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Barriers to Prevention and Treatment of Type 2 Diabetes Mellitus: A Qualitative Analysis of Women in East Sikkim, India
Get PDFDiabetes Mellitus is a metabolic disorder that affects more people in India than anywhere else in the world (Ramachandran et. al., 2010). A recent national study concluded that Sikkim, a small northeastern state in the Himalayas, has the highest prevalence of Diabetes Mellitus compared to any other state in India. In order to determine why this is so, this study looks at the barriers women face when attempting to prevent and treat Type 2 Diabetes Mellitus (T2DM) in East Sikkim. Fieldwork for this study was facilitated by The Volunteer Health Association of Sikkim, and took place in Gangtok and a small village near Sikkim’s border. Qualitative data for this study was collected through semi-structured interviews and focus group discussions with state health officials, private practicing doctors, and both rural and urban women living with T2DM. It was found that housewives faced barriers not experienced by men, however no other gender-specific barriers were identified. Lack of knowledge surrounding the prevalence of T2DM, lack of knowledge about the causes of the disease, limited doctor-patient interactions, limited access to health services for rural populations, and the inability to seek treatment as a result of socioeconomic standing were all identified as non gender-specific barriers
Placeness: Mongolia A Call for the Creation of a Human Impact Assessment
Get PDFSense of place, place-‐based identities, and “placeness” are fundamental ways through which human beings understand their physical place in the world. The means by which most Mongolians—and indeed most human beings—strive for placeness is fairly simple. First, one decides what location will become their place. Their place may be predetermined (i.e. a birthplace) or chosen (based on the wildlife, the scenery, the neighborhood, etc.). Once one has a place, sense of place necessarily follows. One’s place becomes the standard by which locations are understood, and by which one understands oneself. The latter process constitutes the formation of place-‐based identities, which inform how one will strive for the feeling of placeness.
Although the outcomes may vary, this framework can be seamlessly applied to any community, and is especially applicable in Mongolia. Mongolia is going through incredible demographic transitions, making it an especially unique location to study the different ways in which people understand their place in the world. The implications of individuals’ understandings of place were explored in four research locations: Galuut soum (Bayankhongor aimag), the UB ger district, Ulaanbaatar, and Ulgii (Bayan-‐Ulgii aimag). The senses of place, place-‐based identities and placeness of citizens in each of these locations were studied through literature review and synthesis, interviews, surveys and participant observation, and supplemented by photographs and vignettes. In the end, this research illuminated two trends. First, various cultural and geographical factors give rise to a diversity of social identities within Mongolia. Secondly, the deep importance of family to Mongolians tends to homogenize individual identities.
At the end of this paper, I propose the creation of a law on Human Impact Assessments, which would require the assessment of the role of sense of place, place-‐based identities, and placeness in communities affected by the activities of the central government and private companies
Ulaanbaatar’s Ger District Issues: Changes and Attitudes
Get PDFSeveral of Ulaanbaatar’s current issues are directly related to Ulaanbaatar’s sprawling Ger District. The Ger District is home to approximately 736,000 residents, 61% of Ulaanbaatar’s population (Galimbyek, 2015). The significant growth in Ulaanbaatar is shown by its 52.8% of residents who were born outside of the city, the majority of migrants moving into the Ger District due to a lack of housing. (Chilkhaasuren & Baasankhuu, 2012). The development of Ulaanbaatar has not kept up with the rapid growth leading to inadequate infrastructure in much of the Ger District. In turn, inadequate infrastructure has lead to high pollution levels, negatively affecting public health.
In this research, I (1) identify the Ger District’s problems, (2) look at what change has been made and what change is planned to be made to reduce Ger District related problems, and (3) analyze the opinions of Ger District residents and urban area residents alike to find perceptions of the problems, and general attitude towards life in the Ger District. I did this by using literary sources, 11 interviews, 49 surveys and observations. The purpose of this research is to assess what change is happening to minimize Ger District related issues, especially pollution as it is linked to negative impacts on public health. Also, this research assesses the opinions of Ulaanbaatar residents regarding the Ger District to increase knowledge of what change is most accepted.
I found that a majority of Ulaanbaatar’s population is aware that problems associated to the Ger District do exist. This is important, as to inspire change, people must be aware of present issues. I also found that against what I had predicted, a large number of Ulaanbaatar residents, both those living in urban and ger areas would either like to or do like living in ger areas. A number of people stated that they would like to live in the Ger District with improved infrastructure. It is my hope that my results will give insight as to how change should be made
Structuring a Comparative Assessment: Lessons on Advocacy Monitoring, Evaluation, and Learning
No full textThis document examines an experimental method of conducting a comparative assessment of policy influence by a cohort of US-based, international non-governmental organizations (INGOs). The assessment was conducted while I was the Policy Influence Evaluation Intern with Oxfam America (OA), and centers on the food aid reform campaign. Through desk research, the assessment focused on retrieving and analyzing quantitative data. Design considerations for the final technical report metrics were influenced by research limitations, subject matter literature, and organizational concepts. Findings and results from original metrics present a synthesis of quantifiable data pertaining to alternative media and policy maker access. Significant learning was achieved in distinct areas, such as, identifying campaign strengths and weaknesses, INGO coalition contributions, and important sources of technical information from which data can be extracted. There exists no concrete evidence of attribution to policy influence, yet the most valuable lessons emerged after the project concluded: Oxfam America’s (OA) internal data collection system must be improved before looking outward; and that when assessing a campaign’s effectiveness and strategy, we must do so with a holistic mindset.
Keywords: policy influence, comparative assessment, quantitative dat
Protecting Ecosystems, Culture, and Human Rights in Chile Through Indigenous and Community-Conserved Territories and Areas
Get PDFIn environmental conservation circles around the world, the contributions of indigenous peoples and local communities to the sustainable maintenance of ecosystems and natural resources are being given increased attention. Whether for cultural, spiritual, economic, or other purposes, the use of traditional and local knowledge of habitat and resource management is slowly making its way into the modern environmental movement. These managed areas, known as Indigenous and Community-Conserved Territories and Areas, or ICCAs, are defined by the International Union for Conservation of Nature as “natural and/or modified ecosystems containing significant biodiversity values, ecological services and cultural values, voluntarily conserved by Indigenous peoples and local communities, through customary laws or other effective means”.
The ICCA concept constitutes a new way of thinking about environmental protection while incorporating the preserving of the human rights of indigenous peoples. After spending eight months working with a human rights NGO in Temuco, Chile, the author has focused on the ICCA concept for his capstone project. Through participatory research and collaborative efforts of his Chilean and indigenous Mapuche colleagues, the author answers the research question, “What are the major benefits of ICCAs, and what are the principal barriers to their broader support and effective legal recognition in Chile?” Based on his findings, the author outlines a comprehensive project proposal that seeks to address the underlying issues that have served to marginalize indigenous peoples in Chile. Furthermore, the proposal also supports the appropriate legal mechanisms required to give ICCAs – and their indigenous and local stewards – formal legal recognition
Too Many Rented Rooms: Creative Expression in the Tibetan Community and the Foreign Artist
Get PDFThough Tibetan society has always had a literary and creative bent, the genre of secular Tibetan poetry is still very much burgeoning. One of the most unexpected consequences of the Chinese occupation of Tibet and the subsequent exile of thousands of Tibetans has been the emergence of a new genre of testimonial writing by refugees, the majority of which is written in the English language. The corpus of work within this genre is still relatively small, but growing all the time, and this expansion begs several complex questions, foremost of which is what purpose such writing serves and to whom it is directed. This paper will provide an overview of the progression towards self-expression in modern Tibetan literature, beginning with the ways in which it departs from tradition. It will also profile some of the most prominent Tibetan poets in exile and their views on the function of written testimonies, their efficacy in the Free Tibet movement and their predictions for the genre in the future. Also included will be an account of the author’s attempts to promote personal writing in the exile community of Dharamsala (the home of the His Holiness the Fourteenth Dalai Lama and the site of the Tibetan government in exile). The paper will conclude with a consideration of the possible roles and responsibilities of foreign writers in Tibetan communities in exile through the author’s own efforts to record the stories of Tibetan refugees with limited English language proficiency in a creative testimonial format written from the perspective of an outsider. These elements combined provide a fairly complete summary of the current state of creative self-expression among Tibetans in exile
The Kakawin Sutasoma: A Look at ‘Bhinneka Tunggal Ika’ & Perceptions of the Text’s Religious Implications
Get PDFThis study, to be concise, is an analysis of the religious aspects of the epic Sutasoma. Written in the 14th century CE during the height of the Majapahit Empire of East Java, this kakawin has raised several questions about its religious orientation, messages, and motives; questions, which, given the religious ambiguity of the time, are extremely difficult to answer. The Sutasoma also contains the famous line, “bhinneka tunggal ika,” which, often translated as “unity in diversity,” has since been adopted as the Indonesian national motto. The context and meaning of this passage has also been heavily contested. This study, therefore, is an attempt to contribute to these ongoing debates. By comparing the works of published scholars with the words of a diverse group of Indonesian individuals, this work explores the various interpretations of the story, its characters, and the “bhinneka tunggal ika” passage. Not only does this work examine the subtleties of the religious aspects of the famous story, it also serves to demonstrate that ancient literature, regardless of its distance from the present day, still remains relevant in modernity
Percepciones de la muerte y la espiritualidad cristiana-aymara entre los proveedores del cuidado a los adultos mayores en Putre
Get PDFResearch Question: How does Cristian-Aymaran spirituality influence medical decisions and perceptions of death during the end of life care of Aymaran elders?
Objective: To describe the perceptions of spirituality and death among the providers of end of life care in the commune of Putre in order to determine the role of such beliefs in the medical decisions of Aymaran elders with the goal of improving the methods of care.
Background: Statistically the population of Chile is getting older creating a greater need for end of life care programs. In Putre, specifically, the need for end of life care is particularly prevalent because of the large population of elderly people. The Aymaran culture and faith has a strong presence in the community and in health practices, as do the primary Christian establishments (Catholic, Evangelical, and Pentecostal). Spirituality has been shown to greatly influence the process of dying and perceptions of death among elders. Methods: This was a descriptive study conducted in the town of Putre, Chile during the month of November. Data was collected through a series of semi-structured interviews with providers of end of life care, including biomedical, traditional, spiritual, familiar, and community care givers.
Results: The population of elders in Putre was estimated at 25-30 percent of the population. Most elders are perceived to be healthy and care for themselves and their spouses independently. However, when they do fall ill, most frequently they are required to go to the hospital in Arica and often are not able to return to Putre, whether for health or familiar reason. Moving to Arica was associated with decreased health and faster death. Faith in God and respect for Aymaran spirits both greatly augment the ability of elders to accept death as a natural process, resulting in low rates of death anxiety. Each provider of care focused on a specific aspect of well-being (physical, mental, emotional, social), but all recognized the importance of religious beliefs at the end of life.
Conclusions: In order to attend to the end of life care needs of the elderly population of Putre, respect for the intercultural spiritual beliefs of the Christian-Aymaran majority is required. Additionally, elders prefer to stay in Putre until they die and should be empowered to do so through better health programs and resources in the rural town
American History Content-Based Instruction in China
Get PDFThis project demonstrates materials developed over a three-year period in Chinese international schools for the teaching of U.S. history to ESL learners. It includes an outline for a two-year curriculum with a regular weekly cycle, as well as a close look at strategies and tested activities intended to facilitate understanding of this complex topic and to encourage students to participate beyond passive reception. Specific cultural issues of teaching U.S. history in China are discussed, including issues of ideology and censorship
Cal Poly Study Abroad Program Design for Facilitation of Intercultural Competency
Get PDFIn the field of international education, we strive to assist students in their development through a study abroad experience, by either preparing them to study abroad, by creating intentional reflective practices to allow them to understand what they are learning while abroad and/or supporting them upon return to help them articulate their experiences either to career, academic and/or personal goals.
Specifically, at Cal Poly, San Luis Obispo, they have adopted the philosophy of providing students with an opportunity to learn through direct experience. Cal Poly’s guiding educational philosophy, often referred to as “Learn by Doing”, is one that the Study Abroad Office has attempted to apply when it promotes the study abroad opportunities it offers as “Learn by Going”. If Cal Poly students are to “learn by doing” and the Cal Poly President supports study abroad opportunities and other co-curricular experiences as vehicles for reaching the campus vision and goals, for meeting global challenges and being competitive in a global economy, it follows that there is a need to provide a more holistic support system to all students who study abroad regardless of the type of program they pursue in order for them to understand the knowledge, skills and attitudes they are acquiring from the experience.
This program proposal is designed for Cal Poly students who study abroad as a programmatic and holistic structure that would facilitate students learning’s throughout the study abroad experience (before, during and after) and one that would facilitate the acquisition of intercultural competence. By participating in a program such as the one being proposed, students will be able to identify the specific skills to become interculturally competent, to understand how to work toward the acquisition of those skills and otherwise how to optimize their study abroad experiences. Program goals include (1) Provide a comprehensive program to encourage the development of intercultural competence in students who study abroad. (2) Increase understanding and acceptance of cultural differences in students who study abroad and increase their awareness to their attitudes towards those differences. (3)Provide students who study abroad the opportunity to reflect on and integrate what they have learned from their study abroad experience through interaction with others who have studied abroad. (4) Enable students to connect their study abroad experiences to their current experiences/situations, their campus community and to their future career, academic and personal goals