Matching Items (212)
Description
During the nineteenth century, children's physical health became a dominant theme in France and Great Britain, two of Europe's pediatric pioneers. This dissertation examines how British and French doctors, legislators, hospital administrators, and social reformers came to see the preservation of children's physical health as an object of national and international concern. Medical knowledge and practice shaped, and was shaped by, nineteenth-century child preservation activities in France and Great Britain, linking medicine, public health, and national public and private efforts to improve the health of nations, especially that of their future members. Children's hospitals played a significant role in this process by promoting child health; preventing and combating childhood diseases; fostering pediatric professionalization and specialization; and diffusing medical-based justifications for child welfare reforms in the second half of the century. This deeply contextualized tale of two hospitals, Great Ormond Street Hospital for Children in London (1852) and Sainte-Eugénie in Paris (1855), traces a crescendo in the interest, provision, and advocacy for children's medical care over time: from foundling homes and dispensaries to specialized hospitals with convalescent branches and large outpatient clinics. As a comparative study of the medicalization of children's bodies between 1820 and 1890, this dissertation also investigates the transnational exchange of medical ideas, institutions, and practices pertaining to child health between France and Great Britain during a period of nation-building. Specialized pediatric institutions in Paris and London built upon and solidified local, national, and international interests in improving and preserving child health. Despite great differences in their hospital systems, French and British children's hospital administrators and doctors looked to one another as partners, models, and competitors. Nineteenth-century French and British concerns for national public health, and child health in particular, had important distinctions and parallels, but medical, institutional, and legislative developments related to these concerns were not isolated activities, but rather, tied to transnational communication, cooperation, and competition.
ContributorsSchreiner, Stephanie (Author) / Fuchs, Rachel G. (Thesis advisor) / Green, Monica (Committee member) / Szuter, Christine (Committee member) / Thompson, Victoria (Committee member) / Arizona State University (Publisher)
Created2014
Description
The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land and natural resources. Cultural transmission (the transfer of beliefs, ideas, and behaviors from one culture to another) from outsider health institutions should presumably aid in closing this health gap by transferring knowledge, practices, and infrastructure to prevent and treat disease. This study examines the biosocial construction of the disease ecology of tuberculosis (TB) in indigenous communities of the Paraguayan Chaco with varying degrees of cultural transmission from outside institutions (government, religious, and NGOs), to determine the influence of cultural transmission on local disease ecologies. Using a biocultural epidemiological framework for the analysis of human infectious disease ecology, this study employed an interdisciplinary, mixed methods approach to examine the interactions of host, pathogen, and the environment in the Paraguayan Chaco. Three case studies examining aspects of TB disease ecology in indigenous communities are presented: (1) The effective cultural transmission of biomedical knowledge to isolated communities, (2) Public health infrastructure, hygiene, and the prevalence of intestinal parasites: co-morbidities that promote the progression to active TB disease, and (3) Community-level risk factors for TB and indigenous TB burden. Findings from the case studies suggest that greater influence from outside institutions was not associated with greater adoption of biomedical knowledge of TB. The prevalence of helminthiasis was unexpectedly low, but infection with giardia was common, even in a community with cleaner water sources. Communities with a health post were more likely to report active adult TB, while communities with more education were less likely to report active pediatric TB, suggesting that healthcare access is the major determinant of TB detection. More research is needed on the role of non-indigenous community residents and other measures of acculturation or integration in TB outcomes, especially at the household level. Indigenous TB burden in the Chaco is disproportionately high, and better understanding of the mechanisms that produce higher incidence and prevalence of the disease is needed.
ContributorsVansteelandt, Amanda (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Stone, Anne (Thesis advisor) / Hruschka, Daniel (Committee member) / Rojas de Arias, Antonieta (Committee member) / Arizona State University (Publisher)
Created2014
Description
Research related to food deserts, areas with limited access to healthy and affordable food options, has focused primarily on issues of healthy food access, food quality and pricing, dietary outcomes, and increased risk for chronic diseases among residents. However, upstream challenges that might play a major role in the creation and perpetuation of food deserts, namely problems in the supply chain, have been less considered. In this qualitative study, researchers conducted semi-structured interviews with local produce supply chain representatives to understand their perspectives on the barriers to, and potential solutions for, supplying affordable produce to underserved areas in Phoenix, AZ. Through industry and academic experts, six representatives of the supply chain were identified and recruited to take part in one-hour interviews. Interviews were audio-recorded, transcribed, and coded into categories using a general inductive approach. Using the qualitative analysis software NVIVO to assist in data analysis, themes and subthemes emerged. Results suggested that considerable barriers exist among the representatives for supplying fresh, affordable produce in Phoenix-area food deserts, including minimum delivery requirements beyond the needs of the average small store, a desire to work with high-volume customers due to transportation and production costs, and the higher price point of produce for both store owners and consumers. Conversely, opportunities were identified that could be important in overcoming such barriers, including, tax or economic incentives that would make distribution into food deserts financially viable, infrastructural support for the safe handling and storage of fresh foods at existing retail outlets, and the development of novel distribution mechanisms for producers such as mobile markets and food hubs. Future research is needed to determine if these findings are representative of a larger, more diverse sample of Arizona produce supply chain representatives.
ContributorsLacagnina, Gina (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Hughner, Renee (Committee member) / Barroso, Cristina (Committee member) / Arizona State University (Publisher)
Created2015
Description
Many studies have shown that access to healthy food in the US is unevenly distributed and that supermarkets and other fresh food retailers are less likely to be located in low-income minority communities, where convenience and dollar stores are more prevalent grocery options. I formed a partnership with Phoenix Revitalization Corporation, a local community development organization engaged in Central City South, Phoenix, to enhance the community's capacity to meet its community health goals by improving access to healthy food. I used a community-based participatory approach that blended qualitative and quantitative elements to accommodate collaboration between both academic and non-academic partners. Utilizing stakeholder interviews, Nutrition Environment Measures Surveys (NEMS), and mapping to analyze the community's food resources, research revealed that the community lacks adequate access to affordable, nutritious food. Community food stores (n=14) scored an average of 10.9 out of a possible 54 points using the NEMS scoring protocol. The community food assessment is an essential step in improving access to healthy food for CCS residents and provides a baseline for tracking progress to improve residents' food access. Recommendations were drafted by the research partnership to equip and empower the community with strategic, community-specific interventions based on the research findings.
ContributorsCrouch, Carolyn (Author) / Harlan, Sharon (Thesis advisor) / Eakin, Hallie (Committee member) / Aftandilian, David (Committee member) / Arizona State University (Publisher)
Created2011
Description
This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in forming the design of the current implementation at the Southern Nevada Health District (SNHD). The result of the system deployment at SNHD was considered as a basis for projecting the practical application and benefits of an enterprise architecture. This approach has resulted in a sustainable platform to enhance the practice of public health by improving the quality and timeliness of data, effectiveness of an investigation, and reporting across the continuum.
ContributorsKriseman, Jeffrey Michael (Author) / Dinu, Valentin (Thesis advisor) / Greenes, Robert (Committee member) / Johnson, William (Committee member) / Arizona State University (Publisher)
Created2012
Description
Contemporary urban food security in the US is influenced by complex, multidimensional, and multi-scale factors. However, most assessment methods and intervention efforts in food security research are: 1) narrowly focused on environmental factors (i.e. the presence or absence of quality food outlets), 2) divorced from the human dimension and, 3) ultimately disempower communities to affect change at the local level. New approaches are needed to capture the lived experiences and unique perspectives of people potentially most vulnerable to food insecurity, while also empowering people to become change agents in their lives and in the wider community. This thesis argues that sustainability problem solving frameworks such as transformational sustainability research (TSR), and community-based participatory research (CBPR) provide promising bases from which to address these deficiencies. Through interactive workshops with youth in Canyon Corridor, a neighborhood in Phoenix, Arizona, I demonstrate the potential of concept mapping, sketch mapping, and intervention mapping methods that prioritize participation and co-production of knowledge to: 1) better understand the contextual, community-identified factors that contribute to food security or food insecurity, 2) identify and adapt interventions for the local context and, 3) promote community agency and action. Workshop outcomes suggest the relevance of these frameworks and methods, and the potential for more people- and place-based approaches to food security research.
ContributorsTalbot, Kathleen (Author) / Eakin, Hallie (Thesis advisor) / Wiek, Arnim (Committee member) / Szkupinski-Quiroga, Seline (Committee member) / Arizona State University (Publisher)
Created2012
Description
There has been a push to create and implement school wellness policies. Childhood obesity statistics suggest that schools may have an important role to play in promoting wellness. Childhood obesity has become a significant problem in the United States. The percentage of obese children in the United States has more than doubled since 1970, and up to 33% of the children in the United States are currently overweight. Among the 33% of children who are overweight, 25% are obese, and 14% have type 2 diabetes, previously considered to be a condition found only in adults. This mixed-method study with a string qualitative component study examined three aspects of federally mandated local wellness polices. The study investigated the policies themselves, how the policies are understood in the local school setting, with a particular focus on the impact the policies have had on school meals. The bulk of the research data was generated through 8 in-depth interviews. The interviews were conducted with key stakeholders within 2 elementary school districts in Arizona. In addition, the evaluation of 20 local wellness polices was conducted via a rubric scoring system. The primary component found to be lacking in local wellness policies was the evaluation method. Recommendations for school districts include the establishment of a clear method of measurement.
ContributorsCrawford, Sara S (Author) / Mccarty, Teresa L. (Thesis advisor) / Molnar, Alex (Thesis advisor) / Montoya, Araceli (Committee member) / Arizona State University (Publisher)
Created2011
Description
At first glance, trends in increased hunger and obesity in the United States (US) would seem to represent the result of different causal mechanisms. The United States Department of Agriculture (USDA) reported that nearly 50 million Americans had experienced hunger in 2009. A year later, the Centers for Disease Control and Prevention published a report showing that 68% of the US population was either overweight or obese. Researchers have found that these contrasting trends are actually interrelated. Being so, it is imperative that communities and individuals experiencing problems with food security are provided better access to healthy food options. In response to the need to increase healthy food access, many farmers markets in the US have received funding from the USDA to accept vouchers from federal food security programs, such as the Supplemental Nutrition Assistance Program (SNAP). In Downtown Phoenix, Arizona, one organization accepting vouchers from several programs is the Phoenix Public Market. However, the mere existence of these programs is not enough to establish food security within a community: characteristics of the population and food environments must also be considered. To examine issues of food security and public health, this thesis utilizes geographical information systems (GIS) technology as a tool to analyze specific environments in order to inform program effectiveness and future funding opportunities. Utilizing methods from community-based participatory research (CBPR) and GIS, a mapping project was conducted in partnership with the Market to answer three questions: (1) what is the demographic makeup of the surrounding community? (2) What retailers around the Market also accept food security vouchers? And (3) where are food security offices (SNAP and WIC) located within the area? Both in terms of demographic characteristics and the surrounding food environment, the project results illustrate that the Market is embedded within a population of need, and an area where it could greatly influence community food security.
ContributorsRawson, Brooke (Author) / Vargas, Perla A (Thesis advisor) / Booze, Randy (Committee member) / Vaughan, Suzanne (Committee member) / Arizona State University (Publisher)
Created2011
Description
The gold standard for bone measurement is DXA (dual energy X-ray absorptiometry). Typically, to observe changes in bone by DXA, a minimum of a 4-month intervention is required. Serum osteocalcin (OST) (a bone formation marker) and quantitative ultrasound (QUS) of the calcaneus can be used as indicators of bone change but the sensitivity and time course of these indices to short term interventions are unknown. The purpose of this study was twofold: to compare monthly changes in OST and QUS in response to jump training and to evaluate the relationship between DXA, OST and QUS. Young women with QUS t-scores less than 1.0 were randomized into a jump training (J) (n=16) or control (C) (n=16). J consisted of a progressive routine of 1 and 2-footed jumping performed 3 days per week for 4 months. Body composition, QUS and OST were measured at baseline, and monthly for 4 months. DXA and 24-hour dietary recalls were completed at baseline and 4 months. Low attrition rate (12.5%) and high compliance (98%) with the exercise intervention was recorded. No significant correlations between QUS and OST existed. No significant differences were observed between groups at baseline in body composition or bone variables. Monthly increases in OST were observed but there were no significant differences over time between groups in any bone variables. OST and QUS may be indicative of short term bone changes but these variables were not specifically sensitive to the jumping intervention in this population of women.
ContributorsHeumann, Kristin Joelle (Author) / Swan, Pamela D (Thesis advisor) / Alvar, Brent (Committee member) / Chisum, Jack (Committee member) / Lee, Chong (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2011
Description
Food security literature has a heavy emphasis on physical barriers, often employing spatial analysis or market-based approaches, but the human dimensions of food security remain unexplored. This has resulted in a disconnect between the understanding of the problem and proposed interventions, as the contextual factors and lived experiences of residents are not considered. There are many barriers and opportunities for food security that are not spatially fixed (e.g. family relations, social capital) that may be important but are unrepresented in these types of studies. In order to capture these barriers and opportunities, community stakeholders need to play a fundamental role in the problem analysis and visioning stages. This study utilized community-based participatory research methods to engage an important stakeholder in the future food environment, youth, to 1) understand how the youth of Canyon Corridor describe their food environment, and thus capture contextual aspects of food security 2) adapt CBPR methods to engage youth in a visioning session to elicit their ideal community food environment and 3) determine if these applications of CBPR can empower youth of Canyon Corridor to mobilize towards a more secure food environment. I found that while the youth did identify many barriers to food security (i.e. transportation, cost, availability), this community also had significant strengths, particularly social capital, that allowed them to overcome what would be food insecurity. Despite their conclusions on food security, youth did desire many changes for the future food environment and felt increased empowerment after the workshops. Thus this shows the need for incorporating methods that also acknowledge the role of social and individual factors and how they interrelate with the physical environment in relation to food security.
ContributorsSchoon, Briar (Author) / Eakin, Hallie (Thesis advisor) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Szkupinski-Quiroga, Seline (Committee member) / Arizona State University (Publisher)
Created2012