Beliefs Matter: Cultural Beliefs and the Use of Cervical Cancer-Screening Tests

In this article we examine the influence of cultural beliefs on behavior or, more specifically, beliefs about cervical cancer risk factors and the use of Pap exams. Individual Latinas' (Hispanic women) holding of beliefs similar to Latinas' generally (cultural consonance) did not significantly influence their use of Pap exams. Rather, structural factors such as medical insurance, age, marital status, education, and language acculturation explained Latinas' use of this medical service. However, when Latinas held beliefs similar to those of Anglo women, then they were significantly more likely to have had a Pap exam within the past two years. Latinas whose beliefs were closer to those of physicians were significantly less likely to have had the exam recently. Arriving at these findings involved both ethnographic interviews and survey research. That these beliefs proved to be significant influences on behavior suggests not only the important ways that beliefs matter but that ethnographic methods for examining those beliefs also matter. [ Latinas and cervical cancer, Pap exams, culture and behavior, ethnography and survey research ]     

The idea of health: history,medical pluralism,and the management of the body in Emilia-Romagna,Italy

Basic beliefs about health in north central Italy derive from an approach to the personal management of the body that is not just reactive but also proactive. This article examines a complex field of health factors in relation to historical processes and a system of medical pluralism. Rapid demographic and social changes over the past century have brought an accommodation of ancient medical beliefs to more recent germ-oriented principles. An enduring belief in the permeability of the body leads to an emphasis on moderation in personal conduct to prevent debilitation, whether by atmospheric insults, microbial infection, or modern-day miasmas such as pollution or additives in food. The idea of health itself is analyzed to show how biomedicine varies across societies and how historical processes have shaped contemporary cultural patterns and led to generational continuities and differences in beliefs and behaviors. This information may also improve interactions between patients and health care providers.     

Giving birth to gonolia: "culture" and sexually transmitted disease among the Huli of Papua New Guinea

The "culture concept" has been challenged on a number of fronts, both by medical anthropologists researching AIDS and in the discipline of cultural anthropology more generally. Medical anthropologists have argued against the "etiologization" of culture, and cultural anthropologists have taken issue with the tendency to treat beliefs and practices as static and seamlessly shared. Using the narrative of one Huli woman's shifting explanation of a diagnosis of syphilis, this article argues that, rather than avoid the notion of culture, we should strive for representations that demonstrate how individuals use discourses in expedient, ad hoc, and yet deeply felt ways. This article also argues for the importance of a sociology of knowledge approach to understanding local notions of etiology. The woman's understanding of her situation was strongly influenced by her entry into a new "community" of women who had similarly been diagnosed with a sexually transmitted disease.     

Wild beans of the greater southwest:Phaseolus metcalfei andP. ritensis

Cocolmeca (thePhaseolus metcalfei group) are leguminous root perennials of the uplands (1,000–2,500 m elevation) of southwestern North America. Their cultural significance has been underestimated both within and beyond their natural range, where they have been utilized in prehistoric and historic times. Ambiguities in both scientific taxonomy and folk taxonomy obscure the fact that bothP. metcalfei andP. ritensis have been widely used as systemic medicine, food, in fermentation, as forage, and as glue. The use of the seeds as green and dried bean foods was historically extensive, but was abandoned due to changes in Indian subsistence patterns and in the availability of the plants themselves. Herb dealers today are responsible for transport of the roots as far north as the Navajo in Utah; it is suggested that cross- cultural merchants may have been responsible for their diffusion historically or even prehistorically. Bean seed from the two species contain 20.5–30.9% crude protein. Germ plasm conservation and screening are needed in order to evaluate further the potential of these species as cultivated food and forage crops for semiarid uplands.     

Social Learning and the Maintenance of Cultural Variation: An Evolutionary Model and Data from East Africa

Human societies maintain between-group variation despite mixing of people and ideas. In order for variation to remain, migrants or their children must preferentially adopt local norms, customs, and beliefs. Yet the details of how cultural variation is maintained, despite mixing, remain unknown. This article addresses this problem by using a simple model of the evolution of cultural learning to interpret the results of a study of cultural variation in a small region of East Africa. I argue that the manner in which migrants of two diverse regions adapt to local beliefs and behavior depends on the costs and accuracy of learning in each domain. Observational studies are never definitive tests of any hypothesis, but these results suggest that conclusions about the significance of cultural learning for understanding individual attitudes and behavior depend strongly upon the domain of investigation.     

Diagnostic Dilemmas and Cultural Diversity in Emergency Rooms

Language and cultural beliefs play an extremely important role in the interaction between patients from diverse cultural groups and physicians. Especially in emergency rooms, there are many dangers in missed communications. A patient from a foreign culture, especially one who does not speak English, often expresses symptoms in ways that are unfamiliar to many American physicians. Specific areas of cultural vulnerability can be identified for the major ethnic groups in the United States as they interact with the scientific medical system. A short review of folk medical beliefs and recommendations for improving diagnostic accuracy and treatment may assist emergency room staffs in offering care that is culturally acceptable to patients of diverse ethnic backgrounds.     

Taxonomy‐free molecular diatom index for high‐throughput eDNA biomonitoring

Current biodiversity assessment and biomonitoring are largely based on the morphological identification of selected bioindicator taxa. Recently, several attempts have been made to use eDNA metabarcoding as an alternative tool. However, until now, most applied metabarcoding studies have been based on the taxonomic assignment of sequences that provides reference to morphospecies ecology. Usually, only a small portion of metabarcoding data can be used due to a limited reference database and a lack of phylogenetic resolution. Here, we investigate the possibility to overcome these limitations using a taxonomy‐free approach that allows the computing of a molecular index directly from eDNA data without any reference to morphotaxonomy. As a case study, we use the benthic diatoms index, commonly used for monitoring the biological quality of rivers and streams. We analysed 87 epilithic samples from Swiss rivers, the ecological status of which was established based on the microscopic identification of diatom species. We compared the diatom index derived from eDNA data obtained with or without taxonomic assignment. Our taxonomy‐free approach yields promising results by providing a correct assessment for 77% of examined sites. The main advantage of this method is that almost 95% of OTUs could be used for index calculation, compared to 35% in the case of the taxonomic assignment approach. Its main limitations are under‐sampling and the need to calibrate the index based on the microscopic assessment of diatoms communities. However, once calibrated, the taxonomy‐free molecular index can be easily standardized and applied in routine biomonitoring, as a complementary tool allowing fast and cost‐effective assessment of the biological quality of watercourses.     

The scope of ethnomedical science

The subject matter of the field of ethnomedicine is outlined in this paper. Basic concepts and problem concerns are described. The linkages which ethnomedicine has with the other social and biologic disciplines are discussed. Ethnomedicine deals with information pertaining to social adaptation, deviant behavior, illness, disease, medical taxonomy, folk medical knowledge, and systems of medical care. Some of the problems inherent in studying these issues are described. Attention is also given potentially rich areas of inquiry which, heretofore, have not been cast in an ethnomedical context.     

Karma, reincarnation, and medicine: Hindu perspectives on biomedical research

Prior to the completion of the Human Genome Project, bioethicists and other academics debated the impact of this new genetic information on medicine, health care, group identification, and peoples’ lives. A major issue is the potential for unintended and intended adverse consequences to groups and individuals. When conducting research in, for instance, American Indian and Alaskan native (AI/AN) populations, political, cultural, religious and historical issues must be considered. Among African Americans, the Tuskegee Syphilis Experiment is a reminder of racism and discrimination in this country. The goal of the current study is to understand reasons for participating, or not, in genetic research such as the HapMap project and other genetic/medical research from the perspective of the Indian American community in Houston, Texas. In this article, we report on a topic central to this discussion among Indian Americans: karma and reincarnation. Both concepts are important beliefs when considering the body and what should happen to it. Karma and reincarnation are also important considerations in participation in medical and genetic research because, according to karma, what is done to the body can affect future existences and the health of future descendants. Such views of genetic and medical research are culturally mediated. Spiritual beliefs about the body, tissue, and fluids and what happens to them when separated from the body can influence ideas about the utility and acceptability of genetic research and thereby affect the recruitment process. Within this community it is understood that genetic and environmental factors contribute to complex diseases such as diabetes, hypertension, and cancer; and acknowledgment of the significance of environmental stressors in the production of disease. A commitment to service, i.e. “betterment of humanity,” karmic beliefs, and targeting environmental stressors could be prominent avenues for public health campaigns in this population. This study suggests that minority status does not automatically indicate unwillingness to participate in genetic or medical research. Indian Americans were not skeptical about the potential benefits of biomedical research in comparison to other ethnic minority communities in the United States.     

Letter to my doctor

Considerable attention is now being given to ethical conflicts raised by such issues as the disclosure of diagnosis and prognosis, the role of the family in making medical decisions, and the withholding or withdrawing of treatment of terminally ill patients. Already complicated, these issues take on added complexity in contexts where medical professionals and patients have differing cultural beliefs and practices. Ethical dilemmas that develop in multicultural settings have been largely unaddressed. Through the analysis of a case involving the hospital admission and death of a Chinese woman with metastatic lung cancer, we examine some of these dilemmas and their effect on the patient, family, and physicians. Many issues were raised by this case regarding the relationships among ethnic background, bioethics, and medical care.     

Use of traditional and modern health services by Laotian refugees.

Although refugee health care emerged as a special interest in the United States following the influx of almost a million Southeast Asians since 1975, few studies have been done of the influence of refugee traditions on the use of Western medical services. The illness patterns, medical beliefs, and health care behavior of a Southeast Asian refugee group, the Mien from Laos are described in this study. A cohort of 119 Mien refugees living in Richmond, California, was observed for a 6-month period. In-home interviews were undertaken about all episodes of ill health, including treatment and health care decisions. This study shows that the Mien integrate traditional healing beliefs and practices with the use of American health services. Such findings are important because the increasing cultural diversity in the United States, particularly in Western states, necessitates that health care professionals understand the importance of cultural factors for access to and the use of health care by all patients including refugees and other immigrant groups.     

Scars of experience: the art of moxibustion in Japanese Medicine and Society

Beliefs and practices surrounding moxibustion, a cautery technique used in Japan, are analyzed to demonstrate that the concept of holism is culture-bound and that the practice of East Asian medicine is often reductionistic.Pluralistic traditional medical belief systems of historical and contemporary Japan are discussed with reference to moxibustion. Moxa is used in popular family medicine, for ritual purification, as a technique to cure disease or as part of a holistic approach to healing; its symbolic meaning changes according to its usage and it serves to unite disparate medical beliefs.Socialization practices concerning attitudes towards illness reflect pluralistic values derived from traditional medical systems. One dominant set of values encourages patient and family responsibility during the healing process, adaptation to psychosocial relationships regarded as causal in disease occurrence and avoidance of verbal analysis of problems. These concepts, fundamental to East Asian medicine, cannot be readily adapted in the West as part of a holistic approach to health care.     

Concepts of rational taxonomy

The problems are discussed related to development of concepts of rational taxonomy and rational classifications (taxonomic systems) in biology. Rational taxonomy is based on the assumption that the key characteristic of rationality is deductive inference of certain partial judgments about reality under study from other judgments taken as more general and a priory true. Respectively, two forms of rationality are discriminated--ontological and epistemological ones. The former implies inference of classifications properties from general (essential) properties of the reality being investigated. The latter implies inference of the partial rules of judgments about classifications from more general (formal) rules. The following principal concepts of ontologically rational biological taxonomy are considered: "crystallographic" approach, inference of the orderliness of organismal diversity from general laws of Nature, inference of the above orderliness from the orderliness of ontogenetic development programs, based on the concept of natural kind and Cassirer's series theory, based on the systemic concept, based on the idea of periodic systems. Various concepts of ontologically rational taxonomy can be generalized by an idea of the causal taxonomy, according to which any biologically sound classification is founded on a contentwise model of biological diversity that includes explicit indication of general causes responsible for that diversity. It is asserted that each category of general causation and respective background model may serve as a basis for a particular ontologically rational taxonomy as a distinctive research program. Concepts of epistemologically rational taxonomy and classifications (taxonomic systems) can be interpreted in terms of application of certain epistemological criteria of substantiation of scientific status of taxonomy in general and of taxonomic systems in particular. These concepts include: consideration of taxonomy consistency from the standpoint of inductive and hypothetico-deductive argumentation schemes and such fundamental criteria of classifications naturalness as their prognostic capabilities; foundation of a theory of "general taxonomy" as a "general logic", including elements of the axiomatic method. The latter concept constitutes a core of the program of general classiology; it is inconsistent due to absence of anything like "general logic". It is asserted that elaboration of a theory of taxonomy as a biological discipline based on the formal principles of epistemological rationality is not feasible. Instead, it is to be elaborated as ontologically rational one based on biologically sound metatheories about biological diversity causes.     

Three numerical approaches to the classification of Chinese species of genus Abelia

In the last 10—20 years there has bee n increasing awareness of the problem concerning the aims and practices of taxonomy. In particular, there has been growing interest in the development of numerical methods in biological taxonomy as an aid to making systematics a quantitative science, a step which comes in time to almost every scientific discipline. Numerical taxonomy is the evaluation by numerical methods of the affinity or similarity between taxonomic units and the employment of these affinities in erecting a hierarchic order of taxa. The present rapid development of these ideas is presumably a result of the development of computer techniques. Numerical taxonomic approach has been applied to the studies of entomology and microbiology in China to some extent since 1975. But so far it hasn’t been commonly used in botany. The present report is a preliminary study on 9 spp. of the genus Abelia. A set of binary data with 54 characters is used for computing association coefficient; and a set of quantitative data with 47 characters for distance coefficient and correlation coefficient. For the mathematical models were chosen the non-metric simple matching association coefficient, the geometrical distance of Riemannian space and correlation coefficient. Computational procedures are stepwise presented in detail and computer programmes are written in the background of Algol-60 language. Cluster analysis is compared with simple linkage, average linkage and multi-correlation. The results of DC and CC for 9 spp. of Abelia agree closely with the traditional taxonomy, because the data we collected mainly come from morphological characters. It would seem that the results of quantita tive data are more appropriate for seed plants. It is, therefore, postulated that our programes are complementary and very useful to a wide range of classification entities, such as microbes, animals and plants in present situation in China. In conclusion, a comparison between the conventional taxonomy and numerical taxonomy has been made, and a brief discussion of three problems, i.e. the monothetic versus polythetic, divisive versus agglomerative, weighting versus unweighting.     

A Teaching Framework for Cross-cultural Health Care—Application in Family Practice

Significant demographic changes in patient populations have contributed to an increasing awareness of the impact of cultural diversity on the provision of health care. For this reason methods are being developed to improve the cultural sensitivity of persons responsible for giving health care to patients whose health beliefs may be at variance with biomedical models.Building on methods of elicitation suggested in the literature, we have developed a set of guidelines within a framework called the LEARN model. Health care providers who have been exposed to this educational framework and have incorporated this model into the normal structure of the therapeutic encounter have been able to improve communication, heighten awareness of cultural issues in medical care and obtain better patient acceptance of treatment plans.The emphasis of this teaching model is not on the dissemination of particular cultural information, though this too is helpful. The primary focus is rather on a suggested process for improved communication, which we see as the fundamental need in cross-cultural patient-physician interactions.     

Cryptosporidium systematics and implications for public health

There is controversy in the taxonomy of Cryptosporidium parasites and the public health significance of Cryptosporidium isolates from various animals. Recent advances in molecular characterization of Cryptosporidium parasites have allowed the re-examination of species structure of the genus Cryptosporidium. Non-parvum Cryptosporidium spp and new C. parvum genotypes in immunocompromised humans can now be clearly detected. In this article, Lihua Xiao and colleagues summarize the current biological and molecular evidence for different Cryptosporidium spp, and the public health importance of these species and new C. parvum genotypes.     

Patterns and Processes in Cultural Evolution

Darwinian models of cultural change have been motivated, in part, by the desire to provide a framework for the unification of the biological and the human sciences. In this paper, drawing upon a distinction between the evolution of enabling mechanisms for the acquisition and dissemination of knowledge (EEM) and the evolution of epistemic theses as cultural products (EET), we propose a model of how culture emerges as a product of biological evolution on the basis of the concept of reaction norms. The goal of this model is to provide a means for conceptualizing how the biological and the cultural realms are connected, when they start to disconnect, and what the key transitions are. We then assess the viability of a Darwinian approach to cultural change. We conclude that the prospects of producing a Darwinian model of cultural change that unifies the human sciences in a way that mirrors the unification of the biological sciences in the light of Darwin’s theory are rather dim.