Conditions of life in the city: medicine and gendered relations in Maputo,Mozambique

How do material conditions, urban life strategies, and postcolonial medical infrastructures shape the practices of care available to patients and families in Maputo? How do global health interventions articulate with urban economies, colonial legacies, and gendered relations? Under what conditions is health made available in Mozambique's capital? This article explores these questions through the experiences of one young woman as she moves through clinical and city spaces and through changing familial and residential situations. Showing how health is shaped by gendered relations and material circumstances (or condições) as they are refracted through urban space, her experiences make clear that care both requires and creates complex material‐relational conditions rooted in clinic practice, urban forms, and gendered social and familial life. In the midst of complex medical regimes and rapidly changing urban spaces, these conditions constitute the ground on which women access medicine but also give rise to exclusions from forms of care produced by both biomedicine and social relations. Arguing for greater attention to the role of gender, urban space, economy, and exchange in theorizing health in situated urban and transnational spaces, this article advocates for accounts that go beyond biomedical and clinical framings of life, health, and well‐being and that centre relational accounts of life in the city.     

城市景观空间自相关与自相似的尺度特征研究

在RS与GIS技术支持下,以上海市外环以内城市中心区为区域背景,研究城市景观格局空间自相关与分形结构在不同粒度下的变化特征,揭示其对粒度的响应特征和敏感程度。结果表明,城市景观格局的空间自相关性和自相似性依赖于粒度的选择,MoranⅠ与各种景观类型的分维数均存在尺度效应;城市景观格局空间自相关性与自相似性在一定尺度范围内具有尺度依赖性,但二者对尺度的依赖程度不同。空间自相关性具有较高的尺度依赖性;而不同景观类型的自相似性随尺度的变化没有统一规律;城市景观格局的空间自相关性和自相似性对尺度变化的敏感点不同。居住景观的MoranⅠ对尺度变化的敏感点为50m,其他景观类型无明显的敏感点;分维数对尺度的敏感点因景观类型不同而异。     

Perspectives On Tuberculosis Among Traditional Chinese Medical Practitioners In New York City’s Chinatown

This article discusses the perspectives of Chinatown’s traditional Chinese medical practitioners on tuberculosis among New York City’s Chinese laborers. The practice of traditional Chinese medicine (TCM) in the United States is neither regulated nor well understood. Some public health providers have expressed their concern that the use of TCM could prevent Chinese tuberculosis patients from receiving proper, biomedical treatment. Contrary to the suspicion of public health providers, the traditional Chinese medical practitioners in the context of New York City’s Chinatown provide diverse methods of health care, many being familiar with the biomedical explanation for tuberculosis. All TCM informants in this study stated that biomedicine is more effective than Chinese medicine in treating tuberculosis. TCM in tuberculosis therapy is said to complement biomedicine and to restore bodily balance and the general health of patients. This study discusses the political–economic context shaping the explanation and treatment of tuberculosis among traditional Chinese medical practitioners and broadens our understanding of the various contexts in which TCM and biomedicine can be integrated. Furthermore, it is suggested that an opportunity exists for tuberculosis control programs to incorporate TCM practitioners in the effort to control the disease within New York City.     

Clinicians’ views and expectations of human microbiome science on asthma and its translations

Human microbiome science examines the microbiota that live in and on the human body and their role in human health. This paper examines clinicians’ views and expectations of microbiome science in asthma care. Drawing on qualitative interviews with 10 clinicians in Canada, we explore their perspectives for insights into translation of human microbiome science. The emphasis on novelty in much microbiome scholarship, we suggest, does not account fully for the ways in which microbiome science translations may be taken up in multiple ways that are both disruptive to and continuous with contemporary biomedicine. We suggest that clinicians drew on scientific discourses of “evidence” and “facts” as a form of boundary work to re-establish a separation between western biomedicine and alternative health practitioners, and clinical expertise and lay knowledge. We conclude with a discussion of human microbiome science and the emergence of post-Pasteurian modes of health in western biomedicine.     

Do physicians locate as spatial competition models predict? Evidence from Alberta.

This article analyses how physicians choose locations of practice in response to spatial competition forces and considers the implications of such choices for public policy to alleviate shortages of practitioners in rural areas. The predicted geographic distribution of physicians, as determined through spatial competition modelling, was compared with the actual distribution of physicians in 1990 among Alberta''s 19 census divisions. Physicians were found to respond to spatial competition forces in choosing where to practise, with the qualification that 1 urban patient had a demand weight equal to 2.32 rural patients. A policy to attract more physicians to rural areas by means of income subsidies is technically feasible but expensive. The high cost means that alternative policies such as a bigger and more effective ambulance network to transport patients to medical centres should become the focus of public policies to improve health care in rural areas.     

Medicine in Mississippi.

Adequate health care represents an issue that has always troubled rural America. From the earliest days of this country, affordable and quality health care has often been harder to find for those who those to live on the farm or in a small town or any place off the beaten path than it has for residents in urban areas. The State of Mississippi has undertaken an intensive program to widen access to health care--and, especially, to preventive health measures--by utilizing fully all available financial resources, including private foundations, by encouraging increased cooperation from our physicians and hospitals in caring for patients insured by Medicaid, and by involving the community in emphasizing the use of health care practitioners in delivering inexpensive but effective support to our rural population.     

Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia

ABSTRACT: BACKGROUND: It is commonly assumed that indigenous medical systems are strong in developing countries because biomedicine is physically inaccessible or financially not affordable. This paper compares the health-seeking behavior of households from rural Andean communities at a Peruvian and a Bolivian study site. The main research question was whether the increased presence of biomedicine led to a displacement of Andean indigenous medical practices or to coexistence of the two healing traditions. Methodology: Interviews were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification and analysis of households' therapeutic strategies and use of remedies was complemented by quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories. RESULTS: Our findings indicate that the health-seeking behavior of Andean households is independent of the degree of availability of biomedical facilities in terms of quality of services provided, physical accessibility, and financial affordability, except for specific practices such as childbirth. Preference for natural remedies over pharmaceuticals coexisted with biomedical healthcare that was both accessible and affordable. Furthermore, our results show that greater access to biomedicine does not lead to less prevalence of Andean indigenous medical knowledge, as represented by the levels of knowledge about culture-bound illnesses. CONCLUSIONS: The take-home lesson for health policy-makers from this study is that the main obstacle to improved use of biomedicine in resource-poor rural areas might not be infrastructural or economic alone. Rather, it may lie in lack of sufficient recognition by biomedical practitioners of the value and importance of indigenous medical systems. We propose that the implementation of health care in indigenous communities be designed as a process of joint development of complementary knowledge and practices from indigenous and biomedical health traditions.     

Classification of the heterogeneous structure of urban landscapes (STURLA) as an indicator of landscape function applied to surface temperature in New York City

Defining landscape structure and key relationships between landscape structure and function is challenging in urban areas characterized by density and patchy spatial patterns. In order to trace the spatial and temporal patterns of urban landscape structures, compare patterns across cities, or inform urban design principles, we need to classify the landscape in a way that captures context and landscape heterogeneity, but can be broadly applied across different cities or landscape variations within a city. In this study, we introduce a simple and reproducible approach for classifying the structure of urban landscapes (STURLA) that utilizes heterogeneous, composite classes which represent combinations of built and natural features, and examine the response of a landscape function – surface temperature.This classification approach is unique in that it develops composite (as opposed to homogeneous) classes, which are defined a posteriori, based on compositions of adjacent structural elements that emerge in the urban landscape, using a cellular grid to define units of analysis. We test the separability of classes that emerge from this approach, and find that it is possible to discern classes – comprised of the mix of land and building covers common in urban areas – which have meaningfully distinct temperature signatures. This classification approach may be extended to multiple cities and ecological indicators in order to offer insight into the relationship between urban landscape structure and ecosystem response, in a way that accounts for interactions among different types of urban landscape surfaces. We suggest that this approach can support spatial prioritization of landscape function needs in urban development and design approaches for improving particular types of functioning, such as reductions in urban heat.     

以生态景观构建乡村审美空间

乡村审美空间表层是非功利的,实质深层映射出人地关系本质的取向价值,是人地关系永久可持续发展问题。目前乡村研究多注重经济和土地利用,而以现实生态景观构建乡村审美空间还是有待于探讨的重要课题。近年来快速城市化发展,区域中的自然地理性质破坏对于乡村景观是致命的。立足地理生态环境架构乡村审美空间,分析乡村生态景观和审美空间对应的元素,以多尺度景观层面探寻表现在与之相映的景观空间形态结构、格局演化进程与机理响应,进而构建审美空间,组合形成现实的美丽景观体系。将生态文明和社会发展要求安排在景观空间格局配置的中,形成保持整体环境的景观网络。使得风景美的概念渗透在于城镇、乡村以至农田等更广阔的领域,从而建设具有风景画境界的"美丽乡村"。     

Pluralism and pragmatism: knowledge and practice of birth in Morocco

This article examines knowledge and practice surrounding birth in Morocco, using women's narratives of their recent birth experiences, observations of medical encounters, and statements about prescribed behaviors during pregnancy and birth, as well as the vocabulary used to refer to physiological processes, disease conditions, and social relationships. The analysis shows that the three major themes that define the traditional Moroccan ethnophysiology of birth--conceptions of hot and cold, the symbolism of blood, and the metaphors of openness and obstruction--are not inconsistent with the precepts of biomedicine and public health and do not in themselves constitute obstacles either to safe home births or the use of formal health services. Women integrate biomedical and local knowledge and practices and simultaneously seek care from "traditional" and "modern" practitioners, creatively combining elements in accordance with their situations and the means at their disposal. Birth narratives show the eclecticism and flexibility that characterize women's attitudes and behaviors regarding pregnancy and birth. Women's decisions are shaped by two overriding considerations: incertitude about what can happen during the last phase of a pregnancy and ambivalence toward the available alternatives for care, both of which reflect a realistic assessment of their situations. By showing how women make decisions in response to these considerations, this article seeks to clarify some of the links between beliefs and practices and to contribute to ongoing discussions regarding the relevance of local knowledge for patterns of health care.     

三维城市景观生态研究

城市景观元素的三维分析是城市景观研究发展的重要趋势之一。城市形态的结构特征与功能的空间作用不仅体现在二维空间中,同时在三维向度上表现出城市社会经济发展态势与空间演变的相互作用,因此在城市空间格局、过程与功能的讨论中,不能局限于二维平面。首先由三维视角提出城市景观格局及功能网络特征,并结合对航空摄影测量、卫星遥测、机载激光扫描等三维信息获取方法的认识,介绍目前城市景观三维信息提取的相关方法;其次,在三维城市景观生态研究内容方面,重点介绍城市景观要素提取、格局特征及其动态变化、生态环境效应和城市景观功能等相关研究,探讨城市内部的三维建成景观以及绿地景观要素提取与应用,并在传统景观格局分析方法基础上,提出了三维城市景观格局特征测量方法、动态变化监测方法以及动态模拟等相关内容,进一步对三维城市景观在生物多样性、局部气候变化等生态环境效应方面的研究进行了归纳总结;最后借助构建三维景观功能网络的思路,以作为三维城市景观功能优化研究的切入点。     

城市景观破碎化格局与城市化及社会经济发展水平的关系——以北京城区为例

快速城市化引发的景观破碎化加剧对于城市生态系统的过程、功能及其所提供的生态服务功能具有显著的影响。以北京市五环内中心城区为例,采用移动窗口分析、梯度分析与景观指数相结合的方法研究了城市景观破碎化的空间分布格局和内部水平差异,并以此为基础,探究景观破碎化与城市化及社会经济发展水平的关系。结果表明:类型水平上,城市建筑用地景观比例达63%,斑块连通性好,破碎化程度低,而绿地景观占33%,斑块分布不均匀,破碎化程度较高。景观水平上,城市中心和郊区的景观破碎化程度要明显低于城市边缘的城乡过渡区,沿城市化梯度从中心向外围呈现出先上升后下降的趋势。回归分析结果表明,景观破碎化程度与城市化水平之间表现出一种倒"U"型关系,并在城市化水平达42%—45%之间,景观破碎化程度达到峰值。进一步研究表明,人口密度和家庭户数是导致景观破碎化加剧的直接驱动因素,而经济的快速增长对景观破碎化程度的提高具有间接的影响。该研究结果不仅能作为城市生态系统监测的重要指标,还能为城市景观的合理规划提供科学依据,而且对于促进城市的可持续发展具有重要的意义。     

Understanding landscape patterns of temporal variability in avian populations to improve environmental impact assessments

It is recognized that wildlife populations exhibit spatial and temporal variability in patterns of species richness across heterogeneous landscapes. This phenomenon can prove problematic for environmental practitioners when attempting to complete comprehensive environmental assessments (EAs) with limited field surveys. A better understanding of regional spatio-temporal patterns in population dynamics should enhance site-level decision-making. In this study, the variability of seasonal data across the Credit River Watershed, southern Ontario, is assessed for a hierarchy of conservation measures including species richness, and two conservation wildlife response guilds based on primary habitat and area sensitivity. Bird populations were monitored at 24 forest monitoring plots across the watershed by the authors twice a season from 2003 to 2010 following the protocol of Environment Canada's Forest Bird Monitoring Program. The monitoring plots are located within four land management zones identified as 1) urban, 2) transitional, 3) escarpment and 4) rural. Data from the monitoring program are used to compare species richness among plots across the watershed and among land management zones. In addition, the variability of records from each plot over the 8 year period was determined by means of the Coefficient of Variation (CV) statistic. The mean variability of these records at each site within each land management zone was determined in order to assess whether the temporal variability of bird records might affect the integrity of short term assessments. Finally, a one-way ANOVA was applied to learn whether the result of short-term assessments may be further compounded by differences in the response of selected bird guilds to landscape heterogeneity. The results show that there is a significant difference in mean richness of forest birds among the four management zones. The ANOVAs indicate that significant difference is due to the temporal variability of a) breeding forest interior birds rather than edge birds or generalist species and b) breeding area sensitive species rather than area non-sensitive species. Recommendations are made that environmental assessments targeting forest interior bird populations need to plan sampling strategies that recognize this variability, especially for sites within the transitional and urban zones. Planning in the transition or urbanizing landscape should incorporate landscape ecology principles to sustain current levels of richness in forest species.     

Social interactions between the rural and urban monkeys,Macaca mulatta

Social interactions between urban and rural monkeys were studied both in competitive and non-competitive situations. In a competitive foodgetting situation, the urban monkeys dominated the rural ones to a significant degree. In contrast, in all the test situations the urban animals were found to be highly aggressive in their interactions with those of the rural group. Dominance of the urban over the rural monkeys was interpreted as the result of a highly aggressive nature acquired from their prior exposure to the highly competitive environment prevailing in urban areas.This study was concluded at the Panjab University, Chandigarh, India, and was partly financed by NIH grant M-5263. I am thankful to Professor Harry F. Harlow for initiating me into this project.     

Learning the Moral Economy of Commodified Health Care: “Community Education,” Failed Consumers,and the Shaping of Ethical Clinician-Citizens

Leaders of health professional schools often support community-based education as a means of promoting emerging practitioners’ awareness of health disparities and commitment to serving the poor. Yet, most programs do not teach about the causes of health disparities, raising questions regarding what social and political lessons students learn from these experiences. This article examines the ways in which community-based clinical education programs help shape the subjectivities of new dentists as ethical clinician-citizens within the US commodified health care system. Drawing on ethnographic research during volunteer and required community-based programs and interviews with participants, I demonstrate three implicit logics that students learned: (1) dialectical ideologies of volunteer entitlement and recipient debt; (2) forms of justification for the often inferior care provided to “failed” consumers (patients with Medicaid or uninsured); and (3) specific forms of obligations characterizing the ethical clinician-citizen. I explore the ways these messages reflected the structured relations of both student encounters and the overarching health care system, and examine the strategies faculty supervisors undertook to challenge these messages and relations. Finally, I argue that promoting commitments to social justice in health care should not rely on cultivating altruism, but should instead be pursued through educating new practitioners about the lives of poor people, the causal relationships between poverty and poor health, and attention to the structure of health care and provider–patient interactions. This approach involves shining a critical light on America’s commodified health care system as an arena based in relations of power and inequality.     

在风景园林研究中定义“城市中的自然”

本文有关自然和城市关系的成果,可供学界和业界参考。其中的研究例如：城市热岛效应加剧带来的影响;当前城市水管理面临的挑战;以及与城市景观和福祉相关的健康问题研究;景观的无形社会价值等。研究表明,当下正值风景园林研究范式的转变时期,有关城市和自然的思考从对立转变为并置,知识体系也通过将实践和学术研究并行而得以构建。在这种范式转变过程中,“设计驱动型研究”（Research-through-Designing）应该扮演越来越重要的角色     

基于GIS的城市绿地景观引力场研究——以宁波市为例

城市绿地是城市用地的重要组成部分 ,也是城市生态系统的一个子系统。城市绿地景观的评价是城市生态系统研究的重要课题之一。在 GIS技术支持下 ,对城市绿地景观进行了研究。在研究过程中 ,将物理学中“场”的相关理论引入城市绿地景观的研究 ,提出绿地景观引力场的概念及评价方法。绿地景观引力场是城市绿地系统为城市居民提供服务能力的大小或潜力 ,其主要影响因素有绿地景观本身的质量、城市人口分布状况、城市土地利用现状、城市主要交通设施等。在研究中需要建立以下相关模型 :城市阻力的空间分布模型、城市人口的空间分布模型、城市公共绿地的空间分布模型、城市绿地景观引力场的空间分布评价模型。研究结果得出以下结论 :(1)景观引力场用于城市绿地系统的评价 ,能够更好地反映城市绿地的空间分布格局 ;(2 )丰富了城市绿地系统评价的指标内容和评价方法 ;(3)该方法从景观设计上提供了一个可供决策参考的依据 ;(4 )景观引力场还可用于城市其它服务设施的合理性与有效性的评价与研究。     

Integrative approach revealed contrasting pattern of spatial structuring within urban and rural biotypes of Culex pipiens

Population structure of pests is an important issue when designing management strategies to optimize control measures. In this study, we investigated a spatial pattern of genetic and phenotypic variation within seven urban and within six rural populations of Culex pipiens from Vojvodina Province (Serbia) incorporating landscape genetic methods (using allozyme data) and wing size and shape (using geometric morphometric approach). Comparing rural samples, no strong genetic groupings of individuals were detected. Nevertheless, traditional approaches where individuals are pre‐assigned to populations, including F statistics and amova (analysis of molecular variance), revealed low, but significant genetic differentiation among samples. Similarly, phenotypic data (wing size and shape) indicated some level of heterogeneity among rural samples. Contrary to genetic homogeneity found within rural biotype, the individual‐based structuring characterized urban biotype. Geneland revealed the presence of two genetic clusters within urban group which is in concordance with F_ST and amova results. These results showed that sample from Novi Sad (NS) is a distinct genetic unit, which has been likely resulted in intensive insecticide use over several decades. Furthermore, phenotypic differentiation supported the existence of spatial structuring. Therefore, complementary use of molecular markers and phenotypic traits may be a powerful tool for revealing hidden spatial diversity within Cx. pipiens.     

Do protected areas in urban and rural landscapes differ in species diversity?

Previous studies from Central Europe and North America showed that species richness is higher in urban than in rural landscapes. Do protected areas, which can be found in both city and countryside, reflect this species richness pattern? The impact of urban land-use might reduce conservation success and necessitate special management strategies. We compared species richness and species spatial turnover of selected animal and plant taxa (carabids, butterflies, snails, birds, lichens, mosses, vascular plants) in 30 protected areas in the city of Halle and 56 protected areas in the adjacent rural district of Saalkreis (Central Germany). Species were mapped by experienced biologists within a systematic species inventory. We corrected species numbers for the effects of landscape structure (e.g. size, shape and distance of habitats) which might influence species diversity beyond urbanisation effects. Butterflies, birds and lichens had significantly higher species numbers in the rural protected areas. Species spatial turnover was higher among urban areas than among rural areas or pairs of urban and rural areas for most taxa. Diversity in all taxa depended on the size of a protected area. We discussed these patterns in the context of the general urban-rural species diversity patterns. Our results indicate an increasing isolation of species assemblages with urbanisation and highlight that space for protected areas is even more limited in urban than rural areas. An effective conservation of urban species diversity should include both typical urban and semi-natural habitats to cover the full range of species living in cities.     

Experience on healthcare utilization in seven administrative regions of Tanzania

Health care utilization in many developing countries, Tanzania included, is mainly through the use of traditional medicine (TRM) and its practitioners despite the presence of the conventional medicine. This article presents findings on the study that aimed to get an experience of health care utilization from both urban and rural areas of seven administrative regions in Tanzania. A total of 33 health facility managers were interviewed on health care provision and availability of supplies including drugs, in their respective areas. The findings revealed that the health facilities were overburden with higher population to serve than it was planned. Consequently essential drugs and other health supplies were available only in the first two weeks of the month. Conventional health practitioners considered traditional health practitioners to be more competent in mental health management, and overall, they were considered to handle more HIV/AIDS cases knowingly or unknowingly due to shear need of healthcare by this group. In general conventional health practitioners were positive towards traditional medicine utilization; and some of them admitted using traditional medicines. Traditional medicines like other medical health systems worldwide have side effects and some contentious ethical issues that need serious consideration and policy direction. Since many people will continue using traditional/alternative medicine, there is an urgent need to collaborate with traditional/alternative health practitioners through the institutionalization of basic training including hygiene in order to improved healthcare in the community and attain the Millennium Development Goals by 2015.