<p> The substance 3,4-methylenedioxymethamphetamine (a.k.a., MDMA, Ecstasy, Molly, Midomafetamine) is currently listed by the Food and Drug Administration as a breakthrough therapy for post traumatic stress disorder. The drug however remains a Schedule I controlled substance in the United States, and is listed in the top four most frequently used recreational drugs. Use by young people in social venues like all night dance parties (raves) and clubs around the world is widely documented, but evidence suggests that an increasing demographic of users is older adults (over age 27). Research is lacking about how this growing demographic uses MDMA and how assumptions of illegal/deviant models of drug use may or may not apply. Several decades of research on MDMA produced three primary models of use: the psycho-spiritual model, medical/psychotherapeutic model, and the illegal/deviant model. Each model of use is socially constructed along certain epistemological assumptions about users and the sought after outcome or effects of the drug. It is currently unclear which model of use older demographics of users fit within or if an entirely new model of use is needed to understand evolving trends. The current grounded theory investigation used snowball sampling methods to recruit adult participants who actively use MDMA in privacy with their committed partner. Semi-structured interviews were used to explore eight couples&rsquo; experiences using MDMA with their partner. Transcripts were analyzed with an iterative process of open and focused coding, followed by member checking. Major themes reported by couples include <i> a different reason to relate to each other, serving me in so many ways, added depth to relationship and practice returning to MDMA experience</i>. Together, themes from this study support a cognitive-relational model of recreational MDMA use, that is best described as a process that involves acquisition of knowledge, rational thinking, reasoning, and collaboration about ingesting MDMA together, all based on the expectation of durable change to their relationship together and other relationships in their lives. This investigation provides a critical lens for uncovering epistemological assumptions of other models, and provides a pathway for research into the use of medicines and drugs in the context of committed relationships.</p><p>

<p>This dissertation presents the results of ethnographic research conducted between September 2006 -August 2007 at Emeritus University; a large, multidisciplinary institution of natural medicine in the United States. Since its inception in 1978, Emeritus University has emphasized an integrated model of medicine and collaboration between practitioners of natural medicine and their allopathic counterparts. By focusing upon curriculum change and the process of learning among first year students in the Master of Science in Acupuncture and Oriental Medicine (AOM) program, I explore the ways in which increasing emphasis upon integration with biomedical models of education, practice, and research influences the AOM curriculum, the professional values inculcated within first year AOM students, and their sense of professional identity and position within the US medical landscape. In addition, this research elucidates how the interests, goals, and decisions of first year students shape and influence the curriculum and the identity of AOM. My research was informed by critical medical anthropology, which situates schools of medical education, and the experiences of individual students, within the historical and political structures of medical pluralism, state regulation, professionalization, biomedical dominance, and the capitalistic world system.</p> <p>This research contributes to our knowledge of the evolution of a complementary/alternative medicine (CAM) modality within the US, the roles played by a school of CAM in the transformation of AOM's identity; the socialization of students and the process of learning; the role of agency; and the implications of integration for the identity of AOM, its practitioners, and health care in the United States. Emeritus University's emphasis upon integration has resulted in an increasingly standardized and biomedically based curriculum. While participants perceived such changes to be part of the 'Americanization' of AOM, from the perspective of critical medical anthropology, integration has serious implications for the identity of AOM and its practitioners. Far from advancing the critique of Biomedicine and the medical system embodied by the holistic and alternative health movements of the 1960's and 70's, Emeritus University may serve to replicate the hegemony of Biomedicine, underscore the primacy of its practitioners, and pave the way towards co-optation of acupuncture and Oriental medicine in the United States.</p> / Thesis / Doctor of Philosophy (PhD)

Anthropometry can be used in certain circumstances to facilitate comparison of a photograph of a suspect with the potential offender portrayed in video surveillance crime footage. Anthropometry does not have the same success rate in identification as DNA or fingerprinting. However, these types of evidence are not always left at crime scenes. Sometimes the only evidence available relating to an offence is from surveillance videos and research was needed to lend credence to anthropometry as a viable method of identification. An alternative method of detecting individuals from surveillance video, morphology, was also investigated to determine its accuracy in confirming the identity of individuals based on facial descriptions and for use as a comparison tool in forensic identification. Pilot Laboratory Study: A number of different techniques are employed in facial image comparison of living persons. In this study, the effect of rotation on angles and proportions between selected facial landmarks is evaluated as a first step to assess whether facial anthropometry could be usefully applied to facial image comparison. The faces of five volunteers were photographed in the Frankfort plane at different angles of rotation from 0º (frontal) to 90º (side view), rotating every 10º both clockwise and counter-clockwise. Four landmarks were used: right and left ectocanthions, nasion, and stomion. The proportions of the measurements between these landmarks were calculated as well as the angles created by the lines connecting the same landmarks. The results show a consistent and predictable variation between the five subjects. With rotation, the greatest variation is seen where horizontal landmark connecting lines are combined with the ectocanthion/stomion or nasion/stomion lines. There is less variation in the proportions for vertical and diagonally orientated landmark connecting lines. In principle, the data from these empirical measurements could also be used to develop a photogrammetric model of the face which, if calibrated, could be used to correct anthropometric measurements for distortions caused by a camera angle which differs from the one specified in a protocol for facial comparison. The purpose of developing such a model would lie in its use to calculate correction factors to convert observed proportions and angles back to the full-face orientation values, which could then, for example, be used to search a database of the proportions. Investigation of Uncertainty of Anthropometric Measurements: The objective of this study was to estimate the uncertainty in the measurements of the chosen facial proportions caused by landmark placement and by operators taking photographs, including the uncertainty contributions resulting from different people performing these tasks. The aim of this was to simulate effects found in the real world, as there would be different operators both placing landmarks and taking suspect photographs in various police departments. In addition, this study was completed in order to address variables encountered in the Pilot Laboratory Study that occurred as a result of the experimental set up. The first section of the study reviewed the errors involved in measuring facial proportions as a result of variations in landmark placement. Intra and inter-operator studies in landmark placement were conducted and as expected the average and range of coefficients of variation for the set of proportions were larger in the inter-operator error than that obtained in the intra-operator error. The second section of the study reviewed the errors in measuring facial proportions as a result of the process of taking photographs. The lowest variation in facial measurements was seen in the series of photographs taken of a single subject by a single operator and in general, the lowest variation in facial measurements was seen at 45° and the highest variation at 20°. The contributions of errors from landmark placement and photography were determined to produce an overall estimated uncertainty of 5%. When a comparison of 2D images is conducted in this manner this estimation of uncertainty should be taken into account. Anthropometry Study: An existing database of video and photograhic images was examined, which had previously been used in a psychological research project with the aim to test the hypothesis: “Using a comparison of anthropometric facial proportions, it is possible to discriminate between individuals of two samples.” Material avaliable consisted of 80 video (Sample 1) and 119 photograhic (Sample 2) images and were of high resolution, though taken with different cameras. A set of 37 anthropometric landmarks were placed measuring 59 proportions to conduct within sample and between sample comparisons using the following calculations; mean absolute value between proportions, Eulcidean distance and Cosine θ distance between proportions. First, the statistics of the two samples were examined to determine which calculation best ascertained if there were any differences between faces which fall under the same conditions. Subsequent to a between sample, the removal of up to 50% of the lowest variant proportions along with the determination of a subsample of faces requiring human verification were tested. Relative frequency distribution histograms were created from the data and the normal histogram curves of true positive and true negative faces were superimposed to determine their separation rate and how likley it may be to mix up the two categories of faces. Presented results showed that the Cosine θ distance equation using Z-normalized values was the preferred equation because it achieved the largest separation between true positive and true negative faces. Results also indicated that there was no benefit to removing up to 50% of the lowest variant proportions in the comparison of Sample 1 against Sample 2. Finally, applying the Cosine θ distance equation allowed a decrease to five database images to be verified by a human in approximately 75% of the cases tested. Morphology study: A morphological analysis was conducted on high resolution images and although highly relevant to the process of facial identification did not contribute to the continuity of the thesis and thus was included as an Appendix. The morphological analysis was performed on a total of 199 images: 119 photographs and 80 images from video using a checklist of 20 facial characteristics. Each facial characteristic had numerous choices in which it could be described. Once the analysis on all 199 images was carried out, a comparison was conducted between each video (unknown) image and the database of 199 (known) images. In the research conducted, only 2.5% of the comparisons showed a true positive match between video and photograph with zero false positives in the group. Subsequent to analysis it was determined not possible to differentiate between individuals, however, when looking directly at the individuals’ photographs, it is clear that there were differentiating characteristics amongst them. Conclusions: After embarking upon a series of anthropometrical investigations using high resolution images to compare video images with photographic images, it was concluded that anthropometry, when used as a comparison method of identification, does not generate the results necessary for use as evidence in a court of law. Identifying individuals based on a morphological analysis of a check list of features alone also did not result in clear consistent identifications. If descriptions of facial characteristics are to be fully utilized, a side by side comparison is likely to be less subjective. This outcome was as expected and provides additional insights into forensic morphological research.

Thesis (Ph. D.)--Dept. of Community Medicine, University of Adelaide, 1992. / Typescript (Photocopy). Includes bibliographical references (leaves 307-320).

Curanderismo is a holistic form of traditional medicine primarily used by Latin American populations and Hispanic communities in the United States. This type of care focuses on several aspects of health including physical, emotional and spiritual (supernatural). Hispanics are the largest ethnic minority population in the United States and yet healthcare access to this population remains limited by various barriers including lack of insurance, legal status, language, poverty, and other structural factors. Within this context, exploring the perceptions and role of traditional medicine, like curanderismo, as a form of healthcare becomes crucial in understanding and addressing the unique healthcare needs of diverse populations. This research uses the ethnographic method of semi-structured interviews contextualized with participant observations to explore the views and experiences of Hispanic young adults on curanderismo, in efforts to understand how Hispanic individuals perceive and navigate their health care choices while retaining aspects of their cultural background. My findings indicate that the term “curanderismo” does not accurately represent how Hispanic young adults in the United States identify the practices associated with curanderismo. I argue that there are stigmas associated with curanderismo that reflect structural barriers to care that contribute to healthcare disparities within the Hispanic community and further argue that elder female figures have a significant influence on the continuation of curanderismo among Hispanic young adults.

Esta pesquisa retrata uma experiência etnográfica sobre o consumo de medicamentos antidepressivos e ansiolíticos fornecidos por uma farmácia pública aos moradores de uma área formada por três bairros da cidade de Ribeirão Preto-SP. Esta área era formada por casas populares, casas luxuosas e por uma favela, sendo coberta pela Estratégia de Saúde da Família, com a exceção de uma parte das casas populares, a qual era formado pelas casas COHAB (Companhia Habitacional). O bairro com as casas luxuosas foi incluído somente na observação participante e na fotografia. Os motivos do consumo destes medicamentos, investigados com entrevistas abertas, observação participante, diário de campo e fotografia, são justificados através de uma remodelação e reorganização de espaços entre os moradores destes bairros, marcados por desigualdades sociais, de gênero e pela busca de diferenciação, numa hierarquia classificada entre o ideal e o indesejado através do curso de vida dos moradores. A seleção dos entrevistados foi realizada a partir dos dados da dispensação dos medicamentos psicoativos pela farmácia pública fornecedora, a qual também estava incluída na experiência etnográfica, tendo sido a dispensação dos medicamentos incluída na observação participante. O consumo de medicamentos psicoativos foi analisado a partir da ótica de seus consumidores, revelando que estariam contribuindo para perpetuar os papéis sociais frente à dinâmica social, como os relacionados ao gênero e à classe social. A pesquisa revela uma associação entre vida cotidiana e consumo de medicamentos psicoativos, destoante de um produzir saúde, esperado da relação entre serviços de saúde e população, e de uma associação entre doença e uso de medicamentos. Aprofundar questões sociais sobre o consumo de medicamentos em grupos populares poderá evitar seu uso abusivo com a função de produzir um corpo explorado quimicamente por se estender seus limites de produção, aprofundando e silenciando desigualdades sociais. O consumo de medicamentos psicoativos deve ser analisado com cautela, devendo seu consumo ser problematizado. / This research shows an ethnographic experience on the use of antidepressant and anxiolytic medicines provided by a public pharmacy to the residents of an area formed by three sectors of the city of Ribeirão Preto-SP. This area was formed by popular houses, luxury houses and a shantytown, and covered by the Family Health Strategy, with the exception of part of the popular houses, wich was formed by COHAB houses (Housing Company). The neighborhood with luxury houses was included only in a participant observation and in the photograph. The reasons for the use of the medecines, investigated with open interview, participant oservation, a field diary and photograph, are justified through a remodeling and recognization of space between the residents of these neigborhoods, marked by social inequality, gender and the search for differentiation, in a classified hierarchy between the ideal and unwanted y the life´s course of residents. The selection of interviewees was made from the data of the dispensing of psychoactive medicines by the provider public pharmacy, wich was also included in the etnographic experience, having been dispensing of medicines included in participant observation. The use of psychoactive medicines has been examined from the perspective of their consumers, revealing that they were helping to perpetuate social roles in the social dynamicsrelated to gender and social class. The research shows an association between daily life and use of psychoactive medicines, diverging from the production of health, which is waited in the relashionship between health services and population, and diverging from assocition between illness and medication use. Deepening social issues on the consumption of medecines in popular groups may prevent their abuse with the function of producing a body explored chemically because it has extended their limits of production, deepening and keeping quiet the social inequalities. The consumption of psychoactive medecines should be examined with caution, their consumption should be problematized

Esta pesquisa retrata uma experiência etnográfica sobre o consumo de medicamentos antidepressivos e ansiolíticos fornecidos por uma farmácia pública aos moradores de uma área formada por três bairros da cidade de Ribeirão Preto-SP. Esta área era formada por casas populares, casas luxuosas e por uma favela, sendo coberta pela Estratégia de Saúde da Família, com a exceção de uma parte das casas populares, a qual era formado pelas casas COHAB (Companhia Habitacional). O bairro com as casas luxuosas foi incluído somente na observação participante e na fotografia. Os motivos do consumo destes medicamentos, investigados com entrevistas abertas, observação participante, diário de campo e fotografia, são justificados através de uma remodelação e reorganização de espaços entre os moradores destes bairros, marcados por desigualdades sociais, de gênero e pela busca de diferenciação, numa hierarquia classificada entre o ideal e o indesejado através do curso de vida dos moradores. A seleção dos entrevistados foi realizada a partir dos dados da dispensação dos medicamentos psicoativos pela farmácia pública fornecedora, a qual também estava incluída na experiência etnográfica, tendo sido a dispensação dos medicamentos incluída na observação participante. O consumo de medicamentos psicoativos foi analisado a partir da ótica de seus consumidores, revelando que estariam contribuindo para perpetuar os papéis sociais frente à dinâmica social, como os relacionados ao gênero e à classe social. A pesquisa revela uma associação entre vida cotidiana e consumo de medicamentos psicoativos, destoante de um produzir saúde, esperado da relação entre serviços de saúde e população, e de uma associação entre doença e uso de medicamentos. Aprofundar questões sociais sobre o consumo de medicamentos em grupos populares poderá evitar seu uso abusivo com a função de produzir um corpo explorado quimicamente por se estender seus limites de produção, aprofundando e silenciando desigualdades sociais. O consumo de medicamentos psicoativos deve ser analisado com cautela, devendo seu consumo ser problematizado. / This research shows an ethnographic experience on the use of antidepressant and anxiolytic medicines provided by a public pharmacy to the residents of an area formed by three sectors of the city of Ribeirão Preto-SP. This area was formed by popular houses, luxury houses and a shantytown, and covered by the Family Health Strategy, with the exception of part of the popular houses, wich was formed by COHAB houses (Housing Company). The neighborhood with luxury houses was included only in a participant observation and in the photograph. The reasons for the use of the medecines, investigated with open interview, participant oservation, a field diary and photograph, are justified through a remodeling and recognization of space between the residents of these neigborhoods, marked by social inequality, gender and the search for differentiation, in a classified hierarchy between the ideal and unwanted y the life´s course of residents. The selection of interviewees was made from the data of the dispensing of psychoactive medicines by the provider public pharmacy, wich was also included in the etnographic experience, having been dispensing of medicines included in participant observation. The use of psychoactive medicines has been examined from the perspective of their consumers, revealing that they were helping to perpetuate social roles in the social dynamicsrelated to gender and social class. The research shows an association between daily life and use of psychoactive medicines, diverging from the production of health, which is waited in the relashionship between health services and population, and diverging from assocition between illness and medication use. Deepening social issues on the consumption of medecines in popular groups may prevent their abuse with the function of producing a body explored chemically because it has extended their limits of production, deepening and keeping quiet the social inequalities. The consumption of psychoactive medecines should be examined with caution, their consumption should be problematized

O trabalho focaliza as controvérsias que se seguem ao evento da epidemia de cóleramorbus deflagrada na província de Pernambuco no ano de 1855, em torno de práticas e terapias que foram mobilizadas no combate à moléstia. O fio condutor da análise são os embates que se estabeleceram entre a medicina acadêmica e outras formas terapêuticas - particularmente de homeopatas, leigos, negros e índios. Adicionalmente, o trabalho procura pontos de intersecção entre a emergência de um projeto moderno de medicina e a religião, acompanhando a reflexão e a prática produzidas pelos missionários capuchinhos italianos sobre a epidemia. / The work focuses on the controversy following the event of the epidemic of choleramorbus triggered in the province of Pernambuco in the year 1855, around practices and therapies that have been mobilized to fight the disease. The guiding thread of the analysis are the shocks that have been established between academic medicine and other therapeutic methods - particularly of homeopaths, lay people, blacks and indians. Additionally, the work searches points of intersection between the emergence of a modern project of medicine and religion, accompanying the reflection and practice produced by italian capuchin missionaries on the epidemic.

O trabalho focaliza as controvérsias que se seguem ao evento da epidemia de cóleramorbus deflagrada na província de Pernambuco no ano de 1855, em torno de práticas e terapias que foram mobilizadas no combate à moléstia. O fio condutor da análise são os embates que se estabeleceram entre a medicina acadêmica e outras formas terapêuticas - particularmente de homeopatas, leigos, negros e índios. Adicionalmente, o trabalho procura pontos de intersecção entre a emergência de um projeto moderno de medicina e a religião, acompanhando a reflexão e a prática produzidas pelos missionários capuchinhos italianos sobre a epidemia. / The work focuses on the controversy following the event of the epidemic of choleramorbus triggered in the province of Pernambuco in the year 1855, around practices and therapies that have been mobilized to fight the disease. The guiding thread of the analysis are the shocks that have been established between academic medicine and other therapeutic methods - particularly of homeopaths, lay people, blacks and indians. Additionally, the work searches points of intersection between the emergence of a modern project of medicine and religion, accompanying the reflection and practice produced by italian capuchin missionaries on the epidemic.