ANTH 341 FINALS
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University of Calgary *
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Course
341
Subject
Medicine
Date
Jan 9, 2024
Type
docx
Pages
9
Uploaded by ChefKingfisherMaster1076
TERMS:
ORT
o
Oral Rehydration Therapy
o
Diarrheal disease controls a primary objective
o
Major component of WHO programs
FGC
o
Female genital cutting
o
A set of practice from a wide range of cultures that involves cutting and removing of some portion or part of a female genitalia
o
Reviews the sociocultural dynamics of persistence and change in female genital cutting practices
o
Violation of human rights
o
Oppression of women
Positive Deviance
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Observation that in every community, there are certain individuals or groups whose uncommon behaviour and strategies enable them to find better solutions to problems than their peers
Syndemics
o
Pronounced health issues that stem from 3 factors:
Interactions between comorbid diseases, disease clustering, social conditions that exacerbate disease clustering among comorbid disease
o
If see a cluster of things, they appear together
Empacho
o
Sometimes caused by food
o
Indigestion
o
Painful conditions of the gut with explosive evacuations, special skin quality
o
Causes: eating wrong kinds of foods
o
Treatment: massages, purgative
LEARN
o
L: listen with sympathy and understanding to the patient’s perception of the problem
o
E: explain your perception of the problem
o
A: acknowledge and discuss the differences and similarities
o
R: recommend treatment
o
N: negotiate agreement
Leitmotiv of critical epistemology of emerging infectious disease
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All societies across space and time are compromised of struggles between classes and this model can be used everywhere
o
How we talk about infectious diseases
o
How do we know what we know
Sick role obligations
o
The sick person is exempt from normal role responsibilities relative to the nature and severity of the illness
o
The state of being ill is in itself undesirable and carries an obligation to get well
Caida de Mollera
o
Fallen fontanells
o
Incompletely developed palette
o
Diamond shape space on top of the skull in infant, signalling not enough water
o
Pushing up on the roof of the mouth tapping on heels while inverting the child
Neutralization
o
By employing something like this it will neutralize the effect
o
Example: “hot-cold” system in Puerto Rican patients
Ingestion of something “cool” in conjunction with something “hot” is believed to
neutralize any adverse effects
5 themes of Frank and Durden
o
Healthcare options and utilization
o
Local understanding of type 2 diabetes etiology o
Local food practices
o
Gendered differences in healthcare utilization
o
The influence of international migration
Thermal state of medicines
o
Hippocratic humeral system
Focused in 4 states of matter instead of 2: hot, cold, dry, moist
o
If cold, use hot substances or treat it and vice versa
o
The thermal state in which foods are herbal remedies are taken is not relevant to the classification
General medical care: Hot-Cold
o
People can be hot or cold
o
Potentially dangerous
o
Maintain health as a system of balance
Medicine’s hidden curriculum
o
Things med students had to learn but were not explicitly taught
o
To earn for themselves a place in the medical community, medical students must establish their competence
Obesity as structural violence
o
Positively correlated with the encroachment of Western culture and modernization
o
Adverse relationship in affluent social classes
o
A well-recognized structural barrier to healthy eating is poverty
Medicalization
o
The process by which problems or issues not traditionally seen as medical come to be framed as such
PROCOMSI
o
Proyecto de communicacion masiva aplicada a la salud infatil or mass communication project applied to infant health
o
Health promotion project administered by academy for education development and division of education of Honduras
Structural violence
o
Idea that there is a social structure – status and roles
Occupy those statuses and play roles attached to it
Roles are processual part of the system, obligations you have to fulfill
o
Structure of societies can cause harm to marginalized populations
o
These social inequalities can lead to adverse health effects in marginalized populations
Oppression of daily life
o
Adverse social conditions cause oppression (poverty, etc) which leads to inequalities in health
Master-status
o
A status that has special importance for social identity, often shaping a person’s entire life
o
Mastery of medical – real knowledge
PHC
o
Primary health care
o
Want to build infrastructure to make societies able to handle health issues
Obstetrical care: Hot – Cold
o
Patient 4 – medicine can cause rashes for their babies (hot) can take cool medications leading up to birth, avoid vitamins and supplements so recommend taken with cold food
to neutralize the effect
Obesity epidemic and moral panic
o
Moral panic and alarmism associated with the “obesity epidemic” biomedical health professionals are concerned about the very opposite societal tendency, apathy
o
There is a growing societal “normalization” of childhood overweight and obesity
Sociogenic illness
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Rapid spread of illness signs and symptoms affecting members of a cohesive group, originating from a nervous system disturbance involving excitation, loss or alteration of function, whereby physical complaints that are exhibited unconsciously have no corresponding organic aetiology
Cultural competence
o
Used as a way to try to understand perspective of patients/ belief systems
o
Going to gain some degree of understanding in what their patients think
Serious vs Sexual relationships
o
Sexual: casual, or not expected to be monogamous or economic exchange
o
Romantic/serious: expected to be monogamous, might involve some of these more specialized sexual behaviours. Serious relationships in which people can “catch feelings” for each other
3 social epidemiological facts about human obesity
o
Higher levels of fatness and risk of obesity in females rep a fundamental aspect of sexual
dimorphism
o
Obesity is rare in unacculturated primitive populations, but prevalence is often increases
rapidly during modernization
o
The prevalence of obesity is related to social class
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Zabarma
o
Ethnic group of Western Nigeria
o
Social pressure to conform to higher status Arab practice was resisted by creative responses of Zabarma girls
o
Adopted FGC in 2004
Passive/passing?
o
Concealing the attribute
Ya, mutmura
o
Naming the target of the taunt as the underground grain storage pit that is opened and closed, just as the scar tissue is for birth and reinfibulation
Discreditable persona
o
Those who carry stigmas that are not visible during ordinary interaction are potentially discreditable if the stigmatizing features are revealed
o
Conceal or won’t disclose to anyone
Problematics of female sexuality
o
Public discourse holds FGC is about depravation of women’s sexuality and dominance by men
o
Virginity and marriageability – infibulation can be a means for securing a girls reputation for morality and a family’s honour for protecting her morality and ensuring her marriageability
Sick role expectations
o
Cannot be expected to ger well purely
Tope
o
Pseudonym for rural community in the state of Yucatan
o
Previous research identified Tope as a new sending community of international migrants to the United States. The subsequent influx of remittances infused this Indigenous community with previously unavailable goods and services
o
Tope’s transition away from plant-based and towards a more – heavy diet mirrored changes in food systems of other economically developing nations as prices of meat are driven down – increased meat consumption has been correlated with type 2 diabetes
Plasticity
o
The adaptability of an organism to changes in its environment or differences between its
various habitats
Doenca de Crianca
o
The child’s disease
o
Is a sociocultural label developed by the popular medical system and applied to the end stages of severe childhood infectious diseases and malnutrition against a background of grinding poverty
o
Discusses as an analog to persistent diarrhea
o
2 diseases: gotas de serena (a kind of madness like rabies in a dog) and pasmo (paralysis from bad shock, skin turns black and child become unresponsive)
Concealment
o
Conceal from others, leads to late detection and entreatment which furthers the spread and progression of disease
Social-cultural malnutrition
o
The growth failure was due to factors other than poverty and lack of food
o
Pushback in public health proposals
o
Attributed to the capacity of mothers to contribute care
Internalization of stigma
o
Process of self mortification
o
Sufferers experience body dissociated and self-neglect, condition exacerbates
Food sovereignty
o
The right of people to healthy and culturally appropriate food produced through ecologically sound and sustainable methods and the right to define their own food and agricultural systems
Cross-cultural medicine
o
Healthcare providers are finding themselves dealing with increasingly diverse patient populations
o
In addition to language and socioeconomic barriers, there is an increasing awareness of the impact of diverse health and disease belief systems on the interaction of healthcare providers and patients of a different cultural heritage
o
LEARN
Cultural humility
o
Process that requires humility as individuals continually engage in self-reflection and self-critique as lifelong learners and reflective practitioners
o
Patient-centered medical practice
o
Reflexive anthropology
Food security
o
Always exists when all people, have physical and economic access to sufficient safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life
HELP
o
A nationwide volunteer-run self-help organization for individuals with genetical herpes
Illness as Metaphor
o
Types of illnesses stand in for metaphors of social failings
o
Epilepsy, leprosy, STIs, alcoholism and drugs
Social meaning of obesity
o
Adverse relationship in affluent social class
o
Once there, there is an overall level of affluence, obesity is not clustered o
Clustered in the lower classes
TOSTAN
o
Senegalese non-governmental organization wherein women’s empowerment is encouraged through literacy, leadership skills, and social development, allowing women themselves to decide when is the right time to begin to address change in FGC practices
Luta
o
Metaphor of life, a struggle between strong and weak or between weak and weaker
o
An infants inner vitality, will to live
Spiritist surgery
Stigma
o
Sitgma is a scar/mark
o
Traditionally we would mark people who did things they shouldn’t
o
Phenomenon where individual with attribute that is deeply discreted by society is rejected as a result of attribute
Social inequalities and emerging infectious diseases
o
Farmer
Culture, scarcity and maternal thinking
o
Scheper-Hughes
Syndemics, sex and the city
o
Singer, Erickson, Badiane, Diaz, Ortiz, Abraham and Nicolaysen
Hot cold theory of disease
o
Harwood
Two approaches one problem
o
Frank and Durden
Confronting culture
o
Taylor
Anthropology in the clinic
o
Kleinmal and Benson
Cross-culture health care
o
Berlin and Fowkes
The nature of stigma and medical conditions
o
Ablon
Self-mortification and the stigma of leprosy in Northern India
o
Barrett
Genital Herpes – ethnographic inquiry
o
Inhorn
Anthropological perspective on obesity
o
Brown and Konner
Childhood obesity epidemic
o
Moffat
De-medicalizing anorexia
o
O’Conner and Esterik
Socio-cultural dynamics of FGC
o
Gruenbaum
Ethnomedicine and oral rehydration therapy
o
Kendall, Foote and Moartorell
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SHORT ANSWERS
1.
What is the relationship between obesity, gender, modernization, and social class?
o
According to the reading by Brown and Konner, the relationship between obesity and gender can account to the sexual dimorphism. Overall body mass of men is 20% while women have 27%, women are more obese on average than men. Modernization on the other hand have a positive correlation with obesity and is accounted for the changes in diet due to the decreased intake for fibre and an increased in the intake of fats and sugar. In terms of social class, there is a adverse relationship between the two, an increase in social class leads to increase in obesity.
2.
Describe the practice and rationale of neutralization as it pertains to the hot-cold system of medicine. Examples would probably help you make your case
o
In the reading by Harwood (1971), neutralization is a practice that brings the body back to its normal state. The state of being ill leads to an imbalance causing the body to be overly dry, wet, hot, cold or a combination of all. To attain a balance, the patient should receive medication that is opposite from what they are experiencing. For example, a patient has fever (hot) and are given penecilin (cold) medication to treat it but the medication causes diarrhea (hot) which is treated by a cold remedy to neutralize it.
3.
Discuss the local understanding of Type II diabetes among the interview respondents from the Yucatan Maya in your reading on the subject
o
In Frank and Durden’s reading, a small community called Tope located in Yucatan, a interview was conducted regarding to Type II diabetes. The local views type II diabetes as
a result of susto which is a single, stressful or traumatic life event. Many rely on plant-
based remedies rather than medication. The cause of Type II diabetes can be accounted to the dietary food intakes such as heavy calories dense foods. High intake of protein and carbohydrates like more meat, animal fat, processed food and tortillas can cause increase in sugar levels. Another cause is the large intake of sugar sweetened beverages like Coca-Cola every meal. An example is the hot-cold system where a participant reported of developing diabetes as she would cry (hot) in a cold shower due to a traumatic event oand overtime leading to the imbalance causing diabetes.
4.
What are the primary considerations or features of the critical epistemology of emerging infectious disease for which Farmer advocates?
o
Farmer (1996) advocates the 4 features of the critical epistemology in “social inequalities
and emerging infectious disease”. Which are social inequalities that are focused on statues and roles, transnational forces that look at the prevalence on a global scale, dynamics of change where we need to look past the biomedicine model and re-evaluate our biases and knowledges and what qualifies as critical epistemology where we need to
question who has the power and control over funds
5.
Using your reading on the subject as a guide, what do biomedical practitioners mean when they refer to obesity as a form of “structural violence”?
o
According to Moffat’s reading on “Childhood obesity epidemic”, he talks about how nutritionist argue how kids are raised in a society with cheap, unhealthy food that is easy
to prepare and serve. Foods that have high sugar and fat levels and no nutrients. Due to the technological advancement, people have less and less outdoor activities and not burning the recommended calories every day compared to the amount of food we are consuming. In terms of the people who doesn’t have enough money and income or people in minority families, they cannot afford healthier food and settle for processed food which can be linked to childhood obesity. In addition, low socioeconomic status provide structural barrier for children to eat unhealthy and not exercise.These facts can be accounted to “structural violence” which causes groups and families to make unhealthy life choices or that leads to obesity.
6.
Why did PROCOMSI staff believe that ORT could not work as a treatment for cases of diarrhea that locals believed were caused by the folk illness empacho?
o
According to Kendall, Foote and Mortell’s reading, there are 2 factors that can prove that
ORT cannot work as a treatment for cases of diarrhea caused by the folk illness empacho. One factor is that there is resistance in the illness empacho and the use of “purgative” in activities. To which they said that empacho is not considered a disease and do not support the use of purgative. Another factor is that researchers did not encounter empacho as the cause of diarrhea rather respondents would say that it is often caused by dirty water or worms.
7.
Describe how enlightenment ideals underlay early late 19
th
and early 20
th
century efforts to eradicate female genital cutting (FGC) in Africa
o
In Gruenbaum’s reading, he emphasizes the Europeans desire for an enlightenment by removing all practices that are deemed harmful for the people. As the colonizers are trying to implement their own culture and beliefs to the people, Europeans were targeting anything linked to fertility control (FGC), women’s roles and patriarchy. In the 20
th
century, the movement for women’s rights is gaining momentum and attention throughout the world as a result, the blamed is pointed to the culture of Africa for maltreating women.
8.
How does ritual symbolism relate to the placebo effect?
o
The placebo effect has the positive healing effects due to positive expectations on the part of the “patient”. The placebo effect can be viewed as the line between the mind and the body. While the ritual symbolism is composed of the effects after a ritual is performed. They are both related since both are a huge factor in understanding the positive outcome of the healing process. With the positive healing effects of the placebo and the ritual symbolism the healer has to support the patient to promote healing which
they do through the body experiences symbols.
9.
How are cultural ecology and political ecology the same? How are they different?
o
Cultural ecology and political ecology are types of medical ecology that examines health and sickness through traditional ecological knowledge like timing of historical events. But they are also different, cultural ecology is seen in a microlevel analysis and an approach to understanding environmental health concerns within groups. And cultural ecology is tied to the idea of adaptation and maladaptation as well as Malaria and Sickle cell. With political ecology, it uses a macrolevel analysis which examines the interactions between human groups to which assumes that there is inequality between groups. An example of it is the social inequality with the respiratory problems associated with urban
air pollution.
10.
How does the model of cultural competence that Kleinman and Benson present differ from the
explanatory models approach?
o
The first iteration of explanatory models was focused on patient compliance. Where physicians must figure out ways to understand how the patient thinks and helps find some degree of agreement between the patient and the physicians, but it takes time to do the explanatory approach properly. Whereas the cultural competence approach focuses on cooperation between medical and cultural knowledge which to seek ways how to communicate with people of different cultures and assume that people are robots hence must follow culture and beliefs which can lead to generalizations and stereotyping of patients.
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