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Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

This study is based on analysis of ethnographic literature; personal observation of contemporary spirit dance and healing ceremonies in the Fraser Valley of British Columbia; individual interviews with Coast Salish Indian leaders, ritualists, and other spirit ceremonial participants; and on five years of close contact with the Upper Stalo Indians as physician and regional mental health officer. In the Coast Salish area, the North American Indian guardian spirit complex combined the spirit quest of the Plateau tribes with secret society features of Northwest Coast culture. The suppression of the traditional ceremonial by church and government authorities in the decades following the White intrusion is briefly illustrated, and the history of the recent revival of spirit dancing in the Fraser Valley is reported. Ethnographic evidence is cited to demonstrate that the achievement of altered states of consciousness was an essential aspect of the traditional ceremonial: the spirit encounter took place in such a psychophysiologic state, and the traditional spirit quest and spirit dance initiation involved conditions and techniques identical with, or analogous to, those commonly found in the production of altered states of consciousness elsewhere. The seasonal spirit illness of future spirit dancers in traditional Coast Salish culture was a stereotyped pathomorphic, but not pathologic, prelude to the public exhibition of spirit powers in the dance ceremonial. Today it is often fused with psychic and psychophysiologic symptom formation in the context of cultural and social deprivation, a syndrome which the author describes under the heading of anomic depression. Diagnosis of this condition as spirit illness permits re-identification of an estranged Indian person with the aboriginal culture via initiation into spirit dancing. The author presents contemporary spirit dance initiation as a healing process based on the therapeutic myth of death and rebirth of the neophyte who is made to regress to a state of infantile dependency in order to obtain his spirit power and to grow with it into a more rewarding and healthier existence. Personality depatterning and reorientation towards the ideal norms of Salish culture is achieved through shock treatments and various types of sensory deprivation and stimulation, followed by physical exercise and indoctrination. In contemporary Salish theory and practice, persons suffering from depression, anxiety, and somatic complaints unresponsive to Western methods of treatment, as well as persons with behaviour problems, are candidates for the initiation procedure which implies considerable expenses and some risks. The revived ceremonial provides the local native population with an annual winter treatment programme integrating several types of therapy which are identified and discussed. Preliminary data suggest that, as far as the Indian clientele is concerned, the therapeutic effectiveness of this indigenous Salish treatment compares favourably with Western medical approaches, in conditions of ill health in which psychophysiologic mechanisms are prominent, and with Western correctional management of behaviour disorders associated with alcohol or drug abuse. Analysis of the changes occurring in the traditional ceremonial since the revival of spirit dancing, shows that what in the past was a ritual with psychohygienic aspects is now an organized Indian effort at culture-congenial psychotherapy. In an attempt to define and localize modern Salish spirit dancing as a social phenomenon within proposed classificatory schemata, it is characterized as a redemptive movement aiming at total personality change, with nativistic tendencies towards a collective Indian renaissance. / Arts, Faculty of / Anthropology, Department of / Graduate

Recent studies suggest that folic acid nutritional status may be poor among Canadian Indians, particularly among those living in isolated areas. However the prevalence and causes of folic acid deficiency have not been assessed. The present study was conducted in order to assess the magnitude of the problem among British Columbia Indians and to examine the possible relationship between low dietary intakes of folic acid and the occurrence of low blood folate values. Using a 24-hour diet recall, dietary folate intakes were estimated at four relatively isolated Indian reserves (106 subjects) and at three reserves adjacent to urban centres (144 subjects). A more detailed study, involving estimation of dietary folate intake, measurement of serum and red blood cell folate, and examination of related hematological parameters was undertaken at one isolated reserve (Fort Ware, 28 subjects) and two non-isolated reserves (Necoslie and Sechelt, 63 subjects) as well as at a school residence (70 children, age 6 to 16 years). Meal samples were collected and assayed for folic acid, in order to verify the recall calculations. Results indicate that calculated and assayed folate values are similar and are significantly correlated (r=.9694). Total folate consumption is significantly higher at non-isolated reserves than at isolated reserves, and males consume significantly more folic acid than do females. Dietary folic acid intake is higher at the residence than at the reserves. Serum folate values are significantly correlated with dietary folate intake. Serum values are lower at Fort Ware than at Necoslie and Sechelt. Children living on reserves have lower serum folate values than do children living in residence, and have a larger proportion of children classified as "at risk". On the basis of red cell folate values, 16 to 45% of the subjects at the three reserves are classified as "at risk", however, no evidence of megaloblastic anemia is indicated from the hematological examinations. It is concluded that many individuals are either bordering on or are deficient with respect to folic acid. This appears to be a more serious problem at isolated reserves than at those adjacent to urban centres and it is suggested that this is a consequence of the availability, variety and selection of foods. / Land and Food Systems, Faculty of / Graduate

Over the past 30 years, obesity has increased rapidly as an epidemic and major public health concern in the United Stated, particularly among Native American children and adolescents. Native American adolescents have the highest prevalence rates of obesity of all ethnic groups in the United States. Although there has been an increasing effort to develop and evaluate obesity prevention programs for children and adolescents, very little attention has been devoted to understanding culturally effective approaches for ethnic populations. There is a significant gap in the research literature regarding effective obesity intervention and prevention studies for Native American children and adolescents. The purpose of this study was to explore the impact of a culturally based talking circle approach, KCTC-O, for the prevention of obesity among early adolescent Native American (Keetoowah-Cherokee) and to examine the relationships between Cherokee self-reliance; perceived stress levels; and obesity knowledge, attitudes, and behavior. A 7-week intervention in which a 2-condition quasi-experimental design was implemented to compare the KCTC-O experimental condition with a standard school health education (SE) control condition on three outcome variables (Cherokee self-reliance; perceived stress levels; and obesity knowledge, attitudes, and behavior at pre- and post-intervention. A total sample of 100 participants were recruited for this study, 50 participants per condition. The participants were distributed almost evenly in terms of gender: 55 females compared to 45 males for both groups combined. Participants ranged in ages from 10 to 13, with a mean age of 11.5 years of age, and ranged in grades from 4 through 7, with Grade 6 being the most frequently reported grade in school. The results of this study revealed the effectiveness of the KCTC-O condition was not significantly greater than the SE condition. However, although not statistically significant, the results of this study provided some evidence that a culturally based intervention was slightly more effective for the prevention of obesity than a non-culturally based intervention for Native American early adolescents. This study helps to validate the need for more robust obesity prevention programs from a cultural perspective among Native American early adolescents. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

Exposure to environmental chemicals has been shown to affect health status throughout the life course. Quantifying the joint effect of environmental mixtures over time is crucial to determine optimal intervention timing. Establishing causal relationships from environmental mixture data can be challenging due to various factors, including multicollinearity, complex functional form of exposure-response relationships, and residual unmeasured confounding. These issues can lead to biased estimates of treatment effects and pose significant obstacles in accurately identifying the true relationship between the pollutants and outcome variables. Causal interpretation of longitudinal environmental mixture studies encounters challenges. This dissertation explores the use of causal inference in environmental mixture studies, with a particular emphasis on addressing three key challenges. First, there is currently no statistical approach that allows simultaneous consideration of time-varying confounding, flexible modeling, and variable selection when examining the effect of multiple, correlated, and time-varying exposures. Second, the violation of a critical assumption that underpins all causal inference methods - namely, the absence of unmeasured confounding - poses a significant problem, as models that incorporate multiple environmental exposures may exacerbate the degree of bias depending on the nature of unmeasured confounding. Finally, there is a lack of computational resources that facilitate the application of newly developed causal inference methods for analyzing environmental mixtures. In Chapter 2, we introduce a causal inference method, g-BKMR, which enables to estimate nonlinear, non-additive effects of time-varying exposures and time-varying confounders, while also allowing for variable selection. An extensive simulation study shows that g-BKMR outperforms approaches that rely on correct model specification or do not account for time-dependent confounding, especially when correlation across time-varying exposures is high or the exposure-outcome relationship is nonlinear. We apply g-BKMR to quantify the contribution of metal mixtures to blood glucose in the Strong Heart Study, a prospective cohort study of American Indians. Chapter 3, we address the issue of time-varying unmeasured confounding when estimating time-varying effects of exposure to environmental chemicals. We review the Bayesian g-formula under the assumption of no unmeasured confounding, and then introduce a Bayesian probabilistic sensitivity analysis approach that can account for multiple, potentially time-varying, unmeasured confounders and continuous exposures. Through a simulation study, we demonstrate that the proposed algorithm outperforms the naive method, which fails to consider the influence of confounding. Chapter 4, introduces causalbkmr, a novel R package and can be currently be accessed on Github. causalbkmr is designed to support the implementation of g-BKMR, BKMR Causal Mediation Analysis, and Multiple Imputation BKMR, thereby offering a user-friendly and effective platform for executing these state-of-the-art methods in practice in the context of complex mixtures analysis. While the package bkmr is available, the novel package causalbkmr expands upon bkmr by enabling its application specifically to environmental mixture data within a causal inference framework. The implementation of these novel methodologies within causalbkmr allows for the extraction of causal interpretations, thus enhancing the analytical capabilities provided by the package. Chapter 5 concludes with a discussion and outlines potential future directions for investigation.