Des politiques culturelles de la nature : le cas des grottes du vent et de la fertilité au Mexique

Liberation ecology is not set in concrete as an already formed structure of ideas. It is a discourse about nature, Marxist in origin, poststructural in recent influence, politically transformative in intent, but subject still to the fiercest debates.  (Peet and Watts 1996a, p. 37) Avec l’écologie politique, on entre véritablement dans un autre monde, qui n’a plus pour ingrédients une nature et des cultures, qui ne peut donc plus simplifier la question du nombre de collectifs en l’unifiant par..

Lila Abu-Lughod, Dramas of Nationhood: The Politics of Television in Egypt

Quel est le rôle des médias dans les débats culturels sur les identités nationales, religieuses et sociales ? Dramas of Nationhood nous donne un exemple notable d’anthropologie de la place des médias de masse dans l’imagination sociale des personnes. Par cette étude – « non exotique » par excellence –, l’anthropologue Lila Abu-Lughod écrit « contre la culture » se concentrant sur des conversations et des débats dans lesquels des idées culturelles sont formulées et distribuées, plutôt que part..

The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial

Background. Shared decision making contributes to high quality healthcare by promoting a patientcentered approach. Patient involvement in selecting the components of a diabetes medication program that best match the patient's values and preferences may also enhance medication adherence and improve outcomes. Decision aids are tools designed to involve patients in shared decision making, but their adoption in practice has been limited. In this study, we propose to obtain a preliminary estimate of the impact of patient decision aids vs. usual care on measures of patient involvement in decision making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and resource utilization. In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice. Methods. We will be conducting a mixed-methods study comprised of a cluster-randomized, practical, multicentered trial enrolling clinicians and their patients (n = 240) with type 2 diabetes from rural and suburban primary care practices (n = 8), with an embedded qualitative study to examine factors that influence the incorporation of decision aids into routine practice. The intervention will consist of the use of a decision aid (Statin Choice and Aspirin Choice, or Diabetes Medication Choice) during the clinical encounter. The qualitative study will include analysis of video recordings of clinical encounters and in-depth, semi-structured interviews with participating patients, clinicians, and clinic support staff, in both trial arms. Discussion. Upon completion of this trial, we will have new knowledge about the effectiveness of diabetes decision aids in these practices. We will also better understand the factors that promote or inhibit the successful implementation and normalization of medication choice decision aids in the care of chronic patients in primary care practices

Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.

PURPOSE: To determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. METHODS: In this mixed methods multicenter cluster randomized trial, we included patients with type 2 diabetes mellitus and their primary care clinicians. We compared usual care with or without a within-encounter SDM conversation aid. We assessed participant-reported decisions made and quality of SDM (knowledge, satisfaction, and decisional conflict), clinical outcomes, adherence, and observer-based patient involvement in decision-making (OPTION12-scale). We used semi-structured interviews with patients to understand their perspectives. RESULTS: We enrolled 350 patients and 99 clinicians from 20 practices and interviewed 26 patients. Use of the conversation aid increased post-encounter patient knowledge (correct answers, 52% vs. 45%, p = 0.02) and clinician involvement of patients (Mean between-arm difference in OPTION12, 7.3 (95% CI 3, 12); p = 0.003). There were no between-arm differences in treatment choice, patient or clinician satisfaction, encounter length, medication adherence, or glycemic control. Qualitative analyses highlighted differences in how clinicians involved patients in decision making, with intervention patients noting how clinicians guided them through conversations using factors important to them. CONCLUSIONS: Using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence or improved diabetes control in patients with type 2 diabetes. Future interventions may need to focus specifically on patients with signs of poor treatment fit. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov: NCT01502891

Patrimonialisation et politisation de la cérémonie du Feu nouveau : du rituel au spectacle

Cet article interroge la « patrimonialisation indienne » à travers la performance d’un rituel indien sur la place publique d’un chef-lieu de la Huastèque potosine au Mexique. La cérémonie du Feu nouveau, habituellement célébrée par les communautés indiennes au sein de leurs villages, est célébrée depuis 2002 sur la place municipale de Tancanhuitz en présence de touristes. C’est au travers de la mise en scène de cette cérémonie indienne dans la ville municipale et à la télévision que les participants, protagonistes et spectateurs construisent de nouveaux patrimoines indiens dans des espaces traditionnellement associés aux métis. Les protagonistes mobilisent la culture locale comme une ressource identitaire sur le marché mondial et dans une perspective nationale.This article examines indigenous cultural politics through the performance of the New Fire Ceremony on the main plaza of the county-seat Tancanhuitz in the Mexican Huasteca. Since 2002, Nahua and Teenek elders have staged the New Fire Ceremony on the town plaza for tourists and in the presence of a national television program. This “mise en scène” raises the question whether the ceremony acquires new meanings. Here, we argue that the protagonists and the spectators work together to construct a new legacy through the creation of an indigenous patrimony in a space that has traditionally been associated with Mestizos. In this context, the local indigenous ceremony becomes a vehicle to transform a local religious and cultural event into a resource for identity politics at a national and international level.Este artículo analiza el proceso de una “patrimonialización indígena” a través de la celebración de un ritual indígena en la cabecera de un municipio de la Huasteca potosina en México. La ceremonia del fuego que habitualmente se celebra dentro de las comunidades indígenas, se hizo desde el 2002 en la plaza municipal de Tancanhuitz en presencia de gente non indígena, incluso turistas y un programa de televisión. Es así que los protagonistas de esta ceremonia indígena, los pueblos teenek y náhuatl de la Huasteca, creen nuevos patrimonios indígenas en espacios mestizos. Dentro de su contexto nacional, los líderes teenek y náhuatl llegan a movilizar las culturas locales como recursos identitarios en el mercado mundial

Patrimonialisation et politisation de la cérémonie du Feu nouveau : du rituel au spectacle

This article examines indigenous cultural politics through the performance of the New Fire Ceremony on the main plaza of the county-seat Tancanhuitz in the Mexican Huasteca. Since 2002, Nahua and Teenek elders have staged the New Fire Ceremony on the town plaza for tourists and in the presence of a national television program. This “mise en scène” raises the question whether the ceremony acquires new meanings. Here, we argue that the protagonists and the spectators work together to construct a new legacy through the creation of an indigenous patrimony in a space that has traditionally been associated with Mestizos. In this context, the local indigenous ceremony becomes a vehicle to transform a local religious and cultural event into a resource for identity politics at a national and international level

Des modernités autres : L’équinoxe de printemps et la performance de la mexicanité

Cet article porte sur les réponses « modernes », de nature politique, aux discours officiels de l’État mexicain qui s’efforcent de présenter du pays une image unifiée, notamment sur le plan religieux. L’activation d’anciens rites indiens, le jour de l’équinoxe de printemps, est l’occasion pour les populations locales d’affirmer une identité nationale et régionale propre (une certaine mexicanité), et pleinement inscrite dans la modernité. Mais d’un autre côté, ces mêmes rites, « modernisés » ailleurs, condensent sous les aspects de l’ancestralité une idéologie « antimoderne ». L’auteur s’interroge alors sur le statut de ces « autres modernités » qui contestent les visions unificatrices de l’histoire et des sociétés

La música de arpa entre los Nahuas: simbolismo y aspectos performativos

This article offers a comparative analysis of the performative and symbolic aspects of harp music (also called small music) among the Nahua people of the Huasteca Potosina in Mexico. We examine the ways in which music, instruments, related myths, dances and performative events establish a web of significance between the lifeways and the religiosity in these Nahua communities. We analyze the dynamic production of meaning generated through the performance of specific ritual events. We specifically explore the production of ritual events as artistic practices and as performative events that convey meaning through symbolism and ritual experience as the performers construct, express, and enact their lifeways. In this context, the music and dance performances represent not simply forms of entertainment or of cultural transmission, but rather, they constitute a discourse to which end they communicate with the spiritual entities that reside in the natural and social environment