Decolonizing study-abroad programs in nursing in low- and middle-income countries.

Study abroad programs expose scholars, including nursing faculty and students, to different settings and cultures. However, the world of global health is rooted in colonial practices that have the potential to cause harm to communities. In this reflection, we provide lessons we have learned through study abroad that guide strategies for decolonizing our practice while working toward cultural safety and humility.

Admitting privileges: A construction ecology perspective on the unintended consequences of medical school admissions.

Medical-school applicants learn from many sources that they must stand out to fit in. Many construct self-presentations intended to appeal to medical-school admissions committees from the raw materials of work and volunteer experiences, in order to demonstrate that they will succeed in a demanding profession to which access is tightly controlled. Borrowing from the field of architecture the lens of construction ecology, which considers buildings in relation to the global effects of the resources required for their construction, we reframe medical-school admissions as a social phenomenon that has far-reaching harmful unintended consequences, not just for medicine but for the broader world.

Society for Medical Anthropology Statement on Supreme Court Dobbs v. Jackson Women's Health Organization Decision.

This statement summarizes key findings from anthropological and related scholarship on the harmful consequences of inadequate abortion access, leading the Society for Medical Anthropology to register profound concern about the recent Supreme Court decision in Dobbs v. Jackson. After circulation to SMA members for input, a finalized version passed a membership vote by an overwhelming margin.

The changing dynamics of community care and support in rural Malawi: The impact on Women's health and wellbeing at end of life.

In this critical ethnographic study, we examined women's end of life experiences in Malawi, one of the few countries in the world with a national palliative care policy. Specifically, we explored how women's and their caregivers' experiences were shaped by family and community care, and material needs. Interviews and observations with female clients of a non-governmental organization in rural Central Malawi, and with their caregivers, revealed that community-level support was both precarious and critical.

Women's work at end of life: The intersecting gendered vulnerabilities of patients and caregivers in rural Malawi.

Gender inequality in the form of gender-based violence manifests throughout the course of women's lives but has a particularly unique impact at end of life. We sampled 26 patients and 14 caregivers for this qualitative critical ethnographic study. The study purpose was to describe the lived experience of female palliative care patients in rural Malawi and their caregivers.

Who Counts? What Counts? Place and the Limits of Perinatal Mortality Measures.

Maternal and neonatal mortality statistics foreground some possible causes of death at the expense of others. Political place (nation, state) and place of birth (hospital, home) are integral to these statistics; respect for women as persons is not. Using case examples from Malawi and the United States, I argue that the focus on place embedded in these indicators can legitimate coercive approaches to childbirth.

Assessing empathy development in medical education: a systematic review.

Context: Empathy in doctor-patient relationships is a familiar topic for medical scholars and a crucial goal for medical educators. Nonetheless, there are persistent disagreements in the research literature concerning how best to evaluate empathy among physicians, and whether empathy declines or increases across medical education. Some researchers have argued that the instruments used to study 'empathy' may not measure anything meaningful to clinical practice or patient satisfaction.

Exceptional deliveries: home births as ethical anomalies in American obstetrics.

Interest in home birth appears to be growing among American women, and most obstetricians can expect to encounter patients who are considering home birth. In 2011, the American College of Obstetricians and Gynecologists (ACOG) issued an opinion statement intended to guide obstetricians in responding to such patients. In this article, I examine the ACOG statement in light of the historical and contemporary clinical realities surrounding home birth in the United States, an examination guided in part by my own experiences as an obstetrician in home-birth-friendly and home-birth-unfriendly medical milieus.

Midwives' verbal support of nulliparous women in second-stage labor.

Objective: To describe how nurse-midwives verbally support nulliparous women during second-stage labor and document specific details of each second stage.

Design: Descriptive qualitative study.

Setting: A university hospital labor and delivery unit in the southwestern United States.

Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi.

The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks.

Moral maps and medical imaginaries: clinical tourism at Malawi's College of Medicine.

At an understaffed and underresourced urban African training hospital, Malawian medical students learn to be doctors while foreign medical students, visiting Malawi as clinical tourists on short-term electives, learn about “global health.” Scientific ideas circulate fast there; clinical tourists circulate readily from outside to Malawi but not the reverse; medical technologies circulate slowly, erratically, and sometimes not at all. Medicine's uneven globalization is on full display.

The vanishing mother: Cesarean section and "evidence-based obstetrics".

The philosophy of "evidence-based medicine"--basing medical decisions on evidence from randomized controlled trials and other forms of aggregate data rather than on clinical experience or expert opinion--has swept U.S. medical practice in recent years.

Anaerobic digestion of blackwater from vacuum toilets and kitchen refuse in a continuous stirred tank reactor (CSTR).

The objective of this research was mesophilic anaerobic digestion of blackwater from vacuum toilets (BW) and kitchen refuse (KR) in a CSTR within an ecological sanitation system. A detailed investigation of the BW characteristics was carried out. Research on anaerobic digestion was performed with CSTR of 101 volume at HRT of 10, 15 and 20 days.

Grey water treatment in UASB reactor at ambient temperature.

In this paper, the feasibility of grey water treatment in a UASB reactor was investigated. The batch recirculation experiments showed that a maximum total-COD removal of 79% can be obtained in grey-water treatment in the UASB reactor. The continuous operational results of a UASB reactor treating grey water at different hydraulic retention time (HRT) of 20, 12 and 8 hours at ambient temperature (14-24 degrees C) showed that 31-41% of total COD was removed.

Parameter analysis of the IWA Anaerobic Digestion Model No. 1 for the anaerobic digestion of blackwater with kitchen refuse.

The IWA anaerobic digestion model No.1 (ADM1) had been successfully applied to the lab-scale mesophilic blackwater anaerobic digestion (BWAD) plant for cases of only blackwater (BW) feeding and of BW plus kitchen refuse (KR) feeding. In this paper, the simulation results of BW + KR anaerobic digestion are presented and discussed, followed by the analyses and discussion of the critical and important parameters as well as the performance of ADM1 based on these results.

Implementation of the IWA anaerobic digestion model No.1 (ADM1) for simulating digestion of blackwater from vacuum toilets.

The IWA anaerobic digestion model No.1 (ADM1) is applied to the blackwater anaerobic digestion (BWAD) plant in this work. In order to verify the biochemical kinetics, batch experiments were executed.

Psychopathology and familial stress - comparison of boys with Fragile X syndrome and spinal muscular atrophy.

Background: Chronic illness and mental retardation are both associated with an increased rate of behavioural problems in children and with considerable emotional strain in families. The aim of the study was to analyse and compare the specific effects of two exemplary conditions on familial stress and coping.

Methods: Forty-nine boys with Fragile X syndrome (FXS) were compared with 46 boys with Spinal Muscular Atrophy (SMA) and 32 male controls.

Intelligence and cognitive function in children and adolescents with spinal muscular atrophy.

Spinal muscular atrophy is a chronic disease characterised by loss of motor function. The aim of the study was to analyse cognitive functions in a large group of patients with spinal muscular atrophy. It was hypothesised that their intelligence is comparable to controls, but not above average as previously postulated.

Cervical ectopic pregnancy. Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate.

Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervical canal. Diagnosis and treatment of cervical ectopic pregnancy has changed dramatically in the last 15 years. Before 1980, the diagnosis commonly was made when dilation and curettage for presumed incomplete abortion resulted in unexpected hemorrhage.

Donor insemination: a comparison of lesbian couples, heterosexual couples and single women.

Objective: To compare single women, lesbian couples, and heterosexual couples receiving therapeutic donor insemination (TDI).

Design: Chart review followed by anonymous mail questionnaires to donor insemination recipients and their partners.

Setting: Infertility clinic in a university hospital.