Two cases of smallpox from 1540 CE circum-contact (early colonial) Northern Coastal Peru.

OBJECTIVE: This project seeks to create a differential diagnosis for lesions found on the skeletal remains of two children as a means to explore the presence of viral disease in 16th- century Peru. MATERIALS: Extremely well-preserved human remains of two children who died between the ages of 1-2 years old, recovered from the circum-contact (∼1540 CE) cemetery in Huanchaco, Peru. METHODS: Macroscopic and radiographic analysis. RESULTS: Both individuals present with cortical thickening, symmetrical destructive lesions, metaphyseal expansion, perforations, exposure of the medullary cavity, resorption of metaphyseal ends and necrosis of the long bones, and deposited reactive new bone. These features are consistent with osteomyelitis variolosa and bacterial osteomyelitis. CONCLUSIONS: Three features of Individuals IG-124 and IG-493 suggest a highly consistent diagnosis of osteomyelitis variolosa: multiple skeletal lesions, the historical context of the area, and the high mortality rate of non-adults in the circum-contact cemetery. SIGNIFICANCE: Although viral infections are ubiquitous and well documented historically, their etiologies are often difficult to determine in archaeological populations. Orthopoxvirus variola (smallpox) is one of the many viruses whose archaeological impact is still under explored in skeletal remains. LIMITATIONS: The absence of smallpox in other children from the Huanchaco cemetery creates difficulty in ascertaining true prevalence rates or information on potential outbreaks. SUGGESTIONS FOR FURTHER RESEARCH: Further research analyzing aDNA from calculus and/or residues using a DIP-GC-MS method might create a better understanding of how smallpox spread through the region.

The Rhetoric of Decolonizing Global Health Fails to Address the Reality of Settler Colonialism. Gaza as a Case in Point.

This editorial critiques the existing literature on decolonizing global health, using the current assault on health in Gaza as a case in point. It argues that the failure to address the ongoing violence and blatant targeting of health facilities, personnel and innocent civilians demonstrates most clearly the limitations of an approach that is strong on rhetoric and weak on mounting a forthright challenge to the entire system supporting and perpetuating settler colonialism. We propose a more radical rethinking of the position of global health institutions within the current neoliberal system and of the systems of knowledge production that continue to underpin the existing colonial approach to the health of victims of settler colonialism.

Counter-narratives of active aging: Disability, trauma, and joy in the age-friendly city.

Dominant narratives about late life promote active aging, while anti-aging ones mobilize tropes of decline and irrelevance. In contrast, counter-narratives raise questions that spark new conversations about the promising practices that could foster more age-friendly cities. In this article, we describe our feminist and ethnographic approach to interviews and digital storytelling that aim to amplify the voices of marginalized older adults living with disability, violence, and colonialism, and share findings from this endeavor. We discuss the interviews with, and stories shared, by two disabled older adults - an Indigenous woman and a white paraplegic man - and the aging futures their counter-stories suggest. These stories reveal these participants' ongoing struggles to create meaning in their lives, and how their relationships to the physical, cultural, and social environment of the city, including its supports and services, can both support and hinder this becoming.

Radiologists' Role in Decolonizing Global Health.

The colonial origins and power imbalances between Western high-income countries and low- and middle-income countries (LMICs) are barriers to self-reliance and sustained structural improvements to health care systems. Radiologists working in global health (global radiologists) are tasked with improving the state of imaging in LMICs while mitigating the effects of colonial structures and processes. To accomplish this, we need to be aware of factors such as colonialism, neocolonialism, parachute research, and brain drain that contribute to global health inequities. Potential solutions to decolonizing global radiology include commitment to understanding local context; strengthening local capacity for technology advancement, research, and development; and policies and educational programs to combat medical brain drain from LMICs. In this article, we describe how the legacies of colonialism can interfere with improving health in LMICS, despite the best intentions, and provide a call to action for decolonizing our field with intentional approaches and equitable partnerships that emphasize investments in sustainable infrastructure, robust training of personnel, and policies that support self-reliance to match true health system strengthening with our passion for addressing health equity.

The Colonial History of Systemic Racism: Insights for Psychological Science.

The psychological study of systemic racism can benefit from the converging insights of "Black Marxism" and development economics, which illustrate how modern systemic racism is rooted in the political and economic institutions established during the historical period of European colonization. This article explores how these insights can be used to study systemic racism and challenge scientific racism in psychology by rethinking traditional research paradigms to incorporate the histories of race, class, and capitalism. Antiracism strategies that make use of these histories are also discussed, which include disrupting the psychological processes that sustain racist systems.

Colonialism versus Imperialism.

Contemporary scholars routinely argue colonialism and imperialism are indistinguishable. In this essay, I challenge this argument. While it is true the "colonial" and "imperial" overlap and intersect historically, I argue there is a central thread of modern colonialism as an ideology that can be traced from the seventeenth century to mid-twentieth century that was not only distinct from-but often championed in explicit opposition to-imperialism. I advance my argument in four parts. First, I identify key ways in which the colonial can be distinguished from the imperial, including most importantly the specific kind of productive power inherent in colonialism. Second, I examine how colonialism and imperialism evolve in meaning and are redefined by both champions and critics, in relation to each other in the late nineteenth/early twentieth centuries. Third, I examine the historical moment when colonialism and imperialism fully conflate after WWII through the UN process of decolonization as the "salt water thesis" delimits colonialism to mean foreign racialized domination, and it thus becomes synonymous with imperialism. I conclude with an analysis of why the distinction still matters in both theory and practice.

The Impact of Colonialism on Surgical Training Structures in Africa Part 1: Contextualizing the Past, Present, and Future.

Since the first African country attained independence from colonial rule, surgical training on the continent has evolved along 3 principal models. The first is a colonial, local master-apprentice model, the second is a purely local training model, and the third is a collegiate intercountry model. The 3 models exist currently and there are varied perceptions of their relative merits in training competent neurosurgeons. We reviewed the historical development of training and in an accompanying study, seek to describe the complex array of surgical training pathways and explore the neocolonial underpinnings of how these various models of training impact today the development of surgical capacity in Africa. In addition, we sought to better understand how some training systems may contribute to the widely recognized "brain drain" of surgeons from the African continent to high income countries in Europe and North America. To date, there are no published studies evaluating the impact of surgical training systems on skilled workforce emigration out of Africa. This review aims to discover potentially addressable sources of improving healthcare and training equity in this region.

Imperial algorithms: Contemporary manifestations of racism and colonialism.

In this special issue, we invited contributions that critically examined issues of imperialism, colonialism, power, justice, etc. to expand the canon of anticolonial scholarship and critical scholarship in community psychology. Our two objectives were: (1) to build on the canon of anticolonial and critical race scholarship to cultivate an empirical and theoretical body of work and conceptual frameworks about racism and colonialism within the field of community psychology and (2) to unpack the different manifestations of racism in society from the lens of community psychology and reflect on the implications of these varied forms of injustice in the contemporary moment. Rooted in African epistemology and methodology (Martin, 2012), we find the concept of the algorithm to serve as a potent metaphor for the ways in which these oppressive structures operate given the prevalence of algorithms in our daily lives and the algorithm is symbolic of the information age and predictive powers that seem to govern society beyond conscious control. In this sense, imperial algorithms are these structures, patterns, processes, and procedures that perpetuate imperialism. These imperial algorithms manifest as neo-colonialism, surveillance, social engineering, carcerality, reality warping of contemporary racism, health disparities exacerbated by COVID-19, and environmental grids of oppression.

The impact of colonialism on head and neck cancer in Brazil: a historical essay focussing on tobacco, alcohol and slavery.

Colonialism's enduring impact on Brazil has had significant implications for health and oncology outcomes. This historical essay delves into the profound changes brought about by the transatlantic slave trade from Africa to the Americas, particularly in terms of its influence on the economy, sociocultural habits, and health outcomes. This essay explores the enduring connections between the colonial period's operational dynamics in Brazil and the current epidemiological panorama of head and neck cancer (HNC). The examination provides original insights on the role of tobacco and alcohol production and consumption, alongside the investigation of structural racism, which contributes to disparities in access to diagnosis, treatment, and prognosis for patients with HNC. This article presents novel visions and an analysis of evidence-based strategies to disrupt the adverse impact of colonialism's legacy on the epidemiology of HNC in Brazil.

"There's a little bit of mistrust": Red River Métis experiences of the H1N1 and COVID-19 pandemics.

We examined the perspectives of the Red River Métis citizens in Manitoba, Canada, during the H1N1 and COVID-19 pandemics and how they interpreted the communication of government/health authorities' risk management decisions. For Indigenous populations, pandemic response strategies play out within the context of ongoing colonial relationships with government institutions characterized by significant distrust. A crucial difference between the two pandemics was that the Métis in Manitoba were prioritized for early vaccine access during H1N1 but not for COVID-19. Data collection involved 17 focus groups with Métis citizens following the H1N1 outbreak and 17 focus groups during the COVID-19 pandemic. Métis prioritization during H1N1 was met with some apprehension and fear that Indigenous Peoples were vaccine-safety test subjects before population-wide distribution occurred. By contrast, as one of Canada's three recognized Indigenous nations, the non-prioritization of the Métis during COVID-19 was viewed as an egregious sign of disrespect and indifference. Our research demonstrates that both reactions were situated within claims that the government does not care about the Métis, referencing past and ongoing colonial motivations. Government and health institutions must anticipate this overarching colonial context when making and communicating risk management decisions with Indigenous Peoples. In this vein, government authorities must work toward a praxis of decolonization in these relationships, including, for example, working in partnership with Indigenous nations to engage in collaborative risk mitigation and communication that meets the unique needs of Indigenous populations and limits the potential for less benign-though understandable-interpretations.

Reflective questioning to guide socially just global health reform: a narrative review and expert elicitation.

Recent research has highlighted the impacts of colonialism and racism in global health, yet few studies have presented concrete steps toward addressing the problems. We conducted a narrative review to identify published evidence that documented guiding frameworks for enhancing equity and inclusion in global health research and practice (GHRP). Based on this narrative review, we developed a questionnaire with a series of reflection questions related on commonly reported challenges related to diversity, inclusion, equity, and power imbalances. To reach consensus on a set of priority questions relevant to each theme, the questionnaire was sent to a sample of 18 global health experts virtually and two rounds of iterations were conducted. Results identified eight thematic areas and 19 reflective questions that can assist global health researchers and practitioners striving to implement socially just global health reforms. Key elements identified for improving GHRP include: (1) aiming to understand the historical context and power dynamics within the areas touched by the program; (2) promoting and mobilizing local stakeholders and leadership and ensuring measures for their participation in decision-making; (3) ensuring that knowledge products are co-produced and more equitably accessible; (4) establishing a more holistic feedback and accountability system to understand needed reforms based on local perspectives; and (5) applying systems thinking to addressing challenges and encouraging approaches that can be sustained long-term. GHRP professionals should reflect more deeply on how their goals align with those of their in-country collaborators. The consistent application of reflective processes has the potential to shift GHRP towards increased equity.

The Impact of Colonialism on Surgical Training Structures In Africa Part 2: Surveying Current and Past Trainees.

BACKGROUND: As a result of gradual independence from colonial rule over the course of the past century, Africa has developed and evolved 3 primary surgical training structures: an extracontinental colonial model, an intracontinental college-based model, and several smaller national or local models. There is consistent evidence of international brain drain of surgical trainees and an unequal continental distribution of surgeons; however there has not, to date, been an evaluation of the impact colonialism on the evolution of surgical training on the continent. This study aims to identify the etiologies and consequences of this segmentation of surgical training in Africa. METHODS: This is a cross-sectional survey of the experience and perspectives of surgical training by current African trainees and graduates. RESULTS: A surgeon's region of residence was found to have a statistically significant positive association with that of a surgeon's training structure (P <0.001). A surgeon's professional college or structure of residency has a significantly positive association with desire to complete subspecialty training (P = 0.008). College and structure of residency also are statistically significantly associated with successful completion of subspecialty training (P < 0.001). CONCLUSIONS: These findings provide evidence to support the concept that the segmentation of surgical training structures in Africa, which is the direct result of prior colonization, has affected the distribution of trainees and specialists across the continent and the globe. This maldistribution of African surgical trainees directly impacts patient care, as the surgeon-patient ratios in many African countries are insufficient. These inequities should be acknowledged addressed and rectified to ensure that patients in Africa receive timely and appropriate surgical care.

News and Perspectives: Words matter in primatology.

Postings on social media on Twitter (now X), BioAnthropology News (Facebook), and other venues, as well as recent publications in prominent journals, show that primatologists, ecologists, and other researchers are questioning the terms "Old World" and "New World" due to their colonial implications and history. The terms are offensive if they result in erasing Indigenous voices and history, ignoring the fact that Indigenous peoples were in the Americas long before European colonization. Language use is not without context, but alternative terminology is not always obvious and available. In this perspective, we share opinions expressed by an international group of primatologists who considered questions about the use of these terms, whether primatologists should adjust language use, and how to move forward. The diversity of opinions provides insight into how conventional terms used in primatological research and conservation may impact our effectiveness in these domains.

The borderline of science: Western exploration and study of Chinese insect white wax from the seventeenth to the nineteenth century.

Insect white wax is a type of biological wax, mainly produced in Jiading Fu (now Leshan, Sichuan province) in southern Sichuan province, also known as Sichuan wax. It is a special export product in China and an important source of income for local wax farmers. From the seventeenth century onward, Westerners who traveled deep into southwestern China studied the wax, including its geographical distribution, biological experiments, and production techniques. They assessed its commercial prospects and strove to introduce it to Europe and the areas it controlled. Based on the reports of the European scholars' expeditions, travelogues, conference proceedings, and correspondence, this paper examines the history of Western research on the insect white wax and aims to investigate the underlying motivations for the exploration activities, proposes the concept of "object colonialism," and discusses the impact of adopting objects from their countries of origin on the world's political and economic landscape.

Knowledge Gaps Regarding Indigenous Health in Occupational Therapy: A National Survey.

Background. There is a need for the occupational therapy profession to respond to the Truth and Reconciliation Commission of Canada Calls to Action and work towards supporting the health and well-being of Indigenous Peoples. Purpose. (1) To determine the knowledge gaps of occupational therapists about Indigenous health and (2) to create recommendations to address identified gaps and inform responses from the profession. Method. A national needs survey was created and distributed to occupational therapists across Canada to determine the knowledge of occupational therapists about Indigenous health. Survey results were analyzed using thematic analysis and descriptive statistics. Findings. Data collected from 364 survey responses informed six distinct themes representing knowledge gaps of occupational therapists related to Indigenous health as follows: lack of foundational knowledge, power relations, lifelong learner, need for appropriate tools/approaches, respectful collaboration, and environmental influences. Implications. The project offers insight into the role of the occupational therapy profession in the process of reconciliation. Insights are focused on decolonizing occupational therapy practice, building trusting relationships with Indigenous Peoples, and the provision of appropriate training for occupational therapists to engage in culturally safer practices.

Recovering the status quo: tipping points and earthquake aftermaths in colonial India.

Scholars of disaster politics debate how far natural hazards cause or catalyse political change. This paper builds on recent scholarship on tipping points and social contracts to argue that two case studies of historical earthquakes in 1930s British-colonised India invite a focus on the dynamics of cooperation and conflict between state and non-state actors. Officials of the colonial state and its nationalist rivals cooperated after one earthquake even though they otherwise bitterly opposed each other. Cooperation broke down after the second event, just one year later. Yet, in both cases, officials and nationalist leaders shared a broad vision for Indian society, which pushed both sides actively to seek to recover the social and economic status quo ante, preventing potential tipping points from crystallising. These case studies reveal how and why highly fraught social contracts can survive major disasters. The colonial state's transient and reactive approach to disaster governance continued to impact on post-independence India.

Non-Indigenous and Indigenous food-related interactions: How does the transmission of a normativity perpetuate colonialism?

OBJECTIVES: Type 2 diabetes has been considered an epidemic among Indigenous Peoples in Canada. They also suffer more from obesity than non-Indigenous people in the country, a condition that is considered an epidemic worldwide. Various public health and social services professionals are working in Indigenous communities across the country to raise awareness about certain lifestyle habits. The main objective of this article is to analyze the food normativity transmitted to an Indigenous population and to examine its reception. More specifically, the aim is to understand the opportunities of transmission (content and format) and the relational dynamics that these encounters between mostly non-Indigenous professionals and Indigenous Peoples imply. METHOD: The analysis is based on an ethnographic fieldwork in the Anicinabe community of Lac Simon (Abitibi, Quebec). Conducted with a relational approach, interviews and participant observation were carried out. RESULTS: It appears that the Anicinabek have a great knowledge of the "good" eating habits as defined by a biomedical food normativity. A reflexive analysis of my presence in the community as a non-Indigenous anthropologist and an analysis of the Anicinabek's responses to food recommendations lead me to argue that a form of food colonialism, inscribed in welfare (assistance) colonialism, persists while food surveillance seems to be integrated by the Anicinabek. This food normativity is the bearer of a biomedical conception of food and the colonial history of the country colours its transmission to Indigenous Peoples. CONCLUSION: Greater autonomy, namely Indigenous food sovereignty, seems necessary to deconstruct this food assistance structure.

RéSUMé: OBJECTIFS: Depuis plusieurs années déjà, le diabète de type 2 est considéré au stade épidémique chez les Premières Nations au Canada. Ils souffrent aussi davantage d'obésité que les non-Autochtones au pays, une condition qualifiée d'épidémie à l'échelle mondiale. Divers représentants de la santé publique et des services sociaux travaillent dans les communautés autochtones du pays notamment pour les sensibiliser à certaines habitudes de vie. L'objectif principal de cet article est d'analyser la normativité alimentaire transmise à une population autochtone et à en examiner la réception. Plus précisément, il s'agit d'examiner les occasions de transmission (contenu et format) et de comprendre les dynamiques relationnelles que ces occasions de rencontre entre professionnels non-autochtones et Autochtones impliquent. MéTHODE: La présente analyse s'appuie sur des données récoltées dans le cadre d'une enquête ethnographique d'un an au sein de la communauté anicinabe de Lac Simon (Abitibi, Québec). Menées avec une approche relationnelle, des entrevues avec des membres de la communauté ainsi que de l'observation participante ont été réalisées permettant ainsi un accès aux quotidiens des Anicinabek autant au sein de la réserve que lors de séjours sur le territoire. RéSULTATS: À Lac Simon, comme dans d'autres communautés autochtones, les sources de sensibilisation sont nombreuses et accessibles depuis des années : formations, ateliers, activités communautaires et rencontres individualisées sur demande. D'ailleurs, une connaissance des « bonnes habitudes ¼ alimentaires par les Anicinabek est notable. Une analyse réflexive de ma présence au sein de la communauté en tant qu'anthropologue non-autochtone et une analyse des réponses des Anicinabek face aux conseils alimentaires m'amène à soutenir qu'une forme de colonialisme alimentaire, inscrit dans un colonialisme d'assistance, persiste alors qu'une surveillance alimentaire apparait comme intégrée par les Anicinabek. Cette normativité alimentaire est porteuse d'une conception biomédicale de l'alimentation et l'historique colonial du pays teinte sa transmission au sein des populations autochtones. CONCLUSION: Une plus grande autonomie, voire une souveraineté alimentaire autochtone, semble nécessaire pour déconstruire cet encadrement alimentaire.

Filipino Americans' Social and Cultural Experiences of Type 2 Diabetes Management: Cultural Paradox, Ownership, and Success Definition.

BACKGROUND: Although type 2 diabetes mellitus (T2DM) disproportionately affects Filipino Americans, they have not received much attention in the literature. Focusing on how Filipino Americans' social and cultural contextual experiences affect their self-management is critical. This study examined T2DM self-management among Filipino Americans by describing their sociocultural experiences, strategies, and significance of self-management. METHOD: An interpretive descriptive qualitative design was used. Data were analyzed using thematic analysis. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: Filipino Americans (n = 19) with T2DM were interviewed. Three themes emerged: (a) cultural paradox of being Filipino American, (b) movement from invisibility to ownership of T2DM, and (c) definition of successful management of T2DM. CONCLUSION: Results contribute to a greater understanding of Filipino Americans' T2DM self-management experiences. Implications include the provision of culturally congruent health care, being aware of Filipino Americans' sociocultural experiences, and involvement of family/community.

Unsettling Settler Colonialism in Research: Strategies Centering Native American Experience and Expertise in Responding to Substance Misuse and Co-occurring Sexual Risk-Taking, Alcohol-Exposed Pregnancy, and Suicide Prevention Among Young People.

Native American (NA) populations in the USA (i.e., those native to the USA which include Alaska Natives, American Indians, and Native Hawaiians) have confronted unique historical, sociopolitical, and environmental stressors born of settler colonialism. Contexts with persistent social and economic disadvantage are critical determinants of substance misuse and co-occurring sexual risk-taking and suicide outcomes, as well as alcohol exposed pregnancy among NA young people (i.e., adolescents and young adults). Despite intergenerational transmission of resistance and resiliencies, NA young people face continued disparities in substance misuse and co-occurring outcomes when compared to other racial and ethnic groups in the USA. The failure in progress to address these inequities is the result of a complex set of factors; many of which are structural and rooted in settler colonialism. One of these structural factors includes barriers evident in health equity research intended to guide solutions to address these disparities yet involving maintenance of a research status quo that has proven ineffective to developing these solutions. Explicitly or implicitly biased values, perspectives, and practices are deeply rooted in current research design, methodology, analysis, and dissemination and implementation efforts. This status quo has been supported, intentionally and unintentionally, by researchers and research institutions with limited experience or knowledge in the historical, social, and cultural contexts of NA communities. We present a conceptual framework illustrating the impact of settler colonialism on current research methods and opportunities to unsettle its influence. Moreover, our framework illustrates opportunities to resist settler colonialism in research. We then focus on case examples of studies from the Intervention Research to Improve Native American Health program, funded by the NIH, that impact substance use and co-occurring health conditions among NA young people.