Dynamics of kinship and the uncertainties of life: Spirit cults and healing management in northern Thailand

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This thesis is about kinship, health and healing in a Northern Thai village. Although traditional spirit mediums and spirit cult observances in Chiang Mai city are in decline and have led to a breakdown of the matrilineal system, in the village of Baan Yang Luang in Mae Chaem district the belief in matrilineal spirits and ancestors is still maintained in interesting counterpoint to social change. The power of spirits is used to manage human suffering-whether sickness, death or agricultural failure. Kinship in Mae Chaem is based on the relationship between humans and ancestral spirits or lineage guardian spirits. Illness is thought to derive from conflicts among humans or between humans and spirits. Healing is attained by the reforming and reshaping of relationships, and by the reconciliation of conflicted parties. The thesis investigates how matrilineal spirit cults, personhood, and social relatedness are created, shaped and transformed through the struggles of illness and healing management. It examines the complex relations among illness, kinship and personhood in reincarnation, healing, lineage recruitment, sacrifice, and spirit worship. In conclusion, it explores the mutual relationship between the two processes: kinship transformation and healing management, both of which depend crucially on power relations within the society. People use the dynamic aspects of the kinship system to interpret and manage illness; at the same time, illness is used as a means to reform and maintain the fluidity of kin relationships. The dynamic systems of health and kinship enable people to create, choose, negotiate and participate in the transformation of social relations and identity, in order to cope with a changing society. Finally, I hope this study will shed light on how identity, kinship, personhood, and lay medical knowledge are conceived, created and sustained from an emic perspective.This work is funded by the Thai Govenment and Chiang Mai University

Dynamics of kinship and the uncertainties of life : spirit cults and healing management in northern Thailand

This thesis is about kinship, health and healing in a Northern Thai village. Although traditional spirit mediums and spirit cult observances in Chiang Mai city are in decline and have led to a breakdown of the matrilineal system, in the village of Baan Yang Luang in Mae Chaem district the belief in matrilineal spirits and ancestors is still maintained in interesting counterpoint to social change. The power of spirits is used to manage human suffering-whether sickness, death or agricultural failure. Kinship in Mae Chaem is based on the relationship between humans and ancestral spirits or lineage guardian spirits. Illness is thought to derive from conflicts among humans or between humans and spirits. Healing is attained by the reforming and reshaping of relationships, and by the reconciliation of conflicted parties. The thesis investigates how matrilineal spirit cults, personhood, and social relatedness are created, shaped and transformed through the struggles of illness and healing management. It examines the complex relations among illness, kinship and personhood in reincarnation, healing, lineage recruitment, sacrifice, and spirit worship. In conclusion, it explores the mutual relationship between the two processes: kinship transformation and healing management, both of which depend crucially on power relations within the society. People use the dynamic aspects of the kinship system to interpret and manage illness; at the same time, illness is used as a means to reform and maintain the fluidity of kin relationships. The dynamic systems of health and kinship enable people to create, choose, negotiate and participate in the transformation of social relations and identity, in order to cope with a changing society. Finally, I hope this study will shed light on how identity, kinship, personhood, and lay medical knowledge are conceived, created and sustained from an emic perspective.EThOS - Electronic Theses Online ServiceThai Government : Chiang Mai UniversityGBUnited Kingdo

The Specific Anatomical Morphology of Lateral Ankle Ligament: Qualitative and Quantitative Cadaveric based Study

Objective The accurate understanding in morphological features of the lateral ankle ligaments is necessary for the diagnosis and management of ankle instability and other ankle problems. The purpose of this study was to evaluate the anatomical morphology and the attachment areas of lateral ligament complex of ankle joint based on the cadaveric study. Methods Fifty‐four fresh frozen cadaveric ankles were dissected to evaluate the lateral ankle ligaments. Each ligament was separated into two or three small bundles. In the investigated footprint areas, acrylic colors were used as a marker point to locate specific areas of ligament bundle attached to the bone. The Image J software was used to measure and analyze the sizes of the specific footprint areas to achieve descriptive statistical analysis. Results The double bands of anterior talofibular ligament (ATFL) were found as a major type in the present study with 57.41% (31 of 54 ankles) while the single band of ATFL was observed in 42.59% (23 of 54 ankles). The attachment sizes of the ATFL, posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL) were evaluated into two areas; proximal and distal attachments. The average of proximal or fibular part of ATFL, PTFL and CFL were 85.06, 134.27, 93.91 mm2 respectively. The average of distal part of ATFL, PTFL and CFL were 100.07, 277.61, 249.39 mm2 respectively. Conclusion Considering the lateral ankle ligament repaired or reconstruction especially using arthroscopy, the precise understanding in specific detail of the lateral ankle ligament may help both diagnose and select the appropriate treatment for solving the ankle problems. These observations may help the surgeon to perform the surgical procedure for determining the appropriate techniques and avoid complication to patients

Prognostic Factors for All-Cause Mortality in Thai Patients with Fragility Fracture of Hip: Comorbidities and Laboratory Evaluations

Background and Objectives: Although the types of comorbidities and laboratory evaluations are major factors associated with mortality after hip fractures, there have been no studies of the association of these factors and mortality in Thai hip-fracture patients. This study aimed to identify prognostic factors associated with mortality after a hip fracture in the Thai population, including types of comorbidities, treatment-related factors, and laboratory evaluations. Materials and Methods: This five-year retrospective study was conducted in a tertiary care hospital in Thailand. A total of 775 Thai patients who had been admitted with a hip fracture resulting from a simple fall were identified using the International Classification of Disease 10 codes, and a review of their medical charts was conducted. Associations between general factors, comorbidities, laboratory evaluations, treatment factors including type of treatment, and time to death were analyzed using the Cox proportional hazard regression and the hazard ratio (HR). Results: The overall mortality rate of hip fracture patients was 13.94%. Independent prognostic factors found to be significantly associated with mortality were nonoperative treatment (HR = 3.29, p < 0.001), admission glomerular filtration rate (GFR) < 30 mL/min/1.73 m2 (HR = 3.40, p < 0.001), admission hemoglobin concentration <10 g/dL. (HR = 2.31, p < 0.001), chronic obstructive pulmonary disorder (HR = 2.63, p < 0.001), dementia or Alzheimer’s disease (HR = 4.06, p < 0.001), and active malignancy (HR = 6.80, p < 0.001). Conclusion: The types of comorbidities and laboratory evaluation findings associated with mortality in Thai patients with hip fractures include chronic obstructive pulmonary disorder, dementia or Alzheimer’s disease, active malignancy, admission GFR < 30 mL/min/1.73 m2, and admission hemoglobin concentration <10 g/dL. The risks of mortality for Thai hip-fracture patients with these comorbidities or laboratory evaluation findings were 2.5, 4, 7, 3.5, and 2.5 times higher, respectively, than patients without those factors