THE “ART OF RENT”: PAINTERS, TOURISTS, AND CHANGE IN SAN JUAN LA LAGUNA, GUATEMALA

This qualitative case study explores artisanal painters’ views on tourism and their impacts on cultural change in San Juan la Laguna, Guatemala. They struggle with new cultural and economic identities through art. Painting is a way to overcome historical discrimination based on their identity, while they explore, develop, and communicate their cultural identities to themselves and outsiders. By selling paintings of cultural scenes that are of interest to them and to tourists, they strengthen their voices in the marketplace. Harvey’s (2002) concept of “space of hope” and Appadurai’s (2004) concept of “capacity to aspire” frame an understanding of this process of change. The painters in San Juan la Laguna create a space of hope through painting to support indigenous cultural identity and economic identity development. They use their identities to increase their unique position in the market and strengthen their capacity to aspire, that is, to engage with globalization on their own terms to shape their future. This is the “art of rent” (Harvey, 2002): the painters must artfully use their cultural and economic identity to earn rents from tourists. They must craft a space to negotiate the terms of the encounter with globalization to struggle for a better life

Assessment of Modified Patient Education Materials for People with Age-Related Macular Degeneration

Background: Existing research on health literacy identifies a disconnect between the readability of patient education materials (PEMs) and the reading abilities of American adults. For people with age-related macular degeneration (AMD), central vision loss creates an additional barrier to health literacy. This study explored how evidence-based guidelines for creating easy-to-understand written materials influenced the usability of PEMs in people with AMD. Methods: Evidence-based guidelines were applied to modify one PEM. Standardized tools quantified differences in readability and suitability between the original and modified PEM. Twelve people with AMD rated the comprehensibility (design quality) and shared personal preferences during semi-structured interviews. Results: The modified PEM showed statistically significant improvements in readability, suitability, and comprehensibility. Mean readability decreased 5.9 grade levels. Suitability increased from 20% (not suitable) to 82% (superior). Comprehensibility also improved significantly. The majority of the participants indicated the modified PEM made information easier to read (75%), understand (83%) and locate (92%). Qualitative analysis revealed themes related to reading challenges, optical devices, and patient-provider interactions. Conclusion: Applying evidence-based guidelines for low health literacy and low vision created a significant improvement in the usability of written health information. Actively involving people with AMD in the research provided valuable insight. Additional research is warranted

Clinical Decision Science: Proof of concept

Clinical decision science, a newly identified area of scholarship, describes how clinical research is used for a patient, within the context of their unique social conditions. We hypothesize that physicians use sociocultural context as an important input to their decision making. We performed a prospective, randomized, double-blind mixed methods study. Family medicine faculty and residents at a community hospital family medicine residency were included in the study. After academic journal club discussing a primary research paper, physicians were asked if they would prescribe medication for a patient who was similar to the subjects in a research paper. However, social and cultural context was given to the cases. The physicians were block randomized into two groups; Group A was given a case with a patient who had a social and cultural context more conducive to lifestyle modification, while group B had a case more conducive to prescribing medication. Primary outcome was whether or not physicians prescribed medication, allowing for a 2x2 table for analysis. We also asked a free response question regarding the reasoning for their decision and performed qualitative analysis. In group A (n=14), no subjects prescribed medication. In group B (n=18), six subjects prescribed medication. (chi-square statistic with Yates correction 9.95, p=0.001). Thematic analysis in group A showed 22 statements related to medical practice or disease characteristics, and 25 statements related to familial relationships and patient preferences. In group B, subjects who prescribed medication made 30 statements related to medical practice, and 13 statements related to patient preference. Subjects who did not prescribe medication made 10 statements related to medical practice, and 1 statement related to patient preference. This study demonstrates social context of individual patients, together with evidence, affects clinical decision and management. We propose further study into how this affects physician decision making, a scholarly field we call Clinical Decision Science

The Care Squeeze: An Institutional Ethnography of a Nonprofit to Investigate the Diverse Labors Undertaken “To Fight for Better” in Coffee Markets

This study examines the everyday work in international development. Feminist geographers consistently argue that research at the scale of the everyday enables theoretical understandings from the bottom up of how power operates. Yet, geography lacks empirical research on everyday practices in development institutions and theoretical research on everyday labors in these institutions. I examine the consequences of transnational labor dynamics for nonprofit workers’ everyday experiences, institutional structures, and project outcomes. The space where laborers in nongovernmental organizations from the Global North and Global South encounter each other in development institutions is a unique space to examine the intersection of productive, reproductive, and care work. My research questions led me to investigate: What is the work, who does the work, and what does the work do? For this research, I volunteered with an organization called Better Trade Coffee, and collected data through a multi-faceted institutional ethnography including: 520 hours of participant observation, 55 semi-structured interviews, 38 informal interview, textual analysis of 6 years of annual reports, and 3 focus groups with 35 people. In total, I interviewed 45 men and 45 women. I hypothesized that an increase in diverse labors would result in both undervalued and unseen labor, and that this unseen labor would, in turn, alter an organization’s goal to reduce poverty. I found that the most undervalued work was the care work of the office workers, tour guides, and coffee farmers. Consequently, this undervalued work limited the institution’s capacity to achieve its goals to fix inequalities. The limited capacity reflected the workers’ experiences of a care squeeze, which is pressure by society and markets to increasingly perform extra care work with the hope that it will bring a better life. The neoliberal marketplace encourages more care work: for consumers, care is enacted through the purchase of ethical products like direct trade coffee or community tours; for workers, care is enacted through finding a job that is your passion; and for farmers, care is enacted through the production of the best products. Yet the markets do not always value this care work monetarily and economic inequalities are perpetuated. Future research should explore the contradictions and diversity of care squeezes, including who feels it, how they feel it, and the impacts of these experiences on transforming economic structures

The Effects of Pretraining Upon The Training and Transfer of Circuit Board Assembly Skills of Retarded Adults

77 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1974.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

Predicting Insect Development in Changing Climates: Bean Beetle Phenology Modeling

Traditional development models for poikilotherms assume that development rates depend on temperature, but do not allow rates to vary as an individual ages within a life stage. We designed experiments to test this assumption using bean beetles. Our hypothesis is that the time that bean beetle embryos are exposed to a period of higher or lower temperature will impact their development time. According to the age-independent model, embryos spending the same amount of time at each temperature, regardless of when they are exposed to those temperatures, will take the same amount of time to develop. Our preliminary results suggest that this is not the case, supporting the possibility of age-dependent aging

Pre-prosthetic training for a medically complex below knee amputee in a subacute setting: A Case Study

There are many reasons that a person may experience a lower extremity amputation. In fact, according to the Centers for Disease Control and Prevention, more than five hundred Americans lose their limb each day.1 Oftentimes physical therapists play a crucial role in determining the rehabilitation setting that these individuals will go to after their acute rehabilitation phase is complete. Research supports that dysvascular amputees have a better chance of positive outcomes when discharged to an inpatient rehabilitation setting as compared to a skilled nursing facility.2-3 For this particular case, a fifty-eight year old Caucasian female, JS, presented to a skilled nursing facility to the subacute rehabilitation floor following hospitalization due to intractable right lower extremity pain with active cellulitis and non-healing wounds which resulted in a right below knee amputation. Her hospital stay was complicated with acute respiratory failure and bradyarrhythmias and a ST elevated myocardial infarction which required a Boston scientific duel chamber pacemaker placement. JS presented to physical therapy six weeks after her original hospital admission. This case study provides an example of a rehabilitation program used for pre-prosthetic training of a medically complex patient on the subacute unit of a skilled nursing facility. It is imperative that physical therapists in any setting understand the importance of strength training, balance, trunk stability, transfer training, and safety education prior to the amputee receiving a lower extremity prosthetic device. Choosing a discharge destination is an important decision when determining post-acute rehabilitation plans, but there is a significant gap in the research regarding the utilization of a subacute rehabilitation setting. Intensive rehabilitation for patients who have had a lower extremity amputation may significantly alter their future functional status and options when receiving a prosthetic device which is why understanding the foundation of each rehabilitation setting options is so imperative