Homebirth as Actor-Network: Multiple realities The topic of this medical anthropology thesis is a description of homebirth seen through the eyes of Actor-Network Theory. The focus of this work is thus not on the professional concept of homebirth as a biological process or soon-to-be-mothers experience and take on homebirth. Focus is on homebirth in itself, how it is enacted in practice. After the presentation of two points of view on medicine (disease and illness), an introduction into the basic principles and innovations of ANT (including anthropology of symmetry) and works of people, who build their ideas on it (Mol - multiplicity, De Laet - fluidity, Law), the thesis shifts its focus to the description of the whole actor- network, which enacts homebirth via interaction between the actors in practice. These practices are abstracted from the interviews with mothers, a dula and a paediatrician. The description includes people and objects, because according to ANT, they have the same amount of social agency. Homebirth is then enacted by the objects needed for homebirth - tools to make birth easier and to support its process, by people who partake, venues it takes place and the birthing positions it brings. Another part of the actor-network can be found before the homebirth happens - the hunt for information...

Today over 1.1 million people are living with HIV/AIDS in the United States; over the last 4 decades mortality rates have decreased largely made in part because of advancement in awareness and treatment options. Treatment adherence has long been considered a vital component in decreasing HIV/AIDS related mortality and has proven to reduce the risk of transmission. However not all patients take their medicine as prescribed. This research study, sponsored by The North Central Texas HIV Planning Council explored how Patient and Provider communication impacted treatment adherence. By utilizing a mixed-methods approach survey data and semi-structured interviews were used to collect insights from both Patients and Providers. Data gleaned through the interview process provided a perspective that could not be captured by using quantitative methods alone. The results from this research yielded multiple themes related to patient and provider communication with recommendations as to how The North Central Texas HIV Planning Council could address treatment adherence, such as Providers focus on Patients perceived severity based on their understanding of disease and illness; that side-effects remain a concern for patients and should not be dismissed; and finally that the word AIDS is perceived to be more stigmatized and as such organizations providing HIV/AIDS related services should explore alternative names where the word AIDS in not included.

La culture de la naissance peut être assimilée à un rituel de passage à la base de la construction identitairepour la mère et pour l’enfant. Cette transition est conçue de manière différente selon les contextesculturels.À partir d’un travail ethnographique au Portugal et dans l’Amazonie équatorienne, nous avons mis enévidence l’existence de trois systèmes de santé : le biomédical ou système officiel (qui se constituecomme tel à partir du XIX s.), le système traditionnel ou ancestral et le système alternatif (dans ce cas,incarné par les doulas).Autour de ces trois systèmes de santé se tisse une culture de la naissance porteuse, dans chaque cas, d’undiscours légitimant des pratiques présentées comme « adéquates » et les représentations associées.Malgré des différences importantes entre les procédures des protocoles médicaux – propres au systèmeofficiel de santé, au système traditionnel de santé et au système alternatif - pour la prise en charge del’accouchement, de l’alimentation pré-lactée (don du colostrum) et du postpartum, nous avons identifiédes points communs entre eux. Les frontières entre ces différents systèmes de santé, entre la tradition etla modernité, peuvent s’effacer ou demeurer floues.Les pratiques diverses sont associées à des représentations relatives à la mort, les corps, la douleur, lesparadigmes de santé et de maladie, la religion, la propreté et l’hygiène, les liens sociaux, entre autres. / The culture of birth is a ritual of passage which is the basis of the construction of identity for the motherand for the child. This transition is conceived in different ways in distinct cultural contexts.Based on an ethnographic work in Portugal and the Amazonia of Ecuador, we have identified threeexisting health systems: biomedicine or the official system (which was constituted as “official” from the19th century onwards), the traditional system or ancestral system, and the alternative system (in this case,embodied by doulas).In the framework of these three health systems, a culture of birth is woven into a discourse legitimizingtheir practices, which are presented as "adequate", and their representations.Although there are important differences between the procedures of the medical protocols - specific tothe formal health system, to the traditional health system, and to the alternative system - for the deliveryof childbirth, for pre-lactated feeding (colostrum feed), and for postpartum, we also found bridgesbetween them.Sometimes the boundaries between these different health systems, between tradition and modernity, areeither disappeared or blurred.Various practices are associated with representations relating to death, bodies, pain, health and diseaseparadigms, religion, cleanliness and hygiene, social ties, among others.

During the 2013/16 Ebola virus disease outbreak in West Africa, numerous restrictions were placed on the movement and public gathering of local people, regardless of if the area had active Ebola cases or not. Specifically, the district of Koinadugu, Sierra Leone, preemptively enforced movement regulations before there were any cases within the district. This research demonstrates that ongoing regulations on movement and public gathering affected the livelihoods of those involved in agricultural markets in the short-term, while the outbreak was active, and in the long-term. The forthcoming thesis details the ways in which the Ebola outbreak international and national response affected locals involved in agricultural value chains in Koinadugu, Sierra Leone.

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<p>  </p> <p>This project is at the intersections of the anthropology of care, aging and food. The research is conducted in San Francisco among aging Latinos and explores their care relationships. I examine how people define and negotiate what is considered “good” care and “good” food in a society with a prevailing “successful aging” paradigm. The project examines how care is complex and multifaceted and demonstrates how food can be used as a socio-material lens to study care. Food is a part of daily life that is laden with moral, social and political meaning which makes it ideal for studying care interactions. The research takes place in various community settings in San Francisco’s Mission District. These community settings include a local senior center and its food program, the homes of older people and other spaces of significance to the participants (e.g., grocery stores, restaurants, and other neighborhood places). Multiple ethnographic methods such as participant observation, interviews and neighborhood walks were used to collect data. By examining care relationships, I found that caregivers had differing and competing ideas of morality in everyday care and what is “good” for older adults. Studying paradoxes of care and understanding how these tensions and contradictions play out is a crucial component of understanding care as a moral enterprise. Key findings show that many people are not recognized as “caregivers” yet are providing important forms of care that sustain their families and communities. Additionally, studying “rule breaking” that seniors and others engaged in shed light on multiple interpretations of “good” aging care and food. Finally, in a neighborhood that has undergone so much transformation, many older adults saw the changes in the Mission as generally favorable, although those same shifts make the neighborhood relatively unwelcoming to seniors. This research broadens our understanding of “caregiving” by emphasizing the diverse forms of care that people provide throughout the life course.</p>

Kroniska sjukdomar ökar världen över, i både utvecklings- och industrialiserade länder. Mäniskor som lider av kroniska sjukdomar finner ofta den västerländska medicinen oförmögen att behandla deras sjukdommar, och vänder sig istället till traditionell, komplementär och alternativ medicin [TM/CAM]. TM/CAM har visat sig vara effektiv vid prevention och behandling av kroniska sjukdomar, varför det är av stort intresse att undersöka möjligheten för ökad integration av TM/CAM inom de nationella sjukvårdssystemen. Syftet med denna studie är att undersöka de krafter som främjar respektive förhindrar kommunikation och samarbete mellan utövare av ayurveda, västerländsk och traditionell medicin, samt att se hur detta påverkar integrationen av de medicinska subsystemen på Sri Lanka. Fokus för studien är ett specifikt samarbetsprojekt, “The outcome oriented, evidence informed community health promotion program”, vars mål är att integrera ayurveda och västerländsk medicin inom primärvården. En kvalitativ studie genomfördes under tre månader på Sri Lanka med hjälp av semi-strukturerade intervjuer, deltagande observation samt analys av dokument. Paul Unschulds teori om strukturerad konkurrens, samarbete eller integration användes vid tolkningen av resultaten. Resultaten tyder på att den huvudsakliga formen för samexistens mellan ayurveda och västerländsk medicin på Sri Lanka är strukturerad konkurrens, medan samarbetsprojektet siktar mot att uppnå strukturerat samarbete. Det parallella politiska system som styr samexistenseen mellan ayurveda och västerländsk medicin tycks förhindra integration, medan en ökad professionalisering genom nationella regleringar skapar ökat samarbete och integration. Brist på kunskap om ayurveda bland medicinstudenter förhindrar samarbete. Samtidigt kan inflytandet från västerländsk medicin i den auyurvediska universitetsutbildningen till synes både främja och förhindra samarbete och integration. Genom att höja kompetensen omkring forskningsmetodik och hälsovårdsystem hos ayurvediska läkare kan samarbete främjas. Likaså är forskning utformad med hänsyn till ayurvediska grundprinciper samt närvaro av nyckelpersoner med kompetens inom både ayurveda och västerländsk medicin främjande faktorer för samarbete och integration. / Non-communicable diseases [NCDs] are increasing in both developing and developed countries. Western medicine is not able to offer satisfying solutions and treatments for people suffering from NCDs. TM/CAM have shown promise of effectiveness in the prevention and treatment of NCDs and many people now turn to TM/CAM. Hence it is of great interest to investigate the possibilities of increased integration of TM/CAM in national health care systems. This study was carried out in Sri Lanka, with the aim to investigate the main forces promoting and obstructing cooperation and communication between practitioners of Ayurvedic, Western and traditional medicine, in order to see how this affects integration of the medical subsystems. The focus of this qualitative study was the “Outcome oriented, evidence informed Ayurvedic Community Health Promotion Program”; a collaboration project aiming to integrate Ayurveda and Western medicine in primary health care. Semi-structured interviews, participatory observation and document analysis were carried out during three months in Sri Lanka and the results were analysed using Paul Unschuld’s theory on structured competition, cooperation or integration. The results indicate that the overall coexistence of Ayurveda and Western medicine in Sri Lanka is structured competition, while the collaboration project is aiming for structured cooperation. The results further show that the Sri Lankan parallel political approach to integration can be argued to obstruct integration, while the regulation of Ayurvedic practitioners increases cooperation through professionalization. Education is a main influencing factor for cooperation; lack of CAM-knowledge in medical students obstructs cooperation while westernization of Ayurvedic doctors both promotes and obstructs cooperation and integration. Capacity building, research based on Ayurvedic fundamentals and keypersons with knowledge of both sectors are of importance for increased cooperation and integration to come about.

Bipolar disorder is a condition rarely approached in anthropological research, and even less so through the eyes of people living with the disorder. Therefore, to focus on understanding the experience of the state in-between episodes, here referred to as a “white space”, is rare and in need of further examination. The aim of this study was to explore the various experiences of a “white space”, how it is constructed, disrupted, and maintained. The thesis is also an attempt to look at what factors affect these experiences using the anthropology of becoming, and concepts of power and agency. With the interviews of eleven individuals that have experienced different lengths of “white spaces”, a representative of a non-profit organization, a clinical psychologist, and minor participant observation, the author explores the complex views, interpretations, and experiences of a life within a “white space”. Apart from the sub-field of medical anthropology, the thematic framework and concepts involve the anthropology of becoming, agency, and power to explain and discuss the “white space” experience. The analysis shows that a “white space” has many different forms and that agency and power have a great impact on the experience. What the author also discusses in the analysis is the dynamic between what they define as knowledge-production and knowledge-sharing, alongside agency and power in relation to these “white space” experiences. The author emphasizes the importance in using these concepts to further understand and affect the experiences of “white spaces” positively. The conclusion summarizes the findings and emphasizes the need to explore this form of research further.