Culture & Health Final Review Fall 2020

Journalists have a double-standard when writing about poverty and identity in the United States. Stories of upward social mobility make it seem as if anybody could potentially become rich, while people of color living in poverty are portrayed as depending on welfare, lacking motivation, and having poor work ethic. Which of the following article headlines CHALLENGES this double-standard?

"It's Expensive to Be Poor" - The Economist

Of the following quotes from The Shifting Mask of Schizophrenia, which BEST explains medical pluralism?

"The idea that spirit possession was causing bizarre behaviors coexisted with the notion that the pills from the doctors might have helped her daughter's quality of life."

Kleinman writes: "You need to understand that as powerful an influence as the culture of the Hmong patient and her family is on this case, the culture of biomedicine is equally powerful." Which of the following statements DOES NOT reflect a powerful belief within the American culture of biomedicine?

"To achieve health, harmony must exist between healing, feelings, and action."

Washington notes the brutal irony that, "Geography, tradition, and culture intersect to make Blacks likely research subjects for new technologies..."; however they will also likely...:

...be unable to afford these new development. In this way, their sacrifices never benefit their own families, and contribute to the advancement of a racially biased, unequal medical system.

Structural racism...

...can be defined as patterns by which racial inequality is structured through key cultural institutions, policies, and systems.

How old is the youngest Shaman mentioned in the video?

12

How many souls do the Hmong believe a person has?

7

What animal is sacrificed to call Paja's spirit?

A bull

The World Health Organization states that "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Which of the following journalistic accounts BEST exemplifies the holistic value of this definition of health: A. A journalist for The Guardian published an article with the headline, "Being a member of a reading group may extend your life." B. The Department of Homeland Security stated, "In order to protect the health of our citizens, all immigrants who test positive for the zika virus will be denied entry to the country." C. A Kansas City radio station reports on a study with the headline, "Genetic factors lead to an increased breast cancer risk for men." D. According to epidemiologists at the Douglas County Dept. of Health, "There will be at least 1500 new cases of influenza in the city of Lawrence in 2019."

A. A journalist for The Guardian published an article with the headline, "Being a member of a reading group may extend your life."

Fadiman wrote: "Coelho planned to become a Jesuit priest, but was barred by a canon forbidding the ordination of epileptics." Scholars have differentiated illnesses from diseases based on what is at stake in being sick. How would a Hmong shaman assess Coelho's condition? A. Coelho is not experiencing an illness, but rather a sign that he is particularly fit for divine office. B. Because Coelho was not born among the Hmong, it is impossible to treat his condition with traditional remedies. C. Coelho is experiencing a disease characterized by a spiritual rewiring of his neural chemistry. D. Coelho is suffering from a neurological disorder and should seek biomedical treatment.

A. Coelho is not experiencing an illness, but rather a sign that he is particularly fit for divine office.

_________ is when psychological distress becomes expressed through physical symptoms. A. Somatization B. Fabulation C. Sickness D. Disease

A. Somatization

Select the BEST explanation for why the following statement is true: "Any discussion of U.S. inmates is closely bound up with race."

African-Americans have always been dramatically overrepresented in American jails and prisons.

Kleinman's Eight Questions seek to integrate the patient's understanding of their illness into the physician's medical approach and plan of treatment. A patient's perspective on the nature of their health problem, including its causes, likely course of development and appropriate treatments is also known as:

An explanatory model

In the Hmong culture, what is the relationship between human beings and animals?

Animal spirits are connected to human spirits.

In Lissa, Anna discovers that she carries a BRCA mutation that puts her at increased risk of breast cancer. Layla challenges Anna, and asks "Why try to treat a condition that you don't have?" Anna responds, "But...I do have it...I've lived with it my whole life." (119)What would scholars of culture and health say about Anna's condition?

Anna has an illness, but she does not have a disease.

The biomedical approach to illness often conceives of the patient as an autonomous individual whose health, body and decisions are that patient's responsibility alone, while Sherine Hamdy and Coleman Nye aim to describe the social embeddedness of patients' motivations and choices. Which of the following actions from Lissa BEST reflects this biomedical ideal of patient autonomy?

Anna's mother declined the option for surgery because the cancer had already spread to her lymph nodes and there was little chance of survival.

At MCMC, Fadiman observes: "Obstetricians have had to obtain consent for Cesarean sections or episiotomies using embarrassed teenage sons, who have learned English in school, as translators. Ten-year-old girls have had to translate discussions of whether or not a dying family member should be resuscitated..."Aside from why provider-patient communication is essential, why is the question of who is translating important? A. In Hmong society, children possess greater wisdom and command greater respect than their elders; these encounters reinforce generational power differences. B. By failing to work within Hmong power hierarchies, clinicians are not directing crucial questions toward those who possess decision-making power, leading to confusion and shame. C. Since Hmong society is matriarchal, women dominate household leadership; clinicians are blinded by their American patriarchal values in these encounters. D. While doctors' references to "practicing veterinary medicine" may equate Hmong with livestock, they fail to understand the sacred role of animals in Hmong belief systems.

B. By failing to work within Hmong power hierarchies, clinicians are not directing crucial questions toward those who possess decision-making power, leading to confusion and shame.

Miner wrote, "The fact that these temple ceremonies [at the latipo] may not cure and may even kill the neophyte in no way decreases the people's faith in the medicine men." What is the social purpose of such a ritual? A. It highlights irrational and uncivilized features of the Nacirema's health-seeking behaviors. B. It embodies the beliefs of the Nacirema and creates a sense of community and belonging. C. It displays the power of medicine men to perform whatever procedures they feel are appropriate, without regard to the Nacirema's beliefs. D. It reveals the inability of healing to occur without biomedical treatment.

B. It embodies the beliefs of the Nacirema and creates a sense of community and belonging.

"Quesalid did not become a great shaman because he cured his patients; he cured his patients because he became a great shaman," wrote Levi-Strauss. Which of the following is NOT an element of the shamanistic complex? A. The sorcerer's belief in the effectiveness of his techniques B. The power of the sorcerer's healing charm or talisman C. The patient's or victim's belief in the sorcerer's power D. The faith and expectations of the group

B. The power of the sorcerer's healing charm or talisman

In his TED Talk, Abraham Verghese states, "I'd like to introduce you to the most important innovation I think in medicine to come in the next ten years, and that is the power of the h uman hand." Why does Verghese believe that a doctor's touch is so important? A. Mobile and touchscreen technologies have transformed the diagnostic process in modern medicine, allowing for faster and better communication with patients. B. There are limits to what technology can accomplish in medicine, particularly in the absence of connection, trust, and comfort between physician and patient. C. Recent shifts in the ways healthcare providers palpate the abdomen for tenderness and masses have led to exponential increases in the diagnosis of pancreatic cancer. D. A doctor has the ability to channel energy into the patient, which activates the natural healing processes of the body and restores physical and emotional wellbeing.

B. There are limits to what technology can accomplish in medicine, particularly in the absence of connection, trust, and comfort between physician and patient.

__________ means "person with a healing spirit." The Hmong consider that these people have the power to perceive things other people cannot see. Being a person with a healing spirit is a vocation - they will die if they choose to refuse it. A. Ghilk Bhug B. Txiv Neeb C. Ntuj Khaib Huab D. Dab

B. Txiv Neeb

In American medical schools, a white coat ceremony symbolically confers upon medical students a sense of: A. youthfulness and naivete B. collective identity and authority C. individuality and personal aesthetics D. masculinity and intimacy

B. collective identity and authority

Which of the following explanations offers the BEST explanation for why North American researchers have a difficult time recognizing and allowing for cultural differences in emotions?

Because emotions have been subjected to medicalization in North America, researchers assume that the functioning of the human body--and consequently the mind--is universal.

Why does Paja Thao check to see if Uncle Por's nose is broken?

Because if the nose is broken it means the person will die soon.

Which of the following is NOT a key dynamic of globalization?

Biological adaptation

The Oregonian Newspaper recently published an article titled, "When care matches culture, immigrants and people of color benefit" about a community's efforts to provide culturally-responsive mental healthcare in schools. Which of the following attributes of culture is INCORRECT? A. Culture is stored and articulated in language. B. Culture is socially reproduced. C. Culture is genetically transmitted. D. Culture is found in patterns of thought and behavior.

C. Culture is genetically transmitted.

When scholars talk about studies of meaning-making, which of the following statements best describes what they are referring to: A. Efforts to understand how healthcare students decipher medical texts. The way in which they analyze and break down the complicated jargon found in medical textbooks. B. Efforts to understand how individuals come to make sense of how healthcare works. The ways in which they evaluate and decide which clinic to go to or which specialist to see. C. Efforts to understand a person's life-world. The ways in which we assign value and purpose to our experiences, conduct and relationships. The personal and social realities, patterns of actions, and behaviors of people. D. The ways in which patients come to understand what the healthcare providers are telling them.

C. Efforts to understand a person's life-world. The ways in which we assign value and purpose to our experiences, conduct and relationships. The personal and social realities, patterns of actions, and behaviors of people.

"The Hmong were not only trickier, but sicker..." Fadiman documents why the Hmong community had higher morbidity and mortality rates than their American-born counterparts. Which of the following determinants DOES NOT account for these differences in health status? A. Greater numbers of Hmong residents in Merced live in poverty and rely on Medicaid (Medi-Cal) for insurance. B. Clinicians could not understand Hmong patients in their native language, equating their care to "veterinary medicine". C. Hmong carried Hepatitis B from the camps into the U.S., predisposing their children to higher rates of epilepsy. D. Clinicians believed they understood medicine better than the Hmong community and refused to compromise.

C. Hmong carried Hepatitis B from the camps into the U.S., predisposing their children to higher rates of epilepsy.

Peter Sedgwick claimed that, "outside the significance that man attaches to certain conditions, there are no illnesses or diseases in nature." Which of the following BEST explains this statement? A. In nature, everyone is healthy; because it is unnatural to be ill, contracting a disease disrupts the equilibrium between living organisms and their environment. B. Disease and illness are social constructions; contracting a disease is thus a psychological delusion, not an empirical reality. C. Illness and disease are social constructions; humans impose meanings on naturally occurring processes through the creation of these categories. D. All of the above.

C. Illness and disease are social constructions; humans impose meanings on naturally occurring processes through the creation of these categories.

Julia received a diagnosis of an early-stage cancer. She is not experiencing any symptoms, she continues working at her job, and no one has suspected a change in her health. What would medical anthropologists say about her condition? A. Julia has a symbolic disorder, but she does not have a sickness. B. Julia has an illness, but she does not have a disease. C. Julia has a disease, but she does not have an illness. D. Julia has a symbolic disorder, but she does not have an embodied disorder.

C. Julia has a disease, but she does not have an illness.

Which of the following statements is the LEAST ethnocentric? A. "Jose's father did not come to the clinic with his son. He must not value his son's health and wellbeing as much as we Americans do." B. "Acupuncture needles are painful, ineffective, and primitive. Why don't the Chinese use prescription pills to treat pain?" C. "I don't blame South Africans for their country's high rates of HIV. Their mentality about risky sex is simply inferior to ours." D. "I understand why the Sudanese perform female genital modification, but I need to know more about what constitutes human rights in this context."

D. "I understand why the Sudanese perform female genital modification, but I need to know more about what constitutes human rights in this context."

What made Conquergood's campaign in Hmong refugee camps successful? A. He embraced the cultural nuances of the Hmong instead of viewing them as medical noncompliance. B. He related to the Hmong by incorporating their folktales and characters into the campaign to relay messages about rabies. C. He created new characters in Hmong-style to sing and explain sanitation to the Hmong. D. All of the above

D. All of the above

Healing is defined as: A. Any process which allows the individual to succeed in their physical goals. B. The way in which a person overcomes any kind of suffering they experience. This means that healing is much more than just a physical ailment, it can also be about overcoming a financial challenge, for example. C. A doctor giving a patient a clean bill of health. D. Both the medically defined overcoming of disease and disorder and the suffer-defined resolution of a sickness experience or suffering.

D. Both the medically defined overcoming of disease and disorder and the suffer-defined resolution of a sickness experience or suffering.

Traci Brimhall writes in her poem, Shelter in Place, "I thought I loved to verb through the days, but spring annulled that marriage, giving me to stillness." What does the phrase annulled that marriage most likely symbolize in the context of this poem? A. The breakup of a relationship B. Death C. The change of seasons D. The shelter in place policy

D. The shelter in place policy

In the video, what was the primary concern with which the narrator's father struggled?

Distress about his family's departure from the Hmong culture.

A patient in the hospital spoke to Layla and said, "I know a man that donated his kidney to his brother nine years ago... The brother died five years ago and now the man is in renal failure. It's not just transplants that we need." (127).Which of the following statements BEST relates to this particular patient's concern?

Egyptians' poor health is a result of structural inequalities and issues with uneven access and distribution of healthcare resources.

The Occupy Wall Street movement illustrated Karl Marx's argument that there would always be unrest between the working class and the __________ in capitalist societies.

Elites

Which of the following recurring social processes have been identified as a sources of social and psychiatric morbidity in different contexts around the world?

Ethnic Conflict

"A rural Chinese farmer might speak only of shoulder or stomach-aches. A man in india might talk of semen loss or a sinking heart or feeling hot. A Korean might tell you of 'fire illness...' Someone from Iran might talk of tightness in the chest, and an American Indian might describe the experience of depression as something akin to loneliness" (195). These patients' local perspectives on the nature of their health problems are critical components of:

Explanatory models

In Culture & Health, students collect illness narratives, which are components of ethnography--a methodology in which researchers immerse themselves within a community to learn about people's lives. Illness narratives allow us to:

Explore embodied experiences of illness and the cultural values that underlie the condition.

If the funeral rites are not performed correctly, what will happen to Uncle Por?

He will return as a ghost.

Layla tells Anna, "Here [in Egypt] we don't have enough medicine. There [in the United States], you've got too much." (119). While Layla was pointing out disparities between Egypt and the United States in terms of access to treatment, Anna's experience navigating her condition highlighted her fundamental belief that:

High-cost, high technology medicine will benefit patients by raising life expectancies and lessening morbidity for everyone.

"Lia's parents didn't hesitate to say no to [to physicians] or modify the drug dosage or do things however they saw fit...For them, the crisis was the treatment, not the epilepsy." Fadiman notes here a moral position presumed to be shared, and even taken-for-granted by most American consumers of biomedicine--that physicians know best and their authority should be accepted. This latter point reveals:

How Lia's parents expose the hegemony of biomedicine by challenging the taken-for-granted authority of physicians.

Which of the following claims about race is TRUE?

Human variations in skin color are clinal.

_____________ means "originating from a physician or treatment".

Iatrogenesis

In Lissa, one of Layla's professors referred to organ transplants as an equivalent to "giving someone an artificial form of AIDS." (113)What would scholars argue is the significance of this analogy in the context of Egypt and North America?

In North America, organ transplants are presumed to be fundamentally "life-saving" curative events, whereas in Egypt, they are seen as the cause of life-long, chronic complications and treatment needs.

Each year UCSF Benoit Children's Hospital holds a prom for its teenage patients. Why is prom an important ritual for these young people?

It initiates a process of healing as patients temporarily exit the liminal stage of the sick role

The McGill Illness Narrative Interview is widely used in American medical schools today as an interview technique. Which of the following offers the BEST explanation for why this is such an important tool in cross-cultural medicine?

It sets clinicians' expert knowledge alongside--not over and above--the patient's own explanation and viewpoint.

Watters wrote that the pharmaceutical company, GlaxoSmithKline initially faced a formidable challenge in launching an antidepressant medication in Japan. Which of the following was NOT one of its challenges?

Japan did not have a clinical diagnosis of depression prior to the arrival of this antidepressant.

In the midst of rapid changes in the 19th century, Japanese officials were concerned with the rise of social problems, such as juvenile delinquency. They turned to German-trained psychiatrists for advice. Neurasthenia was introduced as an illness of modernity, described as a disease of the nerves. Which of the following statements BEST reflects how a scholar of culture and health would explain the emergence of neurasthenia?

Japanese psychiatrists began medicalizing behaviors as problems to be treated by through biomedical intervention.

What was the product or treatment Dr. Albert Kligman created based on testing prisoners that made him a millionaire?

Medicine to decrease acne

When Anna's mother dies, Layla's parents object to what aspect of Anna's family's arrangements for her burial?

Moving the body away from the place of death.

How did the Hmong dress the dead body in the ceremony shown in the video?

Ornate, decorated clothing

During the era of slavery in the South, the Owner-Physician Pact meant that:

Owners could not sue their physicians AND The slave system was beneficial to both the Southern doctor and the planter or slave owner; each supported the other.

Foucault uses this term to identify an institution devoted to surveillance and control in which the prisoners/or those being monitored would not know they were being surveilled and therefore would always behave as though they were being surveilled.

Panopticon

Which of the following BEST describes why it is particularly problematic that Phase 1 trials typically have used prisoners as research subjects?

Phase 1 trials are in many ways the riskiest--asking "how safe is this drug?" Using prisoners as research subjects for this phase devalues their lives.

Today, the science of cell-line culture and stem cell research was enabled by the work of a scientist who, in 1951, harvested cancer cells from a Black Baltimore housewife named Henrietta Lacks, without her knowledge or consent. Which of the following conclusions BEST reflects Washington's arguments about these biotechnological developments?

Safe, nonexploitative research into surgical technology is in everyone's best interest, but for African Americans to remain open to such research, medical policies and practice will have to do a better job of shielding them from abuse.

In "The Shifting Mask of Schizophrenia in Zanzibar," Abdulridha believed that a biomedical intervention was the best approach to intervene in his sister's condition, and used this orientation as his rationale for controlling her. Abdulridha's efforts are unusual in Zanzibar, because according to the beliefs of many Zanzibaris:

Schizophrenia is a blessing or a burden to be embraced, not a condition to be medicalized.

To prevent the dab from touching its potential victims, the txiv neeb instructs their Hmong clients to perform ceremonies in which they sacrifice objects such as chickens, pigs, water buffalo horn, and bloody spirit-money among other materials. To successfully heal, the txiv neeb, the patient, and the Hmong community need to believe in the power of this practice. The concept that BEST accounts for the effectiveness of this matrix of beliefs is:

Shamanistic complex

Which of the following concerns related to HIV-positive children serving as involuntary research subjects was NOT raised by Washington?

Stripped of their freedom and their family connections, incarcerated HIV-positive children's participation in trials was as legally invisible as the slaves in antebellum experiments.

Fadiman observes: "If [Hmong patients] had summoned the courage to visit the clinic, they wanted to be told that something was wrong and to be given something, preferably a fast-acting antibiotic, to fix it." What must occur for healing to take place?

The clinician and the patient must both acknowledge that the sickness has been resolved.

While Washington couldn't have predicted the 2020 coronavirus pandemic, what reason would she MOST LIKELY give for the United States' failure to contain the outbreak, based on her observations of previous infectious disease pandemics?

The discovery of antibiotics and the successful development of vaccines led to the abandonment of public-health measures designed to prevent infection, leaving healthcare institutions ill equipped to cope with the surge of patients.

The term iatrophobia is defined as:

The fear of medical care.

Ethan Watters argued that, "We should worry about this loss of diversity in the world's differing conceptions and treatments of mental illness in exactly the same way we worry about the loss of biological diversity in nature."Which of the following BEST describes the point Watters is making here?

The loss of diversity of conceptions and treatments of mental illness hinders healers' ability to understand and treat them because mental illnesses are fundamentally social maladies.

From the point of view of pharmaceutical company, GlaxoSmithKline, what was wrong with the phrase kokoro no kaze as a marketing line for explaining the meaning of depression to a Japanese audience?

The metaphor lacked a sense of urgency about the condition, and people might think that medication for this condition was optional.

Medicalization is understood as:

The process by which some aspects of human life come to be considered as medical problems, whereas before they were not considered pathological.

Scientific racism is best described by which of the following:

The ways scientific facts are constructed to support racist ideologies; These 'facts' supported colonialism and slavery, which have had a lasting impact on medicine as practiced today.

Camara Jones of the National Center for Chronic Disease Prevention and Health Promotion, states that race is, "the societal box into which others put you based on your physical features." In other words, race is the social classification of people based on ________________________.

Their phenotype

What does the title of the book, Lissa, mean?

There is still time.

A few years ago, TV celebrity Rachel Maddow was at Rockefeller University to hand out a prize that's given each year to a prominent female scientist. As Maddow entered the auditorium, someone overheard her say, "What is up with the dude wall?" What was Maddow's primary concern with "dude walls" found in medical schools throughout the country?

These portraits reproduce the association between scientific achievement and whiteness, thereby marginalizing those who are neither white, nor male.

Anna gets annoyed at the way people talk about her options for reducing her cancer risk because:

They only focus on reproductive viability or protecting her marriage prospects.

Washington argues that Sims' practice of prescribing opioids after performing surgery on enslaved patients could best be explained by which of the following statements:

This practice had more to do with controlling women's behavior than controlling their pain, because the addiction weakened their will to resist repeated procedures.

What is the purpose of the Seed Ceremony?

To bring the lost souls of he family members back home

In addition to prescribed medications from their physician, the Lees stepped up their use of traditional medicine, spending $1,000 on amulets filled with sacred healing herbs from Thailand. They also tried a host of less costly but time-consuming therapies. These efforts are an example of medical pluralism.What point would a medical anthropologist make about medical pluralism?

Traditional medicine is often complementary to biomedicine, particularly when it addresses a different set of determinants of poor health.

What did Layla accuse her brother of taking before joining protesting events?

Tramadol

Which Japanese word directly translates to English as "depression"?

Utsubyô

In Chapter one, administering "an overdose of ammonium carbonate" to shock a slave out of "shamming an epileptic fit" or when "owners and physicians also blurred the therapeutic line by referring jocularly to whipping as "medicine" for malingering slaves" is referred to as:

Veiled medical violence

Who are the Nacirema? A. The Kwakiutl B. The Australians C. The Americans D. The Mayans

c. The Americans

Which of the following is not a phase in a rite of passage?

resignification--initiate is given a new set of symbols with which they negotiate their new identity

Kleinman states the need for a shift from a model of coercion to a model of mediation in medicine: "Go find a member of the Hmong community, or go find a medical anthropologist, who can help you negotiate...Decide what's critical and be willing to compromise on everything else." Which of the following is the BEST example of a model of mediation?

A clinician attempts to accommodate Hmong patients' needs even if they diverge from the hospital's standard operating procedures.

Janis Hunter Jenkins writes: "A culture provides its members with an available repertoire of affective and behavioral responses to the human condition, including illness...It offers models of how people should or might feel and act in response to the serious illness of a loved one...Individuals in a given time and place will react to illness similarly because they share the same limited repertoire of cultural scripts for how to play their part." (160). A scholar of culture and health would say that this observation references:

A culture-based concept of the "sick role" delineating the expected behaviors of a sick person

In The Shifting Mask of Schizophrenia in Zanzibar, which of the following was NOT a social consequence of Zanzibari's belief in spirit possession?

A decrease in stigma toward the mentally ill in Zanzibar

Where does Magruder suspect the theory that "life is simpler and less stressful for poor people in developing countries" as a reason for the differences in population-level schizophrenia outcomes comes from?

A fantasy of Westerners who are soul-weary from lives of community, competing, and trying to find time for family.

In Lia's hu plig ceremony, "...after a chicken was boiled, it was examined to find out if Lia's soul had returned. Next, the txiv neeb unwound the cord from [a sacrificed pig's] neck and from Foua-and-Lia, and brandished his saber to cut Lia's sickness away." Lia's "soul-calling" is an example of symbolic healing. How does symbolic healing work?

A healer conducts a ritual in the community, selecting objects and assigning them culturally-specific meanings that indicate the effectiveness of his treatment.

Which of the following examples BEST illustrates a racial ideology?

A philosophy department refuses admission to Afro-Brazilian students because faculty members believe them to be incapable of engaging with advanced abstract concepts.

Watters documents the story of Kassim, who is suffering the loss of his daughter. He believes he has picked up spirits from the graveyard while burying his daughter. In an attempt to get rid of the spirits, he goes to a Koran school to have Arabic prayers sung for him, and once the prayer is translated for him, he says it in Kiswahili every night and sleeps soundly. Which aspect of an ethnomedical system is a prayer an example of?

A prescription for therapy

What was the last main ritual shown in the video?

A soul naming ritual for the newborn children in the family.

Which of the following offers an example of how scholars of culture and health study intersectionality?

A study that investigates middle class, Black women who work in corporate America.

What is another name for a "charm box," as depicted in Horace Miner's Body Rituals among the Nacirema? A. A toilet B. A medicine cabinet C. A jewelry box D. A sorcerer's toolkit

B. A medicine cabinet

Which of the following is NOT a social determinant of kidney failure?

Comorbid conditions (having more than one disease).