Educational children's book about tuberculosis translated into Marshallese by Caleb Klipowicz, Me... more Educational children's book about tuberculosis translated into Marshallese by Caleb Klipowicz, Melanie Carbine, and Sheldon Riklon, MD.
Educational children's book about tuberculosis translated into Thai by Kamontip Rasri Klosen and ... more Educational children's book about tuberculosis translated into Thai by Kamontip Rasri Klosen and Wibool Piyawattanametha
Educational children's book about tuberculosis translated into Polish by Bartłomiej Kołodziejczyk... more Educational children's book about tuberculosis translated into Polish by Bartłomiej Kołodziejczyk and Borys Wróbel
Educational children's book about tuberculosis translated into Hindi by Viren Joseph & Pavithra J... more Educational children's book about tuberculosis translated into Hindi by Viren Joseph & Pavithra Joseph.
Educational Children's book about tuberculosis translated into Kannada by
Pavithra Joseph & Glad... more Educational Children's book about tuberculosis translated into Kannada by Pavithra Joseph & Gladys Noel.
Children's book about tuberculosis in Tamil translated by Jayashree Janardhan. With special thank... more Children's book about tuberculosis in Tamil translated by Jayashree Janardhan. With special thanks to Pavithra Antoinette Joseph.
Educational children's book about tuberculosis translated into Marshallese by Caleb Klipowicz, Me... more Educational children's book about tuberculosis translated into Marshallese by Caleb Klipowicz, Melanie Carbine, and Sheldon Riklon, MD.
Educational children's book about tuberculosis translated into Thai by Kamontip Rasri Klosen and ... more Educational children's book about tuberculosis translated into Thai by Kamontip Rasri Klosen and Wibool Piyawattanametha
Educational children's book about tuberculosis translated into Polish by Bartłomiej Kołodziejczyk... more Educational children's book about tuberculosis translated into Polish by Bartłomiej Kołodziejczyk and Borys Wróbel
Educational children's book about tuberculosis translated into Hindi by Viren Joseph & Pavithra J... more Educational children's book about tuberculosis translated into Hindi by Viren Joseph & Pavithra Joseph.
Educational Children's book about tuberculosis translated into Kannada by
Pavithra Joseph & Glad... more Educational Children's book about tuberculosis translated into Kannada by Pavithra Joseph & Gladys Noel.
Children's book about tuberculosis in Tamil translated by Jayashree Janardhan. With special thank... more Children's book about tuberculosis in Tamil translated by Jayashree Janardhan. With special thanks to Pavithra Antoinette Joseph.
Contrary to popular perception, your stone age Michelangelo was more likely to be a Maria, accord... more Contrary to popular perception, your stone age Michelangelo was more likely to be a Maria, according to a recent study of 40,000 -year -old hand stencils reported in American Antiquity. This finding highlights the creative role that female humans played in hunter -gatherer societies, and also has clear implications for the type of mothering they were able to deliver. Recent data published in Nature adds to this picture. Analysis of a fossil tooth from a Neanderthal infant shows that Neanderthal children moved off exclusive breastfeeding at around 7.5 months of age. In comparison, infants in hunter -gatherer societies are not weaned until around three or four years of age. Clearly, female participation in close -range hunting would impact negatively upon child - rearing capacities while lullabies and cave painting would be more conducive to the parent-infant bond. In my view, the human babies who had more time with their caregivers, who were in turn supported by their own families in the task of raising highly dependent, slow- maturing, offspring, found themselves in an ideal learning environment. The parent- infant bond is key to the evolution of language, nonverbal communication and interpersonal emotional skills; the extended childhood increases the duration of learning and innovation.
Background In-hospital logistic management barriers (LMB) are considered to be important risk fac... more Background In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatment initiation (TB-dt), which perpetuates TB transmission and the development of TB morbidity and mortality. We assessed the contribution of hospital auxiliary workers (HAWs) and 24-h TB laboratory services using Xpert (24h-Xpert) on the delays in TB-dt and TB mortality at Beira Central Hospital, Mozambique. Methods A quasi-experimental design was used. Implementation strategy—HAWs and laboratory technicians were selected and trained, accordingly. Interventions—having trained HAW and TB laboratory technicians as expediters of TB LMB issues and assurer of 24h-Xpert, respectively. Implementation outcomes—time from hospital admission to sputum examination results, time from hospital admission to treatment initiation, proportion of same-day TB cases diagnosed, initiated TB treatment, and TB patient with unfavorable outcome after hospitalization (hosp...
Biobanks provide an important foundation for genomic and personalised medicine. In order to enhan... more Biobanks provide an important foundation for genomic and personalised medicine. In order to enhance their scientific power and scope, they are increasingly becoming part of national or international networks. Public trust is essential in fostering public engagement, encouraging donation to, and facilitating public funding for biobanks. Globalisation and networking of biobanking may challenge this trust. We report the results of an Australian study examining public attitudes to the networking and globalisation of biobanks in order to determine factors that may contribute to, and threaten, trust. Our results indicate a generally high level of trust in biobanks and in medical research more broadly. Key factors that can reduce perceived trustworthiness of biobanks are commercialisation and involvement in global networking. However, robust ethical oversight and governance standards can both promote trust in global biobanking and ensure that this trust is warranted.
Biomedical innovation and translation are increasingly emphasizing research using "big data.... more Biomedical innovation and translation are increasingly emphasizing research using "big data." The hope is that big data methods will both speed up research and make its results more applicable to "real-world" patients and health services. While big data research has been embraced by scientists, politicians, industry, and the public, numerous ethical, organizational, and technical/methodological concerns have also been raised. With respect to technical and methodological concerns, there is a view that these will be resolved through sophisticated information technologies, predictive algorithms, and data analysis techniques. While such advances will likely go some way towards resolving technical and methodological issues, we believe that the epistemological issues raised by big data research have important ethical implications and raise questions about the very possibility of big data research achieving its goals.
Research biobanks house collections of biological samples from human populations. While biobanks ... more Research biobanks house collections of biological samples from human populations. While biobanks have traditionally been contained within institutional walls and national borders, enthusiasm for “big data” is driving the formation of transnational biobank networks. The rationale for the global linkage of biobanks is that it increases their “big data” resources and affords opportunities for partnerships between institutions with commensurable ethical, regulatory and institutional structures. The global expansion of biobanks is, however, not entirely benign, as the local implementation of their operations in various country settings inevitably challenges, undermines or displaces local epistemologies and practices. Those countries that dominate the field are also (re)-setting the research agenda and establishing the financial foundations for bionetworks, thereby reconfiguring labour and human resources, technological capabilities, capital and finances, information and information technology, and ideologies and epistemologies. The consequences for (disempowered) local populations is often profound, as they must struggle to make sense of the idea that their tissue and data may be used for unspecified future research by transnational groups with no link or commitment to their community, must deal with divergent standards of research and institutional practice, and must accommodate ongoing uncertainty regarding how data will be analysed and interpreted, and results communicated and translated into policy and practice. Critical engagement with theories of globalisation can facilitate the necessary ethical reasoning required to address not only the “traditional” ethical issues raised by biobanking, such as consent, confidentiality and benefit sharing, but also broader socio-political concerns such as population surveillance and epistemological imperialism.
The formation of transnational biobank networks determines how human biodata is deterritorialised... more The formation of transnational biobank networks determines how human biodata is deterritorialised with consequences for benefit sharing and custodianship of tissue among other issues. In this paper, we examine the grobalisation of the scientific standards and practices of biobanks and the glocalisation of their operations in various country settings. Research biobanks house collections of biological samples from human populations. Originally established by single institutions within national borders, biobanks are increasingly "going global" to maximize their utility and sustainability, while taking advantage of scientific and political enthusiasm for "big data". Establishing transnational networks affords opportunities for biobanks to partner with institutions whose ethical, regulatory and practical structures may enhance a biobank's own global competitiveness-but in ways that potentially circumvent national structures. Furthermore, countries dominant in the field are setting the agenda and financial feasibility of global biobanks. The transnational distribution and compartmentalisation of their operations has differential impacts upon diverse human populations. In this presentation, we critically examine the relationship between the ethics of biobanks and the collaborative research capacity of nation states, their political, academic and social institutional capacity, and the ability of diverse communities to glocalise the standards, practices, and funding models of biomedical science.
Research biobanks house collections of biological samples from human populations. Originally esta... more Research biobanks house collections of biological samples from human populations. Originally established by single institutions within national borders, biobanks are increasingly " going global " to maximize their utility and sustainability and take advantage of scientific and political enthusiasm for " big data ". The grobalisation of the scientific standards and practices of biobanks is coupled with the glocalisation of their operations in various country settings. Countries dominant in the field are setting the agenda and financial feasibility of this research model. Establishing global biobanks affords opportunities to partner with institutions whose ethical, regulatory and practical structures may enhance a biobank's own global competitiveness—but often in ways that potentially undermine or displace national structures. The formation of transnational biobank networks determines how human biodata is deterritorialised with consequences for benefit sharing and custodianship of tissue among other ethico-legal issues. As biobanks circumvent domestic and institutional confines, greater attention must be paid to the moral economy of their operational models and to the ways in which the ethics of biobanks is a spandrel of the collaborative research capacity of nation states, their political, academic and social institutional capacity, and the ability of societies to glocalise the standards, practices, and funding models of biomedical science.
The globalization of science leads to new and exciting collaborative possibilities and research e... more The globalization of science leads to new and exciting collaborative possibilities and research endeavours, but also has important social, ethical and political dimensions to consider. Going global not only magnifies and heightens existing ethical issues in science research, it introduces new and complex ethical considerations. Globalization is heterogeneous and does not, in reality, lead to uniformity, but rather to reconfigurations of labour and human resources, technological capabilities, capital and finances, information and information technology, and ideologies and epistemologies. The globalisation of science has the capacity to fundamentally reconfigure the ways in which we define the world, generate evidence, and determine our priorities. Keep in mind, however, that the globalisation of science is largely driven by those who have the most social, political, and economic capital. In the research context, this means that globalisation affords translocal networks of researchers the opportunity to adopt or partner with institutions in countries with the most favourable ethical, regulatory, and practical. While this no doubt facilitates research, it simultaneously enables countries that are already dominant in the field to drive the agenda and the financial feasibility of research. In this talk, I will unpack key social consequences, ethical considerations and political dimensions of globalising science.
Biobanks of human tissue and data have become an established part of the research landscape—enabl... more Biobanks of human tissue and data have become an established part of the research landscape—enabling molecular research into the aetiology, course and therapy of many diseases. The extensively described ethical issues that surround biobanking include: 1) informed consent and right to withdraw; 2) confidentiality and protection from discrimination; 3) controlling data access; 4) equity, reciprocity and benefit sharing; 5) ownership, commercialization and intellectual property rights, 6) community engagement; and 7) respect for cultural diversity. Specialists broadly agree that addressing these issues is crucial to establishing and maintaining trust between biobanks and the general public, and fostering altruism among tissue donors. The biobank landscape is, however, changing, as the pull of “big data” drives biobanks to “go global”. This amplifies the ethical issues that apply to localized biobanks, and introduces new and complex ethical considerations. For example, the heterogeneity of technical standards and practices across diverse settings challenges the validity and reliability of data analysis; the financial cost of maintaining biobank facilities can encourage commercial arrangements that impact upon benefit sharing; and the transfer of human biological samples across national boundaries can complicate the custodianship of tissue, return of results, and right to withdraw. The ethicolegal, scientific and practical challenges of international biobank networks are heightened by the fact that there is more than one way for a biobank to “go global”. For example, biobanks can centralize their resources and collect samples from numerous countries; share data through virtual networks across several countries; or distribute and compartmentalize activities in different locations. The specific ways in which transnational biobank networks are formed can give rise to idiosyncratic ethical issues. We argue that it is critical that bioethicists engage with these complexities, and that theories of globalisation provide a valuable political frame through which the ethics of international bionetworks may be understood.
Considering the politics and ethics of global health in the context of the Anthropocene, this pan... more Considering the politics and ethics of global health in the context of the Anthropocene, this panel invites papers exploring the synergistic effects of population growth, climate change, overcrowding, malnutrition, globalisation, infectious and zoonotic disease, syndemics, food security and unequal access to resources affecting physical and mental wellbeing, and life expectancy. The Anthropocene favours certain multispecies assemblages such as humans and infectious diseases, but disadvantages others—often resulting in extinction. Human population growth is accompanied by global medical projects dominated by the increasing pull of 'big data' and forms of governance that rely on measuring and controlling populations. Tracing both the proximal and distal influences on human health, this medical anthropology panel explores how economic, ecological, political, community-based and institutional contexts generate and structure the spread, and control, of health, disease, and constructions of the norm. From granular ethnographies of the illness experience to critical analyses of medical surveillance, papers are invited that discuss global health at multiple levels of complexity. With a focus on health, illness and participation in the global medical enterprise, potential topics may include: population health; transnational biomedical research; genomic medicine; personhood in the post-genomic age; global pandemics; vulnerabilities and resilience; and emerging and re-emerging infectious diseases. Submission details to follow shortly. Please visit the conference website for more information: http://www.aas.asn.au/conference/upcoming-conference/
Conference for the Sydney University Network for Bodies, Organs, and Tissues
Human biobanks are being established globally. Their transnational networks are expanding rapidly... more Human biobanks are being established globally. Their transnational networks are expanding rapidly as a consequence of globalisation, with the role of such networks in biomedical research becoming ever more central. Although we may perceive a global coherence in practices of biobanks as they spread internationally, they do not actually exhibit the consistency that we might imagine. The ethical and legal frameworks that govern biobanks might differ across countries, but equally differ across biobanks within the same jurisdiction. In the context of globalisation, where biobanks are sustained by translocal networks of professional staff and facilities, ethical concerns extend further than the traditional issues of consent, confidentiality, withdrawal and feedback to participants. What regulatory issues come into play when tissue is collected in one country and stored in another? Who benefits from the data collection, data mining, and experimental results? How can organisations work to ensure that beneficence, reciprocity, and equity are observed? This paper will foray into the uncharted territory of global biobank governance with a view to the kinds of questions we should be asking.
Consumption, once considered a disease of wasting, has become a commonplace cultural practice. Di... more Consumption, once considered a disease of wasting, has become a commonplace cultural practice. Did a monocausal theory of tuberculosis open the space for the commodification of the body and eventually lead to disease control strategies oriented towards consumerist pharmaceutical interventions?
Through a case study of a TB patient in Ca Mau Vietnam, Paul will explore issues of mandatory com... more Through a case study of a TB patient in Ca Mau Vietnam, Paul will explore issues of mandatory compliance, denied reciprocity and social exclusion among patients in low-income countries offered free medication for an airborne infectious disease.
Background
Tuberculosis (TB) treatment is lengthy and psychologically demanding. Social Cognitiv... more Background
Tuberculosis (TB) treatment is lengthy and psychologically demanding. Social Cognitive Theory (SCT) is a useful model for conceptualising human behaviour in response to stress. SCT situates behavioural, environmental, and personal factors in a relationship of reciprocal determinism. Understanding a patient’s experience requires not only an observation of their behaviour (e.g. presentation for treatment, medication adherence), environmental factors (e.g. social support structures, access to resources), and personal factors (e.g. medical knowledge, expectations of treatment) but also consideration of how these three factors impact upon each other. Personal factors, specifically self-efficacy beliefs, are central to the capacity to exercise control over one’s life. Self-efficacy beliefs are personal judgments of what one can do with whatever resources and skills one possesses to organise and execute courses of actions required to attain designated types of performances. Psychometric tools to measure self-efficacy among TB patients can be a useful means of identifying individual, social, and structural obstacles and facilitators to effective health-seeking behaviours and successful treatment outcomes.
Objectives
This study aimed to determine psychometric characteristics of a Coping Self-Efficacy (CSE) scale among Vietnamese TB patients.
Method
Ethnographic fieldwork in Ca Mau, the southernmost province of Vietnam, led to the development of a context-specific TB Treatment CSE scale aimed at better understanding the experience of regional Vietnamese TB patients. Using convenience sampling, scale domains were developed through structured and semi-structured interviews with 75 newly diagnosed TB patients identified through a community-wide TB screening program in Ca Mau.
Results
The Vietnamese version of the TB Treatment CSE scale contained 27 items across four domains including 5 items on “communication with doctor”, 4 items on “seeking support”, 7 items of “disclosure of diagnosis”, and 11 items on “medication adherence”. Piloting indicated acceptance and feasibility of the scale to measure self-efficacy among both literate and illiterate Vietnamese TB patients.
Lots of science terms have a different meaning in everyday language. Buffer, control, invalid, or... more Lots of science terms have a different meaning in everyday language. Buffer, control, invalid, organic, primer, and sensitivity are just a few examples. Sometimes scientists overlook a key concept because the public understanding of a word is so deeply engrained in popular culture. Recent research published in the journals Complexity, BioSystems and Briefings in Functional Genomics examines the widely misunderstood concept of degeneracy. Scientists have largely overlooked this word, because the familiar usage of degeneracy is completely at odds with its scientific meaning. Many scientists get confused by this term and this can lead to issues understanding systems and explaining how they work.
In standard language, the word ‘degenerate’ refers to undesirable deviation. Even medical doctors refer to harmful degradation as a ‘degenerative’ condition. The scientific term ‘degeneracy’, however, has a much less negative meaning. Degeneracy refers to the variable pathways that can lead to the same outcome or the ability of different structures to perform the same function. For example, different chemical pathways can be used to metabolise food, different proteins can bind to the same molecules, and multiple pathological pathways have been implicated in the clinical symptoms of asthma, chronic obstructive pulmonary disorder, dystonia, attention-deficit/hyperactivity disorder, neuropathic pain, autism, and sleep apnea.
Many scientists have been blind to the concept of degeneracy not only because the term itself is misleading, but also because degeneracy is distributed throughout living systems. A traditional research approach looking for a single cause for any given condition is not able to map multiple processes yielding the same output. Geneticists looking for a single gene for a given function or neuroscientists looking for the brain area responsible for a specific behaviour are examples of a bias that hides degeneracy from scientific thinking. A lot of the time, technological limitations only allow researchers to investigate one structure and one function at a time. Not including degeneracy in scientific models, however, risks ignoring an important part of how living systems operate.
‘Redundant’ is another tricky word used differently in everyday speech and science. In everyday speech, we often use the word ‘redundant’ to refer to something that is unnecessary. To be made ‘redundant’ at the workplace, for example, is to lose your job. In science, redundancy refers to multiple copies of identical structures. However, even among scientists there is confusion between redundancy and degeneracy. For instance, two different genes that code for the same function are often mislabelled redundant. Making a clear distinction between redundancy and degeneracy helps scientists be more precise about the properties of a system. The words we use to think about living systems can be just as valuable as the technology we use to study them.
Degeneracy is a vital property of evolutionary systems. Having multiple different backup pathways is how living systems maintain stability over time and also how they change, adapt and evolve. Degeneracy can be observed in many different systems such as genetic codes, epigenetic programs, immune systems, respiratory networks, bodily movement, human language, and cultural behaviour. Drawing upon the history and philosophy of science as well as examples from contemporary research, this talk will elucidate the structural variation and functional plasticity underlying the dynamic composition of complex living systems.
A proposal to conduct a systematic review asking the research question: "Are patients with active... more A proposal to conduct a systematic review asking the research question: "Are patients with active TB who have mental illness at greater risk for poor TB treatment outcomes (failure, death, default) compared to patients without mental illness?"
Why animal displays are so complex and how they have evolved are active foci of research. Despite... more Why animal displays are so complex and how they have evolved are active foci of research. Despite significant advancements, however, developments in the field of complex animal signaling remain predominantly taxon-specific. Progress towards a unified understanding of complex communication is constrained by the near universal adoption of a linear one-signal-to-one-function framework of categorization. We highlight the non-linear nature of animal communication and propose that integrating systems approaches and thinking can unify and advance animal communication research. A systems approach to animal communication considers the dynamic functions and interactions of signal components across display compositions, contexts, and/or time and importantly introduces concepts of system design principles such as modularity and degeneracy. We place a special emphasis on the previously overlooked concept of degeneracy (different structure/ similar function) as distinct from redundancy (same structure/ same function). Using systems terminology to quantify and analyze signal design patterns will facilitate specific and testable predictions regarding signal robustness and/or evolvability.
DOTS (Direct Observed Therapy, Short-course) is the model of Tuberculosis (TB) treatment advocate... more DOTS (Direct Observed Therapy, Short-course) is the model of Tuberculosis (TB) treatment advocated by the World Health Organisation primarily built around the standardised and supervised treatment of TB patients. In Vietnam, TB treatment is at a critical juncture. International donors are withdrawing because Vietnam has made the transition to a middle-income country, the national budget for TB in Vietnam has been dropped from 105 million VND p.a. to 68 million VND p.a., and the standard of TB treatment is changing from an eight month program including two months of streptomycin injections to a six month program without streptomycin. In the context of these changes, the Woolcock Institute is trialling a community-wide tuberculosis screening program using a new test called GeneXpert which reduces the time taken to detect tuberculosis, including drug-resistant tuberculosis, from 2 weeks to 2 hours. Systematic community-wide screening for TB has not taken place since the mid-20th Century and has many ethical and regulatory issues. If this new diagnostic strategy proves cost-effective and efficient, it will serve as a model for screening methods that will inform public policy in Vietnam and other countries with a high-burden of TB. Investigating how locals embrace or resist medical screening and medical treatment helps to understand how to improve access to healthcare, medical communication strategies, and the administration of TB treatment. Drawing upon ethnographic fieldwork in Cà Mau, the southernmost province of Vietnam, this talk will explore some of the social and cultural dimensions that impact upon the spread and control of TB.
This paper aims to debunk commonly held notions of normality by looking at the history of this mi... more This paper aims to debunk commonly held notions of normality by looking at the history of this misappropriated term in biomedical science. After debunking the myth of normality, this paper explores the heterogeneous construction of human diversity and calls for holistic models of human experience that embrace the integration of variable intersecting factors at multiple levels of complexity. In recent years there has been a strong push towards integrative personalised approaches to mental health. With some methodological and interpretative issues remaining to be resolved, integrative analyses centering on the individual are proving fruitful with a multi-pronged treatment approach being promoted where counsellors, social workers, and social policy makers among others can all view their engagement as interlinked, with no particular agent offering a complete solution on their own. Researchers, clinicians, and educators, benefitting from the ongoing commercialisation of the body, are putting the individual at the nucleus of critical inquiry. With the individual at the centre, reductionism is defied by situating the person as a relational being whose intersubjectivity, life history, and cultural experience are variously factored in all their splendour and complexity.
At the centre of professional approaches to mental health and human performance, the brain holds ... more At the centre of professional approaches to mental health and human performance, the brain holds a magnetic pull over both specialists and the general public. Today, more mental health conditions are diagnosed than science knows how to redress. Putting the brain at the centre of mental health approaches has significant social consequences and drives an industry that capitalises upon culturally constructed notions of normality and abnormality. While acknowledging the mental health practitioners who deliver empowering services to vulnerable populations, people working in the brain sciences are also obliged to critique a neurocentric worldview that encourages brain function to be conceptualised according to a reductionist scientific discourse of normalcy and degeneracy. This presentation will debunk the myth of normality and explore models of human experience that embrace the integration of variable intersecting factors at multiple levels of complexity.
Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single inf... more Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious disease. Vietnam is 1 of 22 countries with a high burden of TB. Even with free medical services available across Vietnam an estimated one third of people with TB do not access treatment. Treatment is lengthy and psychologically
demanding. Informed by interviews with TB patients in Ca Mau, Vietnam, a social cognitive model is presented to gain an understanding of the patient experience. Drawing upon Bandura’s health promotion model, we highlight individual, social, and structural obstacles and facilitators to health seeking behaviour. The model is extrapolated with a focus on self-efficacy. Greater efficacy has been associated with higher health seeking behaviours and mental-wellbeing. Fieldwork in Ca Mau, Vietnam, has led to the development of a context-specific TB Treatment Self-efficacy scale aimed at better understanding the experience of TB patients.
Tuberculosis has been characterised as a ‘disease of capitalism’, a ‘disease of incomplete civili... more Tuberculosis has been characterised as a ‘disease of capitalism’, a ‘disease of incomplete civilisation’, and a ‘disease of incomplete industrialisation’. However, before it gained any of these titles, tuberculosis was known as consumption, ‘a disease of wasting’. Consumption was a major cause of death that afflicted people during their early life and productive years. The growth of the disease to epidemic proportions accompanied the overcrowding of urban centres following the industrial and agricultural revolution. A severe impediment to productivity, consumption was to be avoided at all costs. Any condition that prevented a person’s ability to contribute to the productivity of an industrious society was considered ‘degenerate’—a value-laden misappropriation of the Latin word degeneratus that originally meant simply a change either positive or negative from the general or standard type. In productivist civilisations, standardisation, not diversity, was highly valued. Degeneracy became a consequential label to refer to negative deviation from the norm. Where vaccines and antibiotics were lacking, practices of physical, social and mental hygiene became a moral imperative to maintain worth and avoid degeneracy. Notions of normality were increasingly tied to social values of productivity and medical values of health. Physical, social, and mental hygiene became commodified through mass-produced personal and household cleaning products as well as elite standards of professional mental health care. While consumption was a highly stigmatised disease, it was also a romanticised condition. Perversely, consumption came to shape ideals of feminine beauty, with the emaciated pallor, vulnerable complexion, and morbid fragility of the consumptive persisting in many fashion centres today as the height of feminine glamour. With a consideration of medicalization and hygienic citizenship, this paper discusses tuberculosis, degeneracy, and the irony that consumption, once considered a disease of wasting, is now one of the central drivers of a capitalist assault on biodiversity.
student feedback for undergraduate anthropology course co-convened with Professor Greg Downey, De... more student feedback for undergraduate anthropology course co-convened with Professor Greg Downey, Department of Anthropology, Faculty of Arts, Macquarie University
This unit introduces methodological strategies used in community research. Quantitative strategie... more This unit introduces methodological strategies used in community research. Quantitative strategies, such as questionnaire and survey methods, will be compared with qualitative ones, such as participant observation. The epistemological and ethical dimensions of methodology, and the effects of political imperatives on the conduct of research will be discussed. It includes four weeks of community-based research.
These materials can be used to introduce social and cultural approaches to studying tuberculosis.... more These materials can be used to introduce social and cultural approaches to studying tuberculosis. Covering key relevant concepts from medical anthropology and health sociology, the information is targeted at undergraduate and postgraduate students as well as industry professionals. The concepts covered include agency, biographical disruption, cultural imperatives, dynamic nominalism, exigency, gender, illness narratives, the liminal body, local biologies, looping effect, medicalisation, self-efficacy, stigma, structural violence, surveillance, syndemics, taboos, and victim blaming.
Anonymous student feedback from "Keeping the Body in Mind", which I tutored at Melbourne Universi... more Anonymous student feedback from "Keeping the Body in Mind", which I tutored at Melbourne University in 2011.
This lecture looks at three ethnographies that informed Marcel Mauss' Essay on the Gift, three an... more This lecture looks at three ethnographies that informed Marcel Mauss' Essay on the Gift, three anthropologists who were inspired by Marcel Mauss' work, and three scholars who have developed further theory about reciprocity.
Medical histories are important, not least because they allow clinicians and researchers to asses... more Medical histories are important, not least because they allow clinicians and researchers to assess the construction of knowledge in their discipline. For people working in public health or immunology, The End of Plagues is a worthwhile read. With optimism, Rhodes highlights the need for new vaccines, a better understanding of adjuvants, and the desire to see the last of plagues such as polio. This book will most likely please readers with some laboratory or clinical training or experience. Undergraduate biomedical students would also greatly benefit from reading this book. Rhodes finishes The End of Plagues by expressing the desire to converse with Edward Jenner. Readers will no doubt be left with the same desire to converse with an author who demonstrates an incredible wealth of knowledge and experience in his field.
Senses and Citizenships is published as part of the Routledge Studies in Anthropology series. The... more Senses and Citizenships is published as part of the Routledge Studies in Anthropology series. The book would easily suit undergraduate and postgraduate curricula. The contributors, all anthropologists, have visibly worked closely together to produce a richly integrated volume that samples a breadth of top- ics relating to embodiment and nationalism. As a whole the book is a great package. Broadening the terrain beyond nationalism, the volume also hints at a postnational world where transnational communities are formed around shared embodied experiences, subnational groups assert distinct identities, and supranational incorporation destabilises conventional imaginaries. From pain, toil, and violence, to music and dance as well as more mundane expressions of national belonging, Senses and Citizenships is a robust example of contemporary anthropological scholarship.
Part of the Routledge Studies in Cultural History series, Disease and Crime is a well-integrated ... more Part of the Routledge Studies in Cultural History series, Disease and Crime is a well-integrated collection of essays that span the (post-) colonial history of medicine, law and politics in East Asia and Europe. Comprising eight compact chapters and an admirably well-synthesised introduction, this volume takes an interdisciplinary, cross-cultural and comparative approach. Vibrant theoretical discussions are grounded in context-driven case studies examining the social, cultural and political forces that shape categories of disease and crime.
The mobilisation of medical knowledge for legal purposes is a persistent issue in diverse cultural contexts. As long as science, disease and crime continue to be conflated to aggregate, subjugate, and regulate populations, critical inquiry will be necessary. Disease and Crime offers a sound representation of scholarship in this area. This highly readable volume will interest scholars in anthropology, history, sociology, medical humanities and area studies. It could be used whole or in part as course material for undergraduate or postgraduate students. As an excellent example of solid, high quality, robust scholarship, Disease and Crime will satisfy early career researchers and experienced academics alike.
In The Alzheimer Conundrum the influential Margaret Lock delves more deeply into the immense comp... more In The Alzheimer Conundrum the influential Margaret Lock delves more deeply into the immense complexity of the global medical enterprise than any of her previous research. The opening chapter, Orientations, begins with a list of contemporary global epidemics, only one of which is an infectious disease. With her very first words, Lock points to a major shift in the medical gaze from a preoccupation with contagion to a concern for any condition affecting significant numbers of individuals. Ageing populations around the world put Alzheimer disease and dementia firmly on this list, not just in medicine but also in the popular media, which increasingly refers to the epidemic proportions of chronic non-infectious diseases.
The Remedy by Thomas Goetz and Experiment Eleven by Peter Pringle exist like bookends to a landma... more The Remedy by Thomas Goetz and Experiment Eleven by Peter Pringle exist like bookends to a landmark period in the history of tuberculosis (TB). The Remedy starts with the dawning of the germ theory, and Experiment Eleven covers the blossoming of the antibiotic era. Goetz revolves his story around Robert Koch (1843-1910) and Pringle centres on Albert Schatz (1920-2005). Both protagonists had wartime experiences working in medicine that stimulated them to work on infectious disease, both had exceptional laboratory skills, and both made major contributions to developing a treatment for tuberculosis. Neither protagonist, however, went without his own battles. Goetz describes Koch’s rivalry with his contemporary, Louis Pasteur (1822-1895), and Pringle uncovers Schatz’s bitter legal fight with Selman Waksman (1888-1973) over who should be given credit for the discovery of streptomycin, the first antibiotic effective against tuberculosis. By adding another character into the mix, Arthur Conan Doyle (1859-1930), Goetz sets out to demonstrate how the deductive methods of science became part of mainstream culture. Pringle, on the other hand, is rather straightforward in providing a detailed account of how streptomycin, one of the first antibiotics, became patented. In writing about the lives of eminent scientists who have worked on tuberculosis, Goetz and Pringle have written nuanced and richly contextualised histories well worth reading.
Tuberculosis is old news, but it's not passé. Despite an onslaught of antibiotics, vaccines, and ... more Tuberculosis is old news, but it's not passé. Despite an onslaught of antibiotics, vaccines, and public health interventions, tuberculosis persists as a widespread infectious killer, second only to HIV/AIDS. Given the availability of effective treatments tuberculosis should be confined to history, but it is not.
Romanticised by some, stigmatised by others, tuberculosis by virtue of its infectious nature is a... more Romanticised by some, stigmatised by others, tuberculosis by virtue of its infectious nature is a social disease. Robert Koch discovered the bacillum in 1882. Antibiotics to treat the disease were discovered in the 1940s. In the interim, Albert Calmette and Camille Guerin developed a vaccine that became available in the 1920s. Like a number of historiographies of tuberculosis, Armus’ book looks at that critical period covering the discovery of the bacillum, the development of vaccinations, and the advent of antibiotic treatment. With a focus outside the Global North, The Ailing City is one of the first books to document the social life of tuberculosis in a South American city.
Writing the history of tuberculosis does not simply involve tracing how humans travelled from uncertainty to reason in searching for a cure for a disease. Tuberculosis fundamentally altered the human landscape in a range of significant ways and its history is not linear. The incapacity to sequester the spread and devastation of tuberculosis opened the space for all manner of regulations, surveillance and secular moralising that infiltrated the most intimate parts of peoples’ lives. With unparalleled command of his topic and an incredible amount of primary resources, Armus analyses social context and the culture of medical practice in a multifaceted history of tuberculosis in Buenos Aires.
Review of "Replacement of Neanderthals by Modern Humans, Volume 1: Cultural Perspectives" edited ... more Review of "Replacement of Neanderthals by Modern Humans, Volume 1: Cultural Perspectives" edited by Takeru Akazawa, Nishiaki Yoshihiro, and Aoki Kenichi, and "Volume 2: Cognitive and Physical Perspectives" edited by Takeru Akazawa, Naomichi Ogihara, Hiroki C. Tanabe and Hideaki Terashima, published by Springer.
When considering the same psycho-physiological phenomenon in a variety of different historical an... more When considering the same psycho-physiological phenomenon in a variety of different historical and cultural contexts, what would you expect to find? Sleep paralysis is a captivating case study for such a project.
Across different cultures, the physical experience of sleep paralysis is remarkably consistent. A sleeping person, generally reclining in the supine position, has the sensation of waking up in the middle of the night. They feel vividly aware of their surroundings but incapable of motor action. For a stressful period of time lasting up to a couple of minutes, the individual feels awake but paralysed, even feeling unable to breathe. Eventually, their body is able to move again, but the experience can leave an unforgettable trace on their being. Adler calls the phenomenon a night-mare (with a hyphen) thus not giving credence to the western medical definition of sleep paralysis. Nonetheless, her book is still called Sleep Paralysis, which suggests the sort of compromises anthropologists make to popularise their ethnography. A minor clash, however, between ethnographic methodology and marketable literature does not retract from Adler’s wonderful work, which bridges a divide between her discipline and a wider audience.
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Books by Paul Mason
Pavithra Joseph & Gladys Noel.
Pavithra Joseph & Gladys Noel.
role that female humans played in hunter -gatherer societies, and
also has clear implications for the type of mothering they were able
to deliver. Recent data published in Nature adds to this picture.
Analysis of a fossil tooth from a Neanderthal infant shows that
Neanderthal children moved off exclusive breastfeeding at around
7.5 months of age. In comparison, infants in hunter -gatherer societies
are not weaned until around three or four years of age. Clearly, female
participation in close -range hunting would impact negatively upon child -
rearing capacities while lullabies and cave painting would be more
conducive to the parent-infant bond. In my view, the human babies
who had more time with their caregivers, who were in turn supported by their own families in the task of raising highly dependent, slow- maturing, offspring, found themselves in an ideal learning environment. The parent-
infant bond is key to the evolution of language, nonverbal communication
and interpersonal emotional skills; the extended childhood increases the duration of learning and innovation.
Tuberculosis (TB) treatment is lengthy and psychologically demanding. Social Cognitive Theory (SCT) is a useful model for conceptualising human behaviour in response to stress. SCT situates behavioural, environmental, and personal factors in a relationship of reciprocal determinism. Understanding a patient’s experience requires not only an observation of their behaviour (e.g. presentation for treatment, medication adherence), environmental factors (e.g. social support structures, access to resources), and personal factors (e.g. medical knowledge, expectations of treatment) but also consideration of how these three factors impact upon each other. Personal factors, specifically self-efficacy beliefs, are central to the capacity to exercise control over one’s life. Self-efficacy beliefs are personal judgments of what one can do with whatever resources and skills one possesses to organise and execute courses of actions required to attain designated types of performances. Psychometric tools to measure self-efficacy among TB patients can be a useful means of identifying individual, social, and structural obstacles and facilitators to effective health-seeking behaviours and successful treatment outcomes.
Objectives
This study aimed to determine psychometric characteristics of a Coping Self-Efficacy (CSE) scale among Vietnamese TB patients.
Method
Ethnographic fieldwork in Ca Mau, the southernmost province of Vietnam, led to the development of a context-specific TB Treatment CSE scale aimed at better understanding the experience of regional Vietnamese TB patients. Using convenience sampling, scale domains were developed through structured and semi-structured interviews with 75 newly diagnosed TB patients identified through a community-wide TB screening program in Ca Mau.
Results
The Vietnamese version of the TB Treatment CSE scale contained 27 items across four domains including 5 items on “communication with doctor”, 4 items on “seeking support”, 7 items of “disclosure of diagnosis”, and 11 items on “medication adherence”. Piloting indicated acceptance and feasibility of the scale to measure self-efficacy among both literate and illiterate Vietnamese TB patients.
In standard language, the word ‘degenerate’ refers to undesirable deviation. Even medical doctors refer to harmful degradation as a ‘degenerative’ condition. The scientific term ‘degeneracy’, however, has a much less negative meaning. Degeneracy refers to the variable pathways that can lead to the same outcome or the ability of different structures to perform the same function. For example, different chemical pathways can be used to metabolise food, different proteins can bind to the same molecules, and multiple pathological pathways have been implicated in the clinical symptoms of asthma, chronic obstructive pulmonary disorder, dystonia, attention-deficit/hyperactivity disorder, neuropathic pain, autism, and sleep apnea.
Many scientists have been blind to the concept of degeneracy not only because the term itself is misleading, but also because degeneracy is distributed throughout living systems. A traditional research approach looking for a single cause for any given condition is not able to map multiple processes yielding the same output. Geneticists looking for a single gene for a given function or neuroscientists looking for the brain area responsible for a specific behaviour are examples of a bias that hides degeneracy from scientific thinking. A lot of the time, technological limitations only allow researchers to investigate one structure and one function at a time. Not including degeneracy in scientific models, however, risks ignoring an important part of how living systems operate.
‘Redundant’ is another tricky word used differently in everyday speech and science. In everyday speech, we often use the word ‘redundant’ to refer to something that is unnecessary. To be made ‘redundant’ at the workplace, for example, is to lose your job. In science, redundancy refers to multiple copies of identical structures. However, even among scientists there is confusion between redundancy and degeneracy. For instance, two different genes that code for the same function are often mislabelled redundant. Making a clear distinction between redundancy and degeneracy helps scientists be more precise about the properties of a system. The words we use to think about living systems can be just as valuable as the technology we use to study them.
Degeneracy is a vital property of evolutionary systems. Having multiple different backup pathways is how living systems maintain stability over time and also how they change, adapt and evolve. Degeneracy can be observed in many different systems such as genetic codes, epigenetic programs, immune systems, respiratory networks, bodily movement, human language, and cultural behaviour. Drawing upon the history and philosophy of science as well as examples from contemporary research, this talk will elucidate the structural variation and functional plasticity underlying the dynamic composition of complex living systems.
demanding. Informed by interviews with TB patients in Ca Mau, Vietnam, a social cognitive model is presented to gain an understanding of the patient experience. Drawing upon Bandura’s health promotion model, we highlight individual, social, and structural obstacles and facilitators to health seeking behaviour. The model is extrapolated with a focus on self-efficacy. Greater efficacy has been associated with higher health seeking behaviours and mental-wellbeing. Fieldwork in Ca Mau, Vietnam, has led to the development of a context-specific TB Treatment Self-efficacy scale aimed at better understanding the experience of TB patients.
SETU Semester 1, 2017
Faculty of Arts
ATS1255_CLAYTON_DAY_ON_S1-01 Encountering cultures: Introduction to anthropology 1
Lecture slides:
https://prezi.com/_cxgegsxr1jm/marcel-mauss/?utm_campaign=share&utm_medium=copy
Lecture presentation:
https://www.youtube.com/watch?v=u1vkNPDwFhY
The mobilisation of medical knowledge for legal purposes is a persistent issue in diverse cultural contexts. As long as science, disease and crime continue to be conflated to aggregate, subjugate, and regulate populations, critical inquiry will be necessary. Disease and Crime offers a sound representation of scholarship in this area. This highly readable volume will interest scholars in anthropology, history, sociology, medical humanities and area studies. It could be used whole or in part as course material for undergraduate or postgraduate students. As an excellent example of solid, high quality, robust scholarship, Disease and Crime will satisfy early career researchers and experienced academics alike.
Writing the history of tuberculosis does not simply involve tracing how humans travelled from uncertainty to reason in searching for a cure for a disease. Tuberculosis fundamentally altered the human landscape in a range of significant ways and its history is not linear. The incapacity to sequester the spread and devastation of tuberculosis opened the space for all manner of regulations, surveillance and secular moralising that infiltrated the most intimate parts of peoples’ lives. With unparalleled command of his topic and an incredible amount of primary resources, Armus analyses social context and the culture of medical practice in a multifaceted history of tuberculosis in Buenos Aires.
Across different cultures, the physical experience of sleep paralysis is remarkably consistent. A sleeping person, generally reclining in the supine position, has the sensation of waking up in the middle of the night. They feel vividly aware of their surroundings but incapable of motor action. For a stressful period of time lasting up to a couple of minutes, the individual feels awake but paralysed, even feeling unable to breathe. Eventually, their body is able to move again, but the experience can leave an unforgettable trace on their being. Adler calls the phenomenon a night-mare (with a hyphen) thus not giving credence to the western medical definition of sleep paralysis. Nonetheless, her book is still called Sleep Paralysis, which suggests the sort of compromises anthropologists make to popularise their ethnography. A minor clash, however, between ethnographic methodology and marketable literature does not retract from Adler’s wonderful work, which bridges a divide between her discipline and a wider audience.