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- All Subjects: Cultural Anthropology
- All Subjects: Naloxone
- Creators: Gaughan, Monica
Description
More than 40% of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, with more than 46 people dying every day from overdoses involving prescription opioids, (CDC, 2017). Over the years, lawmakers have implemented policies and laws to address the opioid epidemic, and many of these vary from state to state. This study will lay out the basic guidelines of common pieces of legislation. It also examines relationships between 6 state-specific prescribing or preventative laws and associated changes in opioid-related deaths using a longitudinal cross-state study design (2007-2015). Specifically, it uses a linear regression to examine changes in state-specific rates of opioid-related deaths after implementation of specific policies, and whether states implementing these policies saw smaller increases than states without these policies. Initial key findings of this study show that three policies have a statistically significant association with opioid related overdose deaths are—Good Samaritan Laws, Standing Order Laws, and Naloxone Liability Laws. Paradoxically, all three policies correlated with an increase in opioid overdose deaths between 2007 and 2016. However, after correcting for the potential spurious relationship between state-specific timing of policy implementation and death rates, two policies have a statistically significant association (alpha <0.05) with opioid overdose death rates. First, the Naloxone Liability Laws were significantly associated with changes in opioid-related deaths and was correlated with a 0.33 log increase in opioid overdose death rates, or a 29% increase. This equates to about 1.39 more deaths per year per 100,000 people. Second, the legislation that allows for 3rd Party Naloxone prescriptions correlated with a 0.33 log decrease in opioid overdose death rates, or a 29% decrease. This equates to 1.39 fewer deaths per year per 100,000 people.
ContributorsDavis, Joshua Alan (Author) / Hruschka, Daniel (Thesis director) / Gaughan, Monica (Committee member) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Under-representation of women doctors in medical work force despite their overwhelming majority in medical schools is an intriguing social issue for Pakistan raising important questions related to evolving gender relations in Pakistani society. Previous research on the broader issue of under-representation of women in science has focused primarily on the structural barriers to women’s advancement. It does not account for the underlying subtle (and changing) gendered power relations that permeate everyday life and which can constrain (or enable) the choices of women. It also does not address how women are not simply constructed as subjects within intersecting power relations, but actively construct meaning in relation to them. It raises interesting questions about the cultural shaping of subjectivities, identities and agency of women within the web of power relations in a society such as Pakistan.
To analyze the underlying dynamics of this issue, this dissertation empirically examines the individual, institutional and social factors which enable or affect the career choices of Pakistani women doctors. Based on the ethnographic data obtained from in-depth, person centered, open ended interviews with sixty women doctors and their families, as well as policy makers and the stake holders in medical education and health administration in Lahore, Pakistan this dissertation seeks to address the complex issues of empowerment and agency in the context of Pakistani women, both in individual and collective sense.
Participation in medical education is ostensibly an empowering act, but dissecting the social relations in which this decision takes place reveals that becoming a doctor actually enmeshes women further in the disciplinary relations within their families and society. Similarly, the medical workplaces of Pakistan are marked by entrenched gendered hierarchies constraining women’s access to resources and their progression through medical career. Finally, the political implications of defining work in medicine, and devaluing care in capitalist economies is explored.
To analyze the underlying dynamics of this issue, this dissertation empirically examines the individual, institutional and social factors which enable or affect the career choices of Pakistani women doctors. Based on the ethnographic data obtained from in-depth, person centered, open ended interviews with sixty women doctors and their families, as well as policy makers and the stake holders in medical education and health administration in Lahore, Pakistan this dissertation seeks to address the complex issues of empowerment and agency in the context of Pakistani women, both in individual and collective sense.
Participation in medical education is ostensibly an empowering act, but dissecting the social relations in which this decision takes place reveals that becoming a doctor actually enmeshes women further in the disciplinary relations within their families and society. Similarly, the medical workplaces of Pakistan are marked by entrenched gendered hierarchies constraining women’s access to resources and their progression through medical career. Finally, the political implications of defining work in medicine, and devaluing care in capitalist economies is explored.
ContributorsMasood, Ayesha (Author) / Tsuda, Takeyuki (Thesis advisor) / Wutich, Amber (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2017
Description
According to traditional Chinese medicine, the month following childbirth is an important period marked by an imbalance of two opposing forces that together make up one’s health and wellbeing. A set of specialized practices called zuoyuezi (sitting the month) aid both the woman’s recovery and restoration of the balance, and require the help of someone else, usually the woman’s mother or mother-in-law. While studies conducted on the practice’s psychosocial and physical benefits have produced varied results, zuoyuezi continues to persist in Hong Kong, China, and Taiwan. Since the late twentieth century, professional zuoyuezi centers have become very popular as a commercial health care business. While the month experiences of Taiwanese and Chinese women have been widely studied, there is little research on physicians’ opinions regarding the practice, especially in Western medical settings. Taiwanese physicians, who have been trained in the Western medical tradition, present interesting case studies as both experts in Western medicine and citizens in traditional Taiwanese society. The purpose of this project is to observe how Taiwanese physicians negotiate primarily cultural practices with their professional training, and whether there is a conflict between physicians’ beliefs about zuoyuezi and physicians’ personal experiences with the practice. Twenty-seven semi-structured interviews of Taiwanese physicians were conducted at two sites in Taiwan regarding their perspective and understanding of zuoyuezi and their personal experiences with it. Following qualitative analysis, the findings showed that physicians used their Western medical training to explain the traditional worldview that holds zuoyuezi. Secondly, physicians acknowledged the benefits of zuoyuezi and the influence of culture as two primary factors in its continued existence. Finally, physicians incorporated zuoyuezi into their personal lives while modifying the traditional practices. Overall, Taiwanese physicians did not appear to have direct conflict with the cultural practice, zuoyuezi, using their medical expertise to rationalize its existence while becoming active participants and co-creators in the practice.
ContributorsChou, Cecilia (Author) / Maienschein, Jane (Thesis advisor) / Gaughan, Monica (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2017
Description
Abstract
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.
Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study.
Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.
Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).
Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.
Keywords: Naloxone, opioid overdose, overdose education, overdose response program
ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor)
Created2021-04-12
Description
In this dissertation, I examine how social perceptions of physical disability shape interactions in healthcare. Drawing upon the lived experience and insights of Diné (Navajo) individuals with physical disabilities, family members, and Diné
on-indigenous healthcare workers and service providers, I explore the interrelationship of social perceptions of physical disability with understandings of identity and performance of personhood. Embedded within discourses and critiques of ableism/disablism, narratives highlight the interconnection of constructs of personhood and productivity.
Findings show that social perceptions of physical disability are closely linked to broader cultural norms surrounding concepts of health/illness. I offer a critical analysis of contemporary impacts of colonization and historical trauma on the physical, emotional, sociocultural and economic wellbeing of Diné people and those who fill service provision roles for this diverse population. Situated within broader contexts of defining constructs of ‘Whiteness’ and ‘Indigeneity’, the role of culture and discourses regarding stereotypes are particularly prominent factors in shaping relationships.
This interdisciplinary ethnography brings together contributions from Anthropology, Disability Studies, and Indigenous paradigms. Placing a particular emphasis on the social dynamics in two urban centers in the state of Arizona, this ethnography centers on analyzing areas of medical practice that work well, as well as gaps in the provision of healthcare services, with a particular focus on systemic and infrastructural barriers. These concerns are shared not only by Diné individuals with
physical disabilities and family members, but also by non-indigenous service providers and healthcare professionals.
on-indigenous healthcare workers and service providers, I explore the interrelationship of social perceptions of physical disability with understandings of identity and performance of personhood. Embedded within discourses and critiques of ableism/disablism, narratives highlight the interconnection of constructs of personhood and productivity.
Findings show that social perceptions of physical disability are closely linked to broader cultural norms surrounding concepts of health/illness. I offer a critical analysis of contemporary impacts of colonization and historical trauma on the physical, emotional, sociocultural and economic wellbeing of Diné people and those who fill service provision roles for this diverse population. Situated within broader contexts of defining constructs of ‘Whiteness’ and ‘Indigeneity’, the role of culture and discourses regarding stereotypes are particularly prominent factors in shaping relationships.
This interdisciplinary ethnography brings together contributions from Anthropology, Disability Studies, and Indigenous paradigms. Placing a particular emphasis on the social dynamics in two urban centers in the state of Arizona, this ethnography centers on analyzing areas of medical practice that work well, as well as gaps in the provision of healthcare services, with a particular focus on systemic and infrastructural barriers. These concerns are shared not only by Diné individuals with
physical disabilities and family members, but also by non-indigenous service providers and healthcare professionals.
ContributorsVarvarezou, Dimitra (Author) / Maupin, Jonathan N (Thesis advisor) / Gaughan, Monica (Committee member) / Williams, Deborah (Committee member) / Arizona State University (Publisher)
Created2020
Description
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.
Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys
questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This
study was conducted in a residential treatment center (RTC) with the institutional review board's
approval from Arizona State University. BHTs aged 18 years and above, working at this RTC
were included in the study.
Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.
Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).
Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.
ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-12
Description
Contact tracing was deployed widely during the COVID-19 pandemic to attempt to stop the spread of SARS Co-V-2. This dissertation investigates the research on contact tracing from a scientometric perspective and looks qualitatively at how case investigators and contact tracers conducted public health practice during the pandemic. Through approaching the public health practice of contact tracing from both a broad, top-down angle, and an on the ground experiential approach, this dissertation provides insight into the issues facing contact tracing as a public health tool.
ContributorsWhite, Alexandra C. (Author) / Jehn, Megan (Thesis advisor) / Hruschka, Daniel (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2022