Surgery computer: a quiet revolution for general practice.

This paper shows how a well planned computer system can transform a practice''s programme of prevention and surveillance, for long the Cinderella subjects in our Health Service. It was not necessary to employ specially trained staff to operate the computer and our receptionists adapted quickly and successfully: in fact, a new and interesting job coordinating the new routines has evolved which will include the preparation and presentation of a wide range of practice statistics. After initial hostility the computer has been accepted by the staff and its ability to increase the efficiency of the practice at all levels is now well recognised. Attention to the manual records, including updating summary sheets, was a vital part of our transition, and satisfactory office routines for recording all information daily is as essential. Since the computer was introduced the accuracy of our filing has improved dramatically. Rates of uptake for all immunisations and cervical cytology examinations are much better and the surveillance of various groups, whether by health visitors, nurses, or doctors, is no longer haphazard. The costs are within the scope of any practice, but positive encouragement by government (probably financial) would make acceptance of computers more likely. This would certainly encourage practitioners to take the initiative in prevention and surveillance, thereby ensuring that general practice remains the focus of a patient''s overall care in the next decades.     

Physiological anthropology design: a comparative study between Germany and Japan

With the recent globalization of industrial products, there is doubt as to whether the methodology of Physiological Anthropology has also been standardized. The purpose of this study is to assess signs of standardization through a comparative analysis of Physiological Anthropology design in Germany and Japan. This survey investigates its characteristics through four factors: comfort, usability, sensation and aesthetics.Both nations regard the first three indicators as important. The difference in assessment is, however, considerable. While German physiological anthropologists use subjective evaluation by means of questionnaires, somatometry and biomechanical analysis, their Japanese counterparts apply physiological measurements of the higher nervous system and the autonomic nervous system. Polymorphism and improving functional potentiality have recently gained increasing respect in Japan.Notions of aesthetics are not consciously analyzed in both countries. If the sense of beauty of product design relates to a physical and mental response, developing a systematic analysis on this factor would be a useful task for Physiological Anthropology.     

Qat use in North Yemen and the problem of addiction: A study in medical anthropology

Travelers to North Yemen nearly invariably report that Yemeni people are universally addicted to the drug qat and that the problems of the country are related to this. On the other hand, the majority of Yemenis claim that qat is not only harmless, but that it has many virtues. After describing the chemistry of the drug and the customs of use, this paper addresses the question of the concept of addiction in terms of data gathered during an extensive field study of qat use. Questions of latency, tolerance and availability are discussed, while particular attention and data are devoted to an examination of the analgesic hypothesis. It is concluded that a more complex theory is needed to deal with drug dependencies and that social and cultural perspectives must be added to concepts of the physiological and psychological effects of drugs if progress is to be made toward understanding institutional drug use such as is found with regard to qat.     

Physiological anthropology: past and future

Environmental studies in adaptive human biology by North American anthropologists have a history of strong investigative research. From both laboratory and field work, we have gained major insights into human response to physical and social challenges. While these results were considered by most professionals to belong within evolutionary biology, in fact the intellectual structure sprang almost entirely from physiological equilibrium models. Consequently, physiological process itself was the focus. Further, most of the physiological patterns were not linked directly to important outcomes such as work output, reproductive success or survival.About 1975, American physiological anthropologists, led by Paul Baker, turned to studies of health, change and stress response. These studies were strong, but were still neither genetic nor evolutionary in intellectual structure. Evolutionary human biology was taken over by a new body of theory now called "behavior ecology", positing that selfish genes control human behavior to promote their own reproduction. This was paralleled by strong use of evolutionary theory in some areas of molecular biology. However, although physiological anthropologists have not focused on evolution, we have been developing powerful causal models that incorporate elements of physiology, morphology, physical environment and cultural behavior. In these "proximate" biocultural models, it is of little importance whether outcomes such as work or energy management are genetically based.Our future offers two major challenges. First, we must confirm causal links between specific physiological patterns and outcomes of practical importance to individuals and societies. Second, if we are to take our place in evolutionary biology, the one overarching theory of life on earth, we must understand the heritability of physiological traits, and determine whether they play a role in survival and reproduction.     

The symbolic interaction of industrial work groups: A study in social anthropology

Norman O'Neil is Professor of Anthropology at University of Hull, UK     

Psoriasis: evolution and revolution

Psoriasis is a model disease in dermatology. It is a common disease that affects at least 2 to 3 % of the population. It is an illness characterized by an excessive reaction of the skin, in term of proinflammatory cytokines release, to no specific attacks: these attacks can be immunological, mechanical, metabolic, drug-induced or psychological. This excessive reaction is characterized by epidermal proliferation combined with incomplete terminal differentiation, as well as an inflammatory response responsible for the chronic nature of the lesions. The way to understand psoriasis is therefore to reach a better appreciation of the messages that enable the skin cells to initiate an inflammatory response, and by better understanding the way in which the inflammatory cells responsible for innate and acquired immune responses are capable of bringing about proliferation and abnormal epidermal differentiation. Taking an interest in psoriasis is therefore taking an interest in all facets of skin physiology and in all the ways the skin reacts to attacks from the environment. Every year for more than thirty years, more than 300 publications have endeavoured to explore one aspect or another of psoriasis from a clinical, epidemiological, physiopathological or therapeutic point of view. There is no new technique for observing the skin that has not been immediately applied to the study of psoriasis - which is privileged to enjoy the reflected progress made in dermatology. Nor has psoriasis remained untouched by whims of fashion, all manner of scenarios having been suggested to explain it, right from a scarring disease to an autoimmune illness through a genetic or psychosomatic disorder. Psoriasis is at the origin of a medical revolution mounted to supplement and enhance the effectiveness of evidence-based medicine ; it is the "patient-centred medicine". Psoriasis only exceptionally jeopardizes life. Conversely, it is a disease that does affect quality of life. The patient alone must be the judge of his or her quality of life, and it is therefore up to the patient, not the doctor, to gauge the severity of psoriasis and hence decide on reasonable therapeutic indications. Psoriasis, then, cannot be treated without placing the patient, not the illness, at the centre of therapeutic negotiations. The 20th century has seen the disease targeted by boundless efforts ; the 21st century will see the development of medical techniques that allow the patient, in all its complexity, to be positioned at the centre of therapeutic efforts. This revolution began in dermatology, centring around psoriasis, and is spreading progressively to all chronic disorders and all disciplines. New quite interesting therapeutic weapons are available from a few months making possible to better adjust the therapeutic strategies of psoriasis to the patients needs but they are expensive opening again the debates on the limit of the social solidarity.     

Demographic anthropology in the study of matrimonial exchanges in a Dogon isolate

The Dogon population of Boni lives in the south-Sahelian bush of Mali, on several abrupt mountains. It forms a community within which each of its members finds a spouse. This criterion of membership is based on a concept of population taken in the “genetic sense”. This population is small (5000 persons approximately) and it forms a genetic isolate. Matrimonial exchanges are very important in the process of evolution of populations thus it can be useful to construct explanatory models. Different analysis levels allow to better describe a phenomenon resulting from a complex system of interdependent factors.

-the global analysis is quantitative and shows the high endogamic level observed within each village and each mountain,

-the qualitative analysis, motivated by a genetic study associated to criteria of choice of the spouse.

-an anthropological analysis will be presented as a third possible level in the matrimonial market analysis. It consists of investigating alliance cycles based on the study of brother-sister pairs and implying three marriages. The high frequency of the type of cycle raises questions and incites to researching a coherent interpretation.

     

Substance and process: Reappraising the premises of the anthropology of law

Conclusion The anthropology of law works best through the use of the holistic approach that Hoebel recommended in the early stages of the subdiscipline. That approach includes the study of trouble cases, of patterns of actual law-related behavior, and of abstract rules or principles, the last being not the least among them. The quest should ideally be joined, however, so as to generate data that lend themselves to cross-cultural comparison and the formulation of politico-legal principles of a general sort, a goal which numerous anthropologists of law have already espoused in their work. But as Smith and Roberts caution, this is particularly difficult with regard to substantive law content, because substantive law is a particularly culture bound domain: there is considerable variability from society to society in its specific content. The structural comparison of substantive law notions as they occur within the boundaries of particular societies, by contrast, presents one fruitful alternative approach, one which carefully reflects the realities of intergroup politics. Through a political analysis of variability in cognitive models of law can better be seen as a reflection of, and an underpinning to, the socio-economic base that correlates with it.Nader indirectly calls attention to the fact that the law realm is best viewed from an explicitly political vantage. She notes that a lack of interest in substantive law has been accompanied by a relative loss of interest in political development, two tendencies which Koch also cites. But the very element of political developmental dynamics, as has been seen, forms a crucial component in understanding the variability in substantive law models and, more broadly, law's ideational side (see Moore ). Polities that wield considerable power potentials can generate and accomodate co-occurring non-isomorphic law models, and, indeed, it seems advantageous from the elite vantage for them to do so. With respect to their political strategies, societies with more modest power potentials also seem to avail themselves of such discordances to some degree. The result is a complex involvement with substantive law in most societies, and certainly at the state level.Daisy Hilse Dwyer is Assistant Professor of Anthropology at Columbia University.

---