- Browse by Subject
Browsing by Subject "Marginalization"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item The impact of social determinants of health on management of stage I non-small cell lung cancer(Elsevier, 2022-06) Namburi, Niharika; Timsina, Lava; Ninad, Nehal; Ceppa, DuyKhanh; Birdas, Thomas; Surgery, School of MedicineBACKGROUND: Social Determinants of Health (SDOH) can be important contributors in health care outcomes. We hypothesized that certain SDOH independently impact the management and outcomes of stage I Non-Small Cell Lung Cancer (NSCLC). STUDY DESIGN: Patients with clinical stage I NSCLC were identified from the National Cancer Database. The impact of SDOH factors on utilization of surgery, perioperative outcomes and overall survival were examined, both in bivariate and multivariable analyses. RESULTS: A total of 236,140 patients were identified. In multivariate analysis, SDOH marginalization were associated with less frequent use of surgery, lower 5-year survival and, in surgical patients, more frequent use of open surgery and lower 90-day postoperative survival. CONCLUSION: SDOH disparities have a significant impact in the management and outcomes of stage I NSCLC. We identified SDOH patient groups particularly impacted by such disparities, in which higher utilization of surgery and minimally invasive approaches may lead to improved outcomes.Item The lived experience of women affected wtih matted hair in southwestern India(2014) Dhaske, Govind Ganpati; Adamek, Margaret E.; Sugawara, Carmen Luca; Rosario, José R.; Vernon, Robert, 1947-Descriptions about the matting of hair given by medical practitioners show a significant commonality indicating it as a historic health problem prevalent across the globe, however with less clarity about its etiopathogenesis. In southwestern India, the emergence of matting of hair is considered a deific phenomenon; consequently, people worship the emerged matted hair and restrict its removal. Superstitious beliefs impose a ritualistic lifestyle on affected women depriving them of health and well-being, further leading to stigma, social isolation, and marginalization. For unmarried females, the matting of hair can result in dedication to the coercive devadasi custom whereby women end up marrying a god or goddess. To date, the state, academia, and disciplines such as medicine and psychology have paid far too little attention to the social, cultural, and health concerns of the women affected by matted hair. A Heideggerian interpretive phenomenological study was conducted to document the lived experience of women affected by the phenomenon of matting of hair. The subjective accounts of 13 jata-affected women selected through purposive sampling were documented to understand their health and human rights marginalization through harmful cultural practices surrounding matting of hair. Seven distinct thematic areas emerged from the study exemplified their lived experience as jata-affected women. The prevalent gender-based inequity revealed substantial vulnerability of women to health and human rights marginalization through harmful cultural practices. The ontological structure of the lived experience of matting of hair highlighted the unreflective internalization of religious-based discourse of matting of hair. The hermeneutic exploration revealed events that exemplified jata-affected women’s compromised religiosity, and control of their well-being, human development, and ontological security. The religious-based interpretation of matting of hair and associated practices marginalize the health and human rights of affected women through family members, institutions, society, and religious-based systems. The study demonstrates the need for collaborative, evidence-based interventions and for effective domestic as well as global policies to prevent the health and human rights violations of women through cultural practices. The study offered foundational evidential documentation of the phenomenon of matting of hair as a harmful cultural practice that compromises women’s right to health and well-being.