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- All Subjects: Elderly
- All Subjects: Tiwanaku culture
- Creators: Buikstra, Jane E.
- Creators: Baker, Laurie
The coastal Ilo Chiribaya polity is associated with the Andean Late Intermediate Period in the lower Osmore drainage of southern Peru. Previous analyses indicate that Chiribaya sites in this area formed a señorío, an Andean chiefdom with separate occupational groups of fishers and farmers. The most complex excavated Chiribaya site in this region is Chiribaya Alta. At this time, excavations have sampled nine of the cemeteries present at the site. Two of these cemeteries, four and seven, have the most elaborate burials at the site and are each associated with different occupational communities.
This dissertation examines community, gender, and age identities at Chiribaya Alta through the use of three case studies. The first case study argues that the iconographic designs on coca bags interred with the dead signified occupational community identities. Coca bags buried in cemetery four have designs relating to mountains and farming, whereas those from cemetery seven have symbols associated with water. These designs correspond to the occupational community groups associated with each of these cemeteries. The second case study uses grave good presence and absence to examine the nature of gender roles and identity at Chiribaya Alta. Multiple correspondence analysis indicates that normative gender roles are reflected in grave good assemblages, but that gender identity was flexible at the individual level. The final case study presents newly generated age-at-death estimations using transition analysis combined with mortuary analyses to explore the manner in which gender and age intersect for older individuals at Chiribaya Alta. This final paper argues that there is an elderly identity present amongst individuals at Chiribaya Alta and that gender and age intersect to impact the lives of older men and women differently.
Radiogenic strontium and stable oxygen isotope data from human dental and skeletal elements are used to characterize intra- and inter-individual paleomobility patterns at Omo M10. When contextualized with archaeological evidence, these data reveal multigenerational interaction through migration between communities in the highland Tiwanaku heartland and at Omo M10. The observed greater mobility of females and juveniles at Omo M10 indicates that women and families played an essential role in maintaining social relationships and persistent cultural continuity in Moquegua Tiwanaku life. Contact with the highlands waned over time as disruption in the urban highland centers likely weakened ties to peripheral lowland communities.
Stable carbon and nitrogen data from human dental and skeletal elements are employed to estimate intra- and inter-individual paleodietary patterns. Results indicate diet at Omo M10 varied depending on an individual’s community affiliation, sex, age, and level of mobility; diet broadly changed over time with shifting levels of interaction with highland Tiwanaku communities. Intra-individual biogeochemical analyses of migration and diet at Omo M10 contribute a nuanced perspective on the diverse experiences of multigenerational colonists on the periphery of the Tiwanaku polity.
According to the dual diaspora model of Tiwanaku colonial organization in the Moquegua Valley of southern Peru, Chen Chen-style and Omo-style ethnic communities who colonized the valley maintained distinct ethnic identities in part through endogamous marriage practices. Biodistance analysis of cranial shape data is used to evaluate regional gene flow among Tiwanaku-affiliated communities in Moquegua. Overall, results of biodistance analysis are consistent with the dual diaspora model. Omo- and Chen Chen-style communities are distinct in mean cranial shape, and it appears that ethnic identity structured gene flow between ethnic groups. However, there are notable exceptions to the overall pattern, and it appears that marriage practices were structured by multiple factors, including ethnic affiliation, geographic proximity, and smaller scales of social organization, such as corporate kin groups.
Social network analysis of cranial shape data is used to implement a multi- and mesoscalar approach to social organization to assess family-based organization at a regional level. Results indicate the study sample constituted a social network comprised of a dense main component and a number of isolated actors. Formal approaches for identifying potential family groups (i.e., subgroup analysis) proved more effective than informal approaches. While there is no clear partition of the network into distinct subgroups that could represent extended kin networks or biological lineages, there is a cluster of closely related individuals at the core of the network who integrate a web of less-closely related actors. Subgroup analysis yielded similar results as agglomerative hierarchical cluster analysis, which suggests there is potential for social network analysis to contribute to bioarchaeological studies of social organization and bioarchaeological research in general.
Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.
Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).
A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.