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Bates BR, Carrasco-Tenezaca M, Mendez-Trivino AM, Mendoza LE, Nieto-Sanchez C, Baus EG, Grijalva MJ. Identifying Barriers and Facilitators for Home Reconstruction for Prevention of Chagas Disease: An Interview Study in Rural Loja Province, Ecuador. Trop Med Infect Dis 2023; 8:tropicalmed8040228. [PMID: 37104353 PMCID: PMC10140971 DOI: 10.3390/tropicalmed8040228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Chagas disease (CD) is a tropical parasitic disease spread by triatomine bugs, which are bugs that tend to infest precarious housing in rural and impoverished areas. Reducing exposure to the bugs, and thus the parasite they can carry, is essential to preventing CD in these areas. One promising long-term sustainable solution is to reconstruct precarious houses. Implementing home reconstruction requires an understanding of how householders construct barriers and facilitators they might encounter when considering whether to rebuild their homes. METHODS To understand barriers and facilitators to home reconstruction, we performed in-depth qualitative interviews with 33 residents of Canton Calvas, Loja, Ecuador, a high-risk endemic region. Thematic analysis was used to identify these barriers and facilitators. RESULTS The thematic analysis identified three facilitators (project facilitators, social facilitators, and economic facilitators) and two major barriers (low personal economy and extensive deterioration of existing homes). CONCLUSIONS The study findings provide important loci for assisting community members and for agents of change in home reconstruction projects to prevent CD. Specifically, the project and social facilitators suggest that collective community efforts (minga) are more likely to support home reconstruction intentions than individualist efforts, while the barriers suggest that addressing structural issues of economy and affordability are necessary.
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Affiliation(s)
- Benjamin R Bates
- School of Communication Studies, Ohio University, Athens, OH 45701, USA
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Center for International Studies, Ohio University, Athens, OH 45701, USA
- Centro de Investigación para la Salud en America Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito 170530, Ecuador
| | - Majo Carrasco-Tenezaca
- Centro de Investigación para la Salud en America Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito 170530, Ecuador
| | - Angela M Mendez-Trivino
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Center for International Studies, Ohio University, Athens, OH 45701, USA
| | - Luis E Mendoza
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Center for International Studies, Ohio University, Athens, OH 45701, USA
| | - Claudia Nieto-Sanchez
- Centro de Investigación para la Salud en America Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito 170530, Ecuador
- Socio-Ecological Health Research Unit, Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Esteban G Baus
- Centro de Investigación para la Salud en America Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito 170530, Ecuador
| | - Mario J Grijalva
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Center for International Studies, Ohio University, Athens, OH 45701, USA
- Centro de Investigación para la Salud en America Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito 170530, Ecuador
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Souvannasacd E, Engblom H, Van Eck RN, Renger R, Basson M. Lessons learned in evaluating system interdependencies using qualitative methods. Eval J Australas 2022; 22:108-125. [PMID: 36051982 PMCID: PMC9431899 DOI: 10.1177/1035719x211066961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article shares lessons learned while evaluating the system interdependencies for a clinical and translational research centre (CTR). It explores the methodological challenge of discussing system concepts (e.g., cascading failures, feedback loops, and reflex arcs) with layperson participants during evaluation interviews. The article discusses the iterative process of moving from structured interview approaches in favor of an open narrative approach for data collection and lessons learned.
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Affiliation(s)
| | | | | | | | - Marc Basson
- The University of North Dakota, School of Medicine and Health Sciences, Grand Forks, ND, United States
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Abstract
The refusal of blood products by Jehovah's Witness patients has provoked court proceedings, social science research, and contemporary fiction, all of which emphasize a seemingly intractable conflict between religious and secular ways of being. This article takes a different approach, focusing instead on the space that Witness patients have carved out for their accommodation in a major pediatric research hospital. Using discourse analysis and interview data, I map the way moralizing discourses surrounding Witness families have shifted over the past 70 years alongside advancements in bloodless medicine. I argue that Witnesses have helped to enable their present accommodation and recognition by marshaling particular forms of economic, human, and social capital, and consider whether their success might be attainable by other treatment-resisting patient groups. Thus, this article explores the shifting limits of multicultural accommodation and the conditions that make understanding, collaboration, and compromise possible.
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Affiliation(s)
- Carey DeMichelis
- 1 Applied Psychology and Human Development, Joint Centre for Bioethics, University of Toronto. Toronto, Ontario, Canada
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Soejarto DD, Gyllenhaal C, Kadushin MR, Southavong B, Sydara K, Bouamanivong S, Xaiveu M, Zhang HJ, Franzblau SG, Tan GT, Pezzuto JM, Riley MC, Elkington BG, Waller DP. An ethnobotanical survey of medicinal plants of Laos toward the discovery of bioactive compounds as potential candidates for pharmaceutical development. Pharm Biol 2012; 50:42-60. [PMID: 22136442 PMCID: PMC3534868 DOI: 10.3109/13880209.2011.619700] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
CONTEXT An ethnobotany-based approach in the selection of raw plant materials to study was implemented. OBJECTIVE To acquire raw plant materials using ethnobotanical field interviews as starting point to discover new bioactive compounds from medicinal plants of the Lao People's Democratic Republic. METHODS Using semi-structured field interviews with healers in the Lao PDR, plant samples were collected, extracted, and bio-assayed to detect bioactivity against cancer, HIV/AIDS, TB, malaria. Plant species demonstrating activity were recollected and the extracts subjected to a bioassay-guided isolation protocol to isolate and identify the active compounds. RESULTS Field interviews with 118 healers in 15 of 17 provinces of Lao PDR yielded 753 collections (573 species) with 955 plant samples. Of these 955, 50 extracts demonstrated activity in the anticancer, 10 in the anti-HIV, 30 in the anti-TB, and 52 in the antimalarial assay. Recollection of actives followed by bioassay-guided isolation processes yielded a series of new and known in vitro-active anticancer and antimalarial compounds from 5 species. DISCUSSION Laos has a rich biodiversity, harboring an estimated 8000-11,000 species of plants. In a country highly dependent on traditional medicine for its primary health care, this rich plant diversity serves as a major source of their medication. CONCLUSIONS Ethnobotanical survey has demonstrated the richness of plant-based traditional medicine of Lao PDR, taxonomically and therapeutically. Biological assays of extracts of half of the 955 samples followed by in-depth studies of a number of actives have yielded a series of new bioactive compounds against the diseases of cancer and malaria.
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Affiliation(s)
- D D Soejarto
- Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Fortin AH, Haeseler FD, Angoff N, Cariaga-Lo L, Ellman MS, Vasquez L, Bridger L. Teaching pre-clinical medical students an integrated approach to medical interviewing: half-day workshops using actors. J Gen Intern Med 2002; 17:704-8. [PMID: 12220367 PMCID: PMC1495097 DOI: 10.1046/j.1525-1497.2002.00628.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Teaching medical students to integrate patient-centered skills into the medical interview is challenging. Longitudinal training requires significant curricular and faculty time. Unsupervised students risk harm if they uncover and inappropriately manage psychosocial issues in actual patients. They fear saying the wrong thing in emotionally charged situations. Two half-day workshops for pre-clinical students integrate patient- and physician-centered interviewing. The first occurs early in the first year. The second, late in the second year, presents interview challenges (e.g., breaking bad news). Ten professional actors portray standardized patients (SPs). Groups of 10 to 15 students interview an SP, each eliciting a part of the patient's story. Qualitative evaluation revealed that, for many students, SPs afford the opportunity to experiment without harming real patients. Students view the workshops as effective (mean score for first-year students, 6.6 [standard deviation (SD), 1.0], second-year students, 7.1 [SD, 0.7] on a Likert-type scale: 1 = not at all effective to 8 = very effective).
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Affiliation(s)
- Auguste H Fortin
- Department of Medicine, Office of Education, Yale University School of Medicine, New Haven, CT 06721, USA.
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