The ‘Psychic Surgeon’ and the schizophrenic patient: Crisis in a ‘Medicodrama’

This paper is concerned with a Filipino psychic surgeon confronted by a particularly challenging case of a kind perhaps unprecedented in his practice. The paper describes and analyzes how the practitioner modified his usual clinical performance and adapted his actions to demands of an extremely difficult situation. The case is viewed in wider perspective relative to the significance of performative acts of healing in a pluralistic medical setting.     

The circadian system of ruin lizards: a seasonally changing neuroendocrine loop?

Previous studies have shown that the amplitude of daily melatonin production in cultured ruin lizard pineal organs explanted in the summer is significantly higher than that from organs explanted in the winter. To test whether seasonal photoperiodic changes are decoded autonomously by the pineal gland, pineals explanted in summer were cultured in vitro and exposed to changes between winter and summer photoperiods. The changes in photoperiod duration did not affect the daily profiles of in vitro melatonin production. The discrepancy between the present in vitro results and those from lizards exposed to winter or summer photoperiods before pineal explantation supports the view that circadian information entering the pineal gland via its innervation is involved in determining seasonal changes of melatonin production in ruin lizards. We further examined whether a central component of the circadian system of ruin lizards, specifically the retinae of the lateral eyes, expresses similar seasonal changes in function as does the pineal gland. We did not find any difference between summer and autumn-winter in the effectiveness of either bilateral retinalectomy or optic nerve lesion-at the level of the optic chiasm-in altering circadian locomotor behavior in constant conditions. Both surgical procedures mostly induced a shortening of the free-running period of the locomotor rhythm of similar magnitude in all seasons. Thus, the retinae do not appear to participate in the seasonal reorganization of the circadian system in ruin lizards.     

The Gellnerian modality revisited: towards a ‘genealogy’ of cultural homogenization and nation-state congruency

This paper re-evaluates Ernest Gellner's theory of nations and nationalism and particularly his conceptions of cultural homogenization and congruency. The paper shows how Gellner's historical and epistemological stance naturalizes homogenization processes and rationalizes modern history as an inevitable trajectory of congruency making of states and nations. The paper proposes, nonetheless, to deploy a critical framework and read Gellner's notions of congruency and cultural homogenization as a ‘social imaginary’/‘fantasy’. That is, understanding congruency as a sociopolitical project that idealizes a certain imaginary as positive, necessary and inevitable – a ‘fantasy’ that sets to secure and stabilize discursively the contingency of social relations. It is suggested, moreover, to deploy a Foucauldian genealogical technique in an attempt to de-naturalize congruency and homogenization practices and expose the conditions of their emergence in modern history.     

The Efficacy and Tolerability of ‘Polypills’: Meta-Analysis of Randomised Controlled Trials

Background

To assess the blood pressure and lipid-lowering efficacy and tolerability of ‘polypills’ used in cardiovascular disease prevention trials.

Methodology/Principal Findings

Systematic review and meta-analysis. Search strategy: The Cochrane Central Register of Controlled Trials, Medline, and PubMed databases were searched for eligible trials. Study inclusion criteria: Randomised controlled trials of at least six weeks duration, which compared a ‘polypill’ (that included at least one anti-hypertensive and one lipid-lowering medication) with a placebo (or one active component). Outcome measures: Change from baseline in systolic and diastolic blood pressures, and total and LDL-cholesterol; discontinuation of study medication and reported adverse effects. Of 44 potentially eligible studies, six trials (including 2,218 patients without previous cardiovascular disease) fulfilled the inclusion criteria. Compared with placebo, ‘polypills’ reduced systolic blood pressure by −9.2 mmHg (95% confidence interval (CI): −13.4, −5.0) diastolic blood pressure by −5.0 mmHg (95%CI: −7.4, −2.6), total cholesterol by −1.22 mmol/L (95%CI: −1.60, −0.84) and LDL-cholesterol by −1.02 mmol/L (95%CI: −1.37, −0.67). However, those taking a ‘polypill’ (vs. placebo or component) were more likely to discontinue medication (20% vs 14%) (Odds ratio: 1.5 (95% CI: 1.2, 1.9)). There was no significant difference in reported adverse effects amongst those on a ‘polypill’ (36% vs. 28%) (OR: 1.3 (95%CI: 0.7, 2.5)). There was high statistical heterogeneity in comparisons for blood pressure and lipid-lowering but use of random-effects and quality-effects models produced very similar results.

Conclusions/Significance

Compared with placebo, the ‘polypills’ reduced blood pressure and lipids. Tolerability was lower amongst those on ‘polypills’ than those on placebo or one component, but differences were moderate. Effectiveness trials are needed to help clarify the status of ‘polypills’ in primary care and prevention strategies.     

Nations: Old and new Comments on Anthony D. Smith's ‘The myth of the “Modern Nation” and the myths of nations’

Abstract

Do common ethnicity and ethnic solidarity constitute preconditions for the successful formation of modern nations? In response to Anthony Smith's contention to this effect, it is here argued that ethnic solidarity at a large‐enough scale to constitute a nation is a problematic notion. Solidarities beyond small local communities require ideological and political underpinning. Rather than being preconditions of nation‐formation, ethnic homogeneity and solidarity are often products of a stable history of state and nation formation. The failures of some modern nation‐states with diverse ethnic compositions are an indication of inadequacy of resources for achieving stable ‘governability’.     

Optimizing development time in a seasonal environment: The ‘ups and downs’ of clinal variation

Summary This paper explores the problem of adapting development time to changes in the length of time conditions are favourable for growth and reproduction (season length). It is shown that systematic changes in season length along some gradient such as latitude can generate either simple clines in development time or saw-tooth clines. The relationship between development time and body size gives rise to a corresponding variation in body size. The generation of a saw-tooth cline does not require sharp environmental changes. Both types of clinal variation are observed in insects.     

The ‘shifting baseline’ phenomenon: a global perspective

In this paper we demonstrate that low level ‘artisanal’ fishing can dramatically affect populations of slow-growing, late-maturing animals and that even on remote oceanic islands, stocks have been depleted and ecosystems degraded for millennia. Industrialised fisheries have developed during different decades in different regions of the world, and this has almost always been followed by a period of massive stock decline. However, ecosystems were not pristine before the onset of industrial fishing and it is difficult to assess the ‘virgin’ state of a population given that it may have been subject to moderate or even high levels of fishing mortality for many centuries. A wide range of information is available to help define or deduce historic marine population status. These include ‘traditional’ written sources but also less conventional sources such as archaeological remains, genetic analyses or simple anecdotal evidence. Detailed information, collected specifically for the purpose of determining fish stock biomass tends to exist only for recent decades, and most fishery assessments around the world (and thus time-series of biomass estimates), are less than 30 years long. Here we advocate using a wider range of multidisciplinary data sources, although we also recognise that it can be difficult to separate natural variability associated with changing climatic conditions from human-induced changes through fishing. We consider whether or not recovery of degraded ecosystems is ever possible and discuss a series of one-way ratchet like processes that can make it extremely difficult to return to a former ecosystem state.     

‘Pho’ Phai and faux phais: The market for fakes and the appropriation of a Vietnamese national symbol

When Hanoi's favorite painter Bui Xuan Phai died in 1988, he became a legend in Vietnamese art circles. He was known as much for his paintings of ‘Old’ Hanoi streets ‐ earning him the nickname of Pho'Phai or ‘street’ Phai‐ as for his frequent visits to the underground cafes where banned writers spent their evenings drinking and philosophizing. As the Vietnamese economy improved in the early 1990s, a clientele for his paintings began to develop among Westerners visiting Hanoi. Gradually, it became increasingly clear that most of the paintings on the market attributed to Phai were in fact forgeries. This article will discuss the expectations of Westerners and their interest in an ‘authentic’ Vietnamese painting and its contrast to Vietnamese visions of their city in decay. The article illustrates how opposite notions of ‘authenticity’ and history define the cultural production of taste and alter perceptions about art and the ‘Orient.’     

The prevention and eradication of smallpox: a commentary on Sloane (1755) ‘An account of inoculation’

Sir Hans Sloane''s account of inoculation as a means to protect against smallpox followed several earlier articles published in Philosophical Transactions on this procedure. Inoculation (also called ‘variolation’) involved the introduction of small amounts of infectious material from smallpox vesicles into the skin of healthy subjects, with the goal of inducing mild symptoms that would result in protection against the more severe naturally acquired disease. It began to be practised in England in 1721 thanks to the efforts of Lady Mary Wortley Montagu who influenced Sloane to promote its use, including the inoculation of the royal family''s children. When Edward Jenner''s inoculation with the cow pox (‘vaccination’) followed 75 years later as a safer yet equally effective procedure, the scene was set for the eventual control of smallpox epidemics culminating in the worldwide eradication of smallpox in 1977, officially proclaimed by WHO in 1980. Here, we discuss the significance of variolation and vaccination with respect to scientific, public health and ethical controversies concerning these ‘weapons of mass protection’. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society.     

Chemical ‘generalists’ and behavioral ‘specialists’: a comparison of host finding by Stelidota geminata and Stelidota octomaculata

Host orientation by two nitidulid beetles was compared: Stelidota geminata (Say), which is very broad in its' host range, and Stelidota octomaculata (Say), a species whose feeding is restricted primarily to acorns. In a no-choice assay, both species responded to all food substrates offered and neither showed a significant preference among substrates (except banana versus wood fungi for S. octomaculata), or between aseptic and inoculated treatments; however, S. geminata readily displayed both phototactic flights and host-orienting flights, whereas S. octomaculata never exhibited phototactic flight and never responded to food odors by flying to the source. Furthermore, when upwind-walking response was compared, S. octomaculata walked to the source at a rate of 0.16±0.01 cm/s, which was significantly lower than that of S. geminata, with a rate of 0.54±0.02 cm/s. Turning frequency on the way to the source also differed between the two species, whereas distance traveled, number of pauses, and duration of pauses did not differ significantly. We submit that both species represent olfactory generalists, and that the restricted host range of S. octomaculata compared to S. geminata is not mediated by differences in long-range response to host odors, but rather is due to differences in other behaviors such as a reduced rate of locomotion, post-landing behavior, and possibly ecological factors.     

Aboriginal ‘Difference’ and ‘Autonomy’ Then and Now: Four Decades of Change in a Western Desert Society

In just a few decades, Aboriginal people living near Australia's Western Desert fringe have experienced an extraordinarily intense trajectory of change: from a highly autonomous nomadic existence, through ‘first contacts’, the pastoral and mission frontiers, the devastating impacts of alcohol and of Western lifestyle diseases, the outstation movement, resource exploration and mining, a long but largely successful struggle for native title, and much else. In this paper, notions of ‘difference’ and ‘autonomy’ are used to explore these transformations. The situation among the Mardu is here linked to the gulf between government policies and lived Aboriginal experience. If the self‐management thrust of 1970s policies achieved partial restoration of Aboriginal autonomy, recent Federal Government policies are intent on intervention to reduce difference and claw back some of that autonomy. Their determination to force Aboriginal people out of their ‘dysfunctional’ ‘cultural museums’ (homeland settlements) and into greater economic engagement ignores the crucial underpinnings of security and identity among remote Aborigines. The retention of difference, albeit at considerable social cost and entrenched disadvantage, is still strongly preferred by Mardu to the kinds of engagement with the dominant society that not only assault their sense of self but also threaten to overwhelm whatever autonomy remains to them.