In the Journals

In the journals…

Summer is over and the journals are full of interesting articles!

Nowadays in the journals there is increasing thought on how anthropology and social developments are and should be interconnected. American Anthropologist highlights this discussion from an interesting different angle in a review essay. It offers a sampling of the kinds of public projects anthropologists launched in the immediate aftermath of 9/11, and it reflects on some of the ways in which that event has had a profound and lasting effect on the public aspects of the discipline. It echoes the deeply personal nature of the event by offering a selection of first-person reflections from anthropologists whose work was especially touched by the disaster.

While the DSM-V is in the making (release in 2013), Culture, Medicine and Psychiatry presents an opinion article about the classification of dementia. It places the Diagnostic and Statistical Manual in a meaningful historical and cultural context and ponders the future of “Alzheimer’s”, which has evolved from a rare diagnosis in younger patients to a worldwide epidemic common in the elderly. In this opinion piece, the authors use a constructivist approach to review the early history of the terms “Alzheimer’s disease” and related concepts such as dementia, as well as the more recent nosological changes that have occurred in the four major editions of the DSM since 1952.

The article on “chronic homework”, discussing the task of moving health care for those with chronic illnesses from clinic to home, does not only shed light on the practice of homework in local home contexts, but is also inspiring from a theoretical point of view. It provides the reader with a clear example of the choice for a theory (to understand practice). The authors show that the “colonization” of the popular domain could easily be understood from a Foucauldian perspective as another emerging mode of governmentality, but that this conceptualization can oversimplify the way specific practices of homework are re-imagined and redirected by patients and significant others in their home surroundings. In light of this re-invention of homework in local home contexts, the authors foreground another conceptual trope, describing chronic homework as a borderland practice.

Social Science and Medicine has a section in issue 73 about genetics, biology and health. Three authors discuss the relations between these in four articles and connect this relatedness to the well-known discussion on agency and structure. The importance of the articles lies in the clear sighted perspective and the skillfull ways they navigate the controversies surrounding social conditioning and biological determinism.

Another section’s article (implicitly) deals with the same discussion on agency and structure, although the topic is different. The article considers children’s (8-18 years old) health-seeking practices in Ghana. The use of both qualitative and quantitative leads to the finding that many young people in Ghana play a major role in seeking healthcare for themselves and others. Young people’s ability to secure effective healthcare is often constrained by their limited access to social, economic and cultural resources and information; however, many interviewees actively generated, developed and consolidated such resources in their quest for healthcare. Despite the dominant view within Western biomedicine that children and medicines should be kept apart, these authors argue that policy should take young people’s medical realities as a starting point for interventions to facilitate safe and effective health-seeking.

Starting from the declaration of Mildred Blaxter in 1978 that ‘The activity know as “diagnosis” is central to the practice of medicine but is studied less than its importance warrants’, issue 74 discusses a wide range of issues regarding diagnosis. The interesting thing of a sociology of diagnosis is that the diagnosis does not only refer to the range of nosologies, taxonomies and other authoritative classification systems for diagnostic guidance. It also finds expression outside of the classificatory infrastructure, namely every time an individual decides he or she is ill and presents this supposition to someone with diagnostic authority. Usually a doctor (but also a nurse practitioner, physiotherapist or others) examines the patient, assesses the evidence, and diagnoses their ailment. The diagnosis may (or may not) take into account a lay version of events; may (or may not) rely upon clinical judgment, or alternatively laboratory findings; and may (or may not) align with the patient’s own diagnosis of her symptoms. This special issue brings together a collection of empirical pieces confirming the statement of Blaxter and thereby convincingly shows that a sociology of diagnosis can form a concrete body of work and can both deploy, and contribute to, the sociological understandings of health, illness and health care.

Sociology of Health and Illness presents an insightful paper on the experiences of people having cancer. It explores the anxiety associated with the fear of recurrence, which seems widespread among patients, and shows how this can lead to an enhanced bodily awareness and a pronounced tendency to interpret mundane sensations as symptoms of pathology. It is argued that this syndrome is best understood not in cognitive terms, as a form of irrationality, but rather as resulting from damage to certain aspects of social competence, namely one’s “everyday health competence”. In investigating this issue, the author draws upon his personal experience of breast cancer diagnosis, surgery and adjuvant therapy; and on a broadly phenomenological approach to examining the relationship between bodily sensations and practical reasoning about experience. The implications for clinical practice are considered briefly, which is unfortunate as it raises several important questions on how health care practitioners can come to an understanding of the experiences of patients. The simple fact that this author uses a phenomenological approach, and especially his own experience with cancer, drives us to fundamentally ask ourselves whether it is possible to really understand illness when one is in good health. It forces us to reexamine the question of coming to understand, and it both stresses and questions the importance of being attentive to patients and to their small signs revealing what is at stake for them. The concept of attentiveness, and its relation to care, is discussed in a theoretical article in Nursing Ethics.

In the September issue of Health Joanna L. McParland et al. discuss “experience and perceptions of injustice” in relation to chronic pain issues. The authors have conducted semi-structured interviews with chronic pain sufferers and connected social status to specific justice-related themes. La Fleur F. Small investigates the “determinants of physician utilization, emergency room use, and hospitalizations among populations with multiple health vulnerabilities”, whereas Berg & Grimes stress the importance of locally-based research on risk factors for unsafe sex among men who have sex with men. In another recent article in Health, Christina Sinding et al. connect patient involvement to a possible exacerbation of health care and/or social disparities, thus creating a “critical literature” on patient involvement.

The International Journal of Social Psychiatry has updated its design and layout with its current issue. Mary V. Seaman conducts a selective review on psychosis in immigrants from the Caribbean to Canada. Her results show a very limited knowledge-base on prevalence of psychosis in Afro-Caribbean immigrants to Canada.  Bener & Ghuloum reveal “gender differences in knowledge, attitudes and practices towards mental illness in a sample of Qatari and other Arab expatriates residing in the State of Qatar”. An article from Japan describes results of a 10-year prospective cohort study of mood disorder patients with a focus on social adjustment. An article we found particularly interesting is “Perceived community participation in tsunami recovery efforts and the mental health of tsunami-affected mothers: Findings from a study in rural Sri Lanka”. The authors associate community social resources with reduced risks for mental health problems of tsunami-affected mothers using data from 325 families. Among the online-first articles, results of a study from Germany suggest that migration history is an independent risk factor for depression among females.

The use of animals in medicine is the topic of a current article by Soewo & Adekanola in the Journal of Ethnobiology and Ethnomedicine. Their research on “Traditional-Medical Knowledge and Perception of Pangolins (Manis sps) among the Awori People, Southwestern Nigeria” questions the feasibility of integrating sustainability into traditional medicinal use of endangered species. Animals are also at the center of an ethnoveterinary study on the use of medicinal plants for domestic animals and cattle among peasants in the Sierras de Córdoba in Argentina. The authors compare traditional veterinary knowledge with the use of medicinal plants for human ailments by their study participants and conclude that ethnoveterinary medicine is a “fountain of vernacular knowledge” that lends itself to future testing of plants’ healing properties.

James Staples discusses disabled men’s perceptions of their gendered identities in the September issue of the Journal of the Royal Anthropological Institute. Staples argues that living with bodily impairments to his informants does not mean feeling emasculated. Instead, “impairments are shown […] to reshape understandings of the masculine” with the informants performing their identities in various ways.

In addition, the journal contains a number of health-related book reviews. Anne-Lise Middlethon reviews Elisabeth Hsu’s “Pulse diagnosis in early Chinese medicine: the telling touch”. Anna Lora-Wainwright writes that Hyde’s “Eating spring rice: the cultural politics of AIDS in Southwest China” “situates [sex-workers] within the cultural politics of sex tourism in an ethnic minority region, the politics and aesthetics of statistics, and official and local discourses on sexuality and AIDS”. Also discussed: “Global health: why cultural perceptions, social representations, and biopolitics matter” by Mark Nichter.

Rikke Schmidt Kjaergaard argues that framing of news in scientific journals is not so different from framing in mass media in Science as Culture. As an example, Kjaergaard chooses the discourse on South Korean research Hwang (who was found guilty of fraud in 2005) in two journals: Science and Nature.

Psychosomatic Medicine offers an excellent article summary feature, allowing scholars without a subscription to this journal to get the gist of the current issue. In September, two articles deal with associations between type D personality and mortality in patients with heart failure. Shen et al. investigate the risks of acute organ dysfunction and death for patients in the ICU setting in Taiwan, and conclude that among the ICU patient population those suffering from schizophrenia have higher risks. Finally, Colloca & Miller critically discuss the state of research on the nocebo effect (defined as: “disclosure of information to patients about potential side effects can itself contribute to producing adverse effects”) and its implications for medical care.

Jörg Niewöhner analyses an ethnographic approach to environmental epigenetics in the September issue of BioSocieties (  Susan Pickard discusses the “normal” in health and illness at old age, arguing for “pluralistic conceptions of health” as health co-exists with morbidity in older persons. Ulrike Felt & Ruth Müller examine how women make sense of their experiences with genetic testing for hereditary breast and ovarian cancer in Austria. The fourth article in this month’s issue is by Jack Price. The author adds to a debate on human brain reconstruction his views that such an endeavor is biologically impossible, whether desirable or not.

By: Melanie Böckmann & Klaartje Klaver

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