Anthropology & Medicine最新文献_第9页

Vaccinal chronicity: immunotherapy, primary care, and the temporal remaking of lung cancer’s patienthood in Cuba 疫苗慢性性:古巴肺癌患者的免疫治疗、初级保健和时间重塑

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2022-01-02 DOI: 10.1080/13648470.2022.2041549

Nils Graber

{"title":"Vaccinal chronicity: immunotherapy, primary care, and the temporal remaking of lung cancer’s patienthood in Cuba","authors":"Nils Graber","doi":"10.1080/13648470.2022.2041549","DOIUrl":"https://doi.org/10.1080/13648470.2022.2041549","url":null,"abstract":"Abstract The Cuban biotechnology industry is producing cancer immunotherapy, in particular, therapeutic vaccines that actively stimulate the immune system to stabilise the tumour. These products aim to transform metastatic malignancies into a chronic disease. Since 2010, this therapeutic concept has been integrated within a public health experiment, consisting of the large distribution of immunotherapies, including in primary healthcare centres, to enhance access and assess its effectiveness on a wider population of patients. Such experimental intervention, consisting of post-marketing clinical trials, has focused only on lung cancer, one of the most widespread and lethal cancers on the island. Combining interviews with ethnographic observations focusing on care performed by professionals, patients, and their relatives, this paper analyses the experience of lung cancer chronicity under this type of immunotherapy in Cuba. It shows how a certain form of continuity is made between prophylactic and therapeutic vaccination to shape a new temporality of cancer care, through the integration within primary care, constant access to biotechnology, and multiple care practices directed to strengthen the immunotherapy’s efficacy. If vaccinal chronicity remains fragile due to its experimental dimension and the fact that long-term survivorship is still an exceptional phenomenon, lung cancer patienthood is deeply transformed through a shared effort of the people and the state to provide more stable, meaningful, and inclusive care.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"13 1","pages":"45 - 60"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81925192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronicity and the patient’s decision-making work. The case of an advanced cancer patient 慢性与患者的决策工作。一个晚期癌症患者的病例

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2022-01-02 DOI: 10.1080/13648470.2022.2041546

S. Besle, A. Sarradon-Eck

{"title":"Chronicity and the patient’s decision-making work. The case of an advanced cancer patient","authors":"S. Besle, A. Sarradon-Eck","doi":"10.1080/13648470.2022.2041546","DOIUrl":"https://doi.org/10.1080/13648470.2022.2041546","url":null,"abstract":"Abstract This paper focuses on the particular situation of an advanced cancer patient whose condition has taken a chronic turn. We argue that chronicity of this kind sometimes falls at the frontier of Evidence Based Medicine because the uncertainty about the patient’s condition can lead physicians to resort to clinical trials or non-licensed drugs to prevent the disease from progressing. This situation leaves plenty of scope for individual adjustments between patients and their doctors. Advanced cancer is regarded here not just as a biological event but as a chronic illness and a ‘negotiated reality’. We argue that the chronicity of advanced cancer patients’ situation broadens the patients’ scope for ‘work’, and we have called this specific type of patient’s work ‘decision-making work’. This paper is based on a case study focusing on Patrick, a middle-aged Frenchman with metastatic lung cancer who underwent oncological treatment for seven years and was strongly determined to find new therapeutic options even if this meant having to go abroad. He actively orchestrated his therapeutic itinerary by reorganising his relationships with the medical world and coordinating the physicians’ work. His particular social position enabled Patrick to bypass some of the current medical rules and to reorganise the usual pattern of distribution of medical responsibilities. The chronicity of his condition placed him at the very frontier of the health care system.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"36 1 1","pages":"76 - 91"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83608115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The nebula of chronicity: dealing with metastatic breast cancer in the UK 慢性星云:处理转移性乳腺癌在英国

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2022-01-02 DOI: 10.1080/13648470.2022.2041547

Cinzia Greco

{"title":"The nebula of chronicity: dealing with metastatic breast cancer in the UK","authors":"Cinzia Greco","doi":"10.1080/13648470.2022.2041547","DOIUrl":"https://doi.org/10.1080/13648470.2022.2041547","url":null,"abstract":"Abstract In this article, I explore how the concept of chronicity is mobilised by different actors in reference to metastatic breast cancer (MBC) and the transformation of the condition as a consequence of medical innovations. I do so by using data collected in the UK between 2017 and 2019 through in-depth interviews with medical professionals involved in the treatment of MBC and with patients living with MBC. I show how chronicity appears as a multidimensional and uncertain concept, which I analyse through the image of the nebula. While the medical literature tends to consider MBC chronic or on route to chronicisation, the medical professionals interviewed were uncertain as to whether MBC can be considered a chronic disease, and attempted to discuss chronicity through survival times, the kind of management possible for the disease, and how it compares to other conditions more commonly considered chronic. In some cases, the patients considered the idea of chronicity a source of hope or a way to link their condition to those of people with other diseases; however, they generally rejected the definition as inappropriate for their experience of the illness. Analysing the fluid uses of the concept of chronicity in the case of MBC contributes to the debate within medical anthropology on how medical categories acquire different values and uses and on the circulation of meanings between the biomedical context and the patient experience.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"63 1","pages":"107 - 121"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78261237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The friend within? The implantable cardioverter defibrillator between saving lives and chronically impairing them 内心的朋友?植入式心律转复除颤器在挽救生命和长期损害生命之间

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2022-01-02 DOI: 10.1080/13648470.2022.2041548

F. Barlocco

{"title":"The friend within? The implantable cardioverter defibrillator between saving lives and chronically impairing them","authors":"F. Barlocco","doi":"10.1080/13648470.2022.2041548","DOIUrl":"https://doi.org/10.1080/13648470.2022.2041548","url":null,"abstract":"Abstract This article considers the way in which a medical technology, the implantable cardioverter defibrillator (ICD), by preventing fatal outcomes, in this case sudden death, deriving from cardiac diseases, and specifically hypertrophic cardiomyopathy, contributes to the development of a particular type of chronicity. While biomedicine celebrates technological advances in treatments and naturalises chronicity, focussing on life expectancy as a victory over the ‘acute’ aspects of the disease, the way in which patients live with the disease is left unquestioned. The article follows Smith-Morris’s (2010) perspective in seeing chronicity as the never-ending process of identifying with one’s disease, adding a focus on the role played by an embodied technology in relation to it. Based on participant observation in a clinical setting and interviews with clinicians, the article interrogates three key themes in the chronicity of cardiac patients implanted with an ICD: risk, quality of life and choice. The data shows a constant tension between managing a one-off potentially fatal ‘acute’ risk and life with serious disruptions due to the limitations imposed by the implanted device. The article argues that patients’ resources for facing the life and identity disrupted by the disease are limited by ideas of what living a diseased body is, which acritically follow discourses of ‘patient choice’ and a ‘technological imperative’ to avoid risk.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"29 1","pages":"61 - 75"},"PeriodicalIF":1.8,"publicationDate":"2022-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87190073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The movement for global mental health: critical views from South and Southeast Asia 全球精神卫生运动:来自南亚和东南亚的批评观点

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2021-12-02 DOI: 10.1080/13648470.2021.2007755

Arnav Sethi

{"title":"The movement for global mental health: critical views from South and Southeast Asia","authors":"Arnav Sethi","doi":"10.1080/13648470.2021.2007755","DOIUrl":"https://doi.org/10.1080/13648470.2021.2007755","url":null,"abstract":"Critiques of psychiatric knowledge and practise have raised several concerns relating to: identification of diagnostic criteria, classification of distinct clinical entities, holistic understandings of causation, ‘legitimate’ treatment modalities, and claims to a universal symptomatology and nosology. This timely volume contributes to these longstanding debates and reminds us about all that is at stake if ‘mainstream’ psychiatric treatment and services are ‘universalised’, or perhaps more appropriately, ‘globalised’. As the contributors, including anthropologists, sociologists, public health professionals, historians, and clinical psychiatrists point out, this is indeed the primary aim of the Movement for Global Mental Health (MGMH). The book is divided into four broad themes: Critical Histories, Limits of Global Mental Health, Alternatives and Afterwords. The conceptually rich introduction covers good ground as it defamiliarises taken for granted assumptions about mental disorders that the MGMH tends to accept uncritically. Each chapter addresses certain problematic assumptions about causation, treatment and pervasiveness of mental disorders.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"14 1","pages":"348 - 350"},"PeriodicalIF":1.8,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78444318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Six hours to study: temporality and ignorance in medical education. 六小时学习:医学教育的暂时性和无知。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2021-12-01 Epub Date: 2021-07-12 DOI: 10.1080/13648470.2021.1890943

Julia Knopes

{"title":"Six hours to study: temporality and ignorance in medical education.","authors":"Julia Knopes","doi":"10.1080/13648470.2021.1890943","DOIUrl":"https://doi.org/10.1080/13648470.2021.1890943","url":null,"abstract":"Individual scientists, clinicians, and other experts cannot have absolute knowledge of all of the theories, methods, models, and findings in their field of practice. Rather, these individuals make choices about the kind of information that will be most meaningful and impactful in their work, while choosing - or being compelled to choose - what knowledge to overlook or ignore: a process identified as sufficient knowledge. In biomedicine, medical students are socialized to deliberately decide what information matters most; so, too, do practicing physicians openly acknowledge that they make choices around knowledge in daily practice. Within this process, time is a critical factor that mediates epistemological decision-making. In other words, how does time bound or restrict what forms and depth of medical knowledge that physicians and future physicians prioritize? When would someone intentionally limit time in order to constrain the amount and types of information he, she, or they acquire? To answer these questions, this study draws upon interviews and participant observation conducted with students at a medical school in the American Midwest. This article seeks to answer the aforementioned questions and to provide a new framework for, and expand discussions of, agnotology in the anthropology of medicine.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"28 4","pages":"429-444"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13648470.2021.1890943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39176710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The emergence of new medical pluralism: the case study of Estonian medical doctor and spiritual teacher Luule Viilma. 新医疗多元化的出现:爱沙尼亚医生和精神导师Luule Viilma的个案研究。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2021-12-01 Epub Date: 2020-08-28 DOI: 10.1080/13648470.2020.1785843

Marko Uibu

{"title":"The emergence of new medical pluralism: the case study of Estonian medical doctor and spiritual teacher Luule Viilma.","authors":"Marko Uibu","doi":"10.1080/13648470.2020.1785843","DOIUrl":"https://doi.org/10.1080/13648470.2020.1785843","url":null,"abstract":"Rather than the harmonious coexistence of different therapeutic practices and meaning systems, medical pluralism involves the contestation of norms and meanings related to legitimacy and authority. The implicit cultural norms that shape local understandings of health and legitimate healing methods become more during periods of social and cultural change. This paper demonstrates the contested nature of medical pluralism based on the case study of one significant figure, Estonian gynaecologist and spiritual teacher Luule Viilma. Well-known to the public as a trailblazer and prominent spokesperson for medical pluralism since the 1990s, Viilma's trajectory from doctor to healer reveals some implicit characteristics and mechanisms of power struggles as evidenced by the 'boundary work' carried out by biomedical specialists. By uniting and bridging biomedicine and spiritual self-help, Viilma became a figure whose presence and teachings gave responsibility and power to individuals and helped to legitimize pluralism in health practices. She had the ambition to redefine, in a fundamental way, perceived norms of legitimacy and authority, as well as the patient's position. From interviews with people who have used Viilma's teachings and material from internet discussion forums, it is apparent that the emergence of new forms of medical pluralism has brought several changes in health-related norms and understandings, including more active personal involvement in health-related information seeking and decision-making.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"28 4","pages":"445-460"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13648470.2020.1785843","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38317949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Peer support workers' conceptions of drug users and the implications for service provision. 同伴支持工作者对吸毒者的概念及其对服务提供的影响。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2021-12-01 Epub Date: 2021-03-03 DOI: 10.1080/13648470.2021.1875317

Jane Anderson

{"title":"Peer support workers' conceptions of drug users and the implications for service provision.","authors":"Jane Anderson","doi":"10.1080/13648470.2021.1875317","DOIUrl":"https://doi.org/10.1080/13648470.2021.1875317","url":null,"abstract":"This paper explores how independently organised peer support workers conceptualise drug users to determine how they deliver their service. The work is undergirded by Spiro's critique of the social view that conceptions of the human are fixed, and his contention that sometimes the concept of the self is set aside for utilitarian purposes. A literature review indicates that different conceptions of the drug user as the 'psychological self' and the 'social self' are variously held by public health, peer support workers employed by public health and independent peer support workers. An ethnographic account thereafter investigates how independently organised peer support workers prioritise three conceptions of the 'social self': drug users are hurt by social exclusion; they can benefit from shared experience; they can achieve social inclusion with peer support. The paper concludes with a discussion on the implications of using social conceptions of drug users in the provision of service and signals considerable scope for investigating how independent organisations of peer support workers attend drug users seeking recovery.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"28 4","pages":"477-492"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13648470.2021.1875317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

From biosociality to biosolidarity: the looping effects of finding and forming social networks for body-focused repetitive behaviours. 从生物社会性到生物团结性:发现和形成以身体为中心的重复行为的社会网络的循环效应。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2021-12-01 Epub Date: 2021-02-22 DOI: 10.1080/13648470.2020.1864807

Bridget Bradley

{"title":"From biosociality to biosolidarity: the looping effects of finding and forming social networks for body-focused repetitive behaviours.","authors":"Bridget Bradley","doi":"10.1080/13648470.2020.1864807","DOIUrl":"https://doi.org/10.1080/13648470.2020.1864807","url":null,"abstract":"Anthropological accounts of biosociality reveal the importance of the social relations formed through shared biomedical conditions. In the context of body-focused repetitive behaviours (BFRBs), like compulsive hair pulling (trichotillomania) and skin picking (dermatillomania), biosociality moves people from isolation towards community. After diagnosis, the powerful moment of discovering 'you are not alone' can lead to immense personal transformations, demonstrating the 'looping effects' of diagnosis and biosociality. Yet, biosocial groups do not simply exist, and must first be formed and found and their sustainability requires ongoing work and care from biosocial actors themselves. Biosociality also means different things to different people, often requiring a negotiation between secrecy and disclosure. This article acknowledges the role of stigma in biosociality, differentiating between private and public biosocial experiences. It argues that through biosociality come acts of biosolidarity, where advocacy can improve the visibility and recognition of illness groups. The circular looping effects of biosociality and biosolidarity demonstrate the way that community activism and biosociality reproduce one another. Through reflections from the anthropologist, biosolidarity is considered as a methodological tool that can help scholars to navigate the boundaries between relatedness, sociality and advocacy in the field and beyond.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"28 4","pages":"543-557"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13648470.2020.1864807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25391996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Vaccines and vitriol: an anthropological commentary on vaccine hesitancy, decision-making and interventionism among religious minorities. 疫苗与刻薄:对宗教少数群体中疫苗犹豫、决策和干预主义的人类学评论。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2021-12-01 Epub Date: 2020-11-13 DOI: 10.1080/13648470.2020.1825618

Ben Kasstan

{"title":"Vaccines and vitriol: an anthropological commentary on vaccine hesitancy, decision-making and interventionism among religious minorities.","authors":"Ben Kasstan","doi":"10.1080/13648470.2020.1825618","DOIUrl":"https://doi.org/10.1080/13648470.2020.1825618","url":null,"abstract":"This commentary addresses the issue of vaccine hesitancy and decision-making among religious minority groups in high-income country settings. Recent measles outbreaks have been attributed to lower-level vaccination coverage among religious minorities, which has inspired targeted as well as wholesale public health interventions and legislation in a range of jurisdictions. The commentary takes the case of self-protective ethnic and religious minority groups, especially Haredi or 'ultra-Orthodox' Jews in the United Kingdom, to address two key aims. First, this commentary flags how damaging representations of religious minorities in recent measles outbreaks can be avoided by better understanding inner processes of vaccine decision-making and acceptance, which can, in turn, help to address hesitancy sustainably and trustfully. Second, the commentary advocates for addressing vaccine hesitancy as part of a broader re-visioning of public health relations with minority groups. This commentary calls on public health services to improve confidence in childhood vaccinations rather than resorting to compulsory (and coercive) vaccination policies in order to address lower-level vaccination coverage. The commentary signposts how essential it is to carefully navigate relationships with minority groups amidst the new forms of public health preparedness that will emerge from the 2020 Coronavirus pandemic (COVID-19).","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"28 4","pages":"411-419"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13648470.2020.1825618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38604399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30