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Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically beneficial because of high dietary intake of varied plant phytochemical compounds. A modern diet that reduces these dietary plant defense phytochemicals below levels typical in human evolutionary history may leave humans vulnerable to diseases that were controlled through a foraging diet. Few studies consider the health impact of the recent drastic reduction of plant phytochemical content in the modern global food system, which has eliminated essential components of food because they are not considered "nutrients". The antimicrobial and anti-inflammatory nature of the food system may not only regulate infectious pathogens and inflammatory disease, but also support beneficial microbes in human hosts, reducing vulnerability to chronic diseases. Waorani foragers seem immune to certain infections with very low rates of chronic disease. Does returning to certain characteristics of a foraging food system begin to restore the human body microbe balance and inflammatory response to evolutionary norms, and if so, what implication does this have for the treatment of disease? Several years of data on dietary and health differences across the foragers and the farmers was gathered. There were major differences in health outcomes across the board. In the Waorani forager group there were no signs of infection in serious wounds such as 3rd degree burns and spear wounds. The foragers had one-degree lower body temperature than the farmers. The Waorani had an absence of signs of chronic diseases including vision and blood pressure that did not change markedly with age while Kichwa farmers suffered from both chronic diseases and physiological indicators of aging. In the Waorani forager population, there was an absence of many common regional infectious diseases, from helminthes to staphylococcus. Study design helped control for confounders (exercise, environment, genetic factors, non-phytochemical dietary intake). This study provides evidence of the major role total phytochemical dietary intake plays in human health, often not considered by policymakers and nutritional and agricultural scientists.
ContributorsLondon, Douglas (Author) / Tsuda, Takeyuki (Thesis advisor) / Beezhold, Bonnie L (Committee member) / Hruschka, Daniel (Committee member) / Eder, James (Committee member) / Arizona State University (Publisher)
Created2012
Description
This dissertation is intended to tie together a body of work which utilizes a variety of methods to study applied mathematical models involving heterogeneity often omitted with classical modeling techniques. I posit three cogent classifications of heterogeneity: physiological, behavioral, and local (specifically connectivity in this work). I consider physiological heterogeneity using the method of transport equations to study heterogeneous susceptibility to diseases in open populations (those with births and deaths). I then present three separate models of behavioral heterogeneity. An SIS/SAS model of gonorrhea transmission in a population of highly active men-who-have-sex-with-men (MSM) is presented to study the impact of safe behavior (prevention and self-awareness) on the prevalence of this endemic disease. Behavior is modeled in this examples via static parameters describing consistent condom use and frequency of STD testing. In an example of behavioral heterogeneity, in the absence of underlying dynamics, I present a generalization to ``test theory without an answer key" (also known as cultural consensus modeling or CCM). CCM is commonly used to study the distribution of cultural knowledge within a population. The generalized framework presented allows for selecting the best model among various extensions of CCM: multiple subcultures, estimating the degree to which individuals guess yes, and making competence homogenous in the population. This permits model selection based on the principle of information criteria. The third behaviorally heterogeneous model studies adaptive behavioral response based on epidemiological-economic theory within an $SIR$ epidemic setting. Theorems used to analyze the stability of such models with a generalized, non-linear incidence structure are adapted and applied to the case of standard incidence and adaptive incidence. As an example of study in spatial heterogeneity I provide an explicit solution to a generalization of the continuous time approximation of the Albert-Barabasi scale-free network algorithm. The solution is found by recursively solving the differential equations via integrating factors, identifying a pattern for the coefficients and then proving this observed pattern is consistent using induction. An application to disease dynamics on such evolving structures is then studied.
ContributorsMorin, Benjamin (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Hiebeler, David (Thesis advisor) / Hruschka, Daniel (Committee member) / Suslov, Sergei (Committee member) / Arizona State University (Publisher)
Created2012
Description
Due to persistent undernutrition in India and the increased demands placed on a woman’s body during childbearing and lactation, the Indian government has implemented a program to provide supplemental nutrition packets to women in rural India. This study examines the factors influencing uptake of nutritional packets by lactating mothers in southern, rural Rajasthan. Women were recruited from 65 villages in Rajasthan, India (n=149, minimum of 2 per village) to evaluate the relationship of nutrition packet uptake and two factors--education levels and distance to the health center.
Level of education had little impact on whether or not women received the nutrition packet. Of those women with no education, 63.1% received the packet. Of those with any education, 63.9% got the packet.
In contrast, distance was strongly correlated with whether or not women received the packet. For example, of the women living within 200 meters of the health center, 93.2% received a nutrition packet. Of the women living between 250 meters and one kilometer of the health center, 68.4% received a nutrition packet. Of the women living over one kilometer from the health center, only 25% received a nutrition packet. The relationship between uptake of packets and women’s perception of distance to the health center was also explored. Out of 50 women who did not receive the packet, all of the women who said there was no health center in their village did live more than one kilometer from a health center. Of the women who lived between 250 meters and one kilometer from the health center, 40% felt it was too far. Of the women who lived more than a kilometer from the health center, 66.7% felt it was too far and 29.6% said there was no health center in their village. Again, it does not appear that ‘too far’ is just a default reason for women, but that actual distance, more so than education, is a major contributing factor in their ability to take the nutrition packet. These findings suggest that improving access to supplemental nutrition packets at the village level may increase uptake by the women.
Level of education had little impact on whether or not women received the nutrition packet. Of those women with no education, 63.1% received the packet. Of those with any education, 63.9% got the packet.
In contrast, distance was strongly correlated with whether or not women received the packet. For example, of the women living within 200 meters of the health center, 93.2% received a nutrition packet. Of the women living between 250 meters and one kilometer of the health center, 68.4% received a nutrition packet. Of the women living over one kilometer from the health center, only 25% received a nutrition packet. The relationship between uptake of packets and women’s perception of distance to the health center was also explored. Out of 50 women who did not receive the packet, all of the women who said there was no health center in their village did live more than one kilometer from a health center. Of the women who lived between 250 meters and one kilometer from the health center, 40% felt it was too far. Of the women who lived more than a kilometer from the health center, 66.7% felt it was too far and 29.6% said there was no health center in their village. Again, it does not appear that ‘too far’ is just a default reason for women, but that actual distance, more so than education, is a major contributing factor in their ability to take the nutrition packet. These findings suggest that improving access to supplemental nutrition packets at the village level may increase uptake by the women.
ContributorsJeffers, Eva Marie (Author) / Hruschka, Daniel (Thesis director) / Maupin, Jonathan (Committee member) / Cook, Jeffrey (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2015-05
Description
Maternal health and mental health have recently become globally recognized as critical areas of focus. The continued research into the relationship between maternal health and mental health—in particular, how they are affected by public policy and infrastructure—is vital to the improvement of general health outcomes. An investigation of literature, current health landscape and indicators, gray literature, and the current policy landscape in an exemplar country (Australia), Bangladesh and Nepal was done. Bangladesh and Nepal were chosen due to the recent amounts of change seen in each country’s maternal health status. Both Bangladesh and Nepal are severely lacking in official mental health services, facilities, and personnel. The analysis revealed flaws and disparities in each country’s current policy landscape. Despite these disparities it should be recognized that policies and programs are being implemented – just in a very piecemeal manner, and not entirely by each country’s respective government. Integration of maternal health services and mental health services is recommended to improve functionality of already existing services. The addition of minimal but necessary components to health systems is recommended.
ContributorsCiampaglio, Kaitlyn Rae (Author) / Gaughan, Monica (Thesis director) / Hagaman, Ashley (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor) / School of Sustainability (Contributor)
Created2015-05
Description
This paper explains what factors influence mental health issues and what type of care is provided in various countries. The countries in this study will include the United States, Japan, Ethiopia and South Africa, all of which have varying degrees of ethnic diversity, economic status and understanding of mental health issues. It discusses the specific healthcare systems in each country, as well as the attitudes and problems associated with depression and schizophrenia, two prevalent mental health disorders. This paper examines the different ways that a diagnosis is reached for schizophrenia and major depression in these different countries, as well as what methods are used for treating individuals with these disorders. It will also examine the prominent notion that schizophrenia has better outcomes in developing countries than in places that have wider medical care available. It then discusses what treatments are available in each country, as well as social constructs that exist regarding those treatments in order to understand the ways that treatments can be expanded to improve outcomes. This paper will then examine the different outcomes of these mental health disorders that are common in each country, and conclude with ideas on how to make global mental health a reality.
ContributorsOlsen, Rachel Lindsay (Author) / Gaughan, Monica (Thesis director) / Wood, Reed (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor) / Department of Psychology (Contributor)
Created2015-05
Description
2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained midwives can meet global maternal health care needs. This study investigates two major questions. What is the role of midwives in diverse international maternal healthcare contexts? How do midwives in these different contexts define their roles and the barriers to providing the best care for women? From May to August 2015, I conducted over 70 interviews with midwives in Netherlands, Sweden, Rwanda, Bangladesh, Australia and Guatemala, interviewing between 6 and 13 midwives from each country. The majority of midwives defined their roles as supporting women's individual capacities and power through normal birth, and knowing when to refer when high-risk complications arise. Although thematic barriers vary by country, midwives in all countries believed that maternal healthcare can be improved by increased collaboration between midwives and other health care professionals, better access to culturally appropriate services, and greater public awareness of the role of midwives.
ContributorsCarson, Anna Elizabeth (Author) / Hruschka, Daniel (Thesis director) / Maupin, Jonathan (Committee member) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
How are perceptions of morality and disgust regarding meat consumption related to each other? Which factor is more salient in determining one's willingness to eat the meat of a specific animal? How do these answers vary across religious groups? This study investigates the ways that concepts like morality and disgust are related to food preferences and hopes to shed light on the mechanisms that enforce culturally sanctioned food taboos. The study compares 4 groups of people in the U.S.: Christians (n = 39), Hindus (n = 29), Jews (n = 23), and non-religious people (n = 63). A total of 154 participants were given surveys in which they rated their feelings about eating various animals. Data from Christian and non-religious groups exhibited similar patterns such as a high likelihood of eating a given animal when starving, while results from Jews and Hindus were consistent with their religion's respective food taboos. Despite these differences, morality and disgust are strongly correlated with one another in almost all instances. Moreover, morality and disgust are almost equally important considerations when determining willingness to eat when starving.
ContributorsParekh, Shaili Rajul (Author) / Hruschka, Daniel (Thesis director) / Jacobs, Mark (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor) / School of Human Evolution and Social Change (Contributor) / Hugh Downs School of Human Communication (Contributor)
Created2014-12
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
Description
The United States is experiencing an increase in the prevalence and influence of complementary and alternative medicine (CAM) in patient healthcare, reflecting the increasingly positive public and professional attitudes on the use of CAM therapies. Despite the growing presence of CAM in U.S. healthcare, there are still many barriers to integration. This study aims to reveal the attitudes of conventional, integrative and CAM practitioners concerning the major challenges of CAM's integration, explore their proposed solutions, and reveal any discrepancies in these attitudes among different types of practitioners. Twenty-eight practitioners were interviewed on the challenges in the five facets of CAM's integration: integration into hospitals, integration into medical schools, insurance coverage for CAM, licensing & regulation of CAM practitioners, and clinical research in CAM. The overall positive attitudes on the benefits of CAM's integration support previous research on the subject; however, the conventional practitioners were unable to extend these benefits to real-world application, and they were unaware of many of the challenges facing CAM's integration. The CAM practitioners attributed many of the problems facing integration to the inability of CAM's philosophy to comply with the current ideology of medical academia, health insurance model, and laws that govern the licensing and regulation of medical practitioners. The CAM and integrative practitioners perceived there to be a large resistance from conventional practitioners, specifically concerning the integration of CAM into education, providing insurance coverage for CAM, and the licensing and regulation of CAM practitioners. They attributed this to a perceived lack of research on safe and effective treatments in CAM. The conventional practitioner responses reflected this weariness of treatment effectiveness in their responses. However, the CAM and integrative practitioners believed these claims to be largely inaccurate, and constructed by the influence and manipulation of large-scale medical corporations and organizations. The participants believed that more evidence-based research in CAM, and increased public awareness in CAM therapies will force conventional practitioners to increase their knowledge in CAM, helping to alleviate their fears and skepticism of CAM therapies. By easing these concerns, dialogue can occur among practitioners of different modalities that will help to ensure a smooth integration of CAM and will raise the quality of patient healthcare by providing safe and effective resources for alternate forms of treatment.
ContributorsJohnston, Shantele Hanna Lee (Author) / Hruschka, Daniel (Thesis director) / Hurlbut, Ben (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2014-05
Description
Fat-stigma has become a popular topic of research in recent years as obesity and Western ideals have made their way around the globe. Previous studies have found that the internalization and expression of body norms can vary dramatically depending on location, gender, and many other cultural factors. Differing levels of body satisfaction have been linked to the internalization of these norms, and the development of low body esteem can result in many physical and emotional problems. Although there is an abundance of research on the topic of fat-stigma, few studies have investigated the related, but seemingly independent, topic of the ideal thin body. Furthermore, limited research has looked directly at body size stereotypes in Guatemala, and those that have, focused solely on Guatemala City. Furthermore, no previous cross-cultural analyses were found comparing body norms among US and rural Guatemalan adolescents. By surveying 9-10 year old students in Acatenango, Guatemala and Phoenix, Arizona, this study compared the preferences as well as stereotypes for average, thin, and fat body sizes in these two contexts. The results of this study illustrate a contrast between a fat-negative and a thin-negative culture, and highlight the complexity of the emergence of body norms around the world. We find that, in contrast to previous studies, neither the western ideal thin body nor obesity stereotypes have been internalized in Acatenango. Furthermore, negative evaluations of fat bodies and positive evaluations of thin bodies seem to be made independently of each other. Americans had a much higher prejudice against fat children and were more likely to be thin-positive (OR=1.997), while Guatemalans were more likely to be thin-negative. On average, the American students were much more polarized in their judgments on different body sizes, and experienced greater levels of body dissatisfaction. Finally, American students favored an ideal figure over one size smaller than Guatemalan students. Results suggest that there are still rural communities that have not been entirely affected by the spread of western body norms.
ContributorsCole, Dawn Michelle (Author) / Maupin, Jonathan (Thesis director) / Hruschka, Daniel (Committee member) / Barrett, The Honors College (Contributor) / School of Geographical Sciences and Urban Planning (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2013-12