Culture and Mental Health

While the classification of psychiatric disorders has been critiqued for failing to adequately account for culture, the inclusion of the Cultural Formulation Interview (CFI) in the DSM-5 has been viewed as a promising development for the inclusion of cultural factors in diagnosis and treatment of mental illness. In this study, we assess the appro-priateness, acceptability, and clinical utility of the CFI among outpatients in a Mexican psychiatric hospital. Our assessment included observations of psychiatric residents' application of the CFI with 19 patients during routine outpatient visits, along with pre-and post-CFI interviews to determine providers' and patients' views of the CFI. The CFI was generally well received by providers and patients, viewed as a way of building trust and increasing providers' understanding of contextual factors influencing mental illness, such as social support. However, the CFI questions specifically related to ''culture'' were of limited effect and both patients and providers did not view them as useful. We discuss implications for the clinical assessment of cultural factors influencing mental health and illness and for the incorporation of the CFI in Mexican clinical settings.

This policy brief has been developed in response to the increasing awareness among policy-makers and the public health community
of the important relationship between culture and health. By exploring the three key public health areas of nutrition, migration
and environment, the policy brief demonstrates how cultural awareness is central to understanding health and well-being and to
developing more effective and equitable health policies. Consequently, it argues that public health policy-making has much to gain
from applying research from the health-related humanities and social sciences.

Representations of disabled women in advertising have been historically problematic.
Largely, such portrayals have reinforced disability and gender stereotypes. This is an
important issue to address because cultural representations have the ability to challenge or support widespread attitudes and beliefs surrounding identity groups. In addition, representations can generate micro level impact, for example, influencing how individual’s perceive themselves. In this article, Thomas’s (1999) concept of psycho-emotional disablism is used to enhance understandings of the relationship between advertising messages and individual psychological and emotional states. The feminist disability studies research presented in this article explores how women with mental health issues navigate advertising portrayals of mental health and gender. The findings develop existing knowledge of psycho-emotional disablism through demonstrating how individuals often use problematic advertising messages and memories of psycho-emotional oppression as a vehicle for positive self-transformation and as a way of resisting cultural stereotypes.

Recent events underscore the morbidity and mortality resulting from structural racism. As cultural specialists, we believe that clinical benefits will accrue from better integrating cultural and societal-structural approaches in psychiatric assessment, care planning, and case management.

Madness is a major disorder of social ties and a universal problem for all societies. The formation and transformation of local treatments of madness are therefore a major area of study within social and cultural anthropology. In this perspective, “treatment” should be understood on three different levels. First, as treatment of the problem that madness poses to social order; Second, as treatment of an ailment on the basis of a therapeutic system that can call upon specialist knowledge or not (e.g. a classification, an etiology, a pharmacopoeia, etc.) in order to identify the disorder or to determine its nature and to then provide the appropriate intervention; Finally, as moral treatment of people experiencing madness and trying to find a solution to their state of disorder.

This article introduces a thematic issue of Transcultural Psychiatry with selected papers from the McGill Advanced Study Institute in Cultural Psychiatry on "Pluralism and Polarization: Cultural Contexts and Dynamics of Radicalization," which took place June 20-22, 2017. The ASI brought together an interdisciplinary group scholars to consider the role of social dynamics, cultural contexts and psychopathology in radicalization to violent extremism. Papers addressed four broad topics: (1) current meanings and uses of the term radicalization; (2) personal and social determinants of violent radicalization, including individual psychology, interpersonal dynamics, and wider social-historical, community and network processes; (3) social and cultural contexts and trajectories of radicalization including the impact of structural and historical forces associated with colonization and globalization as well as contemporary political, economic and security issues faced by youth and disaffected groups; and (4) approaches to community prevention and clinical intervention to reduce the risk of violent radicalization. In this introductory essay, we revisit these themes, define key terms, and outline some of the theoretical and empirical insights in the contributions to this issue. Efforts to prevent violent radicalization face challenges because social media and the Internet allow the rapid spread of polarizing images and ideas. The escalation of security measures and policies also serves to confirm the worldview of conspiracy theory adherents. In addition to addressing the structural inequities that fuel feelings of anger and resentment, we need to promote solidarity among diverse communities by building a pluralistic civil society that offers a meaningful alternative to the violent rhetorics of us and them.

A peer-reviewed paper on the innovative narratological device of the “unreliable author” in the work of Yiddish Modernist writer Der Nister (1884-1950), focusing on his 1929 short story From my Estate (Fun mayne giter). The article situates the short story in the general context of the evolution of Der Nister’s oeuvre and of Soviet Yiddish literature, while also elaborating on the conceptual implications of the “unreliable author” as a compelling early example of the Foucauldian “death of the author”.

Multidisciplinary teams (MDTs) are conventionally recommended in mental health
care literature as an important way to offer holistic treatment provision to patients. This
study aims to explore multidisciplinary teamwork in contemporary mental health
settings, particularly what aids and hinders the process of multidisciplinary teamworking,
and the social work contribution in such teams. In order to attain an in-depth
exploration of these phenomena, a single case study design was employed. Within this
design, data were generated through semi-structured interviews and structured
observation of a mental health MDT in Ireland. These data were analysed using
interpretative phenomenological analysis. The research highlights how the concept of
mental illness is contested within this MDT, with the medical model dominant within
an environment of fluid working arrangements. Professional role blurring and
stereotyping were found to impact the division of labour on this team, with role
negotiation found to be an integral part of retaining a professional’s practice identity.
This research raises concerns for social work’s capacity to function within mental
health MDTs in Ireland, and highlights ways in which social work educators might
respond in order to empower Irish social workers to meet the challenges of mental
health multidisciplinary teamworking.

While mental illness has recently been framed in largely neurobiological terms as “brain disease,” there has also been an increasing awareness of the contingency of psychiatric diagnoses. In this course, we will draw upon readings from medical and psychological anthropology, cultural psychiatry, and science studies to examine this paradox and to examine mental health and illness as a set of subjective experiences, social processes and objects of knowledge and intervention. On a conceptual level, the
course invites students to think through the complex relationships between categories of knowledge and clinical technologies (in this case, mainly psychiatric ones) and the subjectivities of persons living with mental illness. Put in slightly different terms, we will look at the multiple links between psychiatrists’ professional accounts of mental illness and patients' experiences of it. Questions explored include: Does mental illness vary across social and cultural settings? How are experiences of people suffering from
mental illness shaped by psychiatry’s knowledge of their afflictions?

Intravaginal insertion is often associated with the concept of ‘dry’ sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions could be in conflict with the introduction of vaginal microbicide gels. The Africa Centre site was part of the Microbicides Development Programme evaluating PRO2000/5 microbicide gel. We conducted in-depth-interviews and focus-group discussions with women enrolled in the trial as well as women and men from the community. The analysis focused on people's knowledge of intravaginal insertion in the community and trial participants’ experience of using trial gels. Intravaginal use of a variety of products was widely acknowledged. We found that the experience of using trial gels - which made sex ‘hot’, ‘tight’ and ‘dry’ - matched the desired outcomes of intravaginal insertion. We found that vaginal ‘dryness’ described the removal of excessive amounts of unusual discharge, rather than the removal of normal vaginal secretions and that intravaginal insertion is not exclusively associated with a desire for ‘dry’ sex. Study findings provide evidence that vaginal microbicide gels may be more acceptable in communities where intravaginal insertion is practiced than was previously thought.

The autism spectrum disorder (ASD) is increasingly being recognized as a major public health issue which affects approximately 0.5-0.6% of the population. Promoting the general awareness of the disorder, increasing the engagement with the affected individuals and their carers, and understanding the success of penetration of the current clinical recommendations in the target communities, is crucial in driving research as well as policy. The aim of the present work is to investigate if Twitter, as a highly popular platform for information exchange, can be used as a data-mining source which could aid in the aforementioned challenges. Specifically, using a large data set of harvested tweets, we present a series of experiments which examine a range of linguistic and semantic aspects of messages posted by individuals interested in ASD. Our findings, the first of their nature in the published scientific literature, strongly motivate additional research on this topic and present a methodological basis for further work.

Deakin University and the Australian GLBTIQ Multicultural Council Inc. (AGMC) are pleased to provide this research report to the Victorian Commissioner for Gender and Sexuality, Ro Allen, and the Advisory Group: Carmel Guerra, CEO of the Centre for Multicultural Youth; Soo-Lin Quek, Knowledge & Advocacy Manager of the Centre for Multicultural Youth; and Matt Dixon, Director of the Equality Branch of the Department of Premier and Cabinet. The research project involved conducting a case study analysis of the needs of SSAGD (same-sex attracted and gender diverse) young people of multicultural and multifaith (MCMF) backgrounds, and how these needs can be addressed by government, and by their cultural and religious communities.

There is an increasing social demand for innovative, pragmatic solutions to the public health and social care crisis, as highlighted by the NHS in their ‘Five Year Forward View’ (2014), and for ways to ease the disparity between the supply and demand of healthcare provision. The primary challenge to the health care crisis is public funding, followed by an ageing population with a prevalence of long-term physical and mental health conditions that aren’t curable in any obvious medical way (APPGAHW 2017: 11). As Lord Nigel Crisp (co-chair of the APPGGH and former CE of the NHS) wrote in 2016, we need to see 'the transformation of the health and care system from a hospital-centred and illness-based system to a person-centred and health-based system’ (Crisp et al 2016: 2). In recent years, the use of cultural interventions (participatory arts activity, arts-on-prescription, community art, music/art therapy) has risen to prominence as a potential means of addressing some of these aims, but despite growing fields of practice, theory, evidence and research, these initiatives are not yet being fully recognized for their efficacy by central government or commissioning bodies.  
This paper will explore the concept of value in the arts and its relation to the development of arts and health activity in the UK. Through literature review we will explore how the cultural value debate grew, and how it now manifests itself in the burgeoning arts in health ‘movement’, and identify the challenges imposed upon practitioners that stifle progress in the sector and prevent cultural interventions from reaching mainstream acknowledgement as an antecedent to the detrimental ‘social determinants of health’ (APPGAHW 2017: 10). There is a vast literature base dedicated to the topic of value and social impacts in the arts sector, and it has been an ongoing point of contention between artists, academics, commissioners, government and all other stakeholders of the arts for many years. We will explore some of these debates in the first section of this paper to articulate the complexities of the topic, before then honing our attention to cultural health intervention.  

The Internet has become a venue for men who have sex with men to search for sexual partners. Some of these men intentionally seek unprotected anal intercourse with other men (‘bareback’ sex). This paper focuses on the creation, use, and content of Internet personal profiles of men who have sex with men in the greater New York City metropolitan area who use bareback sites for sexual networking. We used a mixed-methods approach to examine data from a cybercartography of Internet sites conducted during the first phase of the research (199 personal profiles) and from in-depth interviews conducted during its second phase (120 men who have sex with men who sought partners online for bareback sex). Results indicate that men generally followed offline stereotypical patterns in their online profiles. However, men who disclosed being HIV-positive were more likely to include face and head pictures. Overall, the images they used were heavily sexualised in accordance with group norms perceived and reinforced by the websites' design and imagery. Bottom-identified men tended to be more explicit in the exposition of their sexual and drug use interests online. This paper highlights how certain virtual and social performances play upon and reinforce other, in the flesh, performances.Internet est devenu un espace de recherche de partenaires sexuels pour les hommes qui ont des rapports avec des hommes (HSH). Certains de ces hommes recherchent spécifiquement des rapports anaux non protégés (sexe «bareback») avec d'autres hommes. Cet article examine la création, l'utilisation et le contenu des profils personnels d'HSH vivant dans la zone métropolitaine du Grand New-York qui utilisent des sites web spécialisés dans le bareback pour développer leur réseau sexuel. Nous avons utilisé une approche mixte pour analyser les données obtenues d'une cyber-cartographie de sites Internet, élaborée dans la première phase de cette recherche (199 profils personnels en ligne), et d'entretiens en profondeur conduits dans la seconde phase de la recherche (120 HSH qui, en ligne, recherchaient couramment des partenaires pour du sexe bareback). Les résultats indiquent que généralement, ces hommes avaient pour modèles de leurs profils en ligne, des stéréotypes rencontrés hors ligne. Cependant les hommes qui révélaient leur séropositivité au VIH étaient les plus susceptibles de joindre des photos de leur visage ou de leur tête à leurs profils. D'une manière générale, les images utilisées par eux étaient fortement sexualisées et conformes aux normes de groupe, perçues et renforcées par la conception et l'imagerie des sites web. Les hommes qui s'identifiaient comme «soumis» avaient tendance à être plus explicites en ligne dans la description de leurs goûts sexuels et pour les drogues. Cet article souligne comment certaines performances virtuelles et sexuelles agissent sur d'autres performances dans la réalité, et les renforcent.Internet se ha convertido en un lugar donde los hombres que tienen relaciones sexuales con hombres (HSH) buscan compañeros sexuales. Algunos de estos hombres buscan expresamente tener relaciones sexuales anales sin protección con otros hombres (también denominado sexo ‘bareback’). En este artículo prestamos atención a la creación, el uso y el contenido de las descripciones personales en Internet de los HSH, del área metropolitana de Nueva York, que usan páginas web bareback para participar en redes sexuales. Utilizamos un enfoque de valoración según varios métodos para analizar los datos de una cibercartografía de páginas de Internet llevada a cabo durante la primera fase de la investigación (199 descripciones personales), y para analizar los datos de entrevistas exhaustivas realizadas en la segunda fase del estudio (120 HSH que buscaban parejas por Internet para tener relaciones sexuales bareback). Los resultados indican que los hombres seguían en general los mismos patrones estereotipados fuera de Internet que en sus descripciones cibernéticas. Sin embargo, era más probable que los hombres que revelaban ser seropositivos incluyeran fotografías de su rostro y cabeza. En general, las imágenes que utilizaban eran altamente sexualizadas, de acuerdo con las normas de grupo que se percibían y reforzaban mediante el diseño y el tipo de imágenes utilizados en las páginas web. Los hombres que también mostraban las partes inferiores de sus cuerpos solían ser más explícitos al exponer por Internet sus intereses sexuales y uso de drogas. En este artículo ponemos de relieve en qué medida ciertos comportamientos virtuales y sociales influyen y refuerzan otros comportamientos en la vida real.

A qualitative study was conducted in a community of 100 female, self-employed commercial sex workers (CSWs), in Morogoro township, Tanzania. Data was gathered through key informant interviews and open-ended questionnaires. Respondents had extensive experiential knowledge of STDs and HIV/AIDS. They pursued several different avenues in attempting to prevent STDs including eating nutritiously to enhance immunologic status, using condoms, and vaginal washing after each act of intercourse. When they acquired a symptomatic STD, they pursued different avenues of treatment including self-treatment with known herbs, traditional healers (herbalists), injectionists, pharmacies, government hospitals, and private clinics. Almost all CSWs explored all options. Many of the key elements for an effective STD prevention and control program are in place and will be made more effective by training medical personnel, traditional healers, and sex workers themselves. Nous avons effectuéune étude qualitative auprès d'une communautéde 100 femmes travaillant comme prostituées indépendantes dans le township de Morogoro, en Tanzanie. Nous avons rassembléces données au cours d'entretiens avec des informatrices cl es et à l'aide de questionnaires ouverts. Les personnes interrogées ont de vastes connaissances, dérivées de l'expérience, sur les maladies sexuellement transmissibles (MST) et le Sida. Elles utilisent différents types de stratégie pour essayer d'éviter les MST, y compris une alimentation destinée à augmenter la résistance immunologique, l'utilisation de préservatifs et le lavage du vagin après chaque acte sexuel. Lorsque ces femmes attrapent une MST symptomatique, elles essaient différents types de traitement, y compris l'automédication par les plantes médicinales connues, les guérisseurs traditionnels (herboristes), les injections, les pharmacies, les hôpitaux publics et les cliniques privées. Presque toutes les prostituées explorent la totalitédes options disponibles. La plupart des éléments indispensables à la création d'un programme de prévention et de contrôle des MST efficace est déjà en place, et l'effcacitéde ce programme sera encore accrue par la formation du personnel médical, des guérisseurs traditionnels et des prostituées elles-mêmes. En un estudio cualitativo llevado a cabo en una comunidad de 100 trabajadoras sexuales independientes en la ciudad de Morogoro, Tanzania, se obtuvieron datos a través de entrevistas informantes claves, y cuestionarios abiertos. Las entrevistadas mostraron tener amplios conocimientos prácticos sobre enfermedades de transmisión sexual, HIV y sida. Seguían varios métodos diferentes para intentar impedir las enfermedades de transmisión sexual, por ejemplo, comer alimentos nutritivos para aumentar su sistema inmunológico, y utilizar condones y lavados vaginales después de cada relación sexual. Si notaban síntomas de alguna enfermedad de transmisión sexual, seguían tratamientos variados como automedicarse con infusiones conocidas, pedir ayuda a curanderos tradicionales (herbolarios), con inyecciones, en farmacias, hospitales estatales y clínicas privadas. Casi todas las entrevistadas exploraban todas las opciones posibles. Muchos de los elementos clave para lograr una prevención adecuada ya están funcionando, además de un programa de control contra las enfermedades de transmisión sexual que seráz más efica si se educa adecuadamente al personal médico, a los curanderos tradicionales y a las mismas trabajadoras sexuales.

Apresenta-se um panorama de ações territoriais marcado pelos movimentos sociais em torno da desinstitucionalização da loucura e da construção dos direitos das pessoas com defi- ciência no Brasil, que configura um novo campo de práticas de terapia ocupacional voltadas às complexas demandas das populações atendidas com o objetivo de ampliação da parti- cipação sociocultural. São ações e estratégias desenvolvidas pelos participantes do Laboratório de Estudos e Pesquisa Arte, Corpo e Terapia Ocupacional da Universidade de São Paulo que estão articuladas às políticas públicas de saúde mental, humanização e cultura, instauradas no Brasil a partir dos anos 2000. Elas integram ensino, pesquisa e assistência, contribuem para a qualidade de serviços ofertados à comunidade e fortalecem as redes de atenção e participação social. Os principais métodos de acompanhamento e avaliação das intervenções estão relacionados à pesquisa qualitativa, à construção de uma reflexão intensiva que busca construir um conhecimento local em terapia ocupacional orientado por ações criativas e pela conjunção de referenciais clínicos, artísticos e culturais. Os projetos desenvolvidos ampliam o acesso da população atendi- da às experiências artísticas e culturais do território, contribuem para a construção de políticas da vida, dinamizando formas de participação, convivência e produção de subjetividade. Configuram-se, assim, tecnologias socioculturais consonantes à importância de fortalecer e sustentar novas propostas para populações expropriadas de suas redes de vida sustentadas pela significativa intervenção de terapeutas ocupacionais.

Palavras-chave Terapia Ocupacional; tendências; arte; saúde; cultura; política pública

Abstract
In this article we present a view of territorial actions marked with social movements related to de-institutionalization of insanity and with building up the rights of physically- and mentally handicapped people in Brasil, which configures a new field of practices of occupational therapy, oriented towards the complex demands of assisted population and targeted on increasing sociocultural participation. Those are actions and strategies implemented by the participants of the Laboratory of Studies and Research Art, Body and Occupational Therapy of the University of São Paulo, which are articulated with the public policies of mental health, humanization and culture set up in in Brazil as of 2000. They involve teaching, research and assistance; they contribute to the quality of services offered to the community and strengthen the assistance and social participation networks. The main methods to follow and evaluate the interventions are related to qualitative research, to building up an intensive reflection in a search to build up local knowledge of occupational therapy guided by creative actions and by crossed clinical, artistic and cultural references. The projects implemented have broaden the access of the population assisted to artistic and cultural experiments in the territory, they have contributed to the construction of life policies enabling ways of participation, of living together and producing subjectivity. Thus, sociocultural technologies are configured in agreement with the importance of strengthening and supporting new proposals for populations expropriated from their life networks, supported by significant intervention of occupational therapists.

Keywords Occupational Therapy; trends; arts; health; culture; public policies

This article offers a commentary on Hassim and Wagner’s article, "Considering the cultural context in psychopathology formulations", published in this issue of the South African Journal of Psychiatry. It clarifies aspects of the concepts of culture and psychopathology. A distinction is drawn between the content of culture and the demarcation of cultures. The former refers to socially acquired meanings and significances that condition subjective experience and the latter to specific, demarcated cultural groups. It is argued that these two meanings of culture must be kept apart, and that only the former is relevant to the project of understanding the range of cultural influences on mental health problems. This is premised on the idea, arising partially from anthropological critique, that while cultural designations (e.g. Maori or Muslim) might serve as important political and identity markers, they obscure rather than reveal the actual influences the subject is exposed to, and which condition subjective experience as seen through the modulation of distress or symptom formation.

Research on behaviourally bisexual Latino men in the USA has not yet examined sexual health issues among men living in diverse areas of the nation, including the Midwest. A community-based participatory research approach was used to engage a diverse sample of 75 behaviourally bisexual men (25 White, 25 Black and 25 Latino). Semi-structured interviews were conducted and standard qualitative analysis procedures were used to explore data from the 25 Latino participants. Men described their unique migration experiences as behaviourally bisexual men in this area of the USA, as well as related sexual risk behaviours and health concerns. Lack of culturally congruent public health and community resources for behaviourally bisexual men in the Midwestern USA were identified as significant barriers. As in other studies, familial and community relationships were significant for the participants, especially in terms of the decision to disclose or not disclose their bisexuality. Additionally, alcohol and other drugs were often used while engaging in sexual behaviours particularly with male and transgender, as well as female, partners. Behaviourally bisexual Latino men may benefit from receiving positive and affirmative individual- and structural-level support in regards to their unique experiences in this and other settings.La recherche sur les hommes latinos et aux comportements bisexuels aux USA n'a pas encore exploré les questions de santé sexuelle parmi ceux qui vivent dans les régions diverses du pays, incluant le Midwest. Une approche de recherche participative communautaire (CBPR) a été utilisée pour examiner un échantillon ethniquement divers composé de 75 hommes bisexuels (25 de race blanche, 25 de race noire et 25 Latinos). Des entretiens semi-structurés ont été conduits et, dans cet article, des processus d'analyse qualitative standard ont été employés pour explorer les données sur les 25 participants latinos. C'est en tant qu'hommes bisexuels vivant dans cette région des USA que les participants ont décrit leur expérience unique de la migration, ainsi que leurs comportements sexuels à risque et leurs préoccupations concernant la santé sexuelle en lien avec cette expérience. L'absence de ressources communautaires et provenant de la santé publique adaptées à la culture des hommes bisexuels vivant dans le Midwest a été identifiée comme un obstacle majeur. De même que dans d'autres recherches, les relations familiales et communautaires étaient très importantes pour les participants, en particulier par rapport à la décision de révéler ou non leur bisexualité. De plus, cette recherche a révélé que les participants prenaient de l'alcool et des drogues avant les rapports sexuels, en particulier avec d'autres hommes et des personnes transgenre, et aussi des femmes. Les hommes latinos bisexuels pourraient tirer profit d'un soutien positif, tant au plan individuel que structurel, relativement à leurs expériences uniques dans cet environnement et dans d'autres.En los estudios sobre hombres latinos con conductas bisexuales de los Estados Unidos todavía no se han analizado los problemas de salud sexual entre los hombres que viven en distintas zonas del país, incluyendo el Medio Oeste. Utilizamos un enfoque de una investigación participativa basada en la comunidad para desarrollar una muestra diversa de 75 hombres con conductas bisexuales (25 hombres de raza blanca, 25 de raza negra y 25 latinoamericanos). Se llevaron a cabo entrevistas semiestructuradas, y para este artículo, se utilizaron métodos de análisis cualitativos estándar para estudiar los datos de los 25 participantes latinoamericanos. Los hombres describieron sus propias experiencias de migración como hombres con conductas bisexuales en esta zona de los Estados Unidos, así como conductas de riesgo sexual relacionadas y consideraciones de salud. Identificamos que uno de los obstáculos principales es la falta de recursos de salud pública y comunidad que sean culturalmente congruentes para hombres con conductas bisexuales en la zona Medio Oeste de los Estados Unidos. Al igual que en otros estudios, las relaciones familiares y de la comunidad eran importantes para los participantes, especialmente en cuanto a la decisión de revelar o no su bisexualidad. Además, estos hombres tomaban con frecuencia alcohol y otras drogas al participar en conductas sexuales, en particular con hombres y travestis, así como con parejas femeninas. Sería muy beneficioso que los hombres latinoamericanos con conductas bisexuales recibieran apoyo positivo y afirmativo a nivel individual y estructural con respecto a sus experiencias únicas en este y otros entornos.

A PhD studentship is available for UK and EU citizens only. The studentship will attract an annual tax-free stipend of £14,777 for up to 3 years, subject to satisfactory progress and will cover the UK/EU tuition fees. You should hold a first degree equivalent to at least a UK upper second class honours degree in a relevant subject. This project would suit a student with a strong background in international health policy and systems. Candidate whose first language is not English must provide evidence that their English language is sufficient to meet the specific demands of their study, the Faculty minimum requirements are: • British Council IELTS-score of 6.5 overall, with no element less than 6.0 • TOEFL iBT-overall score of 92 with the listening and reading element no less than 21, writing element no less than 22 and the speaking element no less than 23.

The objective of this article was to explore, from an anthropological perspective, the social representations that doctors who treat covid-19 in specialized hospitals in Mexico City have, regarding the relationship between their professional performance and the deterioration of their mental health; as well as their social representations of the existing institutional resources to provide them mental health attention and their care-seeking and self-care strategies. Materials and Methods: For this, a qualitative investigation was carried out with semi-structured interviews with 35 doctors who treat covid-19. Results: From the points of view of the doctors, various sociocultural and structural causes of mental
illness related to their professional performance are documented and analyzed, as well as their representations about the inadequacy and/or ineffectiveness of the institution, group, or individual resources
to provide them mental health attention; and some allopathic and non-biomedical forms of care-seeking and self-care. Conclusions: Recommendations are made to address the etiologies of the disease analyzed in a culturally and structurally appropriate way to the context of the pandemic.

Феномен здорового образа жизни и его рефлексия в современной российской культуре // Phenomenon of healthy lifestyle and its reflection in modern Russian culture

В статье делается попытка дать краткий экскурс в историю понятия здорового образа жизни и концептуализировать данный феномен в рамках современной российской культуры.

The article makes an attempt to give a short digression into the history of the concept of a healthy lifestyle and to conceptualize this phenomenon within the framework of modern Russian culture.

In order to explore the relevance of social concepts such as stigma and denial to the transmission of HIV, this qualitative study sought to examine cultural and racial contexts of behaviour relevant to the risk of HIV infection among South Africans. A cultural model was used to analyse transcripts from 39 focus group discussions and 28 key informant interviews. Results reveal how cultural and racial positionings mediate perceptions of the groups considered to be responsible and thus vulnerable to HIV infection and AIDS. An othering of blame for HIV and AIDS is central to these positionings, with blame being refracted through the multiple prisms of race, culture, homophobia and xenophobia. The study's findings raise important questions concerning social life in South Africa and the limitation of approaches that do not take into account critical contextual factors in the prevention of HIV and care for persons living with AIDS.RésuméAfin d'explorer la pertinence des concepts sociaux tels que le stigmate et le déni sur la transmission du VIH, cette étude qualitative a cherché à examiner les contextes culturels et raciaux des comportements à risques pour le VIH chez les Sud Africains. Un modèle culturel a été utilisé pour analyser les transcriptions provenant de 39 groupes focus et de 28 entretiens avec des informateurs clé. Les résultats révèlent comment les positionnements d'ordre culturel et racial influencent les perceptions vis à vis de groupes considérés comme responsables, et par conséquent vulnérables à l'infection à VIH et au sida. Faire porter la responsabilité « sur l'autre » pour le VIH et le sida est au cœur de ces positionnements, l'accusation se réfractant à travers des prismes multiples de race, de culture, d'homophobie et de xénophobie. Les résultats de l'étude soulèvent des questions importantes concernant la vie sociale en Afrique du Sud et les limites des approches qui ne prennent pas en compte les facteurs contextuels qui sont cruciaux pour la prévention du VIH et les soins des personnes vivant avec le VIH.ResumenEn este estudio cualitativo queremos analizar los contextos culturales y raciales de conductas con respecto al riesgo de infección del VIH entre la población sudafricana con el objetivo de estudiar la importancia de conceptos sociales, tales como el estigma asociado a la transmisión del VIH y la negación de poder contagiar el virus. Mediante un modelo cultural, analizamos las transcripciones de 39 grupos de discusión y 28 entrevistas a informantes clave. Los resultados indican de qué modo las posiciones culturales y raciales tienen una influencia en las percepciones de los grupos que se consideran responsables y, por lo tanto, vulnerables a las infecciones del VIH y el sida. Para estas posiciones es de vital importancia la construcción de la otredad en cuanto a quién culpabilizar por el VIH y el sida, de modo que la culpa se refractaría a través de muchos prismas de raza, cultura, homofobia y xenofobia. Los resultados de este estudio plantean preguntas importantes con respecto a la vida social en Sudáfrica y la limitación de enfoques que no tienen en cuenta los factores contextuales de importancia para la prevención de VIH y el cuidado de personas que viven con el sida.

Can Biology help us Understand psychopathology? I believe it can. We presently face a historical moment of mental health crisis worldwide, with reflections both in science and politics. It is a clear that the current paradigm of modern biology, namely Neo-Darwinism and its application to Medicine and public health, show alarming signs of exhaustion and iatrogenic damage to humans and to planetary ecology. In no other field this contradiction becomes so blatant as in public mental health. We are witnessing the growing of a pandemic of mental illness that the scientific system itself helps to construct and is unable to manage. The excessive, widespread, worldwide use of psychotropic medication, the alarming reports of severe iatrogenic side effects; the growing levels of violence, genocide; wars emerging in every corner of the planet, are telling us that our understanding of the world, including its dominant scientific biomedical model is blatantly wrong. Our “scientific” understanding of reality that decisively inform government actions that ultimately induces the population to act with violence and rupture of important biological relationships from which our existence depends. Grossly unnoticed, a new biological paradigm has been proposed and developed in the last decades. This is evident in experimental phenomena observed in practically all fields of biology and medicine, specially, when they show the socio-economic determination of mental health, and major impacts of environmental health, education and level of income. Herein, I present a comprehensive model of human biology and psychopathology rooted in the pioneering scientific works of several important thinkers and therapists such as: the Chilean neurobiologist Humberto Maturana; the psychiatrist Carl Jung, illustrated by contemporary scientific experiments of the American psychiatrist John Weir Perry and the Brazilian woman psychiatrist Nise da Silveira, in the promotion of mental health. I also shortly describe our own documented and published experience in mental health promotion

This paper explores the development of two significant cross­cultural research projects in Pasifika psychology. Both projects were designed to speak into the "silent space" of unexplored Pasifika practices and needs in the field of mental health.

Aims and objectives.  This study examined the cultural attribution of distress in the Chinese, the special role of the family in distress and the specific emotional reactions within distress dictated by culture.Methods.  This phenomenological study illustrated the narrative representation of the experiences of suffering by the Chinese patients with mental illness. Twenty-eight Chinese–Australian patients and their caregivers were interviewed together in their homes. They were invited to talk about the stories of the patients’ experiences of suffering from mental illness. The interviews were recorded and transcribed to be further analysed according to the principles of narrative analysis.Results.  The results of case narration indicated that (1) because of the influence of Confucian ideals, interpersonal harmony was the key element of maintaining the Chinese patients’ mental health, (2) Chinese patients’ failure to fulfil cultural expectations of appropriate behaviours as family members contributed to disturbance of interpersonal relationships and (3) Chinese patients’ failure to fulfil their familial obligations contributes to their diminished self-worth and increased sense of guilt and shame.Conclusion.  The findings of the present study suggest that Chinese people's well-being is significantly determined by a harmonious relationship with others in the social and cultural context. Psychotherapy emphasizing an individual's growth and autonomy may ignore the importance of maintaining interpersonal harmony in Chinese culture.Relevance to clinical practice.  The results of this study contribute to the essential knowledge about culturally sensitive nursing practices. An understanding of patient suffering that is shaped by traditional cultural values helps nurses communicate empathy in a culturally sensitive manner to facilitate the therapeutic relationship and clinical outcomes.