signaling and function, suggesting that n-3 PUFA-enriched diets may have a detrimental effect on host immunity to tuberculosis

Tourism in sub-global assessments of ecosystem services

Published in 2005, the United Nations Millennium Ecosystem Assessment (MA) stressed that influencing governments, businesses and communities to address the supra-national challenge of limiting biodiversity loss and ecosystem degradation requires a fuller understanding of the range of values and benefits people derive from ecosystems, including tourism. The MA was informed by, and has shaped, several conceptually and methodologically distinctive sub-global assessments (SGAs) of ecosystem services. Through content analysis, this paper is the first detailed examination of how tourism features in 14 extant SGAs identified in a database held by a major supra-national environmental organization. Although the SGAs should have incorporated the widest range of specialist subject expertise, tourism scholars played only peripheral roles in producing them even for territories where tourism is a significant land use. The SGAs examined did not benefit from the extensive body of knowledge relating to sustainable tourism. Limited portrayals of tourism restrict the capacity of SGAs in their current format as management solutions. It is also contradictory to the ethos, principles and purpose of ecosystem assessments. With the ecosystem services perspective set to become more important to policy and decision making, the paper argues for greater incorporation of recent progress in sustainable tourism in ecosystem assessment

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys