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Molia S, Saillard J, Dellagi K, Cliquet F, Bart JM, Rotureau B, Giraudoux P, Jannin J, Debré P, Solano P. Practices in research, surveillance and control of neglected tropical diseases by One Health approaches: A survey targeting scientists from French-speaking countries. PLoS Negl Trop Dis 2021; 15:e0009246. [PMID: 33661894 PMCID: PMC7963066 DOI: 10.1371/journal.pntd.0009246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/16/2021] [Accepted: 02/16/2021] [Indexed: 12/24/2022] Open
Abstract
One health (OH) approaches have increasingly been used in the last decade in the fight against zoonotic neglected tropical diseases (NTDs). However, descriptions of such collaborations between the human, animal and environmental health sectors are still limited for French-speaking tropical countries. The objective of the current survey was to explore the diversity of OH experiences applied to research, surveillance and control of NTDs by scientists from French-speaking countries, and discuss their constraints and benefits. Six zoonotic NTDs were targeted: echinococcoses, trypanosomiases, leishmaniases, rabies, Taenia solium cysticercosis and leptospiroses. Invitations to fill in an online questionnaire were sent to members of francophone networks on NTDs and other tropical diseases. Results from the questionnaire were discussed during an international workshop in October 2019. The vast majority (98%) of the 171 respondents considered OH approaches relevant although only 64% had implemented them. Among respondents with OH experience, 58% had encountered difficulties mainly related to a lack of knowledge, interest and support for OH approaches by funding agencies, policy-makers, communities and researchers. Silos between disciplines and health sectors were still strong at both scientific and operational levels. Benefits were reported by 94% of respondents with OH experience, including increased intellectual stimulation, stronger collaborations, higher impact and cost-efficiency of interventions. Recommendations for OH uptake included advocacy, capacity-building, dedicated funding, and higher communities' involvement. Improved research coordination by NTD networks, production of combined human-animal health NTD impact indicators, and transversal research projects on diagnostic and reservoirs were also considered essential.
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Affiliation(s)
- Sophie Molia
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | | | - Koussai Dellagi
- Institut Pasteur International Network, Institut Pasteur, Paris, France
| | - Florence Cliquet
- ANSES, Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | | | - Brice Rotureau
- Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Department of Parasites and Insect Vectors and INSERM U1201, Institut Pasteur, Paris, France
| | - Patrick Giraudoux
- Chrono-environnement Université de Bourgogne Franche-Comté/CNRS, Besançon, France
| | - Jean Jannin
- Société de Pathologie Exotique, Paris, France
| | | | - Philippe Solano
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
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Middleton J, Abdad MY, Beauchamp E, Colthart G, Cooper MJF, Dem F, Fairhead J, Grundy CL, Head MG, Inacio J, Jimbudo M, Jones CI, Konecna M, Laman M, MacGregor H, Novotny V, Peck M, Paliau J, Philip J, Pomat W, Roberts CH, Sui S, Stewart AJ, Walker SL, Cassell JA. Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases. BMJ Open 2020; 10:e041784. [PMID: 33130572 PMCID: PMC7733180 DOI: 10.1136/bmjopen-2020-041784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Our project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data. METHODS AND ANALYSIS The study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author. ETHICS AND DISSEMINATION Challenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.
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Affiliation(s)
- Jo Middleton
- Primary Care and Public Health, and NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, UK
- Evolution, behaviour and environment, School of Life Sciences, University of Sussex, Falmer, UK
| | - Mohammad Yazid Abdad
- Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea
- Infectious Disease Research Laboratory, National Centre for Infectious Diseases, Singapore
| | - Emilie Beauchamp
- International Institute for Environment and Development, London, UK
| | - Gavin Colthart
- Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
- Medicine, James Cook University, Townsville, North Queensland, Australia
| | - Maxwell J F Cooper
- Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Francesca Dem
- New Guinea Binatang Research Centre, Nagada, Papua New Guinea
| | - James Fairhead
- Anthropology, School of Global Studies, University of Sussex, Falmer, UK
| | - Caroline L Grundy
- Sussex Sustainability Research Programme, University of Sussex, Falmer, UK
| | - Michael G Head
- Faculty of Medicine and Global Health Research Institute, University of Southampton, Southampton, UK
| | - Joao Inacio
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
- Global Health and Tropical Medicine, New University of Lisbon Institute of Hygiene and Tropical Medicine, Lisboa, Portugal
| | - Mavis Jimbudo
- New Guinea Binatang Research Centre, Nagada, Papua New Guinea
| | | | - Martina Konecna
- Zoology, Faculty of Science, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Moses Laman
- Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea
| | | | - Vojtech Novotny
- Zoology, Faculty of Science, University of South Bohemia, Ceske Budejovice, Czech Republic
- Ecology, Biology Centre, Institute of Entomology, Ceske Budejovice, Czech Republic
| | - Mika Peck
- Evolution, behaviour and environment, School of Life Sciences, University of Sussex, Falmer, UK
| | - Jason Paliau
- New Guinea Binatang Research Centre, Nagada, Papua New Guinea
| | - Jonah Philip
- New Guinea Binatang Research Centre, Nagada, Papua New Guinea
| | - Willie Pomat
- Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea
| | - Chrissy H Roberts
- Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Shen Sui
- New Guinea Binatang Research Centre, Nagada, Papua New Guinea
| | - Alan J Stewart
- Evolution, behaviour and environment, School of Life Sciences, University of Sussex, Falmer, UK
| | - Stephen L Walker
- Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Hospital for Tropical Diseases and Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jackie A Cassell
- Primary Care and Public Health, and NIHR Global Health Research Unit on Neglected Tropical Diseases, Brighton and Sussex Medical School, Falmer, UK
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Development of a measure to evaluate competence perceptions of natural and social science. PLoS One 2019; 14:e0209311. [PMID: 30601856 PMCID: PMC6314610 DOI: 10.1371/journal.pone.0209311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/04/2018] [Indexed: 11/25/2022] Open
Abstract
Interdisciplinary scientific research teams are essential for responding to society’s complex scientific and social issues. Perceptual barriers to collaboration can inhibit the productivity of teams crossing traditional disciplinary boundaries. To explore these perceptual barriers, survey measures related to perceived competence were developed and validated with a population of earth scientists (n = 449) ranging from undergraduates through professionals. Resulting competence scales included three factors that we labeled as Perceived Respect (PR), Perceived Methodological Rigor (PM), and Perceived Intelligence (Pi). A Mann-Whitney U test revealed that earth scientists perceived social science/scientists as significantly less competent than natural science/scientists. A multivariate multilevel analysis indicated that women perceived scientists as more intelligent than did men. Working with social scientists and holding an earth science PhD changed earth scientists’ perceptions of social science on multiple scales. Our study indicates that competence in scientific disciplines is a multidimensional construct. Our results from earth scientists also indicate that perceptual barriers towards other scientific disciplines should be studied further as interdisciplinarity in scientific research continues to be encouraged as a solution to many socio-scientific problems.
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MacGregor H, Waldman L. Views from many worlds: unsettling categories in interdisciplinary research on endemic zoonotic diseases. Philos Trans R Soc Lond B Biol Sci 2018; 372:rstb.2016.0170. [PMID: 28584178 PMCID: PMC5468695 DOI: 10.1098/rstb.2016.0170] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 01/08/2023] Open
Abstract
Interdisciplinary research on zoonotic disease has tended to focus on ‘risk’ of disease transmission as a conceptual common denominator. With reference to endemic zoonoses at the livestock–human interface, we argue for considering a broader sweep of disciplinary insights from anthropology and other social sciences in interdisciplinary dialogue, in particular cross-cultural perspectives on human–animal engagement. We consider diverse worldviews where human–animal encounters are perceived of in terms of the kinds of social relations they generate, and the notion of culture is extended to the ‘natural’ world. This has implications for how animals are valued, treated and prioritized. Thinking differently with and about animals and about species' boundaries could enable ways of addressing zoonotic diseases which have closer integration with people's own cultural norms. If we can bring this kind of knowledge into One Health debates, we find ourselves with a multiplicity of worldviews, where bounded categories such as human:animal and nature:culture cannot be assumed. This might in turn influence our scientific ways of seeing our own disciplinary cultures, and generate novel ways of understanding zoonoses and constructing solutions. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.
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Affiliation(s)
- Hayley MacGregor
- STEPS Centre, Institute for Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | - Linda Waldman
- STEPS Centre, Institute for Development Studies, University of Sussex, Brighton BN1 9RE, UK
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Albert M, Laberge S. Confined to a tokenistic status: Social scientists in leadership roles in a national health research funding agency. Soc Sci Med 2017; 185:137-146. [DOI: 10.1016/j.socscimed.2017.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 04/07/2017] [Accepted: 05/06/2017] [Indexed: 12/01/2022]
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Mackinnon N, Bhatia U, Nadkarni A. The onset and progression of alcohol use disorders: A qualitative study from Goa, India. J Ethn Subst Abuse 2017; 18:89-102. [PMID: 28665261 PMCID: PMC6506922 DOI: 10.1080/15332640.2017.1326863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Quantitative evidence about the burden of alcohol use disorders (AUDs) needs to be complemented with a nuanced qualitative understanding of explanatory models to help supplement public health strategies that are too often steeped uncritically in biomedical models. The aim of this study was to identify the role of various factors in the onset and persistence of AUD and recovery from AUD. This was a qualitative study nested in a population cohort from Goa, India. In-depth interviews of men with incident, recovered, and persistent AUD covered topics such as changes in drinking habits over time, perceptions and experiences about starting/stopping drinking, and so on. Data were analyzed using thematic analysis. Reasons to begin drinking included social drinking, functional use of alcohol, stress, and boredom. Progression to problematic drinking patterns was characterized by drinking alone, alternating between abstinent and heavy drinking periods, and drinking based on the availability of finances. Some enablers to reduce/stop drinking included consequences of drinking lifestyle and personal resolve; some barriers included availability of alcohol at social events and stress. Some reasons for persisting heavy use of alcohol included lack of family support, physical withdrawal symptoms, peer pressure, stress, and easy availability. This article offers a strong conceptualization and nuanced understanding of AUD across a spectrum of developmental courses. This adds to the limited literature on explanatory models of AUD in India and identifies potential targets for prevention and treatment strategies for AUD in low- and middle-income country settings.
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Affiliation(s)
- Nathalie Mackinnon
- a McGill University , Montreal , Canada.,b Addictions Research Group , Sangath , Goa , India
| | | | - Abhijit Nadkarni
- b Addictions Research Group , Sangath , Goa , India.,c London School of Hygiene and Tropical Medicine , London , United Kingdom
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File K, McLaws ML. Ni-Vanuatu health-seeking practices for general health and childhood diarrheal illness: results from a qualitative methods study. BMC Res Notes 2015; 8:189. [PMID: 25947195 PMCID: PMC4435643 DOI: 10.1186/s13104-015-1151-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND A local perspective on diarrheal illness has been shown to enhance control strategies for diarrheal disease in traditional rural settings. We aimed to assess caregivers' understandings of childhood general and diarrheal illness, in one rural community in Vanuatu, to help formulate control strategies for preventing diarrheal disease. FINDINGS This was a descriptive study using qualitative analysis of responses to open-ended questions to provide a fuller understanding of illness. Thematic analysis with categories derived from medical anthropology was used to analyse responses and draw conclusions. Twenty-nine participants were interviewed; 22 were maternal responses, three were traditional practitioners, two were rural health care workers, one was a spiritual healer and one had a caregiver role. Respondents categorised illness as biomedical or traditional. Explanations of illness were enmeshed in and derived from both the traditional and biomedical system as the illness experience in the child under their care unfolded. Diarrheal severity influenced treatment selection and respondents expressed a preference for biomedical assistance. Respondents articulated a preference for biomedicine as the primary help-seeking resort for small children. Exclusive reliance on either traditional or biomedical options was uncommon. Local herbal remedies were the preferred home treatment when illness was known or mild, while oral rehydration therapy was used when accessing biomedical practitioners. CONCLUSIONS Belief about diarrheal illness was influenced by traditional medicine and biomedicine. New evidence points to a growing preference for biomedicine as the first choice for severe childhood diarrheal illness. Diarrheal illness could be countered by maternal hand hygiene education at the medical dispensary and rural aid post.
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Affiliation(s)
- Karen File
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, 3rd Floor Samuels Building, Sydney, NSW, 2052, Australia.
| | - Mary-Louise McLaws
- Epidemiology in Healthcare Infection and Infectious Diseases Control, School of Public Health and Community Medicine, UNSW Medicine, UNSW, Australia, Sydney, Australia.
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Bardosh K. Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases. Infect Dis Poverty 2014; 3:35. [PMID: 25320672 PMCID: PMC4197218 DOI: 10.1186/2049-9957-3-35] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/16/2014] [Indexed: 11/23/2022] Open
Abstract
Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the “neglected” status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.
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Affiliation(s)
- Kevin Bardosh
- Centre of African Studies, School of Social and Political Science, College of Humanities and Social Science, The University of Edinburgh, 58 George Square, Edinburgh, EH8 9LD UK ; Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB UK
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Bardosh K, Inthavong P, Xayaheuang S, Okello AL. Controlling parasites, understanding practices: the biosocial complexity of a One Health intervention for neglected zoonotic helminths in northern Lao PDR. Soc Sci Med 2014; 120:215-23. [PMID: 25261615 DOI: 10.1016/j.socscimed.2014.09.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 11/25/2022]
Abstract
A parasitological survey in northern Lao PDR showed a remote ethnic minority village to be hyper-endemic for Taenia solium, a Neglected Tropical Disease (NTD) that impacts human and pig health. An intervention combining human Mass Drug Administration (MDA) with porcine vaccination and antihelmintic treatment was then implemented, targeting both T. solium and other soil-transmitted helminths. To understand the biosocial complexity of this integrated One Health intervention, we conducted a rapid ethnographic study exploring the transmission dynamics of T. solium and locally acceptable long-term control options. Informed by two years of project work in the village, this included six focus group discussions, 35 semi-structured interviews, a latrine survey, a school-based education meeting, participant observation and many unstructured interviews conducted over two weeks in October 2013. We found that risk behaviours were mediated by various social determinants including limited market access, interrelationships between alcohol, ancestral sacrifices and the consumption of raw pork, seasonal variations and poor latrine coverage. Only sixteen percent of households had latrines, attributed to the unacceptability of dry latrines, lack of water access, poor building techniques and poverty. Whilst women could explain T. solium transmission, most men and children could not, revealing that distributed posters/leaflets relied too heavily on text and ambiguous images. Compliance with MDA was high due to trust between project staff and village leaders. However understandings of pharmacology, minor side effects, human migration and children's fear of worms may lead to resistance in future programmes. Our research highlights the complexities of controlling T. solium and other soil-transmitted helminths in a remote ethnic minority village and the need to integrate biomedical and participatory approaches. Although we showcase the heuristic value of using rapid ethnography to inform intervention strategies as part of a One Health/NTD agenda, we also identify several possible paradoxes and conundrums in embedding locally-grounded biosocial analysis into NTD programmes. These need to be acknowledged and negotiated by multidisciplinary teams.
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Affiliation(s)
- Kevin Bardosh
- School of Social and Political Science, The University of Edinburgh, 58 George Square, Edinburgh, United Kingdom; Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom.
| | - Phouth Inthavong
- National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang, Vientiane Capital, Lao Democratic People's Republic
| | - Sivilai Xayaheuang
- CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
| | - Anna L Okello
- National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang, Vientiane Capital, Lao Democratic People's Republic; CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
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Aggarwal NK. Applying mobile technologies to mental health service delivery in South Asia. Asian J Psychiatr 2012; 5:225-30. [PMID: 22981050 DOI: 10.1016/j.ajp.2011.12.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 12/07/2011] [Accepted: 12/18/2011] [Indexed: 10/14/2022]
Abstract
Mobile phones have increasingly assumed an important role in the treatment of mental disorders in high-income countries. This paper considers such possibilities in the South Asian context. First, a brief review of mobile phone use in mental disorders is provided. Next, data on the market penetration and dissemination of mobile phones in South Asia is presented. Finally, common barriers to treatment for mental disorders in South Asia are evaluated against solutions that could be derived from mobile technologies. Though not without their risks, mobile phones have the potential to increase engagement, treatment, and retention of South Asian patients with mental disorders in unprecedented ways.
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Affiliation(s)
- Neil Krishan Aggarwal
- Columbia University Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, Suite 1703, Unit 11, New York, NY 10025, USA.
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Critically engaging: integrating the social and the biomedical in international microbicides research. J Int AIDS Soc 2011; 14 Suppl 2:S4. [PMID: 21968091 PMCID: PMC3194163 DOI: 10.1186/1758-2652-14-s2-s4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Randomized controlled trials and critical social theory are known not to be happy bedfellows. Such trials are embedded in a positivist view of the world, seeking definitive answers to testable questions; critical social theory questions the methods by which we deem the world knowable and may consider experiments in the biomedical sciences as social artifacts. Yet both of these epistemologically and methodologically divergent fields offer potentially important advances in HIV research. In this paper, we describe collaboration between social and biomedical researchers on a large, publicly funded programme to develop vaginal microbicides for HIV prevention. In terms of critical engagement, having integrated and qualitative social science components in the protocol meant potentially nesting alternative epistemologies at the heart of the randomized controlled trial. The social science research highlighted the fallibility and fragility of trial data by demonstrating inconsistencies in key behavioural measurements. It also foregrounded the disjuncture between biomedical conceptions of microbicides and the meanings and uses of the study gel in the context of users’ everyday lives. These findings were communicated to the clinical and epidemiological members of the team on an ongoing basis via a feedback loop, through which new issues of concern could also be debated and, in theory, data collection adjusted to the changing needs of the programme. Although critical findings were taken on board by the trialists, a hierarchy of evidence nonetheless remained that limited the utility of some social science findings. This was in spite of mutual respect between clinical epidemiologists and social scientists, equal representation in management and coordination bodies, and equity in funding for the different disciplines. We discuss the positive role that social science integrated into an HIV prevention trial can play, but nonetheless highlight tensions that remain where a hierarchy of epistemologies exists alongside competing paradigms and priorities.
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Béhague DP, Gonçalves H, Victora CG. Anthropology and Epidemiology: learning epistemological lessons through a collaborative venture. CIENCIA & SAUDE COLETIVA 2009; 13:1701-10. [PMID: 18833344 DOI: 10.1590/s1413-81232008000600002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Collaboration between anthropology and epidemiology has a long and tumultuous history. Based on empirical examples, this paper describes a number of epistemological lessons we have learned through our experience of cross disciplinary collaboration. Although critical of both mainstream epidemiology and medical anthropology, our analysis focuses on the implications of addressing each discipline's main epistemological differences, while addressing the goal of adopting a broader social approach to health improvement. We believe it is important to push the boundaries of research collaborations from the more standard forms of "multidisciplinarity," to the adoption of theoretically imbued "interdisciplinarity." The more we challenge epistemological limitations and modify ways of knowing, the more we will be able to provide in-depth explanations for the emergence of disease-patterns and thus, to problem-solve. In our experience, both institutional support and the adoption of a relativistic attitude are necessary conditions for sustained theoretical interdisciplinarity. Until researchers acknowledge that methodology is merely a human-designed tool to interpret reality, unnecessary methodological hyper-specialization will continue to alienate one field of knowledge from the other.
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Affiliation(s)
- Dominique Pareja Béhague
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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The authors reply - Response: a call for the study of multidisciplinary collaboration. CIENCIA & SAUDE COLETIVA 2008. [DOI: 10.1590/s1413-81232008000600006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Albert M, Laberge S, Hodges BD, Regehr G, Lingard L. Biomedical scientists' perception of the social sciences in health research. Soc Sci Med 2008; 66:2520-31. [PMID: 18336978 DOI: 10.1016/j.socscimed.2008.01.052] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Indexed: 12/01/2022]
Abstract
The growing interest in interdisciplinary research within the Canadian health sciences sector has been manifested by initiatives aimed at increasing the involvement of the social sciences in this sector. Drawing on Bourdieu's concept of field and Knorr-Cetina's concept of epistemic culture, this study explores the extent to which it is possible for the social sciences to integrate into, and thrive in, a field in which the experimental paradigm occupies a hegemonic position. Thirty-one semi-structured interviews were conducted to explore biomedical scientists' receptiveness toward the social sciences in general and to qualitative research in particular. We found that these respondents exhibited a predominantly negative posture toward the social sciences; however, we also found considerable variation in their judgments and explanations. Eight biomedical scientists tended to be receptive to the social sciences, 7 ambivalent, and 16 unreceptive. The main rationale expressed by receptive respondents is that the legitimacy of a method depends on its capacity to adequately respond to a research question and not on its conformity to the experimental canon. Unreceptive respondents maintained that the social sciences cannot generate valid and reliable results because they are not conducive to the experimental design as a methodological approach. Ambivalent respondents were characterized by their cautiously accepting posture toward the social sciences and, especially, by their reservations about qualitative methods. Based on the biomedical scientists' limited receptiveness, we can anticipate that the growth of the social sciences will continue to meet obstacles within the health research field in the near future in Canada.
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Affiliation(s)
- Mathieu Albert
- University of Toronto, Wilson Centre, Toronto General Hospital, Toronto, Ontario, Canada.
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