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Co-signature Event Context: Toward a Participatory Electronic Health Record

Person wearing green scrubs, surgical mask, protective eyewear and hair cover with gloves moving a computer mouse.

The days of doctors scratching illegible notes in charts fated to hide in obscure files never read by another soul is long gone. Over the last two decades, paper charts have nearly disappeared as the evolution of the electronic health record (EHR) has come to dominate the healthcare environment not only in the US, but globally. The health record performs multiple types of labor. It serves to facilitate communication in medical care or research; it is a legal document and a record to justify billing. A new diagnosis and billing code must make its first entry into the medical record accompanied by the signature of a clinician authorized to determine this diagnosis. After this initial entry, non-professional personnel may then use this diagnosis for any of the above purposes (communication, billing, legal). This blog post explores how developments like the patient portal of the EHR create new opportunities for interpretation, (read more...)

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West African Migration: The Dangers of a Single Story

“The single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story.”  Chimamanda Ngozi Adichie The Lagos-Abidjan corridor is one of the fastest-growing urban areas in Africa. It is also a migration route that connects mega-cities, peri-urban sprawl, market towns, and villages. For many people residing along the corridor, there are numerous opportunities to be had by jumping on a packed bus, crossing a land border, and tracking down local contacts. Everyday mobility along the Lagos-Abidjan corridor is a far cry from the tired tropes of African migration. Such tropes often feature trafficking, illegal migration, and perilous crossings of the Sahara and Mediterranean. This isn’t the full story—, in fact, it’s just a tiny part of it, as most migration in West Africa is regional. Indeed, the International Organisation for Migration (2015) reports that regional flows account for 84% of movements within West Africa. There is a false but predominant assumption that all sub-Saharan migrants are heading to Europe; one way to counter this is through telling more balanced stories about trans-local and regional migration. (read more...)

Still image from a video tweeted by @NBAonTNT of two basketball jerseys hanging in a locker room. One jersey reads: "Education Reform" and the other reads "Say their names."

Coming Soon: The MultiRepository

This post introduces a new collaborative project coming soon to CASTAC: an archive of online platforms that highlights how researchers have utilized different communicative modes and media in qualitative research and creative work, including in journalism and the arts. Think about how you usually encounter a researcher’s findings, a journalist’s account of an important event, or news of an artist’s latest work. In the early 20th century, you would often do so by reading an article in a newspaper, magazine, book, or academic journal. And although these publications might include pictures, graphs, and cartoons, they often emphasized textual ways of conveying information and ideas. Nowadays, an increasing number of researchers, journalists, and artists use multiple media technologies—often digital—to conduct and publicize their work, including text, graphics, and video, among others. Using and combining broader arrays of communication technologies reflects current media practices, but it also gives researchers and other professionals (read more...)

a ritual figure made of metal and wood with horns and a pitch fork

Fetishes or Cyborgs? Religion as technology in the Afro-Atlantic space

(Editor’s Note: This blog post is part of the Thematic Series Data Swarms Revisited) Afro-Brazilian religions like Candomblé, Umbanda or Xangô, are a cluster of religious practices that originated mostly in West Africa, especially in Yorubaland (Nigeria and Benin), but also in Congo and Angola. Similar to other Afro-diasporic religions (i.e. Vodou in Haity and Santeria in Cuba), Candomblé shares many elements with West African traditional religious practices, like the names and characteristics of their deities (called orixás in Brazilian Portuguese and òrìṣà in Yoruba). These deities embody elements of the natural landscape and atmospheric phenomena that are regarded as personas with their own material and spiritual agency. However, in the whole Afro-Atlantic space the most important common trait is the presence fabricated objects. After a ritual procedure they become the bodies and the material manifestation of the deities themselves. These objects, often referred to as “fetishes,” represent the point of mediation between the material and the spiritual world (Meyer 2012: 15). Indeed, Western conception of materiality is often charged with moral implications, opposed to the pure and transcendent qualities of the spirit (Espírito Santo 2010). Conversely, in Afro-Atlantic religions, objects, elements and atmospheric phenomena are considered to be alive or to have a certain individuality, will or personality, in a way that the scientific Western thought would consider unacceptable. (read more...)

A woman is carrassing her pregnant stomach.

The Best Laid Plans are not Birth Plans

Childbirth has had a long and winding history. This is understandable since it has literally been happening since the beginning of human time. Prior to 1950, many births happened in a familiar home setting attended by a midwife, overwhelmingly a group of female providers. For a fun and fairly accurate representation, enjoy a binge of “Call the Midwife” by the BBC. While often depicted in a romantic way, childbirth prior to the 1930s and 40s was dangerous – sepsis caused 40% of maternal deaths as most deliveries were performed without sterile technique and many women died of hemorrhage (severe bleeding) or preeclampsia and eclampsia (elevated blood pressures in pregnancy and seizures) (6). As science and medicine progressed in the second half of the 20th century, new technologies and techniques moved delivery into a hospital setting attended by physicians, overwhelmingly a group of white male providers. Maternal death in the first quarter of the 20th century was quite common prior to this with as many as 7/100 deaths in the United States (6). While advancements in science and medicine and a shift towards hospital-based delivery improved maternal and fetal/neonatal morbidity and mortality, an unwanted side effect for many patients was the medicalization (and potentially over-medicalization) of the delivery experience (1). In addition, the culture of paternal medicine and the “doctor knows best” mentality meant that this shift encouraged a lack of communication and autonomy for patients. Within bioethics, autonomy means the patient’s right to choose what happens to their body and to make well-informed choices about the plan for their medical care. Currently, the rate of home birth remains low – less than 1% of all births in the United States (2). However, patients want autonomy for what is arguably one of the most impactful experiences of one’s life – the birth of a child. In the 1970s, prenatal educators introduced the idea of the Birth Plan, a standardized document that sets out the values of a patient regarding their birth experience. In 1996 the World Health Organization advocated for use of the Birth Plan with the goal of increasing patient autonomy during birth (1). Studies have demonstrated that patients feel more empowered and using a birth plan is associated with increased patient satisfaction (3). No studies have been done that address providers’ interactions with Birth Plans, but anecdotally there are few obstetrics providers that look upon them favorably. (read more...)

An older couple sits side-by-side on a small red sofa, against a light blue wall. The man wears a green shirt and a plaid sarong. The woman wears a black hijab and a flowery skirt. In front of the sofa are two brightly colored pink and yellow rugs, with green and black patterns. Behind the sofa are a number of pieces of clothing, hung up and spread out. There is a white wall on one end of the room, and a window with a square grill at the other end.

“Legibility by Invitation”: Rohingya Refugees and the Struggle for Political Recognition

Once, in mid-August 2018 in a café tucked away in Klang Valley, Malaysia, Husin, my Rohingya research collaborator, and I sat with Fatimah, a young Rohingya woman. As it was after eight in the evening, I asked if she was worried that she might be detained by the police. “Ah Kak, that’s because the police just want money… if you know how to talk, you don’t have to pay bribe,” Fatimah explained to me in Malay before continuing, “kalau mereka mau tangkap saya, jemputlah [if they/police want to detain me, they are invited to do so]. Saya ada UN card, saya tak takut. [I have the UN card, I am not scared]” (emphasis mine). For Fatimah and other Rohingya refugees I have met in Malaysia, the notion of invite extends to their desire to be seen not just as refugees, but as Rohingya refugees. (read more...)

Interdisciplinarity and Transdisciplinarity: Just Buzzwords?

What is the value of interdisciplinary and transdisciplinary work in the current scientific-technological context? To what extent do collaborative practices present a changing setting for research in Europe but also in other countries? What can we learn from these practices from an anthropological perspective? (read more...)

Black and white microscopic images of textured fibers and spiky balls are distinguished in four panels and labeled with significant morphological features.

Naming Species in Colombia’s Biodiverse Landscapes

There is a unique pair of rules on Sattins Island, in Ursula K. Le Guin’s world of Earthsea. This pair is called The Rules of Names and though these rules circulate among the villagers, they are taught to children by the schoolteacher. Names are allocated on Sattins Island based on a person’s physical characteristics or any other visible aspect of their way of life. The local wizard, for instance, is simply called “Mr. Underhill.” An old wizard known for his ineffective spells but still respected by the villagers, he lives in a cave under a hill and doesn’t enjoy visits. Mr. Underhill was in fact listening to the schoolteacher, Palani, when she was teaching the children about the Rules. Noting his presence, Palani found it instructive to call Mr. Underhill and use his case as evidence for the omnipresence of the Rules. (read more...)