Conceptions of the body are central not only to substantive work in medical anthropology, but also to the philosophical underpinnings of the entire discipline of anthropology, where Western assumptions about the mind and body, the individual and society, affect both theoretical viewpoints and research paradigms. These same conceptions also influence ways in which health care is planned and delivered in Western societies. In this article we advocate the deconstruction of received concepts about the body and begin this process by examining three perspectives from which the body may be viewed: (1) as a phenomenally experienced individual body-self; (2) as a social body, a natural symbol for thinking about relationships among nature, society, and culture; and (3) as a body politic, an artifact of social and political control. After discussing ways in which anthropologists, other social scientists, and people from various cultures have conceptualized the body, we propose the study of emotions as an area of inquiry that holds promise for providing a new approach to the subject.

The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology

www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

basic research and clinical data in an attempt to derive a cohesive model which explains the behavioral effects of the drug. Johnson is an experimental psychologist, and his work underlies many of the chapters which suggest that lithium decreases the behavioral response to novel external stimuli. He then utilizes this foundation to propose a cognitive model for lithium's anti-manic action, its inhibition of violent impulsivity, and its prophylactic effects in recurrent depression. Previous formulations which were clinically based, such as that of Mabel Blake Cohen and her associates, stressed the primacy of depression and noted the \"manic defense\" as an attempt to ward off intolerable depression. In direct contrast, Johnson views mania as the primary disturbance in bipolar disorder. He considers depression in bipolar disease as an over-zealous homeostatic inhibitory responsf to a maniaassociated cognitive overload. Consistent with this, he believes, lit lum exerts its anti-manic effect by decreasing cognitive processing in a manner analogous to his animal studies. Johnson also suggests that lithium exerts its prophylactic effect in recurrent depressions by treating subclinical mania. These concepts are supported by the work of Johnson's associate, Kukopulos, to whom the book is dedicated. The bulk of the research which describes the cognitive disturbance in mania is complex, however, and uncomfortably open to multiple interpretations. Recognized as a preliminary effort, Johnson's formulation may help to guide further research. Although Johnson clearly traces lithium actions through a broad range of subjects, his discussion of the neurophysiological aspects of this drug is notably spotty. In particular, Johnson ignores the work of Svensson, DeMontigny, Aghajanian, and others who suggest that serotonergic systems may play an important role in the antidepressant actions of lithium. As a result, he fails to discuss one of the most important current uses of lithium: as an agent used in conjunction with antidepressant medications to increase treatment response in medication-resistant forms of depression. Lithium augmentation of antidepressant medication also challenges the formulation presented by Johnson. This formulation suggests that lithium should have no therapeutic value in patients, such as those with endogenous depression, who already \"under-process\" cognitive information. The omission of lithium augmentation in depression is clearly unfortunate in this text. Overall, this volume demonstrates the benefits of a single-authored text. It it clearly organized and readable. The bibliography is also broad and useful. In this book, Johnson primarily addresses a research audience, and his model seems designed to stimulate thought rather than to improve clinical technique. In this capacity, his book will be of most interest to behavioral psychologists. Other books, focusing purely on clinical data, may be more useful to clinicians. Nevertheless, the clear organization, the large bibliography, and the thoughtful presentation may make this text a useful addition to a clinical library as well.

The Body in Pain: The Making and Unmaking of the World.

Acknowledgements Introduction 1. Readings and responses 2. Preface to the 1st edition 3. Introduction to the 1st edition 4. Interactive artifacts 5. Plans 6. Situated actions 7. Communicative resources 8. Case and methods 9. Human-machine communication 10. Conclusion to the 1st edition 11. Plans, scripts and other ordering devices 12. Agencies at the interface 13. Figuring the human in AI and robotics 14. Demystifications and re-enchantments of the human-like machine 15. Reconfigurations Notes References.

Human-Machine Reconfigurations: Plans and Situated Actions

The biological existence of human beings has become political in novel ways. The object, target and stake of this new 'vital' politics are human life itself. The contemporary state does not 'nationalize' the corporeality of its subjects into a body politic on which it works en masse, in relation to the body politics of other states competing in similar terms. Biopolitics addresses human existence at the molecular level: it is waged about molecules, amongst molecules, and where the molecules themselves are at stake. Human beings in contemporary Western culture are increasingly coming to understand themselves in somatic terms – corporeality has become of the most important sites for ethical judgements and techniques. Biopolitics was inextricably bound up with the rise of the life sciences, the human sciences, clinical medicine. It has given birth to techniques, technologies, experts and apparatuses for the care and administration of the life of each and all, from town planning to health services.

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The Politics of Life Itself

The initial findings of this study indicate that menopause is regarded as a natural life-cycle transition in Japan in which the biological marker of cessation of menstruation is not considered to be of great importance. Symptom reporting among all respondents is generally low regardless of menopausal status, and symptoms such as shoulder stiffness and headaches, which are reported frequently, are not linked specifically to menopausal status (even though individual informants may perceive them to be so). Symptoms of hot flashes and sudden perspiration are higher among peri- and post-menopausal women, but their prevalence appears to be much lower than research findings from other areas to date. Reports by Japanese gynecologists emphasize that menopausal women are liable to present with numerous non-specific somatic complaints. This may well be an accurate representation of a clinical population, but the findings of this present study indicate that such a picture is by no means representative of the average middle-aged female population in Japan. While occupational differences do not contribute to variation in reported symptomatology (with the exception of lumbago and shoulder stiffness), there are nevertheless considerable differences in the subjective meaning of menopause, many of which can be accounted for by class and occupational differences. Presentation of these differences awaits a future publication, but there is one topic which is of concern to the majority of the respondents from each of the sub-samples. The present generation of women entering their 50's are the first where the majority must face later middle age in a nuclear family, along with their husbands, although both they and their husbands have been socialized for the more distant male/female relationships of an extended family. Japanese women cannot look forward, as they did in the past, to the power and comforts derived from running an extended family; on the contrary many can expect a late middle age of looking after bed-ridden parents or parents-in-law, and a lonely, isolated and often poverty-stricken old age (Steslicke 1984), since many pension programs are by no means adequate. Some of their fears about aging are expressed in their views on menopause, but these fears do not appear to be manifested at all prominently as either psychological or somatic representations. When asked to compare their lives with that of their own mothers, stories of incredible hardships from pre- and immediately post-war Japan are vividly portrayed.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambiguities of aging: Japanese experience and perceptions of menopause.

2 The evolution of menopausal symptoms

Objectives In North America and Europe, it is usually assumed that biological changes associated with the end of menstruation and the onset of specific diseases commonly associated with the postmenopausal condition are universal. Using an anthropological approach in which menopause is understood as a concept that is historically and culturally produced, an argument is made for additional systematic investigation of what protects the majority of women from distress at menopause, and what factors contribute to a healthy old age. Method Survey research based on questionnaire responses, together with open-ended interviews and textual analyses, were used. Results Differences are demonstrated in postmenopausal experiences and symptom reporting in Japan as compared with Canada and the United States. Reporting of hot flashes and nights sweats is significantly lower in Japan. These findings, together with the well established figures about greater longevity and lower incidence of heart disease, breast cancer, and osteoporosis in Japan, compared with North America, indicate that cultural and biological variables act in concert to produce this variation. Theories about the evolution of menopause and demographic data on aging are also discussed. This data challenges the widely held assumption that populations of postmenopausal women only recently have come into existence because of cultural and technological interventions. Conclusions Postmenopausal women have been present in human populations since homo sapiens first evolved. Culturally mediated life styles affect both the menopausal experience and the health of women as they age. Additional investigations are needed.

Menopause : lessons from anthropology

Contested meanings of the menopause.

The boundaries of life now occupy a place of central concern among biological anthropologists. Because of the centrality of the modern biological definition of life to Euro-American medicine and anthropology, the definition of life itself and its contestation exemplify competing uses of knowledge. On the one hand, "life" and "death" may be redefined as partial or contingent ("brain death"), or reconstituted altogether ("virtual" or "artificial life"). On the other hand, the finality and "reality" of death resists such classifications. This volume reflects a growing international concern about issues such as organ transplantation, new reproductive and genetic technologies and embryo research, and the necessity of cross-cultural comparison. The political economy of body parts, organ and tissue "harvesting," bio-prospecting, and the patenting of life-forms are explored herein, as well as governance and regulation in cloning, organ transplantation, tissue engineering, and artificial life systems procedures.

Margaret Lock

Papers

Ambiguities of aging: Japanese experience and perceptions of menopause.

2 The evolution of menopausal symptoms

Menopause : lessons from anthropology

Contested meanings of the menopause.

Remaking life & death : toward an anthropology of the biosciences