Violence in the first millennium BCE Eurasian steppe: Cranial trauma in three Turpan Basin populations from Xinjiang, China.

OBJECTIVES: Violence affected daily life in prehistoric societies, especially at conflict zones where different peoples fought over resources and for other reasons. In this study, cranial trauma was analyzed to discuss the pattern of violence experienced by three Bronze to early Iron Age populations (1,000-100 BCE) that belonged to the Subeixi culture. These populations lived in the Turpan Basin, a conflict zone in the middle of the Eurasian Steppe. METHODS: The injuries on 129 complete crania unearthed from the Subeixi cemeteries were examined for crude prevalence rate (CPR), trauma type, time of occurrence, possible weapon, and direction of the blow. Thirty-three injuries identified from poorly preserved crania were also included in the analyses except for the CPR. Data was also compared between the samples and with four other populations that had violence-related backgrounds. RESULTS: Overall, 16.3% (21/129) of the individuals showed violence-induced traumatic lesions. Results also indicated that most of the injuries were perimortem (81.6%), and that women and children were more involved in conflict than the other comparative populations. Wounds from weapons accounted for 42.1% of the identified cranial injuries. Distribution analysis suggested no dominant handedness of the attackers, and that blows came from all directions including the top (17.1%). Wounds caused by arrowheads and a special type of battle-ax popular in middle and eastern Eurasian Steppe were also recognized. DISCUSSION: A comprehensive analysis of the skeletal evidence, historical records, and archeological background would suggest that the raiding to be the most possible conflict pattern reflected by the samples. The attackers were likely to have been nomadic invaders from the steppe (such as the Xiongnu from historical records), who attacked the residents in the basin more likely for their resources rather than territory or labor force.

Endemic violence in a pre-Hispanic Andean community: A bioarchaeological study of cranial trauma from the Majes Valley, Peru.

OBJECTIVES: This study examines violence-related cranial trauma frequencies and wound characteristics in the pre-Hispanic cemetery of Uraca in the lower Majes Valley, Arequipa, Peru, dating to the pre- and early-Wari periods (200-750 CE). Cranial wounds are compared between status and sex-based subgroups to understand how violence shaped, and was shaped by, these aspects of identity, and to reconstruct the social contexts of violence carried out by and against Uracans. MATERIALS AND METHODS: Presence, location, and characteristics (lethality, penetration, and post-traumatic sequelae) of antemortem and perimortem cranial fractures are documented for 145 crania and compared between subgroups. Cranial wounds are mapped in ArcGIS and the locational distribution of injuries is compared between male and female crania. RESULTS: Middle adult males were disproportionately interred at Uraca, particularly in the elite Sector I. The Uraca mortuary population presents the highest rate of cranial trauma reported for pre-Hispanic Peru: 67% of adults present trauma, and among those, 61.1% present more than one cranial injury. Males exhibit significantly more cranial trauma than females and present a higher mean number of injuries per person. Elite males show the highest mean number of injuries per person, more antemortem injuries, and are the only ones with perimortem cranial trauma, bladed injuries, penetrating injuries, and post-traumatic sequelae. Both sexes were most frequently injured on the anterior of the cranium, while the proportion of posterior injuries was higher for females. DISCUSSION: The rate, intensity, and locational patterns of cranial trauma suggests the community was engaged in raids and/or war with enemy groups, some of which may have increased physical violence between community members. Engaging in violence was likely a prerequisite for burial in the elite sector and was bound up with the generation and maintenance of social status differences linked to male social life.

The emergence of human warfare: Current perspectives.

The origins of warfare have long been of interest for researchers across disciplines. Did our earliest ancestors engage in forms of organized violence that are appropriately viewed as approximations, forms of, or analogs for more recent forms of warfare? Assessed in this article are contrasting views that see warfare as being either a product of more recent human societies or a phenomenon with a much deeper chronology. The article provides an overview of current debates, theories, and methodological approaches, citing literature and data from archaeological, ethnographic, genetic, primatological, and paleoanthropological studies. Synthetic anthropological treatments are needed, especially in efforts to inform debates among nonacademic audiences, because the discipline's approaches are ideally suited to study the origins of warfare. Emphasized is the need to consider possible forms of violence and intergroup aggression within Pleistocene contexts, despite the methodological challenges associated with fragmentary, equivocal, or scarce data. Finally, the review concludes with an argument about the implications of the currently available data. We propose that socially cooperative violence, or "emergent warfare," became possible with the onset of symbolic thought and complex cognition. Viewing emergent warfare as a byproduct of the human capacity for symbolic thought explains how the same capacities for communication and sociality allowed for elaborate peacemaking, conflict resolution, and avoidance. Cultural institutions around war and peace are both made possible by these changes. Accordingly, we suggest that studies on warfare's origins should be tied to research on the advent of cooperation, sociality, and communication.

Translation and purification: Ayurvedic psychiatry, allopathic psychiatry, spirits and occult violence in Kerala, South India.

In this paper, the author traces two parallel movements of institutionalized Ayurvedic psychiatry, an emergent field of specialization in Kerala, India: the 'work of purification' and the 'work of translation' that Latour has described as characteristic of the 'modern constitution.' The author delineates these processes in terms of the relationship of Ayurvedic psychiatry to (1) allopathic psychiatry, (2) bhutavidya, a branch of textual Ayurveda dealing with spirits, and (3) occult violence. The aim is to offer a model of these open and hidden processes and of Ayurvedic psychiatry's positioning within a hierarchical mental health field characterized simultaneously by biopsychiatric hegemony and a persistent vernacular healing tradition. Through these processes, Ayurvedic psychiatry emerges as a relevant actor. It demarcates itself from both allopathic and vernacular epistemologies and ontologies while simultaneously drawing upon aspects of each, and, in this way, shows itself to be both deeply modern and highly pragmatic.

Music as Illness; Music as Healing.

Throughout the Soviet Union, the arts became tied to ethnicity through the project of Socialist Realism. When, in 1991, the Kyrgyz Republic became independent from the Soviet Union, its national narrative continued to be built upon tropes of Kyrgyz ethnicity. Through their engagement with images of the ethno-national self, the arts provide a great source of beauty. Defining beauty as a representation of the self that is pure whole, and stable, Julia Kristeva asserts that beauty and suffering are part of the same phenomena. Arthur Kleinman argues that suffering is best understood as existing within the triangulated relationship of cultural representation, collective experience, and subjectivity. Music too is part of this triangulated relationship, and therefore, a part of suffering. Drawing upon ten months of ethnographic fieldwork in Kyrgyzstan, this article explores the illness experience of a single Kyrgyz musician. In doing so, it illustrates music's role in self-formation and the development of social, economic, and political ties and the shifts that occur in these during illness. In drawing forth the role of music in the construction of racialized ethnicities, this article demonstrates how the experience of transformative beauty can coexist with turmoil, marginalization, and violence.

Making and unmaking ethnicities in the Rwandan context: implication for gender-based violence, health, and wellbeing of women.

OBJECTIVES: To examine ethnicity and gender violence in Rwanda from cultural and historical perspectives and explore the encounters between cultural beliefs and practices and the new gender equality policy and programs and the implications of the particular encounters to the health of women. DESIGN: The study is a qualitative drawing from the growing range of interactive approaches and methods within an ethnographic framework of the research design. Twenty individual interviews, six focus group discussions and two 'community mobilization' dialogs were conducted. RESULTS: Violence has continued and there is a conflict between cultural tradition, the de-ethnicization, and gender equality policies. Some of the gender violence preventive programs are influenced by the ethos of the traditional norms, and therefore unwittingly perpetuate gender-based violence. CONCLUSIONS: In spite of the progress that Rwanda has made in political empowerment of women, it still seems a long way before real gender equality is achieved. It seems that women's empowerment is not only just an opportunity for political participation but also this is important. It is also about the capacity to make effective choices and to translate them into desired actions and outcomes, unfettered by cultural sanctions. Universalised, top-down gender policy programs have not furnished all women with the necessary capacity to make decisions that affect their traditionally all important reproductive functions; to challenge the embedded gender imbalance; and to strive for a holistic wellbeing of their families, where they play a central role. Indeed, some of the policies could have negative implications to the health of women, in particular, with sexually transmitted infections, including HIV and AIDS.

Epidemiology of mixed martial arts and youth violence in an ethnically diverse sample.

Mixed martial arts' (MMAs) growing international popularity has rekindled the discussion on the advantages (e.g., exercise) and disadvantages (e.g., possible injury) of contact sports. This study was the first of its kind to examine the psychosocial aspects of MMA and youth violence using an epidemiologic approach with an Asian American and Pacific Islander (AAPI) adolescent sample (N = 881). The results were consistent with the increased popularity of MMA with 52% (adolescent males = 73%, adolescent females = 39%) enjoying watching MMA and 24% (adolescent males = 39%, adolescent females = 13%) practicing professional fight moves with friends. Although statistically significant ethnic differences were found for the two MMA items on a bivariate level, these findings were not statistically significant when considering other variables in the model. The bivariate results revealed a cluster of risk-protective factors. Regarding the multiple regression findings, although enjoying watching MMA remained associated with positive attitudes toward violence and practicing fight moves remained associated with negative out-group orientation, the MMA items were not associated with unique variances of youth violence perpetration and victimization. Implications included the need for further research that includes other diverse samples, more comprehensive and objective MMA and violence measures, and observational and intervention longitudinal studies.

Violence in the massage parlor industry: experiences of Canadian-born and immigrant women.

We examined and contrasted 129 Canadian-born and immigrant women's experiences of violence and associated structural and interpersonal factors within indoor commercial sex venues. The majority experienced at least one form of structural, interpersonal, or both types of violence, with the attempted removal of a condom during sexual services being cited most frequently. Canadian-born women reported more frequent violent assaults in the survey data. The women's qualitative narratives illustrated that perceptions of violence differed significantly among Canadian versus non-Canadian born women. Findings concerning racialization and gendered relations of power have important implications for prevention and interventions to support victims of abuse.

Communal violence and child psychosocial well-being: qualitative findings from Poso, Indonesia.

This exploratory study examined the health care system in relation to communal violence-related psychosocial wellbeing in Poso, Indonesia, as preparation for conducting a cluster randomized trial of a psychosocial intervention. We employed focus groups with children (N = 9), parents (N = 11), and teachers (N = 8), as well as semi-structured interviews with families affected by communal violence (N = 42), and key informants (N = 33). An interrelated set of problems was found that included poverty, an indigenized trauma construct, morally inappropriate behavior, inter-religious tensions, and somatic problems. Participants emphasized social-ecological interactions between concerns at different systemic levels, although problems were mainly addressed through informal care by families. The programmatic and research implications of these findings are discussed.

Kiyang-yang, a West-African postwar idiom of distress.

In 1984, a healing cult for young barren women in southern Guinea Bissau developed into a movement, Kiyang-yang, that shook society to its foundations and had national repercussions. "Idiom of distress" is used here as a heuristic tool to understand how Kiyang-yang was able to link war and post-war-related traumatic stress and suffering on both individual and group levels. An individual experience born from a traumatic origin may be generalized into an idiom that diverse sectors of society could embrace for a range of related reasons. We argue that, for an idiom to be understood and appropriated by others, there has to be resonance at the level of symbolic language and shared experiences as well as at the level of the culturally mediated contingent emotions it communicates. We also argue that through its symbolic references to structural causes of suffering, an idiom of distress entails a danger for those in power. It can continue to exist only if its etiology is not exposed or the social suffering it articulates is not eliminated. We finally argue that idioms of distress are not to be understood as discrete diagnostic categories or as monodimensional expressions of "trauma" that can be addressed.

Llaki and ñakary: idioms of distress and suffering among the highland Quechua in the Peruvian Andes.

This article examines some of the long-term health outcomes of extreme adversities and the ways in which social inequalities and idioms of distress are historically and socially produced in the Peruvian context. We describe how the highland Quechua of northern Ayacucho construct and experience expressions of distress and suffering such as pinsamientuwan (worrying thoughts, worries), ñakary (suffering) and llaki (sorrow, sadness), in a context of persistent social inequalities, social exclusion and a recent history of political violence. It is concluded that the multiple expressions of distress and suffering are closely related to past and current events, shaped by beliefs, core values and cultural norms and, in this process, transformed, recreated and invested with new meanings and attributions.

Trauma and humanitarian translation in Liberia: the tale of open mole.

The focus of this paper is the intercultural process through which Open Mole and trauma-related mental illnesses are brought together in the postconflict mental health encounter. In this paper, I explore the historical dimension of this process by reviewing the history of Open Mole, and the ways in which it has been interpreted, acted on, and objectified by external observers over the last half-century. Moving into Liberia's recent war and postconflict period, I examine the process by which Open Mole is transformed from a culture-bound disorder into a local idiom of trauma, and how it has become a gateway diagnosis of PTSD-related mental illnesses, and consider how it is produced as an objectified experience of psychiatric disorder in clinical humanitarian contexts. By studying how Open Mole is transformed in the humanitarian encounter, I address the structure and teleology of the humanitarian encounter and challenge some of the foundational assumptions about cultural sensitivity and community-based mental health care in postconflict settings that are prevalent in scholarship and practice today.

Lessons from history: why race and ethnicity have played a major role in biomedical research.

Before any citizen enters the role of scientist, medical practitioner, lawyer, epidemiologist, and so on, each and all grow up in a society in which the categories of human differentiation are folk categories that organize perceptions, relations, and behavior. That was true during slavery, during Reconstruction, the eugenics period, the two World Wars, and is no less true today. While every period understandably claims to transcend those categories, medicine, law, and science are profoundly and demonstrably influenced by the embedded folk notions of race and ethnicity.

Protective factors against suicide attempt risk among African American women experiencing intimate partner violence.

Protective factors (hope, spirituality, self-efficacy, coping, social support-family, social support-friends, and effectiveness of obtaining resources) against suicide attempts were examined in economically, educationally, and socially disadvantaged African American women (100 suicide attempters, 100 nonattempters) who had experienced recent intimate partner violence. Significant positive associations were found between all possible pairs of protective factors. Bivariate logistic regressions revealed that higher scores on each of the seven protective factors predicted nonattempter status; multivariate logistic regressions indicated that higher scores on measures of hope or social support-family showed unique predictive value for nonattempter status. Further, the multivariate model accurately predicted suicide attempt status 69.5% of the time. Partial support was found for a cumulative protective model hypothesizing a linear relationship between the number of protective factors endorsed and decreased risk for suicide attempts. Implications of these findings for community-based preventive intervention efforts and future research are discussed.

Oppression and resiliency in a post-apartheid South Africa: unheard voices of Black gay men and lesbians.

Guided by photovoice, a form of participatory action research that uses documentary photography and storytelling, this study examines how Black gay men and lesbians view themselves in relation to White gay men and lesbians in South Africa. Participants were from 4 South African townships and included 4 women, and 3 men. Participants discussed interracial dating, a lack of education, and information regarding differing sexualities and health care. They reported being sexually and physically assaulted for challenging the heterosexual status quo. Other themes that emerged from this study were classism, cultural traditions of visiting African healers, and segregated social spaces. Amidst oppression and despair, participants showed signs of strength, hope, and optimism.

Uganda mental health country profile.

With the help of the International Consortium for Mental Health Policy and Services, data on country mental health services was gathered through a descriptive, cross sectional study. The study population included policymakers, health providers and consumers of health services. Data was collected at national level from relevant sectors including the Ministry of Health, Butabika National Referral Mental Hospital and four rural districts. The districts were purposively selected because of existing consumer groups. Quantitative data was collected by interviewer-administered questionnaire and record reviews at hospitals and district headquarters. It was observed that the country has inadequate numbers of mental health professionals with poor mental health funding. Such factors, compounded with inappropriate cultural beliefs, are major obstacles to the delivery of mental health services. There is however an attempt by the Government to improve mental health services. The current health policy is an opportunity to improve access to mental health care. Currently there is improved pre-service and in-service training for mental health workers with ongoing rehabilitation and remodelling of the mental health infrastructure in the country. The burden of mental disorders in Uganda is high in a country that is poorly resourced. The majority of the population is rural and still harbours negative cultural beliefs. There is a need to increase advocacy for mental health and develop capacity for professional mental and general health workers to be supported by appropriate policies, facilities and finances.

Social factors related to risk for violence and sexually transmitted infections/HIV among Asian massage parlor workers in San Francisco.

Asian women who work at massage parlors in San Francisco have high levels of risk for sexually transmitted infections (STIs), including HIV, and being victims of violence, which jeopardizes their health and wellbeing. On the basis of mapping, the targeted districts in San Francisco where massage parlors were located, 23 massage parlors were identified where commercial sex activity took place. Using snowball-sampling methods, 43 Asian female massage parlor workers were recruited for focus groups; 21 participants were Vietnamese and 22 were Thai. Qualitative analyses revealed frequent exposure to violence including verbal or physical abuse from customers and gang members, as well as persistent HIV risk behaviors associated with multiple daily sex partners, inconsistent condom use with customers, and forced sex. Social factors related to gender, immigration status, and socioeconomic status appeared to be closely tied to the health and wellbeing of Asian masseuses. Study findings suggest that individualized as well as community-level interventions are necessary to improve these women's health and decrease their prolonged exposure to risks for STIs and violence.