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Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition of California to the list of states that allow physician-assisted

Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition of California to the list of states that allow physician-assisted suicide, is an increasingly relevant subject. Physician-assisted suicide is rarely framed as a healthcare experience, despite being a choice in the process of end-of-life care. The research seeks to bring together the debates about physician-assisted suicide with conversations about health care experiences. The experiences and perspectives of young people are particularly valuable to evaluate now, as their voices will soon be the leaders in the debate over physician-assisted suicide. Within this research, there is an underlying theme of independence of individuals that is present through both the literature review and the body of data collected and analyzed. The study found that there was no significant relationship between the quality of a person's healthcare and their perspectives about physician-assisted suicide.
ContributorsMoeur, Katherine Elizabeth (Author) / Brian, Jennifer (Thesis director) / Graff, Sarah (Committee member) / Stevenson, Christine (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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This work challenges the conventional perceptions surrounding the utility and use of the CMS Open Payments data. I suggest unconsidered methodologies for extracting meaningful information from these data following an exploratory analysis of the 2014 research dataset that, in turn, enhance its value as a public good. This dataset is

This work challenges the conventional perceptions surrounding the utility and use of the CMS Open Payments data. I suggest unconsidered methodologies for extracting meaningful information from these data following an exploratory analysis of the 2014 research dataset that, in turn, enhance its value as a public good. This dataset is favored for analysis over the general payments dataset as it is believed that generating transparency in the pharmaceutical and medical device R&D process would be of the greatest benefit to public health. The research dataset has been largely ignored by analysts and this may be one of the few works that have accomplished a comprehensive exploratory analysis of these data. If we are to extract valuable information from this dataset, we must alter both our approach as well as focus our attention towards re-conceptualizing the questions that we ask. Adopting the theoretical framework of complex systems serves as the foundation for our interpretation of the research dataset. This framework, in conjunction with a methodological toolkit for network analysis, may set a precedent for the development of alternative perspectives that allow for novel interpretations of the information that big data attempts to convey. By thus proposing a novel perspective in interpreting the information that this dataset contains, it is possible to gain insight into the emergent dynamics of the collaborative relationships that are established during the pharmaceutical and medical device R&D process.
Created2016-05
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Description
The study examines cross-cultural perceptions of wastewater reuse from 282 participants from four global sites representing varied levels of socio-economic and political development from the Global North and Global South: Spain, New Zealand, Fiji, and Guatemala. The data comes from the Global Ethnohydrology Survey conducted by the School of Human

The study examines cross-cultural perceptions of wastewater reuse from 282 participants from four global sites representing varied levels of socio-economic and political development from the Global North and Global South: Spain, New Zealand, Fiji, and Guatemala. The data comes from the Global Ethnohydrology Survey conducted by the School of Human Evolution and Social Change during the summer of 2013. The Global Ethnohydrology Study is a transdisciplinary multi-year research initiative that examines the range of variation in local ecological knowledge of water issues, also known as "ethnohydrology." Participants were asked about their willingness, level of disgust, and concern with using treated wastewater for various daily activities. Additionally, they were asked to draw schematic representations of how wastewater should be treated to become drinkable again. Using visual content analysis, the drawings were coded for a variety of treatment levels and specific treatment processes. Conclusions about the perceived health implications from wastewater reuse that can stem from drinking treated wastewater were made. The relationship between humans and wastewater is one that has many direct social and health impacts on communities at large. In reaction to global limitations of freshwater, wastewater serves as a valuable resource to tap into. This research examines the cross-cultural public health concerns about treated wastewater in order to draw conclusions that can aid in strategic implementation of advocacy and public education about wastewater reuse.
ContributorsPatel, Sarah Shakir (Author) / Wutich, Amber (Thesis director) / Rice, Jacelyn (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2015-05
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Description
Understanding more about the similarities and differences in cultural perceptions of climate change-related disease causation can better inform culturally specific public health measures. Using interviews conducted with 685 adults in eight diverse global locations ranging from Fiji and China to England and Phoenix, Arizona, this study explores climate change-disease beliefs

Understanding more about the similarities and differences in cultural perceptions of climate change-related disease causation can better inform culturally specific public health measures. Using interviews conducted with 685 adults in eight diverse global locations ranging from Fiji and China to England and Phoenix, Arizona, this study explores climate change-disease beliefs within and across diverse cultures and comparisons between cultural and scientific models. A cultural consensus analysis was employed to identify a "culturally correct" model for each study site. Next, a scientific model was generated based on current scientific consensus regarding climate change- disease connections. Using the Quadratic Assignment Procedure (QAP), we determined the amount of correlation shared between the scientific model and each cultural model. The analysis revealed a high level of intercorrelation between the models of English speaking, economically developed sites such as Phoenix, Arizona. Additionally, cultural models from the non-English speaking sites were highly intercorrelated with one another. Overall, the English speaking sites tended to have more complex models with a greater density of causal links. Cultural models from the English speaking sites also demonstrated high levels of correlation with the scientific model. In comparison, the cultural models from the non-English speaking sites exhibited little correlation with the scientific model. Based on these findings, we suggest that cultural beliefs related to climate change-related disease causation may be influenced by complex local factors. For example, differences in education and media influences along with localized differences in climate change impacts may, in part, contribute to divergences between the cultural models.
Created2014-05
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Description
Through a standpoint feminist perspective (Harding 2009) I conducted a situational analysis (Clarke, 2015) that examined academic literature and cancer support discussion boards (DBs) to identify how Western biomedicine, specifically oncology, can integrate complementary and alternative medicine (CAM) to improve cancer treatment in children. The aims of this project were:

Through a standpoint feminist perspective (Harding 2009) I conducted a situational analysis (Clarke, 2015) that examined academic literature and cancer support discussion boards (DBs) to identify how Western biomedicine, specifically oncology, can integrate complementary and alternative medicine (CAM) to improve cancer treatment in children. The aims of this project were: 1) to identify the CAM treatments that are being used to alleviate the side effects from oncological treatments and/or treat pediatric cancers; 2) to compare the subjective experience of CAM to Western biomedicine of cancer patients who leave comments on Group Loop, Cancer Compass and Cancer Forums, which are online support groups (N=20). I used grounded theory and situational mapping to analyze discussion threads. The participants identified using the following CAM treatments: herbs, imagery, prayer, stinging nettle, meditation, mind-body therapies and supplements. The participants turned to CAM treatments when their cancer was late-stage or terminal, often as an integrative and not exclusively to treat their cancer. CAM was more "effective" than biomedical oncology treatment at improving their overall quality of life and functionality. We found that youth on discussion boards did not discuss CAM treatments like the adult participants, but all participants visited these sites for support and verification of their cancer treatments. My main integration recommendation is to combine mind-body CAM therapies with biomedical treatment. This project fills the gap in literature that ignores the ideas of vulnerable populations by providing the experiences of adult and pediatric cancer patients, and that of their families. It is applicable to areas of the social studies of medicine, patient care, and families suffering from cancer. KEYWORDS: Cancer; Complementary and Alternative Medicine; Situational Analysis; Standpoint Feminism
ContributorsEsposito, Sydney Maria (Author) / Martinez, Airín (Thesis director) / Hruschka, Daniel (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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Description
Operation Toothbrush is an initiative established to combat the oral healthcare disparity within young children who reside in Arizona. By working with elementary and preschool children, the project educated them and their families about the importance of oral hygiene in informative and intuitive manner. The project incorporated the help of

Operation Toothbrush is an initiative established to combat the oral healthcare disparity within young children who reside in Arizona. By working with elementary and preschool children, the project educated them and their families about the importance of oral hygiene in informative and intuitive manner. The project incorporated the help of Pre-Dental volunteers, dental practices, and the Woodside Grant to obtain the supplies, information, and assistance necessary to conduct the initiative.
ContributorsTsiperfal, Nathan (Co-author) / Mansukhani, Kunal (Co-author) / Virdee, Gitika (Co-author) / Loebenberg, Abby (Thesis director) / Ostling, Michael (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / W. P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description
In 2015, the World Health Organization cited antibiotic resistance as one of the greatest current challenges to global public health. A major driver of the evolution of antibiotic resistance is the overuse and misuse of these drugs. While antibiotic stewardship, education campaigns, and health policy attempt to limit drug use

In 2015, the World Health Organization cited antibiotic resistance as one of the greatest current challenges to global public health. A major driver of the evolution of antibiotic resistance is the overuse and misuse of these drugs. While antibiotic stewardship, education campaigns, and health policy attempt to limit drug use globally, public understanding of antibiotic resistance and its consequences are lacking. The goal of this study is to analyze the social and cultural influences of antibiotic knowledge and usage behavior. Over a three-month period, I interviewed 211 laypersons in Guatemala, Spain, the Netherlands, India, South Africa, and New Zealand to understand their ideas, perceptions, and behaviors regarding antibiotics and compared results across countries. While an overall consensus across countries does exist, I found significant differences between low and high income countries as well as between low and high antibiotic consumption countries. Additionally, I found that having increased public health knowledge is related to lower antibiotic "risky" behavior. These results help contextualize national data on antibiotic consumption and resistance by illustrating relationships between access, beliefs, and consumption patterns within populations. The results also inform the development of community and culture specific educational campaigns regarding antibiotic resistance.
ContributorsHarris, Carlyn Larson (Author) / Maupin, Jonathan (Thesis director) / Gaughan, Monica (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description
Chemotherapy refers to the use of chemical agents to inhibit or stop the growth of rapidly dividing cancer cells. There are many side effects of systemic chemotherapy, which are caused because the drug not only kills cancer cells but healthy cells as well (American Cancer Society, 2017). Common side effects

Chemotherapy refers to the use of chemical agents to inhibit or stop the growth of rapidly dividing cancer cells. There are many side effects of systemic chemotherapy, which are caused because the drug not only kills cancer cells but healthy cells as well (American Cancer Society, 2017). Common side effects include fatigue, hair loss, bruising/ bleeding, infection, anemia, nausea and vomiting, appetite changes, constipation, diarrhea, oral sores, nerve and muscle pain, dry skin and color change, kidney dysfunction, weight loss, cognitive difficulties, mood changes, sexual dysfunction, and fertility problems (American Cancer Society, 2017). Research shows that complementary and alternative medicine (CAM) may help relieve some of the side effects of chemotherapy. Examples of CAM include herbal medicine, dietary supplements, acupuncture, yoga, Tai Chi, massage, electromagnetic therapy, meditation, biofeedback, music, dance, and guided imagery (Johns Hopkins Medicine, 2017). The aim of this creative project was to design a third-party website to provide information to patients undergoing chemotherapy and their family members regarding the use of CAM for the treatment of chemotherapy-induced side effects. Rationale for this project stemmed from a preliminary research step. We analyzed and coded for presence or absence of CAM-specific information on the websites of 20 National Cancer Institute-designated comprehensive cancer centers across the United States. Fifty percent of websites were double-coded. Inter-rater reliabilities (kappa values) for coding of the presence or absence of specific CAM therapies ranged from 0.38 for acupuncture to 1.00 for exercise and yoga, expressive arts, and herbs (mean kappa = 0.75). Fourteen of the 20 websites mentioned meditation or mindfulness; 13 mentioned nutrition; 12 mentioned acupuncture; 11 mentioned exercise or yoga; 11 mentioned massage; 8 mentioned expressive arts; and 3 mentioned herbs. Frequencies for presence of either a description of the specific CAM therapy or an explanation of how the therapy works were lower. We then conducted a literature review using PUBMED to find peer-reviewed research on the efficacy of the previously described seven CAM therapies. The literature search focused on systematic reviews and meta-analyses published within the past 10 years. Based on the literature obtained, we created summaries of the scientific evidence for each CAM therapy. This information is now provided on our third-party website in tabular form with summative statements. The website describes in lay language: chemotherapy, chemotherapy side effects, CAM, seven specific CAM therapies, and evidence for the efficacy or lack thereof of each. Per the American Nurses Association (2015), it is our responsibility to advocate for our patients through education and holistic treatment. The role of the nurse is to educate the patient about treatment options; however, it is not within the nurse's scope of practice to prescribe a treatment. As such, this website should not be viewed as a prescription for CAM therapies, but instead as a user-friendly and easily accessible resource for informed decision-making regarding the adjunctive use of CAM therapies.
Created2017-12
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Description
My aims with this research project were to conduct a network analysis on collaborators in the ¡Viva Maryvale! project, a diabetes prevention program in Maryvale, AZ. The goals of the social network analysis were to measure the connections that collaborating organizations have to each other, the strength of these connections,

My aims with this research project were to conduct a network analysis on collaborators in the ¡Viva Maryvale! project, a diabetes prevention program in Maryvale, AZ. The goals of the social network analysis were to measure the connections that collaborating organizations have to each other, the strength of these connections, and the activities that connected organizations collaborate on. I hypothesized that performing a network analysis would inform me of the strengths and weaknesses of the ¡Viva Maryvale! project in order to advise the next steps of a targeted approach to diabetes prevention among vulnerable populations, thus affecting public health outcomes in the greater Phoenix Valley.
ContributorsKellog, Anna (Author) / Shaibi, Gabriel (Thesis director) / Soltero, Erica (Committee member) / School of Public Affairs (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description
Background: Endometriosis is a condition characterized by the growth of the endometrium, or the tissue that lines the uterus, outside of the uterus, and it is diagnosed through the presence of endometriotic lesions in the pelvic region. The disease is most often associated with abnormal and painful vaginal bleeding. Currently,

Background: Endometriosis is a condition characterized by the growth of the endometrium, or the tissue that lines the uterus, outside of the uterus, and it is diagnosed through the presence of endometriotic lesions in the pelvic region. The disease is most often associated with abnormal and painful vaginal bleeding. Currently, minimal literature exists concerning the management of endometriosis in low and middle-income countries (LMICs), which may influence the lack of a cultural competent understanding of menstruation in LMICs and, therefore, a lack of evidence-based policies concerning menstruation.

Methods: Social and cultural barriers influencing endometriosis reporting and management in LMICs were examined through a systematic literature review. Online databases yielded a list of relevant studies. Then, use of MAXQDA, a qualitative data analysis software program, helped to extract and code specific text segments from each study that pertain to the research topic. In-context analysis of coded segments revealed the most common trends, which were organized into broader themes.

Results: Findings demonstrated that social and cultural ideas regarding vaginal bleeding influenced the lack of disease reporting and management of endometriosis in LMICs. Socioeconomic challenges include a lack of hygiene and sanitation measures and education regarding menstruation and vaginal bleeding. Also, many diseases associated with the abnormal vaginal bleeding are often disregarded and not prioritized in clinical settings. It also became clear that cultural taboos regarding menstruation and vaginal bleeding often create feelings of anxiety and fear in women and girls throughout communities in LMICs. However, further research is needed to examine the ways in which women in those communities treat symptoms of irregular vaginal bleeding related to endometriosis.

Conclusions: Socioeconomic, gender, and sex-related factors may influence the ways in which endometriosis is reported and treated and may affect the way the related diseases are understood. Evidence-based policies using a culturally competent understanding of abnormal vaginal bleeding in LMICs may help positively affect the reproductive health of women and girls in such areas.
ContributorsSantora, Emily (Author) / Maienschein, Jane (Thesis director) / Abboud, Carolina (Committee member) / Hagaman, Ashley (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Social Transformation (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05