Charles Mather

Shrines and the Domestication of Landscape

Landscapes reflect predominant patterns of social action and thought. In this article, the relationship between landscapes and shrines in Kusasi territory in northern Ghana is explicated in terms of the domestication of the natural world. Focusing on a particular settlement, I argue that Kusasi shrines embody local and tribal histories. Field observations and interviews reveal that the Kusasi use shrines to demarcate physical territories according to social divisions. Through shrines and their associated rites, the Kusasi transform the physical world into a ceremonial landscape. The transformation of the physical world is part of a ritual process involving the domestication of natural and spiritual forces. Shrines are sites of mediation where the Kusasi reiterate established meanings and generate new ones.

The influence of ethnicity and gender on navigating an acute coronary syndrome event

Background: Ethnicity and gender may influence acute coronary syndrome patients recognizing symptoms and making the decision to seek care. Objective: To examine these potential differences in European (Caucasian), Chinese and South Asian acute coronary syndrome patients. Methods: In-depth interviews were conducted with 20 European (Caucasian: 10 men/10 women), 18 Chinese (10 men/eight women) and 19 South Asian (10 men/nine women) participants who were purposively sampled from those participating in a large cohort study focused on acute coronary syndrome. Analysis of transcribed interviews was undertaken using constant comparative methods. Results: Participants followed the process of: having symptoms; waiting/denying; justifying; disclosing/ discovering; acquiescing; taking action. The core category was ‘navigating the experience’. Certain elements of this process were in the forefront, depending on participants’ ethnicity and/or gender. For example, concerns regarding language barriers and being a burden to others varied by ethnicity. Women’s tendency to feel responsibility to their home and family negatively impacted the timeliness in their decisions to seek care. Men tended to disclose their symptoms to receive help, whereas women often waited for their symptoms to be discovered by others. Finally, the thinking that symptoms were ‘not-urgent’ or something over which they had no control and concern regarding potential costs to others were more prominent for Chinese and South Asian participants. Conclusion: Ethnic- and gender-based differences suggest that education and support, regarding navigation of acute coronary syndrome and access to care, be specifically targeted to ethnic communities.

Time and the structuring of ritual performance in the xenotransplantation debate

Advancements in biotechnology provoke fundamental questions about the relationship of humans to the natural world. A crisis arises as the knowledge, practice, and policies concerning biotechnology grow further out of step with each other. This paper examines the role of ritual performance as a means of resolving this crisis, uniting the organic with the socio-moral aspects of science, technology and regulatory policy. Ritual performance is evident in the public discussions of the United States’ Secretary’s Advisory Committee on Xenotransplantation (SACX). In an attempt to understand the cultural responses to new knowledge, this paper examines the transcripts of several SACX meetings for its ritual elements and references to authority. We find that time is used by scientists to structure ritual performance in a way that guides public policy and attitudes toward xenotransplantation.

Implications of design on infection prevention and control practice in a novel hospital unit: the Medical Ward of the 21st Century.

The physical design of hospital wards is associated with transmission of pathogenic organisms and hospital-acquired infections. A novel hospital unit, the Medical Ward of the 21st Century (W21C), optimizes features for infection prevention and control practices. Ethnographic research on the W21C versus conventional hospital wards examined the experiential and behavioural elements of the different designs. Three recurring themes emerged regarding the design features on the W21C and included visual cues, ‘having a place for things’, and less sharing of spaces and materials. Observational data of healthcare worker practices demonstrated significantly higher compliance with hand hygiene opportunities on the W21C compared with older hospital units. These findings suggest how the physical design of a hospital ward may enhance infection prevention and control practices.

Weight and Patients’ Decision to Undergo Cardiac Surgery

Obese patients are less likely to have cardiac surgery than normal weight patients. This could be due to physician or patient decision-making. We undertook a qualitative descriptive study to explore the influence of obesity on patients’ decision-making to have cardiac surgery. Forty-seven people referred for coronary artery bypass graft (CABG) surgery were theoretically sampled. Twelve people had declined cardiac surgery. Participants underwent in-depth interviews aimed at exploring their decision-making process. Data were analyzed using conventional content analysis. Though patients’ weight did not play a role in their decision, their relationship with their cardiologist/surgeon, the rapidity and orchestration of the diagnosis and treatment, appraisal of risks and benefits, previous experience with other illness or others who had cardiac surgery, and openness to other alternatives had an impact. It is possible that there is a lack of comfort or acknowledgment by all parties in discussing the influence of weight on CABG surgery risks.

Ethno-Cultural Considerations in Cardiac Patients' Medication Adherence.

We aimed to develop an in-depth understanding about factors that influence cardiac medication adherence among South Asian, Chinese, and European White cardiac patients. Sixty-four patients were purposively sampled from an ongoing study cohort. Interviews were audio-recorded and transcribed for analyses. Physicians’ culturally sensitive communication and patients’ motivation to live a symptom-free and longer life enhanced adherence. European Whites were motivated to enhance personal well-being and enjoy family life. South Asians’ medication adherence was influenced by the desire to fulfill the will of God and family responsibilities. The Chinese were motivated to avoid pain, illness, and death, and to obey a health care provider. The South Asians and Chinese wanted to ultimately reduce medication use. Previous positive experiences, family support, and establishing a routine also influenced medication adherence. Deterrents to adherence were essentially the reverse of the motivators/facilitators. This analysis represents an essential first step forward in developing ethno-culturally tailored interventions to optimize adherence.

Meanings of the heart among a group of older Sikh immigrant women with cardiovascular disease

Abstract In this article, we attempt to document the meaning of the heart to Sikh women suffering from cardiovascular disease. Analyzing transcripts from open-ended semi-structured interviews, we look for themes associated with both depictions of the heart in Sikh scripture and prior anthropological studies on heart distress in other cultures. Findings from our analysis are comparable to anthropological studies of heart distress in women from other cultures, with the common strain being that women understand their domestic role obligations as a source of emotional stress that can cause heart distress. Depictions of the heart in Sikh scripture differ from our participants’ experiences, though both emphasize internality and unity. The notions of internality and unity in Sikh scripture are connected with a healthy heart, but in the lives of our participants, internality and unity are a form of emotional duress that plays a role in heart distress.

Unpacking animal metaphors for commercial relationships in the biotechnology industry

Metaphors are cognitive instruments with the capacity to influence how humans think about the world. Guiding our representations and shaping our experiences, metaphor is of anthropological interest because it is an integral aspect of culture. This paper aims to highlight the role of metaphor in the biotechnology industry. In particular, animal metaphors provide a means of consolidating information. In a culture where time is highly restricted, metaphors enable the speedy transmission of knowledge, placing information in a familiar context or cultural model. Ethnographic findings reveal that animal metaphors contribute to a larger conceptual framework that equates biological evolution with commercial relationships. Depending on the context, metaphors both conceal and reveal different aspects of the financial world, affecting interpretations of the market.