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- Creators: Barrett, The Honors College
- Creators: Arizona State University
- 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.
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.
Survivors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) often experience chronic symptoms that include fatigue, shortness of breath, and brain fog. The collection of ongoing post-COVID-19 symptoms have been classified as Post-Acute Sequela of SARS-CoV-2 (PASC). Older adult patients are especially susceptible to experiencing PASC related complications and have a high risk for long-term cognitive impairment symptoms. Definitions for categorizing PASC- associated cognitive impairment and neuropsychological assessments used to evaluate cognitive impairment are inconsistent between studies examining older adults. This systematic review aims to identify which neuropsychological tests best identify cognitive impairments associated with PASC and suggest a guide to standardize the measurement of PASC-related cognitive impairments. Through a literature search using PubMed, we included within this review 14 studies that fulfilled our inclusion and exclusion criteria evaluating middle-aged and older adult populations affected by PASC-associated cognitive impairments. The majority of the studies used tests designed to screen for general cognitive function to test for the prevalence of cognitive impairment, with the most common one being Montreal Cognitive Assessment (MoCA), followed by MMSE and TICS. MoCA reported the highest prevalence of the general cognitive screeners which suggests higher sensitivity and specificity. Telephone Interview for Cognitive Status (TICS) demonstrated similar scores as MoCA despite administration being remote while MMSE identified the lowest prevalence. Four studies also used domain-specific cognitive evaluations and reported instances of cognitive impairment in individuals who had previously tested healthy. Furthermore, the results gathered in this review were stratified based on disease symptom severity. This review identifies MoCA to be better suited for evaluating general cognitive impairment in older adults. TICS has the added utility in being able to access a wider range of older adults through remote screening. Disease severity must be clearly defined to allow better comparisons between studies and allow for standardization. Early identification of PASC-associated cognitive impairment in middle-aged and older adults can be performed using general cognitive function evaluations and administering a baseline cognitive evaluation one month after infection is suggested.
This honors thesis explores the potential use of LoRa technology for detecting moisture in a diaper. Tests of both onboard and external humidity sensors coupled with LoRa transmission are incredibly promising. The potential scale of the final device also shows much promise, measuring smaller than a U.S. dime. However, the estimated cost for producing these proof-of-concept units in bulk is $19.41 per unit. While this is believed to be a pessimistic estimate of the price, the cost of production remains too high regardless for large-scale implementation. The thesis concludes by emphasizing the need for further research and development to optimize the design and reduce the cost of production. Despite the limitations imposed by price, the idea of using LoRa in detecting moisture in a diaper remains intriguing and promising, however, RFID technology has many advantages, such as size, cost, and passive power features.