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- All Subjects: healthcare
- Creators: School of Life Sciences
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Description
Over the past three decades, medical anthropology research, published within both public health and anthropological journals, demonstrates both the prevalence of traditional folk medicine in Latino populations in the United States and the potential difficulty of negotiating these beliefs and practices with clinical, western biomedicine. I bring attention to what might be a narrative of divergent values that occurs in Latino communities in the United States. A well-documented source (Pachter, 1994) of this clash is the culturally pervasive use of folk medicine in Latino layperson populations seeking biomedical care in the Unites States (U.S.). Numerous studies (Padilla, 2001; Koss 1972) suggest that a significant portion of Latinos in the continental United States call upon folk knowledge to diagnose, reinterpret, and treat illness. The Puerto Rican population seems to be no exception, though few studies are specific to native-born Puerto Ricans living in Puerto Rico, where the issue of access to quality public health care becomes increasingly problematic. In this honors undergraduate thesis project, I conduct a review of the literature that bridges anthropology and public health research and proceed to describe a study I conducted on Culebra Island, Puerto Rico in May of 2015. The study aims to determine whether patient satisfaction can be linked to being treated by a physician hailing from a similar cultural background, or if an irredeemable disparity between patient and provider present a roadblock to health outcomes. I found that the Puerto Rican physicians are receptive to folk illness (symptoms) and consider folk therapy as part of the treatment regimen. The physicians make patients feel understood, which might improve treatment adherence and thus health outcomes. Still, respondents demonstrated that there is high patient trust in the biomedical model by emphasizing the use of conventional medications in tandem with the folk therapy. Nevertheless, the health care provider's disposition in regards to folk knowledge and modalities are important but does not present a roadblock to optimal care and health outcomes as much as access, available services or clinic resources.
ContributorsVanasse-Torres, Elena Georgina (Author) / Maupin, Jonathan (Thesis director) / Maienschein, Jane (Thesis director) / MartÃÂnez, AirÃÂn (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
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
Description
This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and their experiences within the healthcare system in the context of their sexual orientation. The data collected from these interviews was used to create an analysis of the healthcare experiences of those who identify as queer. Although the original intention of the project was to chronicle the experiences of LGB women specifically, there were four non-binary gender respondents who contributed interviews. In an effort to not privilege any orientation over another, the respondents were collectively referred to as queer, given the inclusive and an encompassing nature of the term. The general conclusion of this study is that respondents most often experienced heterosexism rather than outright homophobia when accessing healthcare. If heterosexism was present within the healthcare setting, it made respondents feel uncomfortable with their providers and less likely to inform them of their sexuality even if it was medically relevant to their health outcomes. Gender, race, and,socioeconomic differences also had an effect on the patient-provider relationship. Non-binary respondents acknowledged the need for inclusion of more gender options outside of male or female on the reporting forms often seen in medical offices. By doing so, medical professionals are acknowledging their awareness and knowledge of people outside of the binary gender system, thus improving the experience of these patients. While race and socioeconomic status were less relevant to the context of this study, it was found that these factors have an affect on the patient-provider relationship. There are many suggestions for providers to improve the experiences of queer patients within the healthcare setting. This includes nonverbal indications of acknowledgement and acceptance, such as signs in the office that indicate it to be a queer friendly space. This will help in eliminating the fear and miscommunication that can often happen when a queer patient sees a practitioner for the first time. In addition, better education on medically relevant topics to queer patients, is necessary in order to eliminate disparities in health outcomes. This is particularly evident in trans health, where specialized education is necessary in order to decrease poor health outcomes in trans patients. Future directions of this study necessitate a closer look on how race and socioeconomic status have an effect on a queer patient's relationship with their provider.
ContributorsRajan, Sindhu (Co-author) / Bradley, Arianna (Co-author) / Larson, Michelle (Co-author) / Alvarado, Aimee (Co-author) / Ingram-Waters, Mary (Thesis director) / Arnold, Michelle (Committee member) / School of Molecular Sciences (Contributor) / School of Social Transformation (Contributor) / T. Denny Sanford School of Social and Family Dynamics (Contributor) / College of Public Service and Community Solutions (Contributor) / School of Human Evolution and Social Change (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Healthcare systems and health insurance are both concepts implemented in every country to provide access to the general population. Countries undergo healthcare reforms in order to increase the performance of the system. In 2010, the Affordable Care Act (ACA) was introduced in the United States to increase coverage and create a more inclusive health insurance market. For comparison, the recent reforms in Chile and Singapore were observed as points to determine what concepts work well and what can be implemented in the U.S. system. Unlike the United States, Chile and Singapore completely altered the system that was previously in use. In Chile, the reforms began in the 1970s and made two more major changes in 1973 and early 2000s. Singapore began its reform in the 1960s and created the medical savings account system that is still in use today. To analyze the system further, the medical professions of neurology, physician assistants and optometry were compared in each country. In regards to neurology, the coverage of services in Chile and Singapore are similar in that select medical procedures are covered. In contrast, the United States offers coverage on a case-by-case basis. For physician assistants, such a profession does not exist in Chile or Singapore. In the United States, the profession is rapidly expanding, and coverage is offered for most services provided. Optometry is a stand-alone profession in both the U.S. and Singapore. The services provided by the optometrists are selectively covered by insurance, depending on whether it is considered a medical problem. Chile covers the services often provided by optometrists, however, the ophthalmologist is the provider, as optometry does not exist. This study concluded that the U.S. should continue to provide a more inclusive healthcare system that includes vision and dental care. The U.S., like Singapore, should also adopt a more integrative system. Under this system, patient care would be provided in a way that professionals specializing in the care are included in every step of the process.
ContributorsLa, Jenny (Co-author) / Feruj, Farihah (Co-author) / Morrison, Sarah (Co-author) / Gaughan, Monica (Thesis director) / Essary, Alison (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Emerging Information Technology, Storage and Evaluation within Healthcare: A Discerning IMT Analysis
Description
The introduction of novel information technology within contemporary healthcare settings presents a critical juncture for the industry and thus lends itself to the importance of better understanding the impact of this emerging "health 2.0" landscape. Simply, how such technology may affect the healthcare system is still not fully realized, despite the ever-growing need to adopt it in order to serve a growing patient population. Thus, two pertinent questions are posed: is HIT useful and practical and, if so, what is the best way to implement it? This study examined the clinical implementation of specific instances of health information technology (HIT) so as to weigh its benefits and risks to ultimately construct a proposal for successful widespread adoption. Due to the poignancy of information analysis within HIT, Information Measurement Theory (IMT) was used to measure the effectiveness of current HIT systems as well as to elucidate improvements for future implementation. The results indicate that increased transparency, attention to patient-focused approaches and proper IT training will not only allow HIT to better serve the community, but will also decrease inefficient healthcare expenditure.
ContributorsMaietta, Myles Anthony (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
In this study, we propose and then assess the efficacy of a new approach to static suspension to correct for facial paralysis. Our method involves placing barbed sutures through the superficial muscular aponeurotic system (SMAS) and anchoring them in the temporal fascia parallel to the underlying facial muscles. We first analyzed the ability of this procedure to improve facial symmetry by comparing the degree of asymmetry between the paralyzed and unaffected sides of a patient's face (N=10) prior to and following surgery. Then, to determine if symmetry is improved as a result of placing the sutures parallel to the direction of facial muscle forces, we measured the vectors of levator labii superioris and zygomaticus major in cadaver hemifaces (N=3) and compared them to the angles of the vectors of correction from the patient sample to angles of muscle vectors in three facial hemispheres from cadaver controls. Results indicate that: (1) facial symmetry was significantly improved in these patients and (2) this improvement. We conclude that, compared to existing protocols, our novel surgical method is a better means of static suspension for reconstruction following onset of facial paralysis as it is simple to perform, easy to replicate, able to be post-operatively adjusted in-office, has a good long-term prognosis, and, as we have demonstrated, effectively corrects the appearance of asymmetry by working with the underlying facial anatomy.
ContributorsLeach, Garrison Alecsander (Co-author) / Joganic, Jessica (Co-author) / Hooft, Nicole (Co-author) / Joganic, Edward (Co-author, Committee member) / Foy, Joseph (Thesis director) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Paleodietary analysis through the interpretation of stable isotopic analyses can be used to determine the approximate diet consumed at archaeological sites. The following question was investigated through the course of this research: What are the differences between the Middle Horizon capital of Tiwanaku and the associated colony of Chen Chen; and what do these differences, including those associated with paleodiet, suggest about interactions between the two sites? The main hypothesis suggested a similar dietary analysis between the two sites with two possible explanations. First, it is possible that similarities between the sites were due to the exchange and consumption of goods at both locations, perhaps through trade. Secondly, it is possible that the similarities were due to the acquisition of similar goods through local sourcing or limited trade. To assess this, an analysis was conducted based on δ13Cdiet (VPDB) values in the comparison of the city center Tiwanaku and the agricultural site of Chen Chen. Archaeological bone samples were processed from a diverse group of individuals at Chen Chen and combined with published values by Tomczak (2001), then compared against δ13C from Tiwanaku, published by Berryman (2010). After conversion to δ13Cdiet (VPDB) as described by Kellner and Schoeninger (2007), it was determined that there was no statistically significant difference between the δ13Cdiet (VPDB) values from either site, suggesting a similar ratio of goods consumed. These values were then compared to baseline values from the region to determine an approximate ratio of C3 to C4 flora or dependent fauna consumed. These data most likely support the second explanation of the main hypothesis, that both sites had access to similar goods through local sourcing or limited trade as an explanation for their similarity. However, because a similar ratio of foods consumed was determined in this analysis, it is still possible that trade occurred in both directions between Tiwanaku and Chen Chen. Additional isotopic analyses would be required to support the first claim, which can be addressed in future research projects.
ContributorsDouglas, Brynn Babette (Author) / Knudson, Kelly (Thesis director) / Spielmann, Katherine (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
With advances in biotechnology, personalized medicine has become an ever-expanding field. Even with so much growth, the critics equally match the proponents of personalized medicine. The source of their disagreement is rooted in the concept of empowerment. This analysis utilizes the personal genomics company 23andMe and their relationship with the Federal Food and Drug Administration to illustrate varying views of empowerment. Specifically, the case study focuses on the ability to provide direct-to-consumer health reports to patients independent of physicians. In doing this, larger issues of what is at stake in personalized medicine are uncovered. These include but are not limited to: who determines what individuals get empowered and what information is determined good versus bad.
ContributorsSilverman, Adam Mattern (Author) / Brian, Jennifer (Thesis director) / Hurlbut, Ben (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / Department of Psychology (Contributor)
Created2015-05
Description
This study looked into the cultural competency of physicians when interacting with patients who identify themselves as part of the Deaf and Hard of Hearing community. Through the course of this paper, it was found that the language barrier between these two communities played a large role in healthcare disparities for the D/HoH community. The language and culture barrier contributed to the misconceptions that are commonly found in the hearing world about the Deaf community, including assumptions about Deaf patients' opinion on their hearing loss, the efficacy of yelling, and the notion that all Deaf people can lip read with 100% accuracy. In addition, the perspectives of both the healthcare professionals and D/HoH patients was analyzed. Finally, the efficacy of current hospitals solutions for the language barrier was evaluated, particularly the use of video interpreting in hospital settings. More lasting solutions were proposed as an extension of this study, with an emphasis on education in all field of healthcare.
ContributorsHernandez, Deborah Andrea (Author) / O'Brien, Robin (Thesis director) / Howard, Pamela (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The NCAA recently declared sickle cell trait (SCT) to be a risk factor for sudden illness and death among student athletes. Fetal hemoglobin (HbF) concentration in adults is negatively correlated with disease severity in sickle cell anemia, although its effect on SCT is not fully understood and the concentration is found to have high variability across populations. Two single nucleotide polymorphisms (SNPs) at the human beta globin gene cluster, rs7482144 and rs10128556, contribute to the heritable variation in HbF levels and are associated with increased HbF concentrations in adults. A sample population of NCAA football student athletes was genotyped for these two polymorphisms, and their allele frequencies were compared to those of other populations. The minor allele of both polymorphisms had allele frequencies of 0.091 in the sample population, which compared closely with other populations of recent African heritage but was significantly different from European populations. The results of this study will be included in a larger study to predict whether these among other polymorphisms can be used as markers to predict susceptibility to heat-related emergencies in NCAA student athletes with SCT, although the small sample size will delay this process until participation in the study increases. Since both rs7482144 and rs10128556 exhibit high levels of linkage disequilibrium, and as their contributions to the heritable variability of HbF concentrations tend to differ greatly between populations of different ancestry, further investigations should be aimed at distinguishing between the effects of each SNP in African American, European, and other populations represented in NCAA football before conclusions can be drawn as to their practical use as genetic markers of heat susceptibility in student athletes with SCT.
ContributorsGrieger, Ryan Wayne (Author) / Stone, Anne C. (Thesis director) / Rosenberg, Michael (Committee member) / Madrigal, Lorena (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05