Mita Banerjee

Captious certainties: makings, meanings and misreadings of consumer-oriented genetic testing

Members of the scientific and medical communities concerned with genetic testing might wonder, why cultural and ethical analyses of genetic testing are increasing again, especially since legal frameworks have, by now, come to provide more solid grounds for the routine application of genetic testing on both levels of application, diagnostics, and prediction. This contribution aims to shed light on the changing concept of genetic testing as it is raised by novel cultural practices and perceptions mainly triggered by direct-to-consumer predictive testing, including the phenomenon of a new genetic exceptionalism “from below”. We are seeking to determine what is at stake in this practice and what consequences arise from it for the medical and scientific community. What exactly happens as we move from diagnostic to prognostic medicine? Above all, this article pivots on the notion of captious certainties, a concept, which we will elaborate on as our argument progresses.

Positive learning and pluriliteracies: Growth in Higher Education and implications for course design, assessment and research

Deeper learning and the development of transferable knowledge and skills are highly desirable goals in Higher Education programs. However, current studies indicate that these goals are rarely achieved. In this article, we will present a model of deeper learning that promotes the development of disciplinary literacies and transferable knowledge. Based on our joint work we will outline a revised course design that aims at putting the principles of deeper learning into practice through a focus on affect, student engagement, knowledge construction, meaning making and active demonstration of understanding as well as reflective practice. Further, we will outline a research agenda for evaluating and assessing deeper learning processes and outcomes in Higher Education and discuss how deeper learning might pertain to the notion of positive learning envisioned by PLATO.

Pharmaceutical care as narrative practice? Rethinking patient-centered care through a pharmacist’s perspective

Illness is a disruptive experience that requires high-quality care. The best evidence-based medical treatment risks losing some of its efficacy, however, when patients feel misunderstood when faced with the complexity of their experiences. They might stop treatment, refuse to disclose relevant information or seek unsound alternatives. A narrative-based approach to health care understands the patient’s case history as a narrative that can be read or analyzed like a story. In other words, this approach honors individual illness experiences through the stories that patients tell. While programs that train ‘narrative competence’ have been successfully implemented in medical education, an application to pharmaceutical training is missing so far. We argue for the necessity to complement evidence-based pharmaceutical practice with narrative-based approaches to ensure high-quality care. Using the perspective of a pharmacist in a case scenario, we exemplify the centrality of “narrative pharmacy” for improving the quality and safety of pharmaceutical health care.

Biopiracy versus one-world medicine – from colonial relicts to global collaborative concepts

BACKGROUND Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism. HYPOTHESIS The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe. STUDY DESIGN Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine. CONCLUSION To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients.

The impact of attachment distress on affect-centered mentalization: An experimental study in psychosomatic patients and healthy adults

Introduction We investigated the impact of attachment distress on affect-centered mentalization in a clinical and a non-clinical sample, comparing mentalization in a baseline condition to mentalization under a condition of attachment distress. Methods The sample consisted of 127 adults who underwent inpatient psychosomatic treatment, and 34 mentally healthy adults. Affect-centered mentalization was assessed by analyzing participants’ narratives on interpersonal situations in a baseline condition with the Levels of Emotional Awareness Scale (LEAS), and an experimental condition inducing attachment distress with the Adult Attachment Projective Picture System (AAP). Unlike the LEAS, the AAP is specifically designed to trigger attachment distress. In both conditions, the narratives were evaluated using the LEAS scoring system. Additionally, we assessed the impact of childhood trauma on affect-centered mentalization with the Childhood Trauma Questionnaire (CTQ). Results While the non-clinical sample displayed the same level of affect-centered mentalization in both conditions, the majority of the clinical sample reached higher scores in the attachment distress condition. There was no strong relationship between reported trauma and mentalization scores. Discussion Our findings lend strong empirical support to the assumption that affect-centered mentalization is modulated by attachment-related distress. Several possible explanations for the differences between and within the clinical and the non-clinical sample are discussed.

Negotiating Pandemic Risk: On the Scandalization and Transcultural Transformation of the Swine Flu

Epidemiology, it would seem, lends itself to an interdisciplinary dialogue between medicine and the humanities in particular ways. More than any other medical discipline, perhaps, epidemiology has triggered responses by cultural theorists and cultural historians, and it has done so on two levels and on account of two, mutually interrelated reasons. First, epidemiology as a discourse and medical practice has been so seductive to cultural theorists because of the metaphorical potential inherent in what Priscilla Wald has termed the “outbreak narrative”.

Reviews: African and World Cinema: Imagining Alternatives

African Film: Re‐Imagining a Continent Josef Gugler James Currey, Oxford, 2003, pb 216pp ISBN 085255561X £14 Revolution: The Explosion of World Cinema in the Sixties Peter Cowie Faber, London, 2004, hb 304pp ISBN 05712 09033 £20.00 www.faber.co.uk Sembene: Imagining Alternatives in Film and Fiction David Murphy James Currey, Oxford and Africa World Press, Trenton, 2001, pb 275 pp ISBN 0 8525 5555 5 £14.95 www.jamescurrey.co.uk Films by Michael Ondaatje (115 min); including: The Clinton Special: A Film About The Farm Show (1974, 71 min) Sons of Captain Poetry (1970, 29 min) Carry on Crime and Punishment (1970, 5 min) Available as a DVD or video from www.mongrelmedia.com Yilmaz Guney: Bir Cirkin Kral (Yilmaz Guney: An Ugly King) Turhan Feyizoglu Ozan Publishing, Istanbul, 2003 645pp www.02anyayincilik.com Fiction and Film: The Influence of Cinema on Writers from Jamaica and Trinidad Lynne Macedo Dido Press, Chichester, 2003, hb 172 pp ISBN 19021 1538 4 £16.95 www.akdpress.com Djibril Diop Mambety: Un cineas...