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1.
Philos Trans R Soc Lond B Biol Sci ; 377(1851): 20210144, 2022 05 23.
Artigo em Inglês | MEDLINE | ID: mdl-35369747

RESUMO

Humans are able to overcome coordination and collective action problems to mobilize for large-scale intergroup conflict even without formal hierarchical political institutions. To better understand how people rally together for warfare, I examine how the politically decentralized Turkana pastoralists in Kenya assemble raiding parties. Based on accounts of 54 Turkana battles obtained from semi-structured interviews with Turkana warriors, I describe the precipitating factors, recruitment process, exhortations and leadership involved in marshalling a raiding party. Details of this ethnographic case shed light on how voluntary informal armies are mobilized, and illustrate how culturally evolved institutions harness our cooperative dispositions at multiple scales to produce large-scale warfare. This article is part of the theme issue 'Intergroup conflict across taxa'.


Assuntos
Pesquisa , Guerra , Animais , Antropologia Cultural , Bovinos , Humanos , Quênia
2.
BMC Health Serv Res ; 22(1): 430, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365140

RESUMO

BACKGROUND: Transitional care implies the transfer of patients within or across care settings in a seamless and safe way. For frail, older patients with complex health issues, high-quality transitions are especially important as these patients typically move more frequently within healthcare settings, requiring treatment from different providers. As transitions of care for frail people are considered risky, securing the quality and safety of these transitions is of great international interest. Nevertheless, despite efforts to improve quality in transitional care, research indicates that there is a lack of clear guidance to deal with practical challenges that may arise. The aim of this article is to synthesise older patients, informal caregivers and healthcare professionals' experiences of challenges to achieving high-quality transitional care. METHODS: We used the seven-step method for meta-ethnography originally developed by Noblit and Hare. In four different but connected qualitative projects, the authors investigated the challenges to transitional care for older people in the Norwegian healthcare system from the perspectives of older patients, informal caregivers and healthcare professionals. In this paper, we highlight and discuss the cruciality of these challenging issues by synthesising the results from twelve articles. RESULTS: The analysis resulted in four themes: i) balancing person-centred versus efficient care, ii) balancing everyday patient life versus the treatment of illness, iii) balancing user choice versus "What Matters to You", and iv) balancing relational versus practical care. These expressed challenges represent tensions at the system, organisation and individual levels based on partial competing assumptions on person-centred-care-inspired individualisation endeavours and standardisation requirements in transitional care. CONCLUSIONS: There is an urgent need for a clearer understanding of the tension between standardisation and individualisation in transitional care pathways for older patients to ensure better healthcare quality for patients and more realistic working environments for healthcare professionals. Incorporating a certain professional flexibility within the wider boundary of standardisation may give healthcare professionals room for negotiation to meet patients' individual needs, while at the same time ensuring patient flow, equity and evidence-based practice.


Assuntos
Cuidadores , Cuidado Transicional , Idoso , Antropologia Cultural , Atenção à Saúde , Pessoal de Saúde , Humanos
3.
PLoS One ; 17(4): e0264509, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35389995

RESUMO

A central question in behavioral and social sciences is understanding to what extent cultural traits are inherited from previous generations, transmitted from adjacent populations or produced in response to changes in socioeconomic and ecological conditions. As quantitative diachronic databases recording the evolution of cultural artifacts over many generations are becoming more common, there is a need for appropriate data-driven methods to approach this question. Here we present a new Bayesian method to infer the dynamics of cultural traits in a diachronic dataset. Our method called Evoked-Transmitted Cultural model (ETC) relies on fitting a latent-state model where a cultural trait is a latent variable which guides the production of the cultural artifacts observed in the database. The dynamics of this cultural trait may depend on the value of the cultural traits present in previous generations and in adjacent populations (transmitted culture) and/or on ecological factors (evoked culture). We show how ETC models can be fitted to quantitative diachronic or synchronic datasets, using the Expectation-Maximization algorithm, enabling estimating the relative contribution of vertical transmission, horizontal transmission and evoked component in shaping cultural traits. The method also allows to reconstruct the dynamics of cultural traits in different regions. We tested the performance of the method on synthetic data for two variants of the method (for binary or continuous traits). We found that both variants allow reliable estimates of parameters guiding cultural evolution, and that they outperform purely phylogenetic tools that ignore horizontal transmission and ecological factors. Overall, our method opens new possibilities to reconstruct how culture is shaped from quantitative data, with possible application in cultural history, cultural anthropology, archaeology, historical linguistics and behavioral ecology.


Assuntos
Evolução Cultural , Antropologia Cultural , Arqueologia/métodos , Teorema de Bayes , Filogenia
4.
Genome Biol Evol ; 14(4)2022 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-35445261

RESUMO

The population dynamics that followed the Out of Africa (OoA) expansion and the whereabouts of the early migrants before the differentiation that ultimately led to the formation of Oceanian, West and East Eurasian macropopulations have long been debated. Shedding light on these events may, in turn, provide clues to better understand the cultural evolution in Eurasia between 50 and 35 ka. Here, we analyze Eurasian Paleolithic DNA evidence to provide a comprehensive population model and validate it in light of available material culture. Leveraging on our integrated approach we propose the existence of a Eurasian population Hub, where Homo sapiens lived between the OoA and the broader colonization of Eurasia, which was characterized by multiple events of expansion and local extinction. A major population wave out of Hub, of which Ust'Ishim, Bacho Kiro, and Tianyuan are unadmixed representatives, is broadly associated with Initial Upper Paleolithic lithics and populated West and East Eurasia before or around 45 ka, before getting largely extinct in Europe. In this light, we suggest a parsimonious placement of Oase1 as an individual related to Bacho Kiro who experienced additional Neanderthal introgression. Another expansion, started before 38 ka, is broadly associated with Upper Paleolithic industries and repopulated Europe with sporadic admixtures with the previous wave (GoyetQ116-1) and more systematic ones, whereas moving through Siberia (Yana, Mal'ta). Before these events, we also confirm Zlatý Kun as the most basal human lineage sequenced to date OoA, potentially representing an earlier wave of expansion out of the Hub.


Assuntos
Homem de Neandertal , África , Animais , Antropologia Cultural , Europa (Continente) , Genética Populacional , Humanos , Homem de Neandertal/genética , Sibéria
5.
BMC Health Serv Res ; 22(1): 545, 2022 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-35461276

RESUMO

BACKGROUND: The use of variable rate intravenous insulin infusion (VRIII) is a complex process that has consistently been implicated in reports of error and consequent harm. Investment in patient safety has focused mainly on learning from errors, though this has yet to be proved to reduce error rates. The Resilient Health Care approach advocates learning from everyday practices. Video reflexive ethnography (VRE) is an innovative methodology used to capture everyday practices, reflect on and thereby improve these. This study set out to explore the use of VRIIIs by utilising the VRE methodology. METHODS: This study was conducted in a Vascular Surgery Unit. VRE methodology was used to collect qualitative data that involved videoing healthcare practitioners caring for patients treated with VRIII and discussing the resulting clips with participants in reflexive meetings. Transcripts of these were subjected to thematic analysis. Quantitative data (e.g. blood glucose measurements) were collected from electronic patient records in order to contextualise the outcomes of the video-observed tasks. RESULTS: The use of VRE in conjunction with quantitative data revealed that context-dependent adaptations (seeking verbal orders to treat hypoglycaemia) and standardised practices (using VRIII guidelines) were strategies used in everyday work. Reflexive meetings highlighted the challenges faced while using VRIII, which were mainly related to lack of clinical knowledge, e.g. prescribing/continuing long-acting insulin analogues alongside the VRIII, and problems with organisational infrastructure, i.e. the wireless blood glucose meter results sometimes not updating on the electronic system. Reflexive meetings also enabled participants to share the meanings of the reality surrounding them and encouraged them to suggest solutions tailored to their work, for example face-to-face, VRIII-focused training. CONCLUSIONS: VRE deepened understanding of VRIII by shedding light on its essential tasks and the challenges and adaptations entailed by its use. Future research might focus on collecting data across various units and hospitals to develop a full picture of the use of VRIIIs.


Assuntos
Hipoglicemia , Insulina , Antropologia Cultural , Glicemia , Humanos , Infusões Intravenosas
6.
BMC Public Health ; 22(1): 828, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35468753

RESUMO

BACKGROUND: Understanding people's subjective experiences of everyday lives with chronic health conditions such as diabetes is important for appropriate healthcare provisioning and successful self-care. This study explored how individuals with type 2 diabetes in northern Vietnam handle the everyday life work that their disease entails. METHODS: Detailed ethnographic data from 27 extended case studies conducted in northern Vietnam's Thái Bình province in 2018-2020 were analyzed. RESULTS: The research showed that living with type 2 diabetes in this rural area of Vietnam involves comprehensive everyday life work. This work often includes efforts to downplay the significance of the disease in the attempt to stay mentally balanced and ensure social integration in family and community. Individuals with diabetes balance between disease attentiveness, keeping the disease in focus, and disease discretion, keeping the disease out of focus, mentally and socially. To capture this socio-emotional balancing act, we propose the term "everyday disease diplomacy." We show how people's efforts to exercise careful everyday disease diplomacy poses challenges to disease management. CONCLUSIONS: In northern Vietnam, type 2 diabetes demands daily labour, as people strive to enact appropriate self-care while also seeking to maintain stable social connections to family and community. Health care interventions aiming to enhance diabetes care should therefore combine efforts to improve people's technical diabetes self-care skills with attention to the lived significance of stable family and community belonging.


Assuntos
Diabetes Mellitus Tipo 2 , Diplomacia , Antropologia Cultural , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Humanos , Autocuidado/psicologia , Vietnã/epidemiologia
7.
Subst Abuse Treat Prev Policy ; 17(1): 24, 2022 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-35346260

RESUMO

BACKGROUND: This meta-ethnography investigates how young adults describe their tobacco use, smoking identities and pathways into and out of regular smoking, to inform future smoking prevention and harm reduction interventions. METHODS: Eight databases were systematically searched using keywords and indexed terms. Studies were included if they presented qualitative data from young adults aged 16-25 reporting smoking histories and/or smoking identities from countries culturally similar to the UK. A systematic and rigorous meta-ethnographic approach was employed, consistent with Noblit and Hare's methodology. RESULTS: Thirty papers were included. Reasons stated for taking up smoking and becoming a smoker included alleviating stress, transforming one's identity, and coping with the transition to further education, employment or leaving home. Many used smoking to aid acceptance within new peer groups, particularly when alcohol was present. Smoking was also perceived as an act of resistance and a coping mechanism for those with marginalised identities. Barriers to quitting smoking included young adults' minimisation or denial of the health risks of smoking and not identifying with "being a smoker". CONCLUSIONS: This meta-ethnography may provide a blueprint to inform the development of health and wellbeing interventions designed specifically for young adults. Smoking cessation interventions should be co-designed with young adults based on their perceived needs, resonant with their desire to quit in the future at key milestones. Harm reduction interventions should address the social aspect of addiction, without reinforcing stigma, particularly for those with marginalised identities.


Assuntos
Abandono do Hábito de Fumar , Fumar , Adolescente , Adulto , Antropologia Cultural , Humanos , Fumar/epidemiologia , Abandono do Hábito de Fumar/métodos , Fumar Tabaco , Uso de Tabaco , Adulto Jovem
8.
BMJ Open ; 12(3): e061754, 2022 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-35301215

RESUMO

INTRODUCTION: Prescribing and medication use in palliative care is a multistep process. It requires systems coordination and is enacted through activities of patients, informal carers and professionals. This study compares practice to idealised descriptions of what should happen; identifying when, how and why process disturbances impact on quality and safety. Our objectives are to:Document an intended model (phase 1, scoping review).Refine the model with study of practice (phase 2, ethnography).Use the model to pinpoint 'hot' (viewed as problematic by participants) and 'cold' spots (observed as problematic by researchers) within or when patients move across three contexts-hospice, hospital and community (home).Create learning recommendations for quality and safety targeted at underlying themes and contributing factors. METHODS AND ANALYSIS: The review will scope Ovid Medline, CINAHL and Embase, Google Scholar and Images-no date limits, English language only. The Population (palliative), Concept (medication use), Context (home, hospice, hospital) framework defines inclusion/exclusion criteria. Data will be extracted to create a model illustrating how processes ideally occur, incorporating multiple steps of typical episodes of prescribing and medication use for symptom control. Direct observations, informal conversations around acts of prescribing and medication use, and semistructured interviews will be conducted with a purposive sample of patients, carers and professionals. Drawing on activity theory, we will synthesise analysis of both phases. The analysis will identify when, how and why activities affect patient safety and experience. Generating a rich multivoiced understanding of the process will help identify meaningful targets for improvement. ETHICS AND DISSEMINATION: Ethical approval granted by the Camden & Kings Cross NHS Regional Ethics Committee (21/LO/0459). A patient and public involvement (PPI) coinvestigator, a multiprofessional steering group and a PPI engagement group are working with the research team. Dissemination of findings is planned through peer-reviewed publications and a stakeholder (policymakers, commissioners, clinicians, researchers, public) report/dissemination event.


Assuntos
Hospitais para Doentes Terminais , Antropologia Cultural , Cuidadores , Humanos , Cuidados Paliativos , Projetos de Pesquisa , Literatura de Revisão como Assunto
9.
Am J Public Health ; 112(S2): S199-S205, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35349326

RESUMO

Objectives. To characterize the effects of the onset of the COVID-19 pandemic on the risk environment of people who use drugs (PWUD) in Tijuana, Mexico. Methods. We used intensive participant-observation ethnography among street-based PWUD and key informants, such as frontline physicians and harm reductionists. Results. PWUD described an unprecedented cessation of police violence and extortion during the initial pandemic-related lockdown, though this quickly reversed and police violence worsened. Government-provided housing and medical treatment with methadone were temporarily provided to PWUD in a dedicated clinic, yet only for PWUD with COVID-19 symptoms. Concurrently, non‒COVID-19‒related hospital care became virtually inaccessible, and many PWUD died of untreated, chronic illnesses, such as hepatitis C, and soft-tissue infections. Border closures, decreases in social interaction, and reduced drug and sex tourism resulted in worsening food, income, and housing insecurity for many PWUD. By contrast, potent illicit drugs remained easily accessible in open-air drug markets. Conclusions. The pandemic exacerbated health risks for PWUD but also offered profound glimpses of beneficial structural changes. Efforts are needed in Tijuana and elsewhere to institutionalize positive pandemic-related shifts and ameliorate novel harms for PWUD. (Am J Public Health. 2022;112(S2):S199-S202. https://doi.org/10.2105/AJPH.2022.306796).


Assuntos
COVID-19 , Usuários de Drogas , Antropologia Cultural , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , México/epidemiologia , Pandemias
10.
Med Anthropol ; 41(3): 287-301, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35266844

RESUMO

Drawing on ethnographic research, I examine the evolution of HIV support groups and biosociality during the "treat-all era" in eSwatini. I show how support groups are shaped by local actors to cater to a need for social solidarity that transcends diagnostic status, and thereby move beyond donors' HIV-centric rationales to use the groups for HIV treatment scale-up. In this particular phase of the HIV epidemic, I suggest, support groups make up a particular kind of biosociality, which is shaped by shared experiences of structural vulnerability to chronic illness, and a desire to be prepared for future diseases and other misfortune.


Assuntos
Infecções por HIV , Antropologia Cultural , Antropologia Médica , Essuatíni , Humanos , Grupos de Autoajuda
11.
Glob Health Action ; 15(1): 2034136, 2022 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-35311627

RESUMO

Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and lower-middle-income countries are often developed and implemented top-down, needs and circumstances vary greatly across locations. Our pilot study in Zanzibar improved care through locally co-created intrapartum clinical practice guidelines (CPGs) and associated training (the PartoMa intervention). This intervention was context-tailored with health-care providers in Zanzibar and now scaled up within five maternity units in Dar es Salaam, Tanzania. This PartoMa Scale-up Study thereby provides an opportunity to explore the co-creation process and modification of the intervention in another context and how scale-up might be successfully achieved. The overall protocol is presented in a separate paper. The aim of the present paper is to account for the Scale-up Study's programme theory and qualitative methodology. We introduce social practice theory and argue for its value within the programme theory and towards qualitative explorations of shifts in clinical practice. The theory recognizes that the practice we aim to strengthen - safe and respectful clinical childbirth care - is not practiced in a vacuum but embedded within a socio-material context and intertwined with other practices. Methodologically, the project draws on ethnographic and participatory methodologies to explore current childbirth care practices. In line with our programme theory, explorations will focus on meanings of childbirth care, material tools and competencies that are being drawn upon, birth attendants' motivations and relational contexts, as well as other everyday practices of childbirth care. Insights generated from this study will not only elucidate active ingredients that make the PartoMa intervention feasible (or not) but develop the knowledge foundation for scaling-up and replicability of future interventions based on the principles of co-creation and contextualisation.


Assuntos
Antropologia Cultural , Motivação , Feminino , Humanos , Parto , Projetos Piloto , Gravidez , Tanzânia
12.
BMC Med Educ ; 22(1): 196, 2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35317790

RESUMO

BACKGROUND: In faculty development, understanding each participant's cultural context is important. However, there is scarce evidence on how to improve cultural understanding in faculty development. Cultural anthropology is a discipline that focuses on developing cultural self-awareness by understanding different cultures. Professionals from this field can be crucial to the goal of cultivating cultural awareness among medical educators. The aims of this study are to 1) develop and modify cultural anthropology sessions in faculty development and 2) evaluate the effectiveness of these sessions, including their long-term impacts. METHODS: The cultural anthropology sessions were organized as part of a longitudinal faculty development program-Foundation Course for Medical Education-at Kyoto University in Japan. The study included 47 medical educators participating in faculty development and three lecturers: two cultural anthropologists and a medical educator. We developed the cultural anthropology sessions and implemented them in the longitudinal faculty development program. In these sessions, cultural anthropologists used inquiry-guided reflection. An action research methodology was employed and repeated in four cycles from 2015 to 2018. Qualitative and quantitative data were collected during the action research cycles. The qualitative data were thematically analyzed. RESULTS: The cultural anthropologists' inquiries fostered learning during the sessions, and three themes-cultural relativism, attention to context, and reframing-were synthesized. As a long-term impact of the sessions, the learners reported becoming more aware of the cultural contexts in their daily educational and clinical activities. CONCLUSIONS: The cultural anthropology sessions in the faculty development program were shown to have enhanced the participants' awareness of cultural contexts. The concept and format of these sessions may be used more widely in faculty development programs.


Assuntos
Educação Médica , Docentes de Medicina , Antropologia Cultural , Pesquisa sobre Serviços de Saúde , Humanos , Universidades
13.
Cien Saude Colet ; 27(3): 871-879, 2022 Mar.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-35293465

RESUMO

Drawing on observation-based ethnography, interviews of health personnel and document review, this article describes and examines how, in clinical handling of Chagas disease, infection is treated as latent risk. It suggests that how this risk is managed has enabled a clinical practice to be conducted among people classified as at the indeterminate stage, by adding a dimension of possibility (Is it going to happen?) and potentiality (When and where?). This allows measures to be taken, including administration of medication or permanent monitoring. The reification of latent risk as a phenomenon that is manageable through a process of medicalisation engages, in turn, with other conceptions and specific experiences of risk among the affected groups. Framing the clinical practices deployed to address this risk as objects of study is a first step towards being able to describe and include them concretely in health system organisation.


A través de una etnografía basada en la observación, entrevistas a profesionales y el vaciado de documentación, en este artículo describo y analizo cómo, en la práctica clínica del Chagas, la infección es tratada como un riesgo latente. Sugiero que la gestión que se hace de este riesgo ha posibilitado la práctica clínica entre las personas clasificadas en la etapa indeterminada, añadiendo una dimensión de posibilidad (¿va a pasar?) y de potencialidad (¿cuándo y dónde?) que permite tomar acciones tales como la administración de un medicamento o una monitorización permanente. La reificación del riesgo latente como fenómeno gestionable a través de un proceso de medicalización se articula, a su vez, con otras concepciones y experiencias concretas del riesgo entre los grupos afectados. Situar la práctica clínica de dicho riesgo como objeto de estudio es un primer paso para poderlas describir e incluir como realidades en la organización del sistema de salud.


Assuntos
Antropologia Cultural , Humanos
14.
Cien Saude Colet ; 27(3): 989-998, 2022 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35293476

RESUMO

This study was developed at the intersection of health sciences and anthropology in order to understand the value of traditional Afro-Brazilian Medicine portrayed in houses of Candomblé exploring its member's interactions with the biomedical system of health. The anthropology of health aims to understand the phenomenon of health as a socio-cultural elaboration and from this, develops the notion of cultural health system, the theoretical operator of this study. This proposal can contribute to the challenges faced in the field of collective health by enabling dialogue between cultural health systems, supporting the creation of more effective policies. This ethnographic-inspired article was developed from a specific bibliographic survey, followed by participant observations and interviews with members of the community Ilé Alákétu Asè Ifá Omo Oyá, located in São Paulo. The health practice in candomblé manages to reach gaps left by biomedicine by associating itself in a non-authoritarian, colonialist or exclusive way taking into account the symbolic, cultural, subjective and spiritual processes involved in the processes of illness. This practice brings other possible ways of interpretation, treatment and cure for health problems.


Este estudo foi desenvolvido na interseção entre as ciências da saúde e a antropologia, com finalidade de compreender a importância da medicina tradicional afro-brasileira retratada nas casas de candomblé, explorando interações de seus membros com o sistema biomédico de saúde. A antropologia da saúde objetiva compreender o fenômeno da saúde como uma elaboração sociocultural, e partir disso desenvolve a noção de sistema cultural de saúde, operador teórico deste estudo. Esta proposta pode contribuir para superar os desafios enfrentados no campo da saúde coletiva, ao possibilitar diálogo entre sistemas culturais de saúde, favorecendo a criação de políticas mais eficazes. Este artigo, de inspiração etnográfica, foi desenvolvido a partir do levantamento bibliográfico específico, seguido de observações participantes e entrevistas com membros da comunidade Ilé Alákétu Asè Ifá Omo Oyá, localizada em São Paulo. A prática em saúde no candomblé consegue alcançar lacunas deixadas pela biomedicina, associando de forma não autoritária, colonialista ou excludente saberes de saúde distintos, considerando os processos simbólicos, culturais, subjetivos e espirituais envolvidos nos processos de adoecimento.


Assuntos
Antropologia Cultural , Medicina Tradicional , Brasil , Humanos
15.
BMC Health Serv Res ; 22(1): 361, 2022 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-35303872

RESUMO

BACKGROUND: Patient and public involvement (PPI) is a cornerstone in enhancing healthcare research and delivery, including clinical guideline development. Health outcomes concern changes in the health status of an individual or population that are attributable to an intervention. Discussion of relevant health outcomes impacts the resulting clinical guidelines for practice. This study explores how the input of PPI contributors at the National Institute of Health and Care Excellence (NICE) is integrated into guideline development, particularly in relation to health outcome selection. METHODS: The study used an ethnographic methodological approach. Data comprised: observations of committee meetings, scoping workshops and training sessions, and in-depth interviews with PPI contributors, health professionals and chairs from clinical guideline development committees. Data were analysed thematically. RESULTS: PPI contributors' input in the guideline development process was often of limited scope, particularly in selecting health outcomes. Key constraints on their input included: the technical content and language of guidelines, assumed differences in the health-related priorities between PPI contributors and health professionals, and the linear timeline of the guideline development process. However, PPI contributors can influence clinical guideline development including the selection of relevant health outcomes. This was achieved through several factors and highlights the important role of the committee chair, the importance of training and support for all committee members, the use of plain language and the opportunity for all committee members to engage. CONCLUSIONS: Lay member input during the outcome selection phase of clinical guideline development is achievable, but there are challenges to overcome. Study findings identify ways that future guideline developers can support meaningful lay involvement in guideline development and health outcome selection.


Assuntos
Antropologia Cultural , Participação do Paciente , Humanos , Avaliação de Resultados em Cuidados de Saúde
16.
Br J Sociol ; 73(2): 244-258, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35231134

RESUMO

Classic sociological theories hold that rituals offer opportunities for community integration and cohesion. Rituals allow people to come together across many differences and experience similar thoughts and feelings. Death rituals raise existential questions about the purpose of society and generally foster preexisting social ties. This paper examines the efforts of a US community of volunteers who gather to bury unclaimed, or "abandoned," babies. Drawing on ethnographic research over a two-year period, we advance the concept of cultural palimpsest to capture the process by which a gathering of strangers turns a potentially divisive political issue in to a community forming event. We find that in their efforts to mourn babies to whom they have no connection, these volunteers temporarily foster new social bonds that allow them to work through unresolved grief. Similar processes of ritualistically inverting social meanings occur whenever people gather to turn potentially negative into group forming events.


Assuntos
Antropologia Cultural , Comportamento Ritualístico , Pesar , Humanos
17.
Licere (Online) ; 25(1): 26-67, mar.2022.
Artigo em Português | LILACS | ID: biblio-1366189

RESUMO

Este artigo realiza um estudo comparativo entre as obras Fever Pitch, de Nick Hornby, e Long Distance Love ­ a passion for football, de Grant Farred. A proposta é analisar o que se refere aos conceitos de "memória e identidade" e "autobiografia esportiva", como também investigar a forma como os autores apresentam o "ato de torcer" em suas obras para, então, preencher uma lacuna em relação ao estudo comparativo, nos apropriando das diferenças e semelhanças entre as narrativas. Para isso, a metodologia escolhida tomou como base a pesquisa das teorias autobiográficas, em especial o pacto autobiográfico de Philippe Lejeune e Andrew C. Sparkes. Ademais, foram utilizados os conceitos sobre memória e identidade adotados por Stuart Hall, Joel Candau, Michael Pollak e Maurice Halbwachs e as definições sobre historiografia de Alain Courbin e Matthew Taylor. Além da leitura analítica dos livros selecionados, realizou-se uma pesquisa em trabalhos publicados sobre os autores em livros, jornais e periódicos. As décadas de 1970 e 1980 foram selecionadas para que fosse possível efetuar uma comparação entre as obras, considerando que têm, como centralidade, além do torcedor de futebol e sua passionalidade clubística, a literatura esportiva inglesa. Nick, torcedor do Arsenal. Grant, torcedor do Liverpool. Ambos apresentam suas tragédias e epifanias, exibidos num enredo em que a paixão pelo futebol e, principalmente, por seus times, é tratada como uma obsessão, pois promove uma junção entre viver e torcer, tornando-os elementos inseparáveis. Os autores viviam em realidades diferentes. Nick, branco, morava na Inglaterra e podia acompanhar o Arsenal nos jogos. Grant, negro, morava na África do Sul em pleno regime do Apartheid e torcia para o Liverpool, um time eminentemente racista, que não aceitava jogadores negros. A realidade dos torcedores/autores foi retratada neste artigo de forma a mostrar que a relação entre eles é bem maior do que se pode ler em uma autobiografia.


This article performs a comparative study between the works Fever Pitch, by Nick Hornby, and Long Distance Love - a passion for football, by Grant Farred. The proposal is to analyze what refers to the concepts of "memory and identity" and "sports autobiography", as well as to investigate the way in which the authors present the "act of supporting football" in their works to then fill a gap in relation to the comparative study, appropriating the differences and similarities between the narratives. For this, the methodology chosen was based on the research of autobiographical theories, in particular the autobiographical pact of Philippe Lejeune and Andrew C. Sparkes. In addition, the concepts of memory and identity adopted by Stuart Hall, Joel Candau, Michael Pollak and Maurice Halbwachs and the definitions of historiography by Alain Courbin and Matthew Taylor were used. In addition to the analytical reading of the selected books, a research was carried out on published works about the authors in books, newspapers, and periodicals. The 1970s and 1980s were selected so that it was possible to make a comparison between the works, considering that, in addition to the soccer fan and his clubistic passion, English sports literature is central. Nick, Arsenal fan. Grant, Liverpool supporter. Both present their tragedies and epiphanies, displayed in a plot in which the passion for football and, especially, for their teams, is treated as an obsession, as it promotes a junction between living and cheering, making them inseparable elements. The authors lived in different realities. Nick, white, lived in England and could follow Arsenal in the games. Grant, a black man, lived in South Africa under the Apartheid regime and rooted for Liverpool, an eminently racist team that did not accept black players. The reality of the fans / authors was portrayed in this article to show that the relationship between them is much greater than what can be read in an autobiography.


Assuntos
Futebol/história , Autobiografias como Assunto , Identificação Social , Comportamento de Massa , Antropologia Cultural
18.
Artigo em Inglês | MEDLINE | ID: mdl-35270277

RESUMO

Hematologists adequately disclosing bad news is a critical point precluding patient-centered communication. Specific courses on communication for hematologists seem to be rare, as well as research exploring their communicative skills and patterns. We aim at describing the hematologists' behavior during difficult conversations to account for behavioral patterns in communication and provide new insights regarding teaching skills to communicate bad news. We employed a focused visual ethnography to answer the following research: "what are hematologists' behavioral patterns in communicating bad news to patients and families?" The collected data included (1) video recordings, (2) observational field notes, (3) interviews with hematologists. The analysis highlighted four patterns: (1) a technical-defensive pattern, (2) an authoritative pattern, (3) a relational-recursive pattern, and (4) a compassionate sharing pattern. Hematologists seem to have difficulty expressing compassionate caring and empathetic comprehension. Communication skills remain a challenge for hematologists. The study of behavioral patterns can lead to increasingly targeted training interventions for this specific learner population.


Assuntos
Relações Médico-Paciente , Revelação da Verdade , Antropologia Cultural , Comunicação , Empatia , Humanos
19.
Neurourol Urodyn ; 41(3): 724-739, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35114012

RESUMO

AIM: To understand the experience of urinary tract infection (UTI) by synthesizing primary qualitative research findings and developing a conceptual model that illustrates this experience. METHOD: A systematic search of Medline, PsychInfo, Embase, and CINAHL from inception to August 2020 to find qualitative research exploring the experience of UTI. Qualitative evidence synthesis in the form of meta-ethnography was undertaken. Findings are reported in keeping with eMERGe guidance. RESULTS: We included 16 qualitative studies in the synthesis of evidence, providing data from over 1038 participants aged 13-97 years. We developed nine themes: the impact of UTI on my whole body; impact on quality of life, activities, and the associated psychological toll; I know my body and my experience has taught me when I need to seek care; worry and the transition to medicalization; antibiotics are a valuable treatment approach; antibiotics are a last resort; being heard, seen, and cared for with dignity; self-judgment; and the end of the road, a need for information and cure. These themes supported a conceptual model to illustrate the patient experience of UTI. CONCLUSIONS: The conceptual model communicates the wide and varied symptoms of patients' UTI experiences and how they process this and make care decision based on past health experiences. For some, there appears to be a sense of hopelessness and frustration. This model may be used to highlight the need for improvements in diagnostic and treatment pathways. Future research to further understand the nuances of acute, recurrent, and persistent UTI is needed.


Assuntos
Qualidade de Vida , Infecções Urinárias , Antropologia Cultural , Antibacterianos , Feminino , Humanos , Masculino , Pesquisa Qualitativa
20.
Int J Qual Stud Health Well-being ; 17(1): 2035305, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35133256

RESUMO

OBJECTIVES: To explore communication and engagement in everyday situations between persons with young-onset dementia (YOD) living in a nursing home (NH) and the caregivers. METHODS: The study draws on ethnographic methods aligned with participatory design. Three residents with YOD living in a NH and eight staff members were recruited. A narrative approach was used for data collection and analysis. FINDINGS: Three narrative vignettes were developed representing everyday situations in which communication and engagement was enacted among residents and caregiver staff: (a) waiting for something to happen, (b) tensions about everyday communication, and (c) negotiating a combined living + working environment. The findings stress a paradoxical tension rooted in the NH as residence and workplace as well as place of calm and place of boredom. The everyday situations are interpreted differently from the perspective of the residents and staff. CONCLUSION: The identified paradox of planned and spontaneous situations influences communication and engagement in everyday life, and the potentiality for active engagement embedded in contexts of units for residents with YOD. The degree to which everyday activities and encounters are redefined and renegotiated is an important part of caregiving practices in NH settings for residents with YOD.


Assuntos
Cuidadores , Demência , Antropologia Cultural , Comunicação , Humanos , Casas de Saúde
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