Referral Patterns Between Allopathic Physicians and Complementary and Alternative Medicine Practitioners

Introduction and Objectives: The provision of basic healthcare in the United States may be viewed considering two different, and sometimes combined, therapeutic approaches: •Allopathic/osteopathic medicine •Complementary and alternative medicine (CAM) Our study is interested in the intersection of allopathic medicine and CAM. Evidence suggests that Americans are seeking CAM at a similar or even a higher rate than allopathic medicine, yet there seems to be a division between practitioners of each discipline. Isthis division created by a lack of coordination, such as an inadequately established referral system, or by a general lack of knowledge, or by the attitudes of the practitioners? In our study our objectives were: ? To assess the referral patterns between allopathic and CAM practitioners in Chittenden County. ? To examine the various factors that may influence these referral patterns using confidential surveys.https://scholarworks.uvm.edu/comphp_gallery/1017/thumbnail.jp

“What if There's Something Wrong with Her?”‐How Biomedical Technologies Contribute to Epistemic Injustice in Healthcare

While there is a steadily growing literature on epistemic injustice in healthcare, there are few discussions of the role that biomedical technologies play in harming patients in their capacity as knowers. Through an analysis of newborn and pediatric genetic and genomic sequencing technologies (GSTs), I argue that biomedical technologies can lead to epistemic injustice through two primary pathways: epistemic capture and value partitioning. I close by discussing the larger ethical and political context of critical analyses of GSTs and their broader implications for just and equitable healthcare delivery

Examining Cognitive-Affective Reactivity to Racial Stigma: Implications for Risk Behavior

Using electroencephalographic (EEG) research methods, the current study found that neural responses (i.e., late positive potential brain activity) to negatively-valenced visual stimuli (e.g., threatening images) were heightened after exposure to racial stigma cues. In other words, experiencing racial discrimination led to an increase in emotional reactivity to threatening situations. In line with stigma-stress-substance use theoretical frameworks, these findings suggest a neurocognitive basis for the health disparities experienced by African American populations. The findings have implications for culturally cognizant mental health care and public policy, providing a deeper understanding of the unique risk factors and mechanisms affecting racial minority groups. This study is also, to our knowledge, the first to utilize images to operationalize racial stigma, with the potential for future researchers to adopt this paradigm.First-Year Innovation and Research Experience Clinical and Cognitive Neuroscience Laborator

Diversification and agrarian change under environmental constraints in rural China: Evidence from a poor township of Beijing municipality

Working paper du GATE 2007-11This article illustrates the impact of changes related to market reforms and environmental policies on the economic structure in rural China by providing a comparative analysis of several villages in a poor township in Beijing municipality. Two main concomitant phenomena are affecting agricultural and non-agricultural choices in the studied area. First, the introduction of market mechanisms is encouraging local population to engage in new activities that are closer to local comparative advantages. Second, rural households are facing new constraints in the form of environmental protection measures, which have weakened traditional insurance channels provided by forest resources and cattle stock. Drawing on household-level survey data and interviews with village heads conducted in ten villages of Labagoumen township in December 2003, this article analyzes households decisions in response to market reforms and environmental constraints. We find large disparities both between villages and households in the diversification process and discuss the reasons of observed inertia in the region, most households still heavily relying on corn production

Hyaluronan turnover and hypoxic brown adipocytic differentiation are co-localized with ossification in calcified human aortic valves

The calcification process in aortic stenosis has garnered considerable interest but only limited investigation into selected signaling pathways. This study investigated mechanisms related to hypoxia, hyaluronan homeostasis, brown adipocytic differentiation, and ossification within calcified valves. Surgically explanted calcified aortic valves (nﾠ=ﾠ14) were immunostained for markers relevant to these mechanisms and evaluated in the center (NodCtr) and edge (NodEdge) of the calcified nodule (NodCtr), tissue directly surrounding nodule (NodSurr); center and tissue surrounding small ﾓprenodulesﾔ (PreNod, PreNodSurr); and normal fibrosa layer (CollFibr). Pearson correlations were determined between staining intensities of markers within regions. Ossification markers primarily localized to NodCtr and NodEdge, along with markers related to hyaluronan turnover and hypoxia. Markers of brown adipocytic differentiation were frequently co-localized with markers of hypoxia. In NodCtr and NodSurr, brown fat and ossification markers correlated with hyaluronidase-1, whereas these markers, as well as hypoxia, correlated with hyaluronan synthases in NodEdge. The protein product of tumor necrosis factor-? stimulated gene-6 strongly correlated with ossification markers and hyaluronidase in the regions surrounding the nodules (NodSurr, PreNodSurr). In conclusion, this study suggests roles for hyaluronan homeostasis and the promotion of hypoxia by cells demonstrating brown fat markers in calcific aortic valve disease

Commuting and wellbeing: A critical overview of the literature with implications for policy and future research

© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This review provides a critical overview of what has been learnt about commuting’s impact on subjective wellbeing (SWB). It is structured around a conceptual model which assumes commuting can affect SWB over three time horizons: (i) during the journey; (ii) immediately after the journey; and (iii) over the longer term. Our assessment of the evidence shows that mood is lower during the commute than other daily activities and stress can be induced by congestion, crowding and unpredictability. People who walk or cycle to work are generally more satisfied with their commute than those who travel by car and especially those who use public transport. Satisfaction decreases with duration of commute, regardless of mode used, and increases when travelling with company. After the journey, evidence shows that the commute experience “spills over” into how people feel and perform at work and home. However, a consistent link between commuting and life satisfaction overall has not been established. The evidence suggests that commuters are generally successful in trading off the drawbacks of longer and more arduous commute journeys against the benefits they bring in relation to overall life satisfaction, but further research is required to understand the decision making involved. The evidence review points to six areas that warrant policy action and research: (i) enhancing the commute experience; (ii) increasing commute satisfaction; (iii) reducing the impacts of long duration commutes; (iv) meeting commuter preferences; (v) recognising flexibility and constraints in commuting routines and (vi) accounting for SWB impacts of commuting in policy making and appraisal

diversification as part of a csa strategy the cases of zambia and malawi

Climate variability, associated with farm-income variability, is recognized as one of the main drivers of livelihood diversification strategies in developing countries. In this chapter, we present a synthesis of two comprehensive studies from Zambia and Malawi on the drivers of diversification and its impacts on selected welfare outcomes with a specific attention to climatic variables and institutions. We use geo-referenced farm-household-level data merged with data on historical rainfall and temperature as well as with administrative data on relevant institutions. The two case studies demonstrate that diversification is clearly an adaptation response, as long term trends in climatic shocks have a significant effect on livelihood diversification, albeit with different implications. Whereas the long term variation in growing period rainfall is associated with increased crop, labour and income diversification in Malawi, it is only associated with increased livestock diversification in Zambia. With regard to institutions, we find that access to extension agents positively and significantly correlates with crop diversification in both countries, underlining the role of extension in promoting more resilient farming systems in rural Zambia and Malawi. Fertilizer subsidies are among the most important agricultural policies in both countries, where they significantly affect incentives for income diversification – though in opposing ways – providing important policy implications. The two case studies document distinct ways in which incentives for livelihood diversification (measured along different dimensions) are shaped by increased variability in rainfall and rural institutions. The results also demonstrate that diversification can be an effective adaptation response and the risk-return trade-offs are not as pronounced as might be expected