In the 19th century, Western medicine spread widely worldwide and ultimately diffused into Japan. It had a significant impact on previous Japanese medical practice and education; it is, effectively, the foundation of contemporary Japanese medicine. Although Western medicine seems universal, its elements and origins as it has spread to other countries show localized differences, depending on the context and time period. Cultural fusion theory proposes that the culture of a host and influence of a newcomer conflict, merge, or transform each other. It could shed light on how Japanese medicine and medical education have been influenced by and coevolved with Western medicine and culture. Cultural fusion is not assimilation or adaptation; it has numerous churning points where the traditional and the modern, the insider (indigenous) and the outsider (immigrant), mix and compete. In Japan, medicine has a long history, encountering medical practices from neighboring countries, such as China and Korea in ancient times, and Western countries in the Modern period. The most drastic changes happened in the 19th century with strong influence from Germany before World War II and in the 20th century from the impact of the United States after World War II. Recently, the pressure of globalization could be added as one influence. Since cultural fusion is ubiquitous in Japanese medical fields, examples showing how the host and newcomers interact and merge can be found among many aspects of Japanese medicine and medical education, such as curricula, languages, systems, learning styles, assessment methods, and educational materials. In addition, cultural fusion is not limited to influence from the West but extends to and from neighboring Asian countries. Examining cases and previous studies on cultural fusion in Japanese medicine and medical education could reveal how the typical notion that Japan pursued Westernization of its medicine and medical education concealed the traditions and the growth of the local education system. The people involved in medicine in the past and the present have struggled to integrate the new system with their previous ideals to improve their methods, which could be further researched.
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Mariko Morishita and Miho Iwakuma
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Mohan Jyoti Dutta
The culture-centered approach (CCA) to health and risk communication conceptualizes the communicative processes of marginalization that constitute the everyday meanings of health and risks at the margins. Attending to the interplays of communicative and material disenfranchisement, the CCA situates health inequalities amidst structures. Structures, as the rules, roles, processes, and frameworks that shape the distribution of resources, constitute and constrain the access of individuals, households, and communities to the resources of health and well-being. Through voice infrastructures cocreated with communities at the classed, raced, gendered, colonial margins of capitalist extraction, the CCA foregrounds community agency, the capacity of communities to make sense of their everyday struggles with health and well-being. Community voices articulate the interplays of colonial and capitalist processes that produce and circulate the risks to human health and well-being, serving as the basis for community organizing to secure health and well-being. Culture, as an interpretive resource passed down intergenerationally, offers the basis for organizing, and is simultaneously transformed through individual and community participation. Culture-centered health communication, rooted in community agency, drawing upon cultural stories, resources, and practices in subaltern contexts, takes the form of organizing for health, mobilizing agentic expressions toward structural transformations.
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Qiaolei Jiang
Internet addiction is a growing social issue in many societies worldwide. With the largest number of Internet users worldwide, China has witnessed the growth of the Internet along with the development and effects of Internet addiction, especially among the young. Originally reported anecdotally in mass media, Internet addiction has become an issue of great public concern after more than 20 years. The process of Internet addiction as an emerging risk in the Chinese context can be a showcase for risks related to information and communication technologies (ICTs), health, and everyday life. The term Internet addiction was first coined in the Western context and has since been recognized as a technology-driven social problem in China. Plenty of anecdotes, increasing academic research, and public awareness and concerns have put the threat of Internet addiction firmly on the policy agenda. Therefore, for prevention and intervention, research projects, rehab facilities, welfare services, and self-help programs have spread all over the country, and related regulations, policies, and laws have changed accordingly. Although controversies remain, through the staging of, and coping with, Internet addiction, people can better understand China’s digital natives and contemporary life.
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Natalie Fixmer-Oraiz and Shui-yin Sharon Yam
The history, principles, and contributions of the reproductive justice (RJ) framework to queer family formation is the nexus that connects the coalitional potential between RJ and queer justice. How the three pillars of RJ intersect with the systemic marginalization of LGBTQ people—especially poor queer people of color—helps clarify how the RJ framework can elaborate the intersectional understandings of queer reproductive politics and kin.
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Diane R. Wiener
While there are many contestations surrounding the significance, meanings, and interpretations of dis/ability in the field of critical cultural studies, the author presents a variety of foundational as well as emergent concepts, structures, and histories in order to situate these debates. The 30th anniversary of the Americans with Disabilities Act in 2020, increasingly frequent criticisms of the “sea of whiteness” in disability critique, and an attendant call for equitable attention to intersectional theorization and practice, accompanied by a variety of frameworks, are employed to introduce the relevance of these contestations as well as to equip readers with opportunities to engage and study further.
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Felix Reer and Thorsten Quandt
The study of addictive media use has a rather long tradition in media effects research and constitutes an interdisciplinary field that brings together scholars from communication science, psychology, psychiatry, and medicine. While older works focused on radio, film, or television addiction, newer studies have often examined the excessive use of interactive digital media and its consequences. Since the introduction of affordable home computer systems in the 1980s and 1990s, especially the pathological use of digital games (games addiction) has been discussed and investigated intensively. However, early research on the topic suffered from considerable methodological limitations, which made it difficult to assess the spread of the problem objectively. These limitations notwithstanding, the American Psychiatric Association (APA) decided to include the addictive use of digital games (Internet gaming disorder) as a “condition for further study” in its diagnostical manual, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), in 2013. A few years later, the World Health Organization (WHO) officially acknowledged addictive game use as a diagnosable mental condition (gaming disorder) by listing it in the 11th edition of the International Classification of Diseases (ICD-11). Some scholars viewed the decisions of the APA and the WHO with skepticism, arguing that healthy players may be stigmatized, while others greeted them as important prerequisites to facilitate appropriate therapies. Despite the question of whether the inclusion of disordered game use in the manuals of the APA and the WHO has greater advantages than disadvantages, it definitely triggered a research boom. New scales testing the APA and the WHO criteria were developed and applied in international studies. Representative studies were conducted that indicated that at least a small percentage of players seemed to show playing patterns that indeed could be considered problematic. Further, the correlates of gaming disorder have been examined extensively, showing that the addictive use of digital games is associated with particular demographics, motivations, and personality aspects as well as with other diverse impairments, such as physical and psychological health issues and problems in the social and working lives of affected players. However, the debate about the accuracy of the definitions and diagnostic criteria postulated by the APA and the WHO has not ended, and more high-quality research is needed to further improve the understanding of the causes, consequences, and specifics of gaming disorder. In addition, new aspects and innovations, such as micropayments, loot boxes, and highly immersive technologies such as virtual reality or augmented reality systems, may expose gamers to new risks that future debates and research need to consider.
Article
Miho Iwakuma and Daisuke Son
The term “cinemeducation” was coined by Matthew Alexander in 2002, and according to P. Ravi Shankar, it refers to the use of clips from movies and videos to educate medical students and residents on the psychosocial aspects of medicine. As a counterbalance to the biomedicine-centric medical curricula, cinemeducation deals with the psychosocial aspects of medicine and sensitive topics in healthcare, including but not limited to depression, family and marital counseling, doctor–patient relationships, family systems, addiction, mental illness, cultural competency, and foreign patients and their healthcare beliefs. Cinemeducation is particularly useful when the viewing is followed by a discussion, which engages students in active learning of clinically relevant concepts such as informed consent (IC), palliative care, and patient-centeredness. In other words, cinemeducation provides students in the healthcare fields with opportunities to learn about the humanistic aspects of medicine by watching movies or clips that provide insight into human experiences and challenges in medicine. A famous Japanese medical TV series, Shiroi Kyoto (The Great White Tower) will be examined to discuss the cultural fusion that has occurred in Japan, specifically with regard to clinical communication. Based on a novel authored by Toyoko Yamazaki in the 1960s, this series is of interest because the novel was made into a drama twice, first in the 1970s and again in 2003. Accordingly, several significant changes in health communication are noticeable between the first and second versions. Social changes in paternalism in medicine, palliative care, and IC that were adapted from the West and localized in Japan, as cultural fusion are evident in several noteworthy scenes.
Article
Philipp K. Masur
The question of whether and how digital media use and digital communication affect people’s and particularly adolescents’ well-being has been investigated for several decades. Many studies have analyzed how different forms of digital communication influence loneliness and life satisfaction, two comparatively stable cognitive indicators of subjective well-being. Despite this large body of empirical work, the findings remain ambivalent, with studies resulting in positive, negative, or nonsignificant effects. Several meta-analyses suggest that the overall effect of digital communication on life satisfaction is probably too small to suggest a detrimental effect. The net effect of digital communication on loneliness, by contrast, is positive, but likewise small. Yet the studies on which these meta-analyses are based suffer from several limitations. They often adopt a limited perspective on the phenomenon of interest as a disproportionate amount of work focuses on interpersonal differences instead of intra-individual, contextual, and situational effects, as well as their interactions. Furthermore, studies are often based on cross-sectional data, use unvalidated and imprecise measurements, and differ greatly in how they conceptualize digital communication. The diversity in studied applications and forms of digital communication also suggests that effects are most likely bidirectional. Passive digital communication (e.g., browsing and lurking) is more likely to result in negative effects on well-being. Active and purposeful digital communication (e.g., posting, liking, conversating), by contrast, is more likely to result in positive effects. Future research should therefore investigate how the various levels of digital communication (including differences in devices, applications, features, interactions, and messages) interact in shaping individuals’ well-being. Instead of expecting long-term effects on comparatively stable cognitive indicators such as life satisfaction, scholars should rather study and identify the spatial and temporal boundaries of digital communication effects on the more fluctuating affective components of well-being.
Article
Nicole Hudak
Queer healthcare communication spans different literature and topic areas. The medicalization of queer bodies has historically and continues to influence how queer individuals interact and communicate within healthcare settings. Further, heterosexism is rampant within medical institutions that perpetuate the idea that all patients are heterosexual. Because of the influence of heterosexism, medical schools are designed to ignore queer bodies. If queer bodies are acknowledged, they are positioned as something exotic and not presented as a typical patient. Heterosexism is further communicated in patient and provider interactions by providers assuming their patients’ heterosexual identity and assuming all queer patients are promiscuous. In turn, queer patients may make decisions about their healthcare based on providers’ heterosexist attitudes. Providers who practice medicine have also demonstrated their limited knowledge about queer patients and how to care for them. The literature on discrimination of queer patients focuses more on how providers have used both verbal and non-verbal forms of communication. In looking at queer discrimination, queer invisibility demonstrates more covert functions of healthcare communication. Due to the invisibility of queer patients, disclosure becomes a site of interest for researchers. While some queer patients try to seek out queer-friendly providers, researchers have given recommendations on how healthcare providers can improve their queer competency. Finally, some notable topics within queer healthcare communication include queer pregnancy, HIV, and why transgender identity should be a separate topic as transgender people have their own healthcare needs.
Article
L. Brooke Friley and Maria K. Venetis
For individuals who identify as LGBTQ+, disclosing sexual orientation and/or gender identity can be a complex and risky conversation. However, in the medical context this conversation frequently becomes a central part of communication between patient and provider. Unfortunately, this conversation can also become a barrier that prevents patients from receiving or even accessing necessary medical care.
LGBTQ+ individuals have reported experiencing significant discrimination in day-to-day life, and more specifically in patient–provider interactions. This discrimination leads LGBTQ+ individuals to avoid seeking necessary medical care and also frequently results in unsatisfactory care and poor health outcomes. This is of concern as LGBTQ+ individuals present with significantly higher rates of health issues and overall higher risks of cancer, chronic illnesses, and mental health concerns.
Unfortunately, many medical providers are unequipped to properly care for LGBTQ+ patients and lack opportunities for education and training. This lack of experience leads many providers to operate medical offices that are unwelcoming or even inhospitable to LGBTQ+ patients, making it difficult for those patients to access inclusive care. This can be of particular concern when the patient’s sexual orientation or gender identity becomes relevant to their medical care, as they may feel uncomfortable sharing that information with a provider.
Patient self-disclosure of sexual orientation or gender identity to a medical provider not only can contribute to a more positive relationship and improved quality of care but also can improve the psychological outlook of an LGBTQ+ individual. However, potential stigmatization can lead to the concealment of sexual orientation or gender identity information. These acts of concealment serve as intentional mechanisms of impression management within the patient–provider interaction.
When LGBTQ+ patients do discuss their sexual orientation or gender identity with a provider, it is most often because the information is directly relevant to their health and disclosure, and therefore becomes essential and often forced. There are instances where LGBTQ+ patients are motivated to disclose to a provider who they believe will respond positively to information about their sexual orientation or gender identity.
Disclosure of sexual orientation or gender identity may be direct in that it is clear and concrete. It may also be indirect in that individuals may use particular topics, such as talking about their partner, to broach the subject. Participants may also use specific entry points in the conversation, such as during taking a medical history about medications, to disclose. Some individuals plan and rehearse their disclosure conversations, whereas others disclose when they feel they have no other choice in the interaction.
Increasing inclusivity on the part of providers and medical facilities is one way to promote comfortable disclosure of sexual orientation or gender identity. Additionally, updating the office environment and policies, as well as paperwork and confidentiality procedures, can also promote safe disclosure. Finally, improvements to training and education for healthcare professionals and office staff can dramatically improve interactions with LGBTQ+ patients. All of these efforts need to make integration of knowledge about how LGTBQ+ individuals can disclose comfortably and safely a central part of program design.
