Pub Date : 2024-08-17Epub Date: 2024-07-29DOI: 10.1080/01459740.2024.2384749
Lisa Engström
I explore the experience of managing type 1 diabetes with wearable technology. Type 1 diabetes is a chronic illness which requires continuous maintenance to keep the blood glucose levels within range. Using autoethnography, I investigate both the practices of translating information from technology and from senses, and also from health authorities, into practices. I conclude that the management of type 1 diabetes is informed by an urge to control the body, but this situation can be understood otherwise from a logic of care.
{"title":"Controlling the Diabetic Body? Managing Chronic Illness with Wearable Technology.","authors":"Lisa Engström","doi":"10.1080/01459740.2024.2384749","DOIUrl":"10.1080/01459740.2024.2384749","url":null,"abstract":"<p><p>I explore the experience of managing type 1 diabetes with wearable technology. Type 1 diabetes is a chronic illness which requires continuous maintenance to keep the blood glucose levels within range. Using autoethnography, I investigate both the practices of translating information from technology and from senses, and also from health authorities, into practices. I conclude that the management of type 1 diabetes is informed by an urge to control the body, but this situation can be understood otherwise from a logic of care.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17Epub Date: 2024-08-07DOI: 10.1080/01459740.2024.2386583
Dirk Lafaut, Lisa Dikomitis
We draw on ethnographic fieldwork conducted in Brussels (Belgium) on the health care experiences of undocumented migrants. We explore the implications of the double position of the ethnographer, who is both a researcher and a practicing doctor. We describe how the intimate knowledge the ethnographer-cum-clinician holds about the health care system influenced and shaped the data collection, analysis and subsequent policy recommendations. We examine the ethical dilemmas in conducting research from an engaged position about care practices toward vulnerable populations in one's own professional field. We conclude with recommendations on how to challenge and interrupt complexities faced by multi-positioned ethnographers.
{"title":"Ethical and Epistemological Implications of Conducting Ethnographic Fieldwork as a Researcher-cum-Clinician in Brussels, Belgium.","authors":"Dirk Lafaut, Lisa Dikomitis","doi":"10.1080/01459740.2024.2386583","DOIUrl":"10.1080/01459740.2024.2386583","url":null,"abstract":"<p><p>We draw on ethnographic fieldwork conducted in Brussels (Belgium) on the health care experiences of undocumented migrants. We explore the implications of the double position of the ethnographer, who is both a researcher and a practicing doctor. We describe how the intimate knowledge the ethnographer-cum-clinician holds about the health care system influenced and shaped the data collection, analysis and subsequent policy recommendations. We examine the ethical dilemmas in conducting research from an engaged position about care practices toward vulnerable populations in one's own professional field. We conclude with recommendations on how to challenge and interrupt complexities faced by multi-positioned ethnographers.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17Epub Date: 2024-09-05DOI: 10.1080/01459740.2024.2395285
Michelle R Brear, Themby Nkovana, Lenore Manderson
Practice theories offer potential to reveal, understand, and attribute value to the everyday thoughts and actions of dementia caregivers. Drawing on ethnographic data from research in rural South Africa, on everyday dementia care practices, we highlight the profound importance of mundane practices - especially "sitting in wait" - for optimizing wellbeing of people with dementia who are cared for at home. We draw attention to the structural drivers of homebased (informal) care, which is underpinned by state inaction. This situates the act of sitting in wait as both an act of care and an embodied form of structural powerlessness.
{"title":"Sitting in Wait: Everyday Caregiving Practices for People with Dementia in Rural South Africa.","authors":"Michelle R Brear, Themby Nkovana, Lenore Manderson","doi":"10.1080/01459740.2024.2395285","DOIUrl":"10.1080/01459740.2024.2395285","url":null,"abstract":"<p><p>Practice theories offer potential to reveal, understand, and attribute value to the everyday thoughts and actions of dementia caregivers. Drawing on ethnographic data from research in rural South Africa, on everyday dementia care practices, we highlight the profound importance of mundane practices - especially \"sitting in wait\" - for optimizing wellbeing of people with dementia who are cared for at home. We draw attention to the structural drivers of homebased (informal) care, which is underpinned by state inaction. This situates the act of sitting in wait as both an act of care and an embodied form of structural powerlessness.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17Epub Date: 2024-09-05DOI: 10.1080/01459740.2024.2395273
Jonathan Stadler, Fiona Scorgie
In a tragically ironic twist, antiretroviral therapy (ART) that promised an end to AIDS ushered in a syndemic of viral cancers, transforming hope to despair. In this article we draw from the illness narratives of HIV positive women attending a cervical cancer screening clinic in Johannesburg, South Africa, and chart their pathways from HIV to cancer, and their quest for treatment. Our interlocutors described protracted struggles to access surgical procedures to prevent the onset of cervical cancer. Dealt a double blow of HIV and cervical cancer, women's narratives reveal the intersections of exposure to pathogens and the precarity of hope.
具有讽刺意味的是,抗逆转录病毒疗法(ART)承诺终结艾滋病,但却带来了病毒性癌症综合症,将希望变成了绝望。在这篇文章中,我们从南非约翰内斯堡一家宫颈癌筛查诊所就诊的 HIV 阳性女性的疾病叙述中,描绘了她们从 HIV 感染到患癌的过程,以及她们寻求治疗的过程。我们的对话者描述了为获得手术治疗以预防宫颈癌发病而进行的长期斗争。在艾滋病毒和宫颈癌的双重打击下,妇女们的叙述揭示了病原体暴露和希望渺茫之间的交集。
{"title":"Precarity and Hope at the Intersections of HIV and Cervical Cancer in a Johannesburg Clinic.","authors":"Jonathan Stadler, Fiona Scorgie","doi":"10.1080/01459740.2024.2395273","DOIUrl":"10.1080/01459740.2024.2395273","url":null,"abstract":"<p><p>In a tragically ironic twist, antiretroviral therapy (ART) that promised an end to AIDS ushered in a syndemic of viral cancers, transforming hope to despair. In this article we draw from the illness narratives of HIV positive women attending a cervical cancer screening clinic in Johannesburg, South Africa, and chart their pathways from HIV to cancer, and their quest for treatment. Our interlocutors described protracted struggles to access surgical procedures to prevent the onset of cervical cancer. Dealt a double blow of HIV and cervical cancer, women's narratives reveal the intersections of exposure to pathogens and the precarity of hope.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17Epub Date: 2024-08-14DOI: 10.1080/01459740.2024.2388199
Kristin Hedges, Maggie Willson
The social efficacy of vaccines has been a central concern around COVID-19 vaccine uptake rates. As partners on the Vaccinate West Michigan Coalition, we conducted a rapid ethnographic assessment project among adults living in West Michigan. Three case studies are presented to convey the nuanced context around decisions with a focus on the influence of fear, trust, and the ripple effect of healthcare workers' (HCW) beliefs around vaccines. While HCWs' attitudes and beliefs influence their patients, the unique contribution of this study is its focus on how HCWs' perceptions influence friends and family members.
{"title":"Collective Sensemaking and Healthcare Workers' Ripple Effect Influencing Vaccine Hesitancy in West Michigan.","authors":"Kristin Hedges, Maggie Willson","doi":"10.1080/01459740.2024.2388199","DOIUrl":"10.1080/01459740.2024.2388199","url":null,"abstract":"<p><p>The social efficacy of vaccines has been a central concern around COVID-19 vaccine uptake rates. As partners on the Vaccinate West Michigan Coalition, we conducted a rapid ethnographic assessment project among adults living in West Michigan. Three case studies are presented to convey the nuanced context around decisions with a focus on the influence of fear, trust, and the ripple effect of healthcare workers' (HCW) beliefs around vaccines. While HCWs' attitudes and beliefs influence their patients, the unique contribution of this study is its focus on how HCWs' perceptions influence friends and family members.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1080/01459740.2024.2376004
Elspeth Davies
Drawing on fieldwork in Facebook support groups, in this article I explore how people, now patients, learnt to live with Barrett's esophagus, a risk state or "precancer" for a type of esophageal cancer. This diagnosis brought the possibility of both facing and averting cancerous futures into the present. Far from passive recipients, members worked to foreground speculations of "wanted futures" in which prompt surveillance successfully prevented cancer deaths, transforming cancer risk into an opportunity for hope. Speculation here was an ambivalent and active process, involving not only the "observation of potentiality," but the opening up and foreclosing of both desirable and undesirable potentialities.
{"title":"Ambivalent Speculations: Learning to Live with Barrett's Esophagus in the UK Using Facebook Support Groups.","authors":"Elspeth Davies","doi":"10.1080/01459740.2024.2376004","DOIUrl":"10.1080/01459740.2024.2376004","url":null,"abstract":"<p><p>Drawing on fieldwork in Facebook support groups, in this article I explore how people, now patients, learnt to live with Barrett's esophagus, a risk state or \"precancer\" for a type of esophageal cancer. This diagnosis brought the possibility of both facing and averting cancerous futures into the present. Far from passive recipients, members worked to foreground speculations of \"wanted futures\" in which prompt surveillance successfully prevented cancer deaths, transforming cancer risk into an opportunity for hope. Speculation here was an ambivalent and active process, involving not only the \"observation of potentiality,\" but the opening up and foreclosing of both desirable and undesirable potentialities.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2024-07-24DOI: 10.1080/01459740.2024.2376005
Mengzhu An
In today's China, countless parents embark on a journey of moral peril in search of treatment for their children with autism, navigating a bustling yet chaotic market of therapies. Based on 13 months of fieldwork in the Pearl River Delta, this study examines how the boom of China's autism therapy industry has plunged parents, who are relentlessly striving for their children's futures, into deeper vulnerability. I view the "ethics of trying" as parental enactment of their moral agency in seeking therapy and reveal how it serves as a moral engine for the industry's growth in the early 21st century, as well as how it leads to moral tragedies for parents as new norms of therapeutic choice emerge with government and professional guidance compelling them to make optimal therapeutic choices within a critical developmental window. Although parental efforts to avoid "agent-regret" can paradoxically lead to significant remorse, the moral tragedy they encounter can also prompt reflection and reevaluation of their approach to their child's condition.
{"title":"\"As Long as There's a Glimmer of Hope, I'm Willing to Try\": The Moral Experiences of Parental Pursuit for Autism Therapy in Urban China.","authors":"Mengzhu An","doi":"10.1080/01459740.2024.2376005","DOIUrl":"10.1080/01459740.2024.2376005","url":null,"abstract":"<p><p>In today's China, countless parents embark on a journey of moral peril in search of treatment for their children with autism, navigating a bustling yet chaotic market of therapies. Based on 13 months of fieldwork in the Pearl River Delta, this study examines how the boom of China's autism therapy industry has plunged parents, who are relentlessly striving for their children's futures, into deeper vulnerability. I view the \"ethics of trying\" as parental enactment of their moral agency in seeking therapy and reveal how it serves as a moral engine for the industry's growth in the early 21st century, as well as how it leads to moral tragedies for parents as new norms of therapeutic choice emerge with government and professional guidance compelling them to make optimal therapeutic choices within a critical developmental window. Although parental efforts to avoid \"agent-regret\" can paradoxically lead to significant remorse, the moral tragedy they encounter can also prompt reflection and reevaluation of their approach to their child's condition.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2024-07-24DOI: 10.1080/01459740.2024.2376015
Anna Louise Skovgaard, Tine Tjørnhøj-Thomsen, Marianne Johansson Jørgensen, Mette Terp Høybye
A growing concern in clinical literature with the "treatment burden" of living with multimorbidity raises questions about how we can study and produce knowledge on the impact of health care. In this article, we draw on ethnographic material from fieldwork among people with multimorbidity in Denmark and recent theorization on "values" in health care, to show how an ongoing "trying out" and ways of "just getting on with it" are enacted in illness trajectories marked by multimorbidity. Our findings point to the importance of attending to the subject positions that particular healthcare relations and encounters make possible.
{"title":"Making it Work: Everyday Life and Healthcare with Multiple Chronic Illnesses in Denmark.","authors":"Anna Louise Skovgaard, Tine Tjørnhøj-Thomsen, Marianne Johansson Jørgensen, Mette Terp Høybye","doi":"10.1080/01459740.2024.2376015","DOIUrl":"10.1080/01459740.2024.2376015","url":null,"abstract":"<p><p>A growing concern in clinical literature with the \"treatment burden\" of living with multimorbidity raises questions about how we can study and produce knowledge on the impact of health care. In this article, we draw on ethnographic material from fieldwork among people with multimorbidity in Denmark and recent theorization on \"values\" in health care, to show how an ongoing \"trying out\" and ways of \"just getting on with it\" are enacted in illness trajectories marked by multimorbidity. Our findings point to the importance of attending to the subject positions that particular healthcare relations and encounters make possible.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2024-07-24DOI: 10.1080/01459740.2024.2376007
Julie Bønnelycke, Maria Larsen, Astrid Pernille Jespersen
Pregnancy is seen as a window of opportunity for health interventions, with the potential to produce long-term health changes for mother and child. The RCT FitMum investigates the effects of different regimes of physical activity during pregnancy. We suggest that rather than hitting a window of opportunity, the trial works in choreography with different timescapes through the processes of management of time. These timescapes are characterized by linear progression and futurity, alongside composite, complex time. We reconceptualize the intervention as a navigation of flows and passages in collective efforts, providing a situated and sustainable approach to interventions.
{"title":"Pregnancy As Window of Opportunity? A Danish RCT on Physical Activity During Pregnancy.","authors":"Julie Bønnelycke, Maria Larsen, Astrid Pernille Jespersen","doi":"10.1080/01459740.2024.2376007","DOIUrl":"10.1080/01459740.2024.2376007","url":null,"abstract":"<p><p>Pregnancy is seen as a window of opportunity for health interventions, with the potential to produce long-term health changes for mother and child. The RCT FitMum investigates the effects of different regimes of physical activity during pregnancy. We suggest that rather than hitting a window of opportunity, the trial works in choreography with different timescapes through the processes of management of time. These timescapes are characterized by linear progression and futurity, alongside composite, complex time. We reconceptualize the intervention as a navigation of flows and passages in collective efforts, providing a situated and sustainable approach to interventions.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03Epub Date: 2024-06-12DOI: 10.1080/01459740.2024.2364241
Laura Montesi, María Guadalupe Ramírez-Rojas, Jesús Elizarrarás-Rivas
Diabetic foot (DF) is a leading cause of nontraumatic lower-extremity amputations, premature death, and a sign of social inequality in diabetes treatment. In Mexico, the incidence of DF is on the rise yet little is known about its impact among indigenous people, a disadvantaged group. Based on ethnographic research conducted in Oaxaca and analysis of institutional health-data, in this article we show the health care delays that rural indigenous people face when dealing with DF. Indigenous people's uncertainty regarding their right to health and the structural barriers to medical care favor DF complications, a phenomenon that should be read as social suffering. Since health data concerning indigenous health care service users is patchy and imprecise, indigenous people's social suffering is invisibilized. This omission or partiality in the official records limits public health decision-making and undermines the human rights of the population.
{"title":"Health Care Delays and Social Suffering Among Indigenous People with Diabetic Foot Complications in Mexico.","authors":"Laura Montesi, María Guadalupe Ramírez-Rojas, Jesús Elizarrarás-Rivas","doi":"10.1080/01459740.2024.2364241","DOIUrl":"10.1080/01459740.2024.2364241","url":null,"abstract":"<p><p>Diabetic foot (DF) is a leading cause of nontraumatic lower-extremity amputations, premature death, and a sign of social inequality in diabetes treatment. In Mexico, the incidence of DF is on the rise yet little is known about its impact among indigenous people, a disadvantaged group. Based on ethnographic research conducted in Oaxaca and analysis of institutional health-data, in this article we show the health care delays that rural indigenous people face when dealing with DF. Indigenous people's uncertainty regarding their right to health and the structural barriers to medical care favor DF complications, a phenomenon that should be read as social suffering. Since health data concerning indigenous health care service users is patchy and imprecise, indigenous people's social suffering is invisibilized. This omission or partiality in the official records limits public health decision-making and undermines the human rights of the population.</p>","PeriodicalId":47460,"journal":{"name":"Medical Anthropology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}