Every medicine is medicine; exploring inappropriate antibiotic use at the community level in rural Ghana.

BACKGROUND: Inappropriate antibiotic use is an important driver of antibiotic resistance. This study sought to explore inappropriate antibiotic use and confusing antibiotics with other medicines in Ghana using ethnomethodology research approach. METHODS: This was an explorative study involving 15 in-depth interviews among health professionals and private dispensers and eight focus group discussions among 55 community members. Qualitative data were coded using Nvivo 12, thematically analysed and presented as narratives with quotes to support the findings. RESULTS: Self-medication was common and antibiotics were used to treat specific diseases but respondents were not aware these were 'antibiotics'. Various antibiotics were used for indications that in principle do not require systemic antibiotics, like stomach ache and sores on the body. Antibiotics, in particular tetracycline and metronidazole, were poured into "akpeteshie" (local gin) to treat hernia and perceived stomach sores (stomach ulcer). These practices were copied/learnt from various sources like over-the-counter medicine sellers, family, friends, radio/television, drug peddlers, pharmacies and doctors. Medicines in capsules were referred to as 'topaye' or 'abombelt' in Twi (local dialect) and perceived to treat pain associated with diseases. Antibiotics in capsules were described with colours which appeared confusing as some capsules with different drugs in them have similar colours. CONCLUSION: Inappropriate antibiotic use were influenced by general lack of knowledge on antibiotics and identification of antibiotics by colours of capsules which leads to confusion and could lead to inappropriate antibiotic use. There is the need for public health education on appropriate antibiotic use and standardization of appearance of antibiotics and other drugs to optimize use.

A simultaneous search for footprints of early human migration processes using the genetic and folk music data in Eurasia.

In this study, we aimed to illustrate the efficiency of correlation analysis of musical and genetic data for certain common ethnic and ethno-musical roots of mankind. The comparison of the results to archaeogenetic data shows that correlations of recent musical and genetic data may reveal past cultural and migration processes resulting in recent connections. The significance tests verified our hypothesis supposing that propagation of oral musical traditions can be related to early human migration processes is well-founded, because the multidimensional point system determined by the inverse rank vectors of correlating Hg-UCT pairs has a very clear structure. We found that associations of Hgs jointly propagating with associations of UCTs (Unified Contour Type) can be identified as significant complex components in both modern and ancient populations, thus, modern populations can be considered as admixtures of these ancient Hg associations. It also seems obvious to conclude that these ancient Hg associations strewed their musical "parent languages" during their migrations, and the correlating UCTs of these musical parent languages may also be basic components of the recent folk music cultures. Thus, we can draw a hypothetical picture of the main characteristics of ancient musical cultures. Modern and prehistoric populations belonging to a common Hg-UCT association are located to very similar geographical areas, consequently, recent folk music cultures are basically determined by prehistoric migrations. Our study could be considered as an initial step in analysis of the correlations of prehistoric and recent musical and genetic characteristics of human evolution history.

Differences in food consumption in regions of Poland that had been previously under Austrian, Prussian and Russian annexations

Background: It seems that one of the factors affecting the way of nutrition in Poland was the dietary habits of countries that in the late 18th century made partitions, ie. Russia, Prussia and Austria. Therefore, nutrition models in the areas of individual partitions have undergone significant changes. Objective: The aim of the study was to check whether after 85 years after regaining independence there were still differences in the way of feeding indigenous inhabitants of areas previously under Austrian, Prussian and Russian annexation. Material and methods: The data collected during the WOBASZ survey carried out in the years 2003-2005 were used for the analysis. Results: The greatest differences in the way of feeding were found in the area that was previously under the rule of Prussia. The nutrition model was still largely reminiscent of typical German cuisine. There was a large consumption of sausages and spreads, and small vegetables and fruit. Nutrition models in other areas were less characteristic. Conclusions: The way of feeding indigenous people living in areas that were once partitions of Poland is still diverse and similar to the cuisine of the occupying country.

[Health literacy profiles in type 2 diabetes: The ERMIES-Ethnosocio study]. / Analyse des profils de littératie en santé chez des personnes diabétiques de type 2 : la recherche ERMIES-Ethnosocio.

INTRODUCTION: Health literacy refers to the competences and resources required by individuals to meet the complex demands of health in modern society. This paper describes and analyses the health literacy profiles of type 2 diabetic patients included in a 2-year long self-management education programme. METHODS: Nested in the ERMIES randomized controlled trial conducted in Reunion island, the ERMIES Ethnosocio study explored health literacy by means of two complementary approaches: description of health literacy profiles via the French version of the multidimensional "Health Literacy Questionnaire", and a socio-anthropological perspective based on 40 semi-structured interviews carried out in 2012 and then in 2015. RESULTS: The results highlight the existence of 8 constitutive variables in the management of type 2 diabetes in an ordinary context: diet, physical activity, treatment and monitoring of disease (disease management), access to knowledge and skills (health knowledge), relationships with health professionals and social support (expertise, support and social network). They also emphasize the differentiated relationships of individuals to each of these variables, ranging from functional to interactive or critical "levels". DISCUSSION: Considering the development of health literacy with patients and health professionals, and by questioning educational and therapeutic interventions as differentiating processes, this research opens up new perspectives for the approach to social inequalities in health. The combination of social sciences, medical sciences and public health is proving fruitful and potentially operative, provided that the definitions, methods, and strengths and limitations of selected prospects are clearly defined.

Prehistoric deforestation at Chaco Canyon?

Ancient societies are often used to illustrate the potential problems stemming from unsustainable land-use practices because the past seems rife with examples of sociopolitical "collapse" associated with the exhaustion of finite resources. Just as frequently, and typically in response to such presentations, archaeologists and other specialists caution against seeking simple cause-and effect-relationships in the complex data that comprise the archaeological record. In this study we examine the famous case of Chaco Canyon, New Mexico, during the Bonito Phase (ca. AD 860-1140), which has become a prominent popular illustration of ecological and social catastrophe attributed to deforestation. We conclude that there is no substantive evidence for deforestation at Chaco and no obvious indications that the depopulation of the canyon in the 13th century was caused by any specific cultural practices or natural events. Clearly there was a reason why these farming people eventually moved elsewhere, but the archaeological record has not yet produced compelling empirical evidence for what that reason might have been. Until such evidence appears, the legacy of Ancestral Pueblo society in Chaco should not be used as a cautionary story about socioeconomic failures in the modern world.

Identification of Aboriginal children using linked administrative data: Consequences for measuring inequalities.

AIM: The aim of this study was to examine the identification of Aboriginal children in multiple administrative datasets and how this may affect estimates of health and development. METHODS: Data collections containing a question about Aboriginal ethnicity: birth registrations, perinatal statistics, Australian Early Development Census and school enrolments were linked to datasets recording developmental outcomes: national literacy and numeracy tests (National Assessment Program - Literacy and Numeracy), Australian Early Development Census and perinatal statistics (birthweight) for South Australian children born 1999-2005 (n = 13 414-44 989). Six algorithms to derive Aboriginal ethnicity were specified. The proportions of children thus quantified were compared for developmental outcomes, including those scoring above the national minimum standard in year 3 National Assessment Program - Literacy and Numeracy reading. RESULTS: The proportion of Aboriginal children identified varied from 1.9% to 4.7% when the algorithm incremented from once to ever identified as Aboriginal, the latter using linked datasets. The estimates of developmental outcomes were altered: for example, the proportion of Aboriginal children who performed above the national minimum standard in year 3 reading increased by 12 percentage points when the algorithm incremented from once to ever identified as Aboriginal. Similar differences by identification algorithm were seen for all outcomes. CONCLUSIONS: The proportion of South Australian children identified as Aboriginal in administrative datasets, and hence inequalities in developmental outcomes, varied depending on which and how many data sources were used. Linking multiple administrative datasets to determine the Aboriginal ethnicity of the child may be useful to inform policy, interventions, service delivery and how well we are closing developmental gaps.

Received sensitivity: adapting Ainsworth's scale to capture sensitivity in a multiple-caregiver context.

A network of multiple caregivers contributing to the care of an infant is the norm in many non-Western cultural contexts. Current observational measures of caregiver sensitive responsiveness to infant signals focus on single caregivers, failing to capture the total experience of the infant when it comes to the sensitive responsiveness received from multiple sources. The current paper aims to introduce the construct of received sensitivity that captures the sensitivity that an infant experiences from multiple sources in cultural contexts where simultaneous multiple caregiving is common. The paper further presents an adaptation of Ainsworth's Sensitivity versus Insensitivity observation scale to allow for the assessment of sensitivity as received by the infant regardless of who is providing the sensitive responses to its signals. The potential usefulness of the Received Sensitivity scale is illustrated by two case studies of infants from an Agta forager community in the Philippines where infants are routinely taken care of by multiple caregivers. The case studies show that the infants' total experience of being responded to sensitively cannot be simply derived from the sum of individual caregiver sensitivity scores, demonstrating the potential added value of the new Received Sensitivity observation measure.

I've got a feeling: Urban and rural indigenous children's beliefs about early life mentality.

This cross-cultural investigation explored children's reasoning about their mental capacities during the earliest period of human physical existence--the prenatal period. For comparison, children's reasoning about the observable period of infancy was also examined. A total of 283 5- to 12-year-olds from two distinct cultures (urban Ecuador and rural indigenous Shuar) participated. Across cultures, children distinguished the fetal period from infancy, attributing fewer capacities to fetuses. However, for both the infancy and fetal periods, children from both cultures privileged the functioning of emotions and desires over epistemic states (i.e., abilities for thought and memory). Children's justifications to questions about fetal mentality revealed that although epistemic states were generally regarded as requiring physical maturation to function, emotions and desires were seen as functioning as a de facto result of prenatal existence and in response to the prospect of future birth and being part of a social group. These results show that from early in development, children across cultures possess nuanced beliefs about the presence and functioning of mental capacities. Findings converge with recent results to suggest that there is an early arising bias to view emotions and desires as the essential inviolable core of human mentality. The current findings have implications for understanding the role that emerging cognitive biases play in shaping conceptions of human mentality across different cultures. They also speak to the cognitive foundations of moral beliefs about fetal rights.

The importance of the rites of passage in assigning semantic structures to autobiographical memory.

As cultural anthropologists, we noticed an unexpected and interesting convergence of the therapeutic practices suggested in the target article and the rites of passage occurring across multiple societies, as individuals make the transition from one significant age or status to another.

Heterogeneous methodology of racial/ethnic classification may be responsible for the different risk assessments for prostate cancer between Black and White men in Brazil.

OBJECTIVES: To evaluate if the different results of prostate cancer risk between black and white Brazilian men may be associated with the varying methodology used to define participants as either Blacks or Whites. PATIENTS AND METHODS: We evaluated median PSA values, rate of PSA level ≥ 4.0 ng/ mL, indications for prostate biopsy, prostate cancer detection rate, biopsy/cancer rate, cancer/biopsy rate, and the relative risk of cancer between blacks versus whites, blacks versus non-blacks (browns and whites), non-whites (browns and blacks) versus whites, African versus non-African descendants, and African descendants or blacks versus non-African descendants and non-blacks. RESULTS: From 1544 participants, there were 51.4% whites, 37.2% browns, 11.4% blacks, and 5.4% African descendants. Median PSA level was 0.9 ng/mL in whites, browns, and non-African descendants, compared to 1.2 ng/mL in blacks, and African descendants or blacks, and 1.3 ng/mL in African descendants. Indications for prostate biopsy were present in 16.9% for African descendants, 15.9% of black, 12.3% of white, 11.4% for non-African descendants, and 9.9% of brown participants. Prostate cancer was diagnosed in 30.3% of performed biopsies: 6.2% of African descendants, 5.1% of blacks, 3.3% of whites, 3.0% of non-African descendants, and 2.6% of browns. CONCLUSIONS: Median PSA values were higher for Blacks versus Whites in all classification systems, except for non-white versus white men. The rate of prostate biopsy, prostate cancer detection rate, and relative risk for cancer was increased in African descendants, and African descendants or blacks, compared to non-African descendants, and non-African descendants and non-blacks, respectively.

[Science and magic. Motives from ethnology and the psychology of perception in the epistemology of Ludwik Fleck]. / Wissenschaft und Magie : Ethnologische und wahrnehmungspsychologische Motive in Ludwik Flecks Epistemologie.

Fleck's social theory of science refers to many ethnological examples in order to explain how collective thinking and acting constructs certain systems of belief and knowing. According to Fleck, scientific concepts and practices are comparable with magic terms and ceremonies. This essay aims to identify the ethnological sources that Fleck's epistemology is using. By confronting them with other relativistic theories that were circulating in Lemberg during the interwar period, the originality of Fleck's own position can be contextualized and explained as well.

Are we romanticizing traditional knowledge? A plea for more experimental studies in ethnobiology.

In answer to the debate question "Is ethnobiology romanticizing traditional practices, posing an urgent need for more experimental studies evaluating local knowledge systems?" I suggest to follow-up on field study results adopting an inclusive research agenda, and challenge descriptive data, theories, and hypotheses by means of experiments. Traditional and local knowledge are generally associated with positive societal values by ethnobiologists and, increasingly also by stakeholders. They are seen as a way for improving local livelihoods, biocultural diversity conservation and for promoting sustainable development. Therefore, it is argued that such knowledge needs to be documented, protected, conserved in situ, and investigated by hypothesis testing. Here I argue that a critical mindset is needed when assessing any kind of knowledge, whether it is modern, local, indigenous, or traditional.

So close, so far away: analysis of surnames in a town of twins (Cândido Godói, Brazil).

Cândido Godói is a small Brazilian town known for high rates of twin birth. In 2011, a genetic study showed that this localized high rate of twin births could be explained by a genetic founder effect. Here we used isonymic analysis and surname distribution to identify population subgroups within 5316 inhabitants and 665 different surnames. Four clusters were constructed based on different twin rates (P < 0.001; MRPP test). Fisher's α and consanguinity index showed low and high values, respectively, corresponding with observed values in isolated communities with high levels of genetic drift. Values of A and B estimators confirmed population isolation. Three boundaries were identified with Monmonier's maximum difference algorithm (P = 0.007). Inside the isolated sections, surnames of different geographic origins, language, and religion were represented. With an adequate statistical methodology, surname analyses provided a close approximation of historic and socioeconomic background at the moment of colony settlement. In this context, the maintenance of social and cultural practices had strong implications for the population's structure leading to drift processes in this small town, supporting the previous genetic study.

The popularization of the ethnological documentary film at the beginning of the 21st century.

This paper seeks to explain the reasons for the rising popularity of the ethnological documentary genre in all its forms, emphasizing its correlation with contemporary social events or trends. The paper presents the origins and the development of the ethnological documentary film in the anthropological domain. Special attention is given to the most influential documentaries of the last decade, dealing with politics: (Fahrenheit 9/1, Bush's Brain), gun control (Bowling for Columbine), health (Sicko), the economy (Capitalism: A Love Story), ecology An Inconvenient Truth) and food (Super Size Me). The paper further analyzes the popularization of the documentary film in Croatia, the most watched Croatian documentaries in theatres, and the most controversial Croatian documentaries. It determines the structure and methods in the making of a documentary film, presents the basic types of scripts for a documentary film, and points out the differences between scripts for a documentary and a feature film. Finally, the paper questions the possibility of capturing the whole truth and whether some documentaries, such as the Croatian classics: A Little Village Performance and Green Love, are documentaries at all.

Applying the concept of culture to reduce health disparities through health behavior research.

Culture is often cited as an underlying cause of the undue burden of disease borne by communities of color along the entire life cycle. However, culture is rarely defined or appropriately measured. Scientifically, culture is a complex, integrated, and dynamic conceptual framework that is incongruent with the way it is operationalized in health behavior theories: as a unidimensional, static, and immutable character element of a homogeneous population group. This paper lays out this contradiction and proposes a more scientifically grounded approach to the use of culture. The premise is that if the concept of culture were better operationalized, results from studies of diverse population groups would produce findings that are more scientifically valid and relevant to the community. Practitioners could then use these findings to develop more effective strategies to reduce health disparities and improve the health of all population groups. Six steps are proposed to increase our ability to achieve greater clarity on what culture is and to identify how it impacts health behavior and ultimately health outcomes, enabling researchers to build a stronger science of cultural diversity.

Evidence for early hunters beneath the Great Lakes.

Scholars have hypothesized that the poorly understood and rarely encountered archaeological sites from the terminal Paleoindian and Archaic periods associated with the Lake Stanley low water stage (10,000-7,500 BP) are lost beneath the modern Great Lakes. Acoustic and video survey on the Alpena-Amberley ridge, a feature that would have been a dry land corridor crossing the Lake Huron basin during this time period, reveals the presence of a series of stone features that match, in form and location, structures used for caribou hunting in both prehistoric and ethnographic times. These results present evidence for early hunters on the Alpena-Amberley corridor, and raise the possibility that intact settlements and ancient landscapes are preserved beneath Lake Huron.

Representing and intervening: 'doing' good care in first trimester prenatal knowledge production and decision-making.

This article investigates processes of knowledge production and decision-making in the practice of the first trimester prenatal risk assessment (FTPRA) at an ultrasound clinic in Denmark. On the basis of ethnographic material and interviews with professionals facilitating FTPRAs in Denmark, we draw attention to the active engagement of health professionals in this process. Current professional and policy debate over the use of prenatal testing emphasises the need for informed choice making and for services that provide prospective parents with what is referred to as 'non-directive counselling'. Studies focusing on professional practice of prenatal counselling tend to deal mainly with how professionals fail to live up to such ideals in practice. In this article we extend such studies by drawing attention to practices of care in prenatal testing and counselling. In doing so, we identify three modes of 'doing' good care: attuning expectations and knowledge, allowing resistance and providing situated influence in the relationship between the pregnant woman and the professional. Such practices may not be seen as immediately compatible with the non-directive ethos, but they express ways of reducing emotional suffering and supporting a pregnant woman's ability to make meaningful choices on the basis of uncertain knowledge. As such, these practices can be seen as representing another (caring) solution to the problem of paternalism and authoritarian power. In opposition to an ethics aiming at non-interference (non-directiveness) such modes of doing good care express an ethics of being locally accountable for the ways in which programmes of prenatal testing intervene in pregnant women's lives and of taking responsibility for the entities and phenomena that emerge through such knowledge production.

Poverty, sexual experience and HIV vulnerability risks: evidence from Addis Ababa, Ethiopia.

This study explores the relationship between poverty and vulnerability to HIV infection in Ethiopia using primary (quantitative and qualitative) and secondary data from two sub-cities of Addis Ababa. The data show that sexual experience is influenced by diverse factors such as age, gender, economic status and education level. Household economic status and migration explain the nature of sexual experience and level of vulnerability to HIV infection. Poor uneducated women in poor neighbourhoods are more likely to engage in risky sexual encounters despite awareness about the risk of HIV infection as they operate in an environment that provides the 'path of least resistance' (Lindegger & Wood, 1995, p. 7). This article argues that poverty provides a situation where early sexual initiation, 'transactional sex' and an inability to negotiate for safer sex are associated with low income, lack of education and increased vulnerability to HIV infection. This vulnerability is simultaneously contested and accepted as a commitment to even sacrifice one's life for the sake of one's loved ones. As a modest contribution to the 'structural violence' approach, which emphasizes social inequalities based on gender, class, ethnicity and race and inequalities in terms of exposure to risk and access to health care (Massé, 2007), this article challenges the 'African promiscuity' discourse, which 'does not permit policymakers to think beyond sex' (Stillwaggon, 2006, p. 156), and encourages researchers and policymakers to ask the right questions to understand the complexity of HIV/AIDS and seek solutions to the pandemic.