Day 1 :
Keynote Forum
Douglas A Feldman
State University of New York, USA
Keynote: HIV risk among Men who have Sex with Men (MSM) in Hungary
Time : 09:15-10:00
Biography:
Douglas A. Feldman is Professor E meritus of Anthropology from the College at Brock port, State University of New York, former Chair of the Department of Anthropology and former President of the Society for Medical Anthropology. He is author/editor of seven books about HIV/AIDS and anthropology, most recently AIDS, Culture and Gay Men. He has conducted social research on HIV/AIDS in the United States, Hungary, Zambia, Uganda, Rwanda and Senegal. He is the recipient of the Kimball Award for Public and Applied Anthropology and the Distinguished Service Award of the AIDS and Anthropology Research Group.
Abstract:
Research was conducted among gay and bisexual men in Hungary during 2011 to try to learn why Hungarians have a relatively low rate of HIV/AIDS in their country. It was initially hypothesized that men who have sex with men in Hungary have sex with condoms with non-Hungarians, but sex without condoms with other Hungarian men, creating a functional “firewall” keeping most HIV/AIDS infection out of Hungary. While our hypothesis was inconclusive, likely due to small sample size in this qualitative study, it examined key aspects of Hungarian gay male culture. Cultures and subcultural diff erences are important in understanding Hungarian gay male behavior. Th ere was an emphasis on romance and monogamy as an ideal, the importance of personal reputation, a lack of a strong gay community, failure to use condoms when in love, sexual fantasies where condoms were irrelevant, infrequent HIV testing but accurate knowledge of safer sex. One possible solution would be to encourage the use of Pre-Exposure Prophylaxis (PrEP), a daily pill which reduces the risk of HIV infection, among Hungarian MSM who refuses to use condoms.
Keynote Forum
Adenrele Awotona
University of Massachusetts Boston, USA
Keynote: Environmental Health, Poverty and Disaster Risk Reduction
Time : 10:00-10:45
Biography:
Adenrele Awotona is a Professor of Urban Planning and Community Studies, he is the founder and Director of the Center for Rebuilding Sustainable Communities after Disasters and a former Dean of the College of Public and Community Service at the University of Massachusetts, Boston, USA. He was previously a Director of Studies for the British Council International Seminars (“Reconstruction after disasters”) in the UK where he has also served at the University of Newcastle upon Tyne as a Director of Graduate Studies in architecture and urban design. Through research, consultancy and teaching, he has professional experience in several countries in fi ve continents. Similarly, he has been a principal investigator on major research projects funded by various agencies in the USA and UK. A stream of publications has, therefore, emanated from his research and consultancy services. He earned his Ph.D. from the University of Cambridge, UK and a Certifi cate from Harvard University’s Institute of Management and Leadership in Education.
Abstract:
Statement of the Problem: The United Nations General Assembly adopted the 2030 Development Agenda titled Transforming our world: The 2030 Agenda for Sustainable Development on September 25, 2015. It outlines 17 Sustainable Development Goals the first of which calls for an end to “poverty in all its forms everywhere.” Various studies have, however, indicated that the multifaceted forces, both internal and external, which work together to generate and sustain the circumstances of pervasive poverty universally have yet to be properly understood.
Methodology & Theoretical Orientation: The purpose of this presentation is to examine how some of these forces, especially those related to environmental degradation, pitiable environmental health conditions and vulnerability of the underprivileged to disasters of all types, are major hindrances to the abolition of poverty in all places. It also analyzes the complex fundamental causes infl uencing the vulnerability of people and social structures.
Findings, Conclusion & Significance: Disasters, unplanned urban development, ecosystem degradation, and fragile livelihoods undermine the sustainable development of communities. So do inequalities; weak institutions (poor governance, political instability, underdeveloped fi nancial markets, and lack of supportive institutional and policy environments); unresponsive legal and regulatory frameworks; inadequate infrastructural development (including food and nutrition insecurity; inadequate water supply, squalid sanitary conditions and poor waste management; widespread illiteracy and underdeveloped information and communication technologies; lack of healthcare facilities and medical networks; ineffi cient transport networks; and lack of safeguards of urban areas against erosion, flooding, landslides, and disasters); as well as insuffi cient formal structures for environmental sustainability and climate change (such as meager information management systems; almost nonexistence of relevant public education amongst government and community-based agencies).
Recommendations: There is a need for a comprehensive and integrative approach to public policy formulation and implantation that encompasses development planning, human development and disaster risk reduction. This should be addressed through multi-level government and grassroots community efforts, cross-sector initiatives and global actions.
- Medical Sociology and Illness | Healthcare | Gender | Public Health | Medical Anthropology | Addiction
Location: Piedmont - 1
Chair
Douglas A Feldman
State University of New York, USA
Co-Chair
Adenrele Awotona
University of Massachusetts Boston, USA
Session Introduction
Beth Meyer-Frank
Planning to Flourish, USA
Title: Women and Addiction: Empowerment and change through family planning
Time : 11:50-12:20
Biography:
Beth Meyer-Frank, RNP, JD is a dedicated Advocate for the empowerment of women. She recognizes the struggles that women undergo in their quest for physical and mental health, and how their health affects their opportunities, fi nancial security, living situations, and their various roles within the family and society. As a nurse practitioner, she has over 25 years of experience providing high quality healthcare to women in a variety of settings. These settings include community health clinics, women’s health settings, addiction treatment centers, and psychiatric and medical weight loss practices. She is recognized as a compassionate, knowledgeable and experienced clinician. As a nurse practitioner, she has provided care to women in both outpatient and residential substance abuse treatment programs. She is a national and international speaker on the topic of women and addiction, with the focus on the empowerment of addicted women through family planning.
Abstract:
Addicted women have a high number of unplanned pregnancies that many times result in their children being removed from their care. Women often enter treatment for their substance abuse in order to stop using substances, so that they can be reunited with their children. Th eir children are oft en placed in foster care or with family members. Research shows that a high percentage of foster children from addicted homes also develop addictions when older. Thus, the cycle of addiction continues. My goal is to promote the integration of family planning/contraception in gender-responsive treatment programs for women. Contraception and delaying pregnancies provide women the opportunity to address and receive the necessary treatment for the trauma in their individual lives, and gives them a chance to learn about their addiction and prevent relapse. It allows them to address their medical issues, and social issues involving lack of job skills and housing. Addressing all of these issues is essential in order for women to remain sober and provide adequate, consistent, loving, and appropriate parenting. I will include case examples and cite research as part of my presentation that supports the above content. Also, I am in the early stages of developing a pilot project called Insight, Information, and Recovery in a women’s recovery program that off ers a solution to this problem and can be easily replicated. As a nurse practitioner, I feel fortunate to have expertise in the areas of OB/GYN, addiction, and psychiatry, all of which are tied so closely to medical sociology and anthropology. My law degree has provided additional knowledge from a diff erent perspective. I have been presenting at local, national, and international conferences, and would very much like to share my work and learn from others at your conference.
Sonali Shah
University of Glasgow, UK
Title: Growing up, Growing old: Moving through the life course with childhood paralytic polio
Biography:
Sonali Shah adopts qualitative methods to explore the social inclusion and social equity for disabled people across the life course and intersectional identities - ages, genders and ethnicities. A key concern of her research is to ensure the voices of historically marginalised and oppressed populations are listened to and included in policies and practices that affect their well-being and participation in society.
Abstract:
More and more individuals with childhood impairments are moving into older life, and defying previous medical prognosis that they will not survive that long. Their experiences and performance of life course roles in education, employment, marriage, parenthood and retirement are shaped by the social impact of living with impairment and interacting with policies, institutions and cultural environments in ways that are different to people who acquire impairments in later life. Further, despite assumptions that their impairments will remain static, it is expected that this cohort will acquire comorbid and secondary impairments as they age in a disabling society, and encounter ‘barriers to being’ as well as ‘barriers to doing’ (Th omas, 1999). This will inevitably add to the complexity and cost of healthcare, and need for additional resources. Thus further exploration is required for design and implementation of specific intervention that treat patients across the lifespan, as opposed to when they are within a particular generational location. Both, scholars and service professionals, recognize the constraints of age-specific boundaries and the benefit of adopting a life course lens to understand how onset of impairments at particular times of life are related and contribute to each other. An example is childhood paralytic poliomyelitis and post-polio syndrome. This paper draws on the life histories of survivors of paralytic poliomyelitis to understand how the interplay of individual biography and social structures shape experiences of people with childhood impairments as they occupy different generational stages across the life course, and how disability impacts life events, relationships and choices at each stage. The approach can be useful to understand the cumulative effects of childhood impairment as disabled people move through biographical and historical time.
Jerome Ngundue
Walden University, USA
Title: Disparities in Arkansas mandated immunization coverage among natural home and foster-care adolescents
Biography:
Ngundue’s doctoral dissertation focus is immunization; “Disparities in Arkansas Mandated Immunization Coverage among Natural Home and Foster-Care Adolescents”. He is passionate about increasing immunization coverage in Arkansas. He served as Chair of the Health Disparities section, Arkansas Public Health Association. He is a Public Health Preparedness Planner responsible for pandemic influenza, population health, and community resilience since 2012 at Arkansas Department of Health. He enjoys discussing his work and collaborating with communities to ensure their safety. His Ph.D. is in Public Health with concentrations in Community Health, Promotion, and Education from Walden University, Master’s degree in Health Services Administration, University of Arkansas Little Rock, Bachelor degree in Nuclear Medicine Technology, University of Arkansas for Medical Sciences, Little Rock, and Bachelor degree in Biology with Chemistry minor, University of Arkansas Little Rock, AR. His volunteer community services include Kiwanis International, Toastmasters International, Evaluator, Community Programs, Global Health, and Community projects.
Abstract:
Anecdotal evidence indicated vaccine coverage disparities among foster-care (FCA) and natural-home adolescents (NHA). Arkansas laws require 5 vaccines for school entry (FVSE) to prevent 9 common childhood diseases. The study problem was that Pulaski County, Arkansas adolescent birth cohort (PCABC) immunization rates were low compared to U.S. adolescents for these FVSE. Th is study examined the extent to which (1) PCABC immunization rates were signifi cantly different from those estimated for U.S. adolescents in 2006–2008, (2) NHA and FCA immunization rates were different in 2003–2008; (3) Sociodemographic variables mediate associations between home of residence (HOR), NHA or FCA, and up to date (UTD) status for FVSE; and (4) Vaccination game theory (VGT) estimated deaths differ between individual-equilibrium and group-optimum behaviors. The methodologies applied were direct standardization, χ2, multiple logistic regressions, and VGT to analyze PCABC retrospective secondary data from the Arkansas immunization registry. The results revealed that U.S. adjusted UTD coverage rates for Hepatitis B, measles, mumps, rubella and varicella were greater than those for PCABC. Race-adjusted FCA immunization rates were 120% higher than for NHA. Race mediated the association between HOR and UTD FVSE status, and African Americans had 80% greater odds of being UTD with FVSE compared to Caucasians. Group-optimum behavior was associated with fewer estimated deaths than individual equilibrium; thus, it is protective against disease outbreaks. Positive social change may occur among the PCABC when healthcare providers include these results in communications with parents at FCA and NHA community health clinics. Parental vaccine acceptance for their children may increase vaccinations and improve PCABC health and wellness.
Julie-Ann MacLaren
University of London, UK
Title: Developing nurses as mentors and educators in practice – analyzing support and development networks
Biography:
Julie-Ann MacLaren is an experienced nurse educator who is currently Deputy Divisional Lead for Nursing at the School of Health Sciences; City, University of London. Her expertise and passion lies in developing and improving workplace learning for student nurses and midwives. This was the focus of her 2012 doctoral
thesis entitled ‘Inside Mentoring Relationships: Infl uences and Impacts on Mentorship Learning for Acute Care Nurses Working in the NHS’ (Institute of Education, University College London)
Abstract:
Statement Supervised practice as a mentor is an integral component of professionally-accredited nurse mentor education, and is essential to the development of robust undergraduate workplace learning and assessment. However, the literature tends to focus on the mentor-student relationship rather than the relationships facilitating mentors’ workplace learning. This paper begins to redress this gap in the literature by asking the research question: Which relationships are important in developing nurses as mentors in practice, and how are their mentorship impacted by professional, Organizational and political agendas in NHS settings? A qualitative case study of two NHS Trusts was undertaken utilizing a range of data collection methods. In order to explore supervisory and supportive relationships whilst studying for an approved mentorship award (Nursing and Midwifery Council, 2008) semistructured interviews were undertaken with three recently qualified mentors. A snowball interview technique (Noy, 2008) enabled access to those they identified as significant in their own learning to become mentors, who were similarly interviewed about their developmental and support network in practice. In total six mentors were interviewed. Additional Interviews with nurses in senior NHS Trust-based educational roles, and senior policy-making and education figures augmented these initial interviews. In another strand of the research, professional mentorship standards (NMC, 2008) were mapped across each of the mentors’ interview data to gain an idea of their penetration into practice. Finally, each interview participant developed a developmental mentorship network diagram (Dobrow & Higgins, 2005) which identified colleagues significant to their own development as a mentor or educator, and the attributes which enabled this (Andrews & Chilton, 2000; Darling, 1984). The findings reveal complex learning relationships and situational factors affecting mentor development and on-going practice. They suggest that traditional dyadic forms of supervisory mentorship may not offer the range of skills and attributes that developing mentors require. Mentor network type, orientation to learning, learning strategies and organizational focus emerge as the foci of tensions in learning to be a mentor. The study recommends that nursing teams in acute areas further develop a shared culture of learning and development in providing multiple opportunities for supporting developing mentors.
Rose Mmusi-Phetoe
University of South Africa, South Africa
Title: A model for integrating social interventions into primary health care for reducing maternal and neonatal mortality in South Africa
Biography:
Rose Mmusi-Phetoe is a qualified Community Health Nurse, Demographer and Sociologist. Her career started in the eighties when she qualified and worked as a professional nurse and midwife. She moved from bed-side nursing to community health and development field, having realized that health issues are fundamentally social issues. Her career spans more than 20 years in which she continuously engaged with communities on health promotion and development interventions to create a livelihood. Her efforts are characterized by reaching out to the socially excluded and hard to reach populations in SA while working as a Maternal and Child Survival Specialist at UNICEF and as a researcher, planner and policy analyst in the Departments of Health and Population Development. She is currently working as a senior lecturer, Community Health at the University of South Africa.
Abstract:
The maternal mortality ratio and neonatal mortality rate have been persistently high in South Africa. The Maternal and Neonatal Mortality are indicative of the health of the population and reflect deeper issues such as inequitable distribution of the country’s resources, social exclusion, deprivation, and lack of access to quality public services. The purpose of this paper is to illustrate the process of developing a model that meet the overall health needs of the socially excluded, the deprived and the vulnerable women by listing those factors that influence maternal and child health outcomes. From the point of view that individual reproduction and health decision-making take place in a milieu comprising multiple socio-economic and cultural factors, this research further
intended adding to the body of knowledge on maternal and child health in order to influence policies and interventions. Data was collected through a multi-staged, qualitative research design. The results show how structural factors result in high risk for poor maternal and child health outcomes, suggesting that the high rates of poor health outcomes are evidence of deprivation of women’s needs due to poverty leading to an inability to cope with pregnancy and childbirth. The results were used to develop a model that proposes pathways for policy action to confront both the structural and intermediary determinants of maternal and child ill health and mortality. The pathways operate through integrative and inter-sectoral mechanisms intended at empowering women and
enhancing female reproductive health care activities.
Ward Biemans SJ
Society of Jesuits, Netherlands
Title: Mental and physical risks and effects of induced abortion on women
Biography:
Ward Biemans SJ is the author of ‘The Heart and the Abyss. Preventing Abortion’ (Ballarat, 2016). In this book, insights from the fields of medicine, psychology, law, politics, economics, theology and ethics are drawn together. It provides an overview of empirical research on the mental and physical risks and effects of induced abortion. Besides that, it presents two case studies on the abortion legislation and practice in the United Kingdom and the Netherlands, with practical recommendations on how to improve the care to women with unintended pregnancies. As an environmental scientist, he has been engaged in social-scientific and interdisciplinary research and in the implementation of regional governmental policy in the Netherlands. As a Jesuit priest, he is both experienced in bio-ethical research as well as in pastoral care.
Abstract:
Statement of the Problem: Despite a declining trend, globally some 35 per 1,000 women aged 15-44 years undergo an induced abortion each year. Existing research on the mental and physical risks and effects of induced abortion often encounters methodological difficulties, such as the lack of a proper controlling of confounding factors or the lack of a sufficient time span in the study design.
Methodology & Theoretical Orientation: A literature study of empirical research published between 1985 and 2015 has been conducted. Results are analysed from an epidemiological and bio-ethical perspective.
Findings: In 2008, a review of the American Psychological Association did not find evidence that a single abortion would harm a woman’s mental health. However, since then several studies reported Post Traumatic Stress or Post Traumatic Stress Disorder among women after induced abortion. As regards physical risks and effects of induced abortion, a possible link between abortion and breast cancer is still in debate. In recent years a number of Asian studies have reported a signifi cant relative risk for women with a history of induced abortion to develop breast cancer. On the other hand, several Western studies did not find an independent link between abortion and breast cancer. This difference might be explained by the stronger role of confounding factors, such as delayed child birth, nulliparity and the use of oral contraceptives among Western women. Finally, various international studies point to the risk of preterm births in pregnancies following a surgical abortion without pre-treatment. Preterm births are associated with a higher prevalence of major birth defects.
Conclusion & Significance: Women with unintended pregnancies considering an abortion should be informed of mental and physical risks and effects. For future research, cohort studies with a sufficient time span and diversifi ed research strategies are required.
Palesa Sekhejane
Human Sciences Research Council, South Africa
Title: Health system, development, women and children in post-conflict Madagascar, Antananarivo: Views from the local voices
Biography:
Palesa Sekhejane has a PhD in biomedical technology specialised in bio photonics/Nano biosciences. Her studies were majorly on application of laser (Bio photonics) to cancer and diabetic biological models and assessing the biochemical responses. She is currently employed as a research specialist at Africa Institute of South Africa (AISA) within the Human Science Research Council (HSRC). The current research work and interest is focused on public health, biomedical sciences, technology and innovation; global health and health system policies in Africa. Countries researched include Ivory Coast, Madagascar, Guinea Conakry, Angola amongst others.
Abstract:
Political crisis that ended violent in Madagascar exacerbated the conditions of the vulnerable populace (women, girls and children). Women, girls and children became homeless and without livelihood, putting them at worsened social and economic periphery. Healthcare systems in low-and middle-income countries (LMICs) in Sub-Sahara Africa face diverse problems due to shortfall of infrastructure provision, financial commitment, policy implementation and universal, equitable, appropriate high-quality services. Healthcare needs of vulnerable populace are not considered priority perhaps due to their position in the social and economic strata. Therefore, economically and socially vulnerable people do not have an opportunity to adequate and equitable access to healthcare.
Aim: To collect primary narrative or views from women, girls and civil society in Antananarivo regarding healthcare system - challenges or successes in their own experience.
Objective: To locate views of vulnerable populace in building development from the perspective of healthcare system.
Theoretical Framework: Global investment is used in this study as a framework of analysis which encompasses overall health and development of women and children. Key dimensions in this framework are health system, community engagement, policy and innovation.
Findings: Social and human security of women, girls and children (vulnerable group) was significantly reversed post 2009 conflict as men left their households. Available of healthcare facilities is enjoyed by those with money, thus hampering accessibility. The character of Malagasy people, called ‘Fiavarna’ does not allow them to freely voice their concerns and plight, thereby making it difficult to participate in developmental goals.
Conclusion & Significance: Malagasy people make use of indigenous medical intervention to improve their health status; and we find it recommendable to incorporate it as an innovative mechanism in the healthcare system given the contextual challenges. Combination of a deteriorated political and governance morale compromise the health and development of women, girls and children; resulting in a sharp increase in poverty, reduced life span and adverse health outcomes.
Andrew Saxon
Emory University School of Medicine, USA
Title: Evaluating CARE's Community-based approach through a community organizing framework
Biography:
Andrew Saxon is a fourth year medical student at Emory University School of Medicine. An Atlanta native, he has previously lived in Buenos Aires and worked as a paralegal, a community organizer on the 2008 Obama presidential campaign, an administrator for KIPP Public Charter Schools in Washington, D.C., and as a policy analyst for the National Center of Immunizations and Respiratory Diseases at the CDC. He is interested harnessing the power of communities to make children and families healthier. He wants to practice community-based medicine and work in public health as a future physician.
Abstract:
CARE, an international development NGO, is a global leader in using a community-based approach in public health. This study sought to understand how CARE uses community organizing to implement public health interventions among underserved populations in three programs in two countries. The programs were assessed through Ganz’s principles: 1) Leadership development, 2) Creating shared values through storytelling and 3) Catalyzing action through strategy and team building. Programs were selected by CARE staff. Participants were selected by familiarity with the program, diversity, pragmatic sampling techniques and purposively recruited through formal CARE networks. Data collection was completed through sixteen in-depth interviews and two focus groups were conducted from October through December 2016. The sample size was determined by saturation. Each interview and transcript was analyzed for themes around leadership development, storytelling, team-based organizing, community organizing strategies and other topics that were identifi ed as important to the program’s execution. A codebook was created through analysis of literature, the interview guide and transcripts. Transcripts were coded and analyzed using MaxQDA soft ware for usage, frequency, consistency and context of each theme and analyzed across interview subjects and sites. Study findings showed that all programs concentrated on building the capacity of community members to implement program activities. Other important strategies included systems strengthening, coalition building and government outreach. Two of the three projects focused on Freirean liberation education style trainings, developing community member’s understanding of social forces and their role in society. Storytelling and team-based organizing were used sporadically. Each program activated participants to become further involved in community work, including running for local office. CARE’s programs focused on building community capacity through leadership development. Ganz’s framework could enhance the practice of storytelling in recruitment and activation of community members. Building more effective community groups through a team-based structure could be advantageous.