Understanding Genital-Shrinking Epidemics in West Africa: <Emphasis Type="Italic">Koro</Emphasis>, <Emphasis Type="Italic">Juju</Emphasis>, or Mass Psychogenic Illness?

A small-scale epidemic of genital shrinking occurred in six West African nations between January 1997 and October 2003. This article presents a summary and analysis of 56 media reports of these cases. A clinical formulation of these cases considers a variety of explanations from theory and research in social and cultural psychology, psychopathology, and anthropology. Of particular interest is a comparison of genital-shrinking distress in West African settings with koro, a culture-bound syndrome involving fears of genital retraction that is prominent in Southeast Asian settings. The paper concludes with a brief discussion of the role of culture in both the experience of genital-shrinking distress and conceptions of psychopathology.     

"Taming tradition": medicalized female genital practices in western Kenya

This article considers the question of female genital practices at the hands of health workers in western Kenya. Recent articles in Medical Anthropology Quarterly have critically engaged with the biomedical arguments condemning such practices. This article studies the case of medicalized circumcision in which biomedical concerns over health risks have become incorporated in their vernacular practice. Although some suggest that medicalization may provide a harm-reduction strategy to the abandonment of the practice, research in one region challenges this suggestion. It argues that changing and conflicting ideologies of gender and sexuality have led young women to seek their own meaning through medicalized practice. Moreover, attributing this practice to financial motivations of health workers overlooks the way in which these "moral agents" must be situated within their social and cultural universe. Together, these insights challenge the view that medicine can remain neutral in the mediation of tradition.     

Genetic counseling as an occupational specialty: A sociological perspective

Abstract

Observations of client‐counselor interaction during genetic counseling sessions at a metropolitan hospital on the West Coast identified five major problems with which genetic counselors had to deal. Their clients needed: (1) a diagnosis of the disease condition; (2) an evaluation of the genetic nature of the condition; (3) to be taught biomedical information; (4) assistance in coping with psychological stress; and (5) information on available community resources and social service support. The genetic counselors under observation tended to satisfy the clients’ first two needs, the need for a diagnosis and for a genetic evaluation, but they tended not to satisfy the clients’ needs in the areas of education and psychosocial counseling. Genetic counseling appears to demand a synthesis of five different professional skills, those of the medical doctor, the geneticist, the educator, the psychotherapist, and the social worker. These findings are discussed in terms of their relevance for creating programs for training genetic counselors.     

Social interaction in nonhuman primates: an underlying theme for primate research.

Social living is assumed to be a critical feature of nonhuman primate existence inasmuch as most primate species live in social groups in nature. Recent USDA legislation emphasizes the importance of social contact in promoting psychological well-being and recommends that laboratory primates be housed with companions when consistent with research protocols. Our goals were to examine the link between social housing and psychological well-being and to explore the idea that research may be compromised when primates are studied in environments that vary too greatly from their natural ecological setting (individual cage housing versus group housing). Three general points emerge from these examinations. First, providing companionship may be a very potent way in which to promote psychological well-being in nonhuman primates; however, social living is not synonymous with well-being. The extent to which social housing promotes psychological well-being can vary across species and among individual members of the same species (for example, high- and low-ranking monkeys). Secondly, housing conditions can affect research outcomes in that group-housed animals may differ from individually housed animals in response to some manipulation. Social interaction may be a significant variable in regulating the biobehavioral responses of nonhuman primates to experimental manipulations. Finally, a larger number of socially housed subjects than individually housed subjects may be necessary for some biomedical research projects to yield adequate data analysis. Thus, social living has significant benefits and some potential costs not only for the animals themselves, but for the research enterprise.     

The emergence of biomedical anthropology and its implications for the future

Primarily during the past 15 years a distinct new area within physical anthropology has emerged, biomedical anthropology. Physical anthropologists have become heavily involved in studying problems of relevance to the health and illness patterns of living humans. There has been a proportionate increase in biomedically focused papers published in the American Journal of Physical Anthropology, in biomedically focused papers presented at annual meetings of the American Association of Physical Anthropologists, and in physical anthropology doctoral dissertations oriented toward modern biomedical phenomena. Proportionately more physical anthropologists are now employed in medical schools and there has been recent growth in the proportion of physical anthropologists in anthropology departments who claim some aspect of biomedical anthropology as a research interest. Increasingly, physical anthropologists are focusing their research on cardiovascular disease, the leading cause of death in America. These distinct trends are partially a result of the nature of physical anthropology and its unique biocultural perspective. However the growth of applied anthropology, the present academic marketplace, and the availability of research funds are probably also contributing factors. The emergency of biomedical anthropology holds promise for the future of physical anthropology and for its current employment crisis. Careers with academic and nonacademic organizations engaged in biomedical research appear to be a viable alternative to careers in departments of anthropology, for biomedical anthropologists. This will entail some reorientation of graduate training for physical anthropologists. More emphasis will have to be placed on substantive biomedical subjects, research methods, and data management and analysis.     

The soul of medicine

This article considers contributions that the medical humanities have made to biomedical ethics. Philosophy has contributed methods of ethical justification to case analysis and has given birth to the New Professionalism movement. Taking biography as its paradigmatic resource, this movement has refocused medical education on the formation of physicians who not only have certain responsibilities to their patients, but also a regard for the role of the medical profession in working toward social justice. However, reliance on biography is now giving way to a renewed emphasis on autobiography, as educators seek to support medical students through the personal and spiritual journey that confrontation with death, disease, and injustice naturally entails. Reflective methods and techniques characterize this emerging era as educators and students try to preserve and reinvigorate the soul of medicine.     

Early false-belief understanding in traditional non-Western societies

The psychological capacity to recognize that others may hold and act on false beliefs has been proposed to reflect an evolved, species-typical adaptation for social reasoning in humans; however, controversy surrounds the developmental timing and universality of this trait. Cross-cultural studies using elicited-response tasks indicate that the age at which children begin to understand false beliefs ranges from 4 to 7 years across societies, whereas studies using spontaneous-response tasks with Western children indicate that false-belief understanding emerges much earlier, consistent with the hypothesis that false-belief understanding is a psychological adaptation that is universally present in early childhood. To evaluate this hypothesis, we used three spontaneous-response tasks that have revealed early false-belief understanding in the West to test young children in three traditional, non-Western societies: Salar (China), Shuar/Colono (Ecuador) and Yasawan (Fiji). Results were comparable with those from the West, supporting the hypothesis that false-belief understanding reflects an adaptation that is universally present early in development.     

Use and function of genital contacts among female bonobos

Female bonobos, Pan paniscus, show a mounting behaviour that differs physically from that in other primate species. They embrace each other ventroventrally and rub their genital swellings against each other. We investigated five hypotheses on the function of ventroventral mounting (genital contacts) that derive from previous studies of both primate and nonprimate species: (1) reconciliation; (2) mate attraction; (3) tension regulation; (4) expression of social status; and (5) social bonding. We collected data in six field seasons (1993-1998) from members of a habituated, unprovisioned community of wild bonobos at Lomako, Democratic Republic of Congo. No single hypothesis could account for the use of genital contacts, which appeared to be multifunctional. We found support for hypotheses 1 and 3. Rates of postconflict genital contacts exceeded preconflict rates suggesting that the display is used in the context of reconciliation. Rates of genital contacts were high when food could be monopolized and tension was high. However, genital contacts also occurred independently of agonistic encounters. Our study shows rank-related asymmetries in initiation and performance of genital contacts supporting the social status hypothesis: low-ranking females solicited genital contacts more often than high-ranking females while the latter were more often mounter than mountee. Although subordinates took more initiative to achieve genital contact, dominants mostly responded to the solicitation (ventral presentation) with mounting, indicating that the performance benefits both individuals. We suggest that genital contacts can be used to investigate both quality and dynamics of dyadic social relationships among female bonobos. Copyright 2000 The Association for the Study of Animal Behaviour.     

Red is not a proxy signal for female genitalia in humans

Red is a colour that induces physiological and psychological effects in humans, affecting competitive and sporting success, signalling and enhancing male social dominance. The colour is also associated with increased sexual attractiveness, such that women associated with red objects or contexts are regarded as more desirable. It has been proposed that human males have a biological predisposition towards the colour red such that it is 'sexually salient'. This hypothesis argues that women use the colour red to announce impending ovulation and sexual proceptivity, with this functioning as a proxy signal for genital colour, and that men show increased attraction in consequence. In the first test of this hypothesis, we show that contrary to the hypothesis, heterosexual men did not prefer redder female genitalia and, by extension, that red is not a proxy signal for genital colour. We found a relative preference for pinker genital images with redder genitalia rated significantly less sexually attractive. This effect was independent of raters' prior sexual experience and variation in female genital morphology. Our results refute the hypothesis that men's attraction to red is linked to an implied relationship to genital colour and women's signalling of fertility and sexual proceptivity.     

Universal Human Rights and the Problem of Unbounded Cultural Meanings

Freedom from violence stands as an important candidate for a universal human right. By definition, however, such rights apply only to phenomena that are universally perceived and experienced and take predictable expression, a possibility that many contemporary interpretations of cultural theory reject. Yet people who live dramatically different lives—on tourist islands in the West Indies or as hunter-gatherers and reindeer herders in Arctic regions—agree about components that comprise a unitary phenomenon legitimately called "violence." This is consistent with findings from cognitive and neruological science and with a more Geertzian theory that culture understood as meaning is not a thing, cultural variability occurs between individuals, and cultural consensus emerges as a necessary consequence of social interaction among people who participate in common social fields, who engage in common social discourse.     

Clique-based data mining for related genes in a biomedical database

Background  

Progress in the life sciences cannot be made without integrating biomedical knowledge on numerous genes in order to help formulate hypotheses on the genetic mechanisms behind various biological phenomena, including diseases. There is thus a strong need for a way to automatically and comprehensively search from biomedical databases for related genes, such as genes in the same families and genes encoding components of the same pathways. Here we address the extraction of related genes by searching for densely-connected subgraphs, which are modeled as cliques, in a biomedical relational graph.     

Indigenous Koro,a genital retraction syndrome of insular Southeast Asia: A critical review

Koro, a disorder characterized by complaints of genital hyperinvolution and fear of impending death, is found to be indigenous to certain populations of insular Southeast Asia. Koro is similar to, but nevertheless distinct from, the Chinese syndrome which carries its name and serves as the transcultural prototype; the category of genital retraction syndromes is proposed as a substitute for the use of koro» as the transcultural rubric. In a review of the Koro literature, an exploration of the many possible cultural and biomedical factors is begun; the issues and perspectives are relevant to the wider study of culture speck manifestations of genital retraction.     

Combining experiments with multi-cell agent-based modeling to study biological tissue patterning

Agent-based modeling (ABM), also termed ‘Individual-basedmodeling (IBM)’, is a computational approach that simulatesthe interactions of autonomous entities (agents, or individualcells) with each other and their local environment to predicthigher level emergent patterns. A literature-derived rule setgoverns the actions of each individual agent. While this techniquehas been widely used in the ecological and social sciences,it has only recently been applied in biomedical research. Thepurpose of this review is to provide an introduction to ABMas it has been used to study complex multi-cell biological phenomena,underscore the importance of coupling models with experimentalwork, and outline future challenges for the ABM field and itsapplication to biomedical research. We highlight a number ofpublished examples of ABM, focusing on work that has combinedexperimental with ABM analyses and how this pairing producesnew understanding. We conclude with suggestions for moving forwardwith this parallel approach.      

A new solution for biomedical experiments

This article discusses mutual interactions phenomena especially in the case of Transverse ElectroMagnetic (TEM) cell applications as an exposure system in technical and biomedical studies. Problem of mutual interactions between tested objects placed in the electromagnetic field (EMF) is described. A new device for exposure system is presented. Its role is elimination of mentioned harmful phenomenon that leads to falsifications of results.     

Psychosocial stress and infertility

Experimental, theoretical, psychological, and economic barriers have caused physicians to rely on biomedical treatments for infertility at the exclusion of more environmentally oriented ones (e.g., psychosocial stress therapy). An evolutionary model is described for the origin of reproductive failure, suggesting why mammals evolved to be reproductively responsive to the environment and why psychosocial stress should have an especially strong impact on fertility problems. A study of the causal role of psychosocial stress in infertility is then summarized. The paper concludes with implications for future directions for the treatment of infertility and related human reproductive problems.     

Genetic and environmental influences on human psychological differences

Psychological researchers typically distinguish five major domains of individual differences in human behavior: cognitive abilities, personality, social attitudes, psychological interests, and psychopathology (Lubinski, 2000). In this article we: discuss a number of methodological errors commonly found in research on human individual differences; introduce a broad framework for interpreting findings from contemporary behavioral genetic studies; briefly outline the basic quantitative methods used in human behavioral genetic research; review the major criticisms of behavior genetic designs, with particular emphasis on the twin and adoption methods; describe the major or dominant theoretical scheme in each domain; and review behavioral genetic findings in all five domains. We conclude that there is now strong evidence that virtually all individual psychological differences, when reliably measured, are moderately to substantially heritable.     

Reproductive strategies and Islamic discourse: Malian migrants negotiate everyday life in Paris, France

Approximately 37 thousand Malians currently reside in France as part of the West African diaspora. Primarily Muslim, both women and men confront challenges to their understandings of Islamic prohibitions and expectations, especially those addressing conjugal relations and reproduction. Biomedical policies generate marital conflicts and pose health dilemmas for women who face family and community pressures to reproduce but biomedical encouragement to limit childbearing. For many women, contraception represents a reprieve from repeated pregnancies and fatigue in spite of resistance from those who contest women's reproductive decisions as antithetical to Islam. French social workers play a particularly controversial role by introducing women to a discourse of women's rights that questions the authority of husbands and of religious doctrine. Women and men frame decisions and debate in diverse interpretations of Islam as they seek to manage the contradictions of everyday life and assert individual agency in the context of immigration and health politics.     

Pandemic management and developing world bioethics: bird flu in West Bengal

This paper examines the case of a recent H5N1virus (avian influenza) outbreak in West Bengal, an eastern state of India, and argues that poorly executed pandemic management may be viewed as a moral lapse. It further argues that pandemic management initiatives are intimately related to the concept of health as a social 'good' and to the moral responsibility of protection from foreseeable social harm from an infectious disease. The initiatives, therefore, have to be guided by special moral obligations towards biorisk reduction, obligations which remain unfulfilled when a public body entrusted with the responsibility fails to manage satisfactorily the prevention and control of the infection. The overall conclusion is that pandemic management has a moral dimension. The gravity of the threat that fatal infectious diseases pose for public health creates special moral obligations for public bodies in pandemic situations. However, the paper views the West Bengal case as a learning opportunity, and considers the lapses cited as challenges that better, more effectively conducted pandemic management can prepare for. It is hoped that this paper will provoke constructive bioethical deliberations, particularly pertinent to the developing world, on how to ensure that the obligations towards health are fulfilled ethically and more effectively.     

Psychological characteristics of Japanese patients with chronic pain assessed by the Rorschach test

Background  

The increasing number of patients with chronic pain in Japan has become a major issue in terms of the patient's quality of life, medical costs, and related social problems. Pain is a multi-dimensional experience with physiological, affective, cognitive, behavioral and social components, and recommended to be managed via a combination of bio-psycho-social aspects. However, a biomedical approach is still the dominant method of pain treatment in Japan. The current study aimed to evaluate comprehensive psychological functions and processes in Japanese chronic pain patients.