Public health experts have developed education campaigns based on nutritional messaging to alleviate illnesses related to unhealthy food consumption. This thesis examines cultural factors affecting the accessibility of such messaging, such as economic status, ethnicity, role in the family, access to transportation and markets, and familiarity with the topics of messaging. I explore how these variables affect learning and applying new nutrition knowledge in an individual's daily life. The methods used were semi-structured interviews (n=10) and participant observations conducted in an Integrative Medicine clinic at an urban hospital.

Acupuncture has been used for thousands of years to treat a wide range of diseases, but the mechanisms involved in the process have remained a mystery. The present study measures EEG responses to stimulation of a specific acupuncture point, GB37 (Guang Ming), with two different types of manual needle stimulation. Previous studies stimulated for a maximum of 2 minutes. The present study reflects the normal acupuncture treatment time of 20 minutes, with EEG recordings during and for 10 minutes prior to and after stimulation. Our results show no changes in the global spatial and temporal properties of EEG during and shortly after acupuncture treatment of acupoint GB37. The second part of this study examines the global protein expression of glutamic acid decarboxylase (GAD) knockout mice. GAD is the rate-limiting enzyme in the synthesis of GABA, the major inhibitory neurotransmitter in the brain. The protein content of wild type, hetero-, and homozygous GAD knockout mice brains were determined using a LC-MS-based gel-free shotgun profiling of complex protein mixtures. The data was analyzed using the Raculovic algorithm to determine the proteins differences. A short list of 32 proteins was determined with four that have been shown to be significant proteins that influence cell survival and excitotoxicity in the brain and have potential relationships with GABA. These proteins include VATPase, Glutamine synthetase, Beta-synuclein, and Micortuble associated protein (MAP). The proteomics results provide a preliminary best guess list of proteins influencing GAD and GABA production. / by Michael L. Marshall. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

Atendendo à premissa de expor a vivência do pesquisador em inovação e empreendedorismo, esse trabalho trata-se de um estudo de caso adaptado que teve como objetivo, propor um quadro de modelo de negócios para uma organização de Medicina Integrativa. A proposta do modelo de negócios atendeu um processo proposto por Kolb, onde através da experiência concreta, observação reflexiva e experimentação ativa, conseguiu-se realizar a conceptualização abstrata para um modelo de negócios inovador. Engajando-se na racionalidade médica contemporânea, que busca encontrar um mecanismo de cuidado com o indivíduo por práticas e protocolos que possam ser eficientes e de menor custo, e impulsionado pela experiência profissional e interesse de um investidor, realizou-se uma sequência de ações que pudessem formar um modelo de negócios estruturado e que atendesse um negócio inovador. Foi possível observar que: A) O modelo de negócios mostra-se bastante eficaz para compreender um negócio inovador; B) A Medicina Integrativa é um conjunto de práticas que envolve o cuidado global do indivíduo; C) APor meio do modelo de negócios, é possível proporcionar subsídios para alcançar investidores e, por fim, D) Por meio do modelo de negócios foi possível que o principal stakeholder, o médico proprietário, pôde obter, após a aplicação da ferramenta, novas ideias e insights a respeito de ações imediatas e futuras. Para os outros, a compreensão estabeleceu clareza e direcionamento maior dos objetivos, assim como, possibilitou a definição das responsabilidades e prioridades de cada um. / Given the premise of exposing the experience of research in innovation and entrepreneurship, this work is an appropriate case study that aimed to propose a business model framework for an organization of Integrative Medicine. The proposed business model attended a process proposed by Kolb, which through concrete experience, reflective observation and active experimentation, was managed to achieve the abstract conceptualization to an innovative business model. Engaging in contemporary medical rationality, which seeks to find a care facility with the individual for practices and protocols that may be efficient and lower-cost, driven by experience and interest of an investor, was held a sequence of actions that could form a structured business model and that meets an innovative business. It was observed that: A) The business model is the most effective way to understand an innovative business; B) The Integrative Medicine is undoubtedly the most effective and involves less cost in the overall individual care; C) Through the business model, it is possible to provide subsidies to reach investors and, finally, D) Through the business model it was possible that the main stakeholder, the physician owner could get, after application of the tool, new ideas and insights regarding immediate and future actions. For others, understanding clearly established and greater targeting of objectives, as well as made possible the definition of responsibilities and priorities of each.

Integrative medicine (IM) has organized as a new area of specialization in mainstream healthcare. The development of IM is widely attributed to popular demand for the range of therapies known collectively as Complementary and Alternative Medicine (CAM). During the 1990's the rate of acceptance of CAM accelerated among consumers, professions, financing and education. The Medical Expenditure Panel Survey (MEPS) measured CAM utilization and professional service provision during the years 1996 and 1998, but never since. These surveys were unique because they specifically inquired as to whether CAM was provided by a physician, among other types of professionals. This dissertation defines early integrative medicine (MDCAM) as CAM therapies provided by physicians. Because the MDCAM subpopulation is small, MEPS surveys for 1996 and 1998 were combined (N=39,314) to improve statistical power. The theoretical approach employed Abbott's (1988) theory of a system of professions, in which MDCAM represents a professional strategy of client differentiation through the social boundary mechanism of borrowing (Tilly, 2004) specific CAM therapies to satisfy consumer demand. The utility of the theory of a system of professions is discussed for its ability to decouple conceptual-level claims from observable workplace-level behaviors. Nearly one million Americans received CAM therapies from their physicians during the period, and this professional behavior was found in every region of the country. Services provided by physicians included spiritual healing, massage and acupuncture; national population prevalence estimates are provided. This is meaningful because physicians, at the time, were at risk for disciplinary action for providing CAM. The MDCAM subpopulation was similar to those who used both conventional and CAM services from other professional sources (BOTH), however, MDCAM reported much higher prescription medication use. The demographic profile of MDCAM was more similar to those who consume health care services frequently, compared to infrequent consumers. The MDCAM group is distinguished from those who use BOTH by increased utilization of the following services: nutritional advice, biofeedback and meditation. MDCAM is characterized by diagnoses of chronic illness. MDCAM recipients used mainstream medicine, yet employed disease management services offered by the CAM domain.

Doctor of Philosophy / ABSTRACT Integrative medicine (IM) is a dynamic and increasingly prevalent model of primary health care that combines complementary and alternative medicine with mainstream medicine. This research is about the practice of IM and its value to primary health care in Australia. It locates IM within Australian health care by revealing its processes and outcomes in terms of: practice styles, interactions between practitioners and clients and among practitioners, range of diagnostic and treatment options, and health benefits. In this research I examine the nature of integrative medicine (IM) in co-located primary health care practices and consider the influence that integrating mainstream medicine and CAM can have on the perceived quality of primary health care in Australia. My goal was to contribute the knowledge of the phenomenon of IM through a deeper understanding and interpretation of IM gained by investigating the perceptions of core stakeholders, in this case clients and practitioners of IM. This research was situated in the interpretive paradigm and used two research methodologies: hermeneutics (to interpret the value of IM as reported in the literature) and hermeneutic phenomenology (to understand meanings and significance that clients and practitioners attach to their experiences of IM). Data collection involved the collation of existing literature texts and by cumulative case studies (using semi-structured interviews and observation), focus groups, and key informant interviews. Using a blend of methodologies provided a rich and powerful means of understanding the processes and outcomes of IM through the interpretations of its core stakeholders’ lived experiences. In particular I sought perceptions of clients and practitioners of IM about their health and health care including assessment and treatment options, health outcomes, congruence with beliefs and values, collaborative practices and power sharing. Data analysis was conducted concurrently with and subsequent to data collection so that questioning, observation and textual interpretation were progressively guided by the data. A set of meta-themes emerged from the fusion of findings from all phases of the research. These meta-themes represented answers to key research questions. They are: • Power/authority • Mutual respect • Professionalism • Ontological perspectives • Duty of care. This thesis identifies IM practice styles according to different levels of client agency and degrees of power sharing that exist among CAM and mainstream medical practitioners. A theorised model based on the research findings which depicts quality of health care as a variable consequence of diverse practice styles of IM is produced in two parts: Part 1 acknowledges that IM is a variable phenomenon in practice with different levels of collaboration, power-sharing and quality of health care; Part 2 presents an optimum mode of IM practice. Authentically client-centred health care is at the core of all of these practice styles. This thesis has significant implications for the way IM is practised and for primary health care delivery more broadly. IM that is mutually respectful and genuinely collaborative is flexible, inclusive, and socially relevant and has a substantial and far-reaching contribution to make to the quality of primary health care.

abstract / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Doctor of Philosophy / ABSTRACT Integrative medicine (IM) is a dynamic and increasingly prevalent model of primary health care that combines complementary and alternative medicine with mainstream medicine. This research is about the practice of IM and its value to primary health care in Australia. It locates IM within Australian health care by revealing its processes and outcomes in terms of: practice styles, interactions between practitioners and clients and among practitioners, range of diagnostic and treatment options, and health benefits. In this research I examine the nature of integrative medicine (IM) in co-located primary health care practices and consider the influence that integrating mainstream medicine and CAM can have on the perceived quality of primary health care in Australia. My goal was to contribute the knowledge of the phenomenon of IM through a deeper understanding and interpretation of IM gained by investigating the perceptions of core stakeholders, in this case clients and practitioners of IM. This research was situated in the interpretive paradigm and used two research methodologies: hermeneutics (to interpret the value of IM as reported in the literature) and hermeneutic phenomenology (to understand meanings and significance that clients and practitioners attach to their experiences of IM). Data collection involved the collation of existing literature texts and by cumulative case studies (using semi-structured interviews and observation), focus groups, and key informant interviews. Using a blend of methodologies provided a rich and powerful means of understanding the processes and outcomes of IM through the interpretations of its core stakeholders’ lived experiences. In particular I sought perceptions of clients and practitioners of IM about their health and health care including assessment and treatment options, health outcomes, congruence with beliefs and values, collaborative practices and power sharing. Data analysis was conducted concurrently with and subsequent to data collection so that questioning, observation and textual interpretation were progressively guided by the data. A set of meta-themes emerged from the fusion of findings from all phases of the research. These meta-themes represented answers to key research questions. They are: • Power/authority • Mutual respect • Professionalism • Ontological perspectives • Duty of care. This thesis identifies IM practice styles according to different levels of client agency and degrees of power sharing that exist among CAM and mainstream medical practitioners. A theorised model based on the research findings which depicts quality of health care as a variable consequence of diverse practice styles of IM is produced in two parts: Part 1 acknowledges that IM is a variable phenomenon in practice with different levels of collaboration, power-sharing and quality of health care; Part 2 presents an optimum mode of IM practice. Authentically client-centred health care is at the core of all of these practice styles. This thesis has significant implications for the way IM is practised and for primary health care delivery more broadly. IM that is mutually respectful and genuinely collaborative is flexible, inclusive, and socially relevant and has a substantial and far-reaching contribution to make to the quality of primary health care.

Thesis (Ph. D.)--Ohio State University, 2007. / Full text release at OhioLINK's ETD Center delayed at author's request

Includes bibliographical references and index.

Includes bibliographical references and index.