Neuroanthropology

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Archive for the ‘Medical anthropology’ Category

Paul Farmer: This I Believe

Posted by dlende on July 9, 2009

Paul Farmer is a doctor and an anthropologist, and spoke as part of NPR’s series This I Believe. Farmer co-founded Partners in Health, a non-profit organization dedicated to improving health care for the poor around the world. He helped develop DOTS (directly observed therapy), a way to provide care for HIV/AIDS that works in resource-poor settings, as well as community-based approaches to treating multi-drug resistant TB in developing countries.

As an anthropologist he has emphasized the importance of structural violence, the negative impact that systems of power can have on people through racism, gender inequality and political violence, with significant articles in both Current Anthropology and PLoS Medicine.

His most recent book is Pathologies of Power: Health, Human Rights, and the New War on the Poor. You can also read about his lifework in Tracy Kidder’s biography, Mountains beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World.

Hat-tip (and thanks) to Ryan Anderson over at Ethnografix and his anthropological list of inspiring people and work.

Link to full text of Paul Farmer’s This I Believe NPR recording.

Posted in Applied Anthropology, Medical anthropology, Video | 1 Comment »

Community-Based Work and the Importance of Being Integrative – The Ganey Award and Video

Posted by dlende on June 29, 2009

In April I had the honor of receiving the Rodney F. Ganey, Ph.D., Faculty Community-Based Research Award. Given by the Center for Social Concerns at the University of Notre Dame, the Ganey Award goes to a Notre Dame faculty who has done collaborative work in the local community. For those interested in the details of that work, here is the press release – Daniel Lende Wins 2009 Ganey Award.

Neuroanthropology.net has played a central role in the community-based research I have done with my students. These include posts on using humor in recovery from breast cancer, a support group for women with HIV/AIDS, research to help redesign a local hospital waiting room, and the stories that US war veterans wanted to share about their everyday battles with post-traumatic stress disorder.

Two peer-reviewed articles have come out of the community-based research with my students: Embodiment and Breast Cancer among African American Women, and Community Approaches to Preventing Mother-to-Child HIV Transmission: Perspectives from Rural Lesotho. A great community guide, Underneath It All: Humor in Breast Cancer, was put together by the students, community members and myself, and is now used in a local hospital.

One of the best things about the award was that the Center for Social Concerns made this wonderful video with my community partners and my students. Here’s the YouTube link, but I also present it below as it captures why I do this sort of work.

I also want to share a written version of what I said at the CSC award dinner. No, no, not all the thank yous (there were plenty and all richly deserved), but a reflection on my own approach to my work.

I want to close by speaking to why the work I have done has meshed so well with the Center for Social Concerns.

At its core my work is integrative. Notre Dame had encouraged that integrative spirit. These five factors make that spirit a reality.

First is listening, listening to the person across the table. That is the start to doing community-based work and the start to understanding other ideas.

Second is the synthesis of intellectual and social problems. These are human problems, where compassion and involvement can matter as much as intellectual analysis or abstract policy.

Third is a push to make our research international and interdisciplinary, and not just local and field specific. Integration only happens by crossing boundaries.

Fourth is the combination of traditional publishing with other forms of scholarship, such as a community guidebook and electronic publishing. These forms of scholarship can reach many, many more people than a typical peer-reviewed article.

Fifth, being community-oriented, with an insistence that what we do is relevant to more than just the university. Some of the most challenging questions and even our best answers and outcomes can come from those people across the table, the people with whom we are lucky enough to work.

These five factors – listening to others, the synthesis of intellectual and social problems, making our work interdisciplinary, combining traditional publishing with other forms of scholarship, and having a community orientation – all matter. Together they make a tremendous difference in our lives as academics, students, and community partners.

Posted in Applied Anthropology, Medical anthropology, Video | 5 Comments »

Vidéothèque: Videos on Cross-Cultural Health, Sickness and Healing

Posted by dlende on June 15, 2009

The Vidéothèque : Santé, Maladie, Malheur is an absolutely incredible video archive on medical anthropology, with a particular focus on sub-Saharan Africa. I started exploring it when it was mentioned as part of the trance video links, but it’s so rich it deserves its own post – well over 100 video clips that are freely available in Real Media packaging.

Alain Epelboin

Alain Epelboin

The collection has been put together by Alain Epelboin, who has also contributed the lion’s share of footage. Other film makers include Beatriz Soengas, Sylvie Heslot, Susanne Fürniss and Claire Lussiaa-Berdou. The collection is hosted through Réseau Académique Parisien.

Alain Epelboin is a doctor and anthropologist who runs the Labotoire Eco-anthropologie et Ethnobiologie, which is part of the Centre National de la Recherche Scientifique. You can see a video of Alain discussing his work, as well as this informative article – both in French, as are most of the videos.

Some of the videos you can see include Ebola in Congo, this narrated documentary on the Aka of the Central African Republic and the Congo, Traditional Medicine, Culture and AIDS, and Mort et naissance de Masiki.

And here’s the entire list of the Santé, Maladie, Malheur videos.

Posted in Human variation, Medical anthropology, Video | 1 Comment »

The New Performance Enhancing Drugs

Posted by dlende on June 4, 2009

Enhanced Brain
By Andrew Hessert, Andrew Medvecz, Jimmy Miller, Jacquelyn Richard

Barry Bonds elevated his game to the next level with “the clear” and “the cream”, shattering legendary records in the process. Are scientists, students, and other academics about to do the same?

While stars such as Barry Bonds and Jason Giambi continue to defend themselves against their alleged use of performance-enhancing drugs, a new debate over the use of a different kind of performance-enhancing drug has begun to rage in the scientific world.
Barry Bonds Pumped Up
Cognitive enhancers like Adderall and Ritalin have commonly been used as a treatment for behavioral disorders such as Attention Deficit/Hyperactivity Disorder. However, these drugs are now becoming popular “performance enhancing” substances for healthy individuals trying to gain a competitive edge by boosting their overall cognitive function.

Henry Greely, a Stanford Law Professor, advocates for unrestricted availability of these drugs, claiming the enhancers will level the “cognitive playing field” and spark a new era of increased innovation. But Greely and other advocates fail to recognize the severe personal and societal consequences that such availability would generate, looking instead to a pharmaceutical solution that would, in the end, cause more problems than it would solve.

How They Work

Ritalin and Adderall have been on the market since the 1960s to treat conditions like ADD and ADHD (Center for Substance Abuse Research, 2005). While the specific mechanisms of these disorders have yet to be fully elucidated, cognitive enhancers have been successful in controlling or mitigating symptoms in patients. Ritalin (methylphenidate) and Adderall (dextroamphetamine) both inhibit dopamine reuptake, allowing dopamine signals to remain active for longer periods of time (Jones, Joseph, Barak, Caron, & Wightman, 1999). Provigil (modafinil), an alternative to the potentially addictive dopaminergic drugs, operates in similar fashion, but instead blocks reuptake of the neurotransmitter norepinephrine.

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Posted in Brain Mechanisms, Education, Medical anthropology, Neural plasticity, Skill acquisition | 12 Comments »

Tobacco Worse Than Cocaine?

Posted by dlende on May 27, 2009

Gas Deal
By Mariana Cuervo, Elizabeth Montana, Brian Smith, and Sadie Pitzenberger

Is your local gas station attendant a drug dealer? Most people would say no, yet he readily deals all day long with customers looking for their next nicotine fix. Nicotine, the addictive substance in tobacco, keeps its users hooked.

Even though most people do not consider tobacco to be a drug, this post will show that it is exactly that. Tobacco delivers similar neurobiological effects as illegal substances like cocaine, methamphetamine and marijuana, all more commonly associated with the word “drug.” With tobacco, however, advertising and the law contribute to the common perception that tobacco is not a drug.

Tobacco Products

Just like on the street corner, where you might be able to buy crack, marijuana or meth, a gas station offers different types of drugs. Tobacco itself comes in many forms: dip, snuff, cigars and, of course cigarettes.

Chewing tobacco or “dip” is a smokeless form of tobacco, which when packed into the lip allows nicotine to flow into the bloodstream via the gum line. Snuff, a finer form of tobacco, is snorted while cigarettes are smoked. Both provide an alternative way to get a nicotine high.

The ways in which these tobacco products are consumed mirror the techniques of cocaine consumption – coca leaves are chewed, cocaine is snorted, and crack is smoked. So how is tobacco different?
Cigarette Poisons
And just like marijuana tobacco is grown in the ground, picked and dried, and then rolled into cigars and cigarettes. Tobacco has nicotine while marijuana has tetrahydrocannabinol (THC). Both are responsible for getting the user high.

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Posted in Addiction, Applied Anthropology, Medical anthropology | 4 Comments »

Ron Barrett and the Contagion of Swine Flu

Posted by dlende on May 7, 2009

ron-barrett
Ron Barrett, a medical anthropologist joining Macalester College, recently gave this interview Fears over Flu Can Be Contagious on NPR’s All Things Considered.

Ron discussed how his research on a breakout of plague in the northern Indian city of Surat provides insight into today’s reactions to swine flu. His basic point is that with infectious diseases, rumors and fears highlight existing tensions in a community, so stigma and panic can come to play a greater role in people’s reactions than the actual impact of the disease. Case in point – 78% of the medical professionals fled Surat, much more than the estimated third of the population that left.

Ron advocates the importance of transparency and providing reliable information. Otherwise, rumors can become more infectious than the disease itself. Twitter, for example, drove wild speculation about swine flu. So for reliable info, think Obama and his clear recommendations about what to do (wash your hands, cover your mouth when coughing), and not Joe Biden broadcasting fear on The Today Show.

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Posted in Medical anthropology | Leave a Comment »

Lende wins 2009 Ganey award

Posted by gregdowney on May 6, 2009

2009 Ganey F. Ganey award winner, Daniel Lende

2009 Ganey F. Ganey award winner, Daniel Lende

Daniel didn’t even mention this to me, but looking for a photo of him for a poster, I came across this press release: our leading contributor also managed to pick up the University of Notre Dame’s 2009 Rodney F. Ganey, Ph.D., Faculty Community-Based Research Award for his many contributions to community-based research at Notre Dame.

Although he’s done a number of community-based research projects and supported student research (some of which we’ve read about on this site), the press release of the award also singles out his innovative design of the course, ‘Researching Disease: Methods in Medical Anthropology.’ In this class, Daniel has teamed up with local organizations like Imani Unidad, African American Women in Touch, Notre Dame Office of Alcohol and Drug Education, and a support group for veterans suffering with Post Traumatic Stress Disorder (PTSD) in order to place students where they can do research of real consequence to the local community. As the press release describes:

The research has since enabled community organizations to improve the conditions in hospital waiting rooms, educate the public about PTSD and provide better services to women living with HIV/AIDS. Findings have been published electronically on Neuroanthropology.net, and one project was turned into a guide book, “Underneath It All: Humor in Breast Cancer,” which has been used by McKinney-Arnold and Memorial Hospital in South Bend.

If you want to know more, go to the Notre Dame Anthropology news page to check out the video link, or see some of the reports Daniel has posted from the research on Neuroanthropology.net, including a number of pieces by the students themselves.

When Pink Ribbons Are No Comfort: On Humor and Breast Cancer
More Than A Waiting Room
Forever at War: Veterans’ Everyday Battles with Post-traumatic Stress Disorder
Just a Place to Talk: Women and HIV/AIDS

Posted in Medical anthropology | 3 Comments »

The Insidious, Elusive Becoming: Addiction in Four Steps

Posted by dlende on March 10, 2009

bowline_in_four_steps

Trying to describe the process of becoming an alcoholic is like trying to describe air. It’s too big and mysterious and pervasive to be defined… [T]here is no simple reason it happens, no single moment, no physiological event that pushes a heavy drinker across a concrete line into alcoholism. It’s a slow, gradual, insidious, elusive becoming.

-Caroline Knapp

Caroline Knapp wrote those lines near the beginning of her powerful memoir Drinking: A Love Story. Every year I use this book in my class on addiction. Students get drawn into Knapp’s clear and close account of how she began to drink so much, what it is like to be an alcoholic, and how she managed to get to recovery. Every year the book challenges my own thinking as well.

I used that last line—alcoholism as a slow, gradual, insidious, elusive becoming—to end my earlier post on Subjectivity and Addiction: Moving Beyond Just the Disease Model. There I argued that our two views of addiction, a popular one of getting hooked on things and a serious one about tolerance and destructive use, are crucial to understanding what addiction is.

For each category my class stuck up exemplars on the blackboard, from Facebook to hard-core drugs. Then I drew a between the two categories, using a thick two-headed arrow to indicate that the subjective and biological views interact. Both sides matter.

But I’ve realized that is not enough. That double-sided arrow remains woefully inadequate, a place marker that can end being two-faced, saying nothing of consequence, or double-edged, used simply to cut into the other side. That one symbol tells us little about the interactions themselves, about how people and disease mesh. It lends no insight into what Knapp shows us with her book—that addiction is an elusive and terrible becoming.

So how do you become an alcoholic or addict? How do you go from something fun to something all-encompassing? This question matters deeply. One fact, often overlooked in all the moral angst about addiction, is that most people who try alcohol or drugs do not end up addicted to them. They remain on the popular side. But some cross over. In the same passage as the opening quote, Knapp describes the end point: “Alcohol is everywhere in your life, omnipresent, and you’re both aware and unaware of it almost all the time; all you know is you’d die without it, and there is no simple reason why this happens… (8)”

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Posted in Addiction, Learning, Medical anthropology, Psychological anthropology | 2 Comments »

Mark Nichter and Global Health

Posted by dlende on February 24, 2009

Mark Nichter is a prominent medical anthropologist who teaches at the University of Arizona. In this video Nichter speaks on medical anthropology and health policy. We also get more background on Nichter and his work from colleagues and students.

I am using Mark’s new textbook, Global Health: Why Cultural Perceptions, Social Representations, and Biopolitics Matter, in my Intro to Med Anth class this semester, and the students have responded quite positively. It’s a relatively short book, so I am able to use it in conjunction with other texts – not the mega intro to all things med anthro that seems to be the norm out there now. I also like the practical/applied focus that he provides throughout the book.

The last chapter, “Toward a Next Generation of Social Science Research,” is the real pay-off after previous sections on both popular health culture and international health policy. That’s where he discusses global health, syndemics, ecosocial epidemiology, local biology, the importance of studying up, biopolitics, and more. Yes, he packs a lot in – but that leaves room for me as the teacher to discuss more general issues and to provide background for the points he is making.

Mark has several recent articles which will likely interest readers:

Coming to Our Senses: Appreciating the Sensorial in Medical Anthropology (2008) in Transcultural Psychiatry

Reconsidering the Placebo Response from a Broad Anthropological Perspective (2009) in Culture, Medicine and Psychiatry with Jennifer Jo Thompson and Cheryl Ritenbaugh

Qualitative Research: Contributions to the Study of Drug Use, Drug Abuse, and Drug Use(r)-Related Interventions (2004) in Culture, Medicine and Psychiatry with Gilbert Quintero, Mimi Nichter, Jeremiah Mock and Sohaila Shakib

Posted in Applied Anthropology, Medical anthropology | Leave a Comment »

Forever at War: Veterans’ Everyday Battles with Post-traumatic Stress Disorder

Posted by dlende on January 26, 2009

ptsd-iwo-jima“To this day, every time I smell firecrackers or fire arms being shot, I feel like I am right back there. All I have to do is close my eyes and I see the whole scenario over and over again. I can’t erase it.”

Hundreds of thousands of US veterans are not able to leave the horrors of war on the battlefield. They bring the combat home and re-experience it in their minds each and every day, no matter how much time has passed.

“I don’t like people. I just live my life.”

Many PTSD veterans live a life riddled with divorce, unemployment, and loneliness because they are unable to form lasting social networks within civilian life. It is not uncommon for a war veteran plagued with PTSD to desire a solitary life in the mountains. One informant described Montana as the ideal locale – far away and quiet.

“I should have buried him.”

This veteran is still tormented by the fact he did not give an honorable burial to a fellow soldier. He knows he would have met a similar fate if he tried to leave his foxhole; yet his inability to act haunts his memory. He asks himself everyday why he didn’t even try to honor his fallen comrade. He also has never been able to justify why he wasn’t the soldier left unburied on that remote Pacific island.

“I didn’t even have the motivation to kill myself.”

Many of these men and women believe their situation will never improve. Some contemplate suicide as their only relief from the symptoms of PTSD. A number of the veterans we spoke with had thought about or even tried to end their own lives. They also participate in risky activities, threatening their life in a deliberate yet indirect way.

“I always feel like there is someone behind me – following me.”

Being on edge is the only way to survive in combat. Unfortunately, many PTSD veterans are unable to readjust within the civilian world. Everyday life becomes a battlefield.

Something as mundane as walking through a crowded grocery store aisle can be a source of intense anxiety for a veteran suffering from PTSD. Overwhelmed by a feeling that the shoppers behind them are enemies, PTSD veterans always feel as if they are under attack. A trigger as simple as the clashing of shopping carts can make them jump in fear of an imminent explosion. They are forever at war.

OUTREACH

Over the course of 4 months, South Bend veterans with Posttraumatic Stress Disorder (PTSD) have revealed their daily realities to us, five undergraduates at the University of Notre Dame. In conjunction with a course taught by Dr. Daniel Lende entitled Researching Disease: Methods in Medical Anthropology, we have engaged in community-based research with members and supporters of PTSD, Vets, Inc. Here, with the approval and encouragement of these vets, we seek to give their experiences a well-deserved voice.

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Posted in Applied Anthropology, Medical anthropology, Mental Illness, Stress, Violence | Tagged: , , | 11 Comments »