Bakgrund: En hjärtinfarkt ger en irreversibel ischemisk skada genom ocklusion i koronarkärlen runt hjärtat. I Sverige drabbas årligen ca 24 300 personer av en hjärtinfarkt, av dessa överlever ca 75%. Att genomleva en infarkt kan innebära en stor påverkan för individens livskvalitet och relativa hälsa. Känsla av sammanhang och meningsfullhet (KASAM) har en tydlig förankring i individers livskvalitet. Syfte: Syftet var att undersöka patientens livskvalitet efter en genomlevd hjärtinfarkt. Metod: Den icke-systematiska litteraturöversikten baseras på åtta inkluderade kvantitativa artiklar. Artiklarna identifierades och hämtades i databaserna Cinahl och Pubmed. Kvalitetsgranskning har skett med hjälp av granskningsmall för att identifiera utvalda artiklar. Resultat: Fem kategorier framkom: samhällsfaktorer, psykologiska aspekter, fysiologiska aspekter, återgång till vardagen, upplevelser av livskvalitet. Slutsats: Genom att belysa patienters känsla av sammanhang och meningsfullhet efter en hjärtinfarkt, kan det hjälpa sjuksköterskor att få en förståelse och kunskap i främjande av livskvalitet hos patienter som genomlevt en hjärtinfarkt.

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AN ABSTRACT OF THE DISSERTATION OF Sarah K. Muno for the Doctor of Philosophy degree in Anthropology, presented on September 26, 2018 at Southern Illinois University Carbondale. TITLE: LABOR AND SOCIAL IDENTITY IN ANCIENT PERU: A BIOARCHAEOLOGICAL PERSPECTIVE MAJOR PROFESSOR: Dr. Izumi Shimada This dissertation presents a bioarchaeological study of labor and social identity in coastal Peru during the Late Intermediate Period (900 – 1470 CE), using data from contemporaneous Middle Sicán (Sicán Precinct and El Brujo, north coast) and Ychsma (Pachacamac, central coast) mortuary contexts. I combine information about funerary treatment with skeletal evidence of trauma, degenerative joint disease, and muscle attachment site morphology (enthesial changes or EC) to test whether inferred commoners were “over-worked” relative to their elite counterparts, as often assumed based on western, Marxist notions of social class. Much of what has been inferred about socio-economic organization in coastal Peru during the Late Intermediate Period is modeled after the parcialidades described in early Spanish chronicles and colonial documents. In this system, occupation, social status, and ethnicity were intimately intertwined, with common fishers and farmers serving as the “productive base” for privileged members of society, including full-time artisans and their elite patrons. Archaeological evidence of elite sponsored large-scale labor projects, including specialized craft production, in pre-Hispanic coastal Peru accords well with the parcialidad model, but assumptions about the social identities of laborers often go untested. Human skeletal data offer a unique opportunity to redress this situation, providing information about life experience – including patterns of physical activity – that are not typically accessible with other kinds of archaeological data. Bioarchaeological studies of physical activity hold great promise for testing hypotheses about social identity and life experience in ancient societies, but they are not without some limitation. People who engage in strenuous physical activity tend to have more degenerative joint disease and enthesial changes than those who do not, but the precise mechanisms behind this are not well understood. Age and body size are known to influence these skeletal markers, although some researchers have suggested certain entheses may be less sensitive to size and thus more informative about activity, than others. In my sample, there were no discernible differences in skeletal trauma, degenerative joint disease, or ECs between elites and non-elites, or between males and females, when statistically controlling for the influence of age and/or size. These results do not support the hypotheses that non-elites were over-burdened by arduous labor tasks or that exemption from such tasks was part of the social privileges afforded to elites. Therefore, conventional perspectives that tend to conflate elite and non-elite identities with oppressor/oppressed or manager/laborer roles appear to have little relevance for characterizing the social dynamics of labor organization in Middle Sicán and Ychsma socities. My study supports, at least in part, previous research that argues some entheses are less prone to the influence of size than others, and may therefore be more reliable indicators of activity. In this sample, strong statistical correlations between EC scores, age, and size as determined from three humeral measurements were found for fibrous entheses, but humeral size did not correlate to scores for the fibrocartilaginous type. However, current uncertainties about the precise etiology of enthesial changes makes it difficult to interpret variation in EC scores with a high degree of certainty, and thus my study also highlights some of the drawbacks associated with using EC scores to infer patterns of activity. Experimental research to better understand how the timing, duration, and severity of muscle stress and strain influence enthesial development and technological innovations to quantify enthesial size and shape will be key to resolving these issues in the future.

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The current paper examines the relationship between social support, perceived social status and health in the context of the Hispanic Paradox. It was hypothesized that social support will predict perceived social status which, in turn, is an important factor in predicting physical health among Mexican immigrants. The current paper also hypothesized that stress mediates the relationship between perceived social status and health. Three hundred and twenty male and female Mexican immigrants (ages 18-79) completed questionnaires, wore ambulatory blood pressure monitors for 24 hours, and submitted blood samples. Results supported some, but not most hypotheses. Greater social support was related to higher perceived social status (p = 0.01) and stress mediated two indirect relationships between perceived social status and health outcomes. Specifically, as perceived social status increased calories consumed decreased (p = 0.01) and self-reported health improved (p = 0.02). Still, there were no direct relationships between perceived social status and health outcomes and only two stress mediated relationships. Implications of the results and future directions are addressed. The paper discusses the possibility that higher education and possible variations in degree of acculturation among study participants might have resulted in a unique relationship between perceived social status and health. The paper also addresses the role that a high LDS affiliation among participants might play in the relationship between perceived social status and health of Hispanic immigrants. Finally, the relationship between perceived social status and self-reported health as the study's most consistent finding is discussed.

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This thesis presents the array of evidence concerning three crucial aspects of Roman maternity: pregnancy, childbirth, and primary care-givers. I explore how these elements of maternity are represented in the ancient sources and observe how the evidence corresponds to and diverges from the established impressions of these facets of maternity. I consider several issues surrounding the critical, initial moments of the life-cycle and how they are informed by biological factors, social structures, and cultural projections. Motherhood and childhood at Rome have garnered a great deal of interest, but issues of conception, gestation, childbirth, and early infant care have received much less attention. In this thesis they are considered together and thus in light of one another. The first chapter of this study surveys the social context of Roman maternity through an examination of the purpose of an extensive reproductive period, its associated problems, and the impact that such a practice had on Roman attitudes towards pregnancy and childbirth. The second and third chapters of this study are dedicated to an examination of the social and cultural identity of the two slaves who provided crucial functions throughout the pregnancy, delivery, and post-natal care of the Roman mother and child: the obstetrix (midwife) and the nutrix (wet-nurse). The final chapter shifts the focus from couples who sought to create a Roman family of their own to those who chose to limit the size of their families through contraception, abortion, infanticide, or infant exposure. I examine the attitudes towards these methods of family limitation and the critical role that parental intent had in the formation of these perceptions. By drawing on a range of ancient material, chief among which are medical writers, jurists, and funerary inscriptions, I argue that social status and demographic realities, such as high maternal and infant mortality rates, played equally significant roles in these central aspects of Roman maternity, and indeed influenced one another. / Thesis / Doctor of Philosophy (PhD)

No / Bone collagen carbon and nitrogen stable isotope ratios were obtained from three La Tène period inhumation cemeteries in the Czech Republic (Kutná Hora-Karlov, Radovesice I and Radovesice II) and 16 Hallstatt period inhumations in northern Austria. Results indicate that during the La Tène period in Bohemia, overall diet was based on animal protein and plant foods following the C3 photosynthetic pathway, although ¿13C values for two individuals from Kutná Hora-Karlov indicate at least some contribution from C4 plant foods, most likely millet. At Kutná Hora-Karlov, more positive ¿15N values for male individuals buried with items of iron weaponry indicate the existence of a differential dietary system within the male population based on individual ¿warrior¿ status. A comparison with data from a number of Hallstatt period inhumations in northern Austria and a previously published study of a Hallstatt period site in Slovenia [Murray, M.L., Schoeninger, M.J., 1988. Diet, status, and complex social structure in Iron Age Central Europe: Some contributions from bone chemistry. In: Gibson, D.B., Geselowitz, M.N. (Eds.), Tribe and Polity in Late Prehistoric Europe: Demography, Production and Exchange in the Evolution of Complex Social Systems. Plenum Press, New York, pp. 155¿176] enables an examination of the spread of millet as a major dietary component. This data will be of use to studies of diet in prehistoric Europe and provides evidence for dietary divisions relating to social stratification during the La Tène B¿C, a period often seen as less complex than the preceding Hallstatt period.