Tag Archives: culture

Cognitive Development

“Children are naturally curious” (Kail & Cavanaugh, 2010, p. 98), and that is a good thing. The authors are describing a premise of Piagets theory of childhood cognition development. Piaget’s theory is based stages of adaptive learning and identifies stages associated with key development: infancy, school age, preteen, and adolescence. According to Piaget, in infancy, cognition is very basic and focused on sensorimotor schemes that the child forms based on experiences. As the child ages, Piaget claimed, these schemes become more complex. During school age, children start to form schemes based less on function and more on appearance. Preteens, on the other hand, start to understand emotion, individualism, and relative constructs. Adolescents build upon these relative constructs adding abstract thought processes which continues to build their problem solving skills well into adulthood. Vygotsky’s theory of cultural impact on cognitive development stresses that the individual and the environment are interactive, and this interaction has an impact on learning. Scaffolding, or building on information already known, effectively identifies where instruction is needed. Coupling Piaget’s understanding of cognition development with Vygotsky’s understanding of learning environments, a focused efficiency in teaching could be attained.

As we age, though, physiologic neural processing slows and the brain atrophies (Thibault, Gant, & Landfield, 2007). These changes cause information processing to slow bidirectionally, that is as input and output, and accelerates a functional decline in brain activity as we age. This is not a reversal of development but a systematic failure of physiologic processes. The effects of aging on brain tissue directly effect cognition as neural networks of synapses breakdown. Though this process is inevitable, researchers suggest certain diets and moderate exercise that can mediate the damaging effects of aging on cognition (Bugg & Head, 2009; Gómez-Pinilla, 2008).


Bugg, J. M. & Head, D. (2009). Exercise moderates age-related atrophy of the medial temporal lobe. Neurobiology of Aging. Advance online publication. doi:10.1016/j.neurobiolaging.2009.03.008

Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9, 568-578. doi:10.1038/nrn2421

Kail, R. V. & Cavanaugh, J. C. (2010) Aging: A lifespan view (Laureate custom ed.). Mason, OH: Cengage Learning.

Thibault, O., Gant, J. C., & Landfield, P. W. (2007). Expansion of the calcium hypothesis of brain aging and Alzheimer’s disease: Minding the store. Aging Cell, 6(3), 307-317. doi:10.1111/j.1474-9726.2007.00295.x

Cultural Influences on Health Disparities

Disparities in the availability, access, and delivery of health care are a great and growing concern. Some of the factors leading to disparite health include race, socioeconomic status, and gender (Chen, Martin, & Mattews, 2006). Chen et al. describes how race and socioeconomic status are major factors in the United States, based on the Healthy People 2010 data (U.S. Department of Health and Human Services, 2000). According to the results of this study, our public health efforts seem to be misguided. As the researchers of this study indicate, “race and SES effects on child health are best understood in concert, rather than separately” (p. 705). The differences in race and socioeconomic status are a factor only to White and Black children when looking at prevalence rates for activity limitations and circulatory conditions, as illustrated by Chen et al. in Figures 1 and 2. These figures show that higher education actually has a small but negative effect on the health status of Asians and Hispanics while having a dramatically positive effect on Blacks. Additionally, in Figure 3, Chen et al. show a significant negative effect of education on incidence rates for acute respiratory conditions. There is no significant relationship for the same with regards to Whites or Blacks.

This study shows that there are certainly correlations between race, economic status, and differences in the health status of children in America, but these factors might only be relative. We need to understand if other factors can be identified as causative. In order to explain how Whites and Blacks share correlations while Asians and Hispanics share correlations, we might consider the length of time each population has been exposed to American culture. Whites and Blacks have been in America for over 300 years while Asians and Hispanics have migrated more recently. In addition, there is also evidence of attitude and preference differences for minorities towards health care, though the Institute of Medicine (2002) marginalizes this phenomena in their study.

As a health care provider and regardless of the causes of disparities in health status, it is advisable that I understand these causes so that I may better direct a patient’s care with a holistic understanding of the patient.


Chen, E., Martin, A. D., & Matthews, K. A. (2006). Understanding health disparities: The role of race and socioeconomic status in children’s health. American Journal of Public Health, 96, 702-708. doi:10.2105/AJPH.2004.048124

Institute of Medicine. (2002). Unequal treatment: What healthcare providers need to know about racial and ethnic disparities in health. Retrieved from http://www.nap.edu/html/unequal_treatment/reportbrief.pdf

U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health. Washington, DC: Author.

Immunization and Infectious Disease Mitigation

Cultural Models of Immunization and Infectious Disease Mitigation

The members of some communities, such as Puerto Rico, do not understand the scope and severity of some infectious diseases until they become infected (Pérez-Guerra, Zielinski-Gutierrez, Vargas-Torres, & Clark, 2009). The lack of a basic understanding of illness and infection poses a roadblock to mitigating disease transmission within the community. For Pérez-Guerra et al., the perception of severity and mitigation is important as they investigate the difference in attitudes towards dengue infections because dengue cannot be controlled by vaccine and must be mitigated by community participation in mosquito abatement activities. Other infectious diseases, however, can be controlled by vaccine, but efforts to limit infection are met with ignorance or misconceptions (Lau, Griffiths, Choi, & Tsui, 2010; Leask, Sheikh-Mohammed, MacIntyre, Leask, & Wood, 2006).

Public health officials, in concert with community leaders, should seek to educate affected communities about the infectious diseases they face along with effective mitigation strategies and the importance of vaccination, if available. Coreil (2010) describes the importance of cultural models in “[gaining] a deeper understanding of the cultural context of behavior” (p. 83). If behaviors are not understood, then it will be difficult to redirect them. Reaching out to community leaders has the added effect of allowing the leaders to alter the message just enough so that it might be effectively communicated to the community.

Providing a cultural health model allows for a larger scope of audience while effectively tailoring the message so that most of the target audience will appreciate the nature of the message. Approaching health behaviors from a cultural stand-point also offers the advantage of allowing peer support to propagate messages through out the community. This might be especially true when dealing with a multitude of subcultures where the message might better be disseminated via interpersonal means. Eventually, the message will be received by many individuals who will begin to have discussions with others in the community. For communities where individuals are not likely to speak to each other regarding personal health-related matters, the cultural health model allows a general message to reach each individual.


Coreil, J. (Ed.). (2010). Social and behavioral foundations of public health (2nd ed.). Thousand Oaks, CA: Sage.

Lau, J. T. F., Griffiths, S., Choi, K. C., & Tsui, H. Y. (2010). Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infectious Diseases, 10(139), 1-13. doi:10.1186/1471-2334-10-139

Leask, J., Sheikh-Mohammed, M., MacIntyre, C. R., Leask, A., & Wood, N. J. (2006). Community perceptions about infectious disease risk posed by new arrivals: A qualitative study. The Medical Journal of Australia, 185(11/12), 591-593. Retrieved from http://www.mja.com.au/public/issues/185_11_041206/lea10999_fm.pdf

Pérez-Guerra, C. L., Zielinski-Gutierrez, E., Vargas-Torres, D., & Clark, G. G. (2009). Community beliefs and practices about dengue in Puerto Rico. Pan American Journal of Public Health, 25(3), 218-226. doi:10.1590/S1020-49892009000300005

Living Longer and Happier Lives

As we age, we tend to question our mortality and how much longer we have left to live. Not that we can do much about this in order to extend our lives by this time, but if we question our health earlier, we may be able to affect positive change in order to have a longer and more productive quality of life. Dan Buettner (National Public Radio [NPR], 2008; TED, 2009) discusses how difficult it can be to control the effects of aging, but he also offers some options based on his observations of what are termed blue zones. Blue zones are geographic and cultural areas of the where people tend to live longer and healthier lives.

Buettner (NPR, 2008; TED, 2009) describes simple measures that can contribute to increasing a productive life. More importantly, he has uncovered what they do not do. The people who live in these blue zones, according to Buettner, do not tend to take daily supplements, pills, or extracts. Instead, continuous and simple movement for exercise coupled with a sensible cultural diet seems to have the biggest impact.

One of the observations that I have made over the years is that as physical movement declines, physical and emotional strength wane. For example, an otherwise healthy 70 year old woman who accidentally falls and breaks her hip decreases her life expectancy drastically unless physical rehabilitation is utilized to regain her activity level (Keene, Parker, & Pryor, 1993; Lyons, 1997). It is vitally important to maintain a healthy level of activity throughout life.

Diet is very important. Buettner (NPR, 2008; TED, 2009) credits adding nuts to the diet for an average increase of three years of life. The way in which our bodies use energy is very important, and we must supply it with a fuel that is efficient. A wholesome diet, I believe, is the best diet, especially if divided by five or more meals a day.

We cannot have a conversation about improving overall health without addressing some of the unhealthy vices that we tend to indulge in. Instead of outlining each and every thing that is detrimental to our health, I will say that moderation should be the way to combat the effects of vices. We need to enjoy life, and I feel that the mere enjoyment leads to a longer and healthier life; therefore, to strictly limit indulgences would seem to be counter-productive. Moderation should certainly be the way in which to address these issues.

We all want to live longer and healthier lives, but genetics does play a role. There are some aspects of our lifestyle that we are finding that we can change for the better, and the alternatives are not that bad. So long as we live healthy lives, we can enjoy life more completely.


Keene, G. S., Parker, M. J., & Pryor, G. A. (1993). Mortality and morbidity after hip fractures. British Medical Journal, 307, 1248-1250. doi:10.1136/bmj.307.6914.1248

Lyons, A. R. (1997). Clinical outcomes and treatment of hip fractures. American Journal of Medicine, 103(2), S51-S64. doi:10.1016/S0002-9343(97)90027-9

National Public Radio (Producer). (2008, June 8). Can ‘blue zones’ help turn back the biological clock? [Audio podcast]. Retrieved from http://www.npr.org/templates/story/story.php?storyId=91285403&from=mobile

TED (Producer). (2009, September). Dan Buettner: How to live to be 100+ [Web Video]. Retrieved from http://www.ted.com/talks/dan_buettner_how_to_live_to_be_100.html

Naming ceremony

As Knauft (2010) described, before seven months old, “a human spirit is not thought to be completely rooted in their bodies, and they aren’t even given a name” (p.39). This naming ceremony practice reminds me of the ausa vatni of the Old Norse cultures when infants were only named after inspection and acceptance of the father, giving the child the rights and inheritances of the family (Ward, n.d.). Through the ausa vatni, the child was protected under the law of murder; otherwise, the child could be abandoned and left to die without recourse. The differences between the Gebusi and the Norse, though, are obvious. In my culture, infanticide is surely taboo. In fact, my family cherishes the entire process of bearing a child and bringing a new life into the world. In stark contrast to both the Gebusi and the Norse, we tend to name our children very early, even before birth. Some of our children have even gained nicknames prior to birth.

It is difficult to objectively experience the beliefs and rituals of other cultures when they are by design emotively raw. The taboo of our society is important for us to understand for our acceptance and longevity within our own culture. As we learn to vilify practices that are not condoned within our society, we develop a visceral response when these practices are witnessed. It is understandable, but it is not helpful to juxtapose one culture with our own, subjectively, when we are attempting to understand more about it. The visceral reaction will certainly prove detrimental to our experience in creating a judgment versus creating an understanding. Perhaps this is the same reason that human cultures have abhorred other cultures throughout human existence.


Knauft, B. (2010). The Gebusi: Lives transformed in a rainforest world (2nd ed.). New York, NY: McGraw-Hill.

Ward, C. (n.d.). Old Norse names. The Viking Answer Lady. Retrieved from http://www.vikinganswerlady.com/ONNames.shtml

Conversations in the Back of the Ambulance

MS: So, we have about a half-hour ride to the other hospital. Would you be willing to help me out with a project for my anthropology class?

AP: Sure, we’ve been having quite a conversation so far.

MS: Okay, for the record and because of medical privacy concerns I will acknowledge your participation with the initials AP for Anonymous Participant. Also, I have to make sure that I note the generational differences between us.

AP: Well, that shouldn’t be too hard to do.

MS: No, certainly not. For documentation sake, let us say that you are in your 70’s, and we can leave it at that.

AP: I’m closer to eighty, though?!

MS: Wow, can’t even do a guy a favor!

AP: HA! So, what are these questions? I imagine it’s how to pick up the ladies, right?

MS: Yeah, sure, let’s start there! Actually, I wanted to ask more about your views growing up. Politics, religion, et cetera.

AP: Well, let’s start with religion. I think that will be the easiest.

MS: Okay, religion.

AP: Well, let’s see… I grew up in a fairly Protestant family. I mean, we went to church every Sunday and all, but we were never overly religious.

MS: Would you say that you were tolerant of other religions, or did you view your religion as the true religion of your god?

AP: Oh, no! We were very tolerant. We would never look down on anyone else because of their beliefs, especially their religious ties. The only problems that I have ever had with people were, well, the neighborly scuff – whose fence is on whose property – and, of course, mechanics. $1000 to install a $25 part… highway robbery for sure! And, I am sure I won’t like you too much after I get your bill!

MS: Obama will take of that, though, right? Actually, I do want to talk about your political views here in a minute, but let’s keep on religion for now. Do you think your views of religion have changed much over the years?

AP: Well, that’s tough to say. I’m pretty old, and I know that I’m gonna die pretty soon. It makes you think, you know? I mean, I know I want to make sure that I get a chance to tell the kids and the grandkids how proud I am of them, and I pray to God every day that I will get that chance. They all live in different States, so it’s tough to get them all together, lately. But, I find myself talking to God a lot more these days, but I am not sure if I believe in Him any more than I used to, as an adult, I mean. As a kid, he’s like Santa Claus or the Tooth-fairy; you believe in Him for no other reason than you were told to.

MS: Yeah, that’s kinda where I’ve been. I can understand that there might be a consciousness that is ultimately responsible for our creation, but I am not sure if I believe he knows what exactly he has created. Accidental or otherwise, we do exist, and it would only make sense that something put this in motion. Maybe I’m a theist, but mostly I don’t think about it. I’m usually agnostic or atheistic. Perhaps, I’m an agnostic theist?!

AP: Well, when you get as old as me, you want to make sure you are on the good-boy list.

MS: That’s Santa?!

AP: Close enough.

MS: Alright, let’s talk politics. I’ll keep it simple at first. George Washington, good or bad?

AP: Good, no great! He was a great man, Washington.

MS: Tyler?

AP: Who?

MS: Abraham Lincoln?

AP: Great!

MS: Wilson?

AP: What? Woodrow Wilson? Ungh… That was an evil man. Let me tell you about Wilson. Wilson is why this country is the way it is. I imagine that others before him wanted to do some of the things that he did, but sheesh, Wilson was the one that got it done. And, done, indeed, it is.

MS: What was so bad about Wilson?

AP: Have you ever heard of the Great Depression? That was Wilson’s work, there. Yeah, it happened a few years after he died, but the framework was his alone. Who were those other two guys? They came after Wilson…. I can’t think.

MS: Harding and Coolidge?

AP: That’s them. I remember my father telling me that if it weren’t for those two, Hoover wouldn’t have had a chance. Hoover was actually in office during the start of it, the depression. Lucky for me, I don’t remember it. In fact, don’t remember him. I think the first President that I can remember was F.D.R. He was the war President. As far as I recall, though, I think Hoover just ran with the Wilson plan, killing everything Harding and Coolidge did to fix the problems.

MS: So, I’m guessing you are a Conservative? A Republican, perhaps?

AP: I remember waving the flag for Roosevelt, so I guess I was a Democrat, then, you know, at twelve years old, or however old I was then… probably more like nine or ten. But, as I got older, especially from the time the war ended, I started paying attention to politics. I’ll tell you, it makes not one lick of difference if the guy is black, brown, yellow or white; if he’s a politician, he’s both a liar and a thief! We have had very few politicians that were honorable men, very few. And, these Progressives, well, they are the worst of them. This Obama is one of them.

MS: Yes, I believe Obama is a self-proclaimed Progressive.

AP: And, it shows. Wilson was a Progressive. Too many of them are. And, they don’t tell you! That’s the worst of them. They tell you what you want to hear, you elect them, then they do this about-face and spend, spend, spend us into oblivion. Looking back, this is certainly not my father’s country anymore. Ford was good, though. He never gets any recognition.

MS: So, Ford, good; Wilson, bad. Is that right?

AP: Yup!

MS: Interesting. I’m going to have to read up on Ford a bit more. You mentioned something about race a minute ago: “Brown, black, yellow, white”, something. What are your views on race relations in the United States?

AP: Oh, no… You aren’t gonna like me much after this conversation, but I’ll be honest. I always try to be honest.

MS: Okay, Ben Franklin, let me have it.

AP: Ha! Well, I can honestly… heh, honest… say that I have no problem doing business or maintaining friendships with anyone of any race, nationality, or creed. The problem that I have is the laziness and the sense of entitlement that many people have today. Fifty years ago, you didn’t see that, not like today, anyway. It’s just unfortunate that the minorities tend to have this attitude, this air of you’re not better than me, so give me money so I don’t have to work.

MS: Ahh, so the Progressives rear their ugly heads once again!

AP: Exactly! And, that’s what I was talking about. It’s this idea that if we give them money, they will use it to rise up and overcome poverty or something. Almost magical thoughts of levitation, if you will. One day, they will learn that if you keep giving people stuff, there will come a time when they forget how to earn it. Same with me. I’m sure that if the government sent me a check every week for not working, at some point, I would become complacent and not work. I doubt it, but it is possible I guess.

MS: Is it the government’s place to give out all of these entitlements?

AP: Again, I’m old, but I’ve made a pretty decent living for myself over the years. Medicare is a horrible system, but between that and my other insurance, at least you’ll get paid!

MS: Well, I’m not too worried about that. You sign my form, and that’s all I care about for payment. We have people!

AP: Yeah, tough guys always have people. But, community… community and family is what we need to get back to. That used to be enough. Granted, there were times that were really tough, especially for my family when I was born and right before. We had tough times, but we got through them. We were smart about it. We trusted that it couldn’t last too long, and it never did.

MS: Well, one thing that I’ve noticed is the propensity of my generation to move away from family. I think we rely on the internet for communication and planes, trains, and automobiles to visit from time to time.

AP: Well, we had a farm. When the family has a farm, you help run it. Actually, I think it was the farm that kept our heads above water all those years.

MS: I always wanted a farm. Is it still in the family?

AP: Nah. None of the kids wanted to keep it up. It is hard work running that farm, but we sold it off, paid our debts, and invested the rest. Pretty much been living on that after we retired.

MS: So, what was life like on the farm? I mean, family life specifically.

AP: Well, our farm was a part-time venture, so to speak. I would wake up, do some chores, have breakfast, go to work, come home, do some chores, eat dinner, do some chores, go to bed, and repeat. Don’t get me wrong, I enjoyed the hell out of it. The kids helped out when they were old enough, but the wife kept the whole ship running smooth. If it weren’t for her… well, let’s just say I wouldn’t still be here.

MS: Television and movies about years ago seemed to marginalize women. The wives cooked, cleaned, did the laundry, had babies… you’re laughing?

AP: My wife cooked, cleaned, did the laundry, had babies, sure, but I cooked, I cleaned, I did laundry, and I was very involved in the raising of our children. Don’t let those programs fool you. Family was family. We did it all. In fact, we both left for work at about the same time, though she would get home sooner than me. She only worked around the corner.

MS: You are describing a very concerted effort at keeping house and home.

AP: If you find a young woman to love, you take good care of her, and she will take good care of you. I remember a few guys that would mistreat their ladies, but back then, well, back then, we took care of things like that. Times get tough, but don’t mistreat your lady.

MS: Speaking of your wife, she said that she would meet us up here. So, I should give her all the respect in the world?

AP: Anything less, and I’ll smack you one!

MS: It seems chivalry ain’t dead!

AP: Not as long as I’m around, and I ain’t going anywhere, yet!

MS: No, it seems that you will be around to cause her grief for a little while longer, at least, but not with me. It seems like we’ve arrived. It was absolutely great hearing your story. I am honored. Is there anything that you would like to add?

AP: Yeah, tell the driver not to hit so many bumps next time!

MS: He’ll be opening the doors here in a minute. You can tell him yourself. Thank you again.

AP: Anytime, but next time, come by the house. I don’t need another ambulance bill!

MS: Understood.

As a paramedic, I enjoy many benefits. The single best benefit is certainly the ability to meet new people and talk to them. For this assignment, I felt it best to rely on the random nature of my job to gain the perspective of someone I have never met before. There are limitations, though, to this method of choosing a potential informant for this interview. Paramedics are bound by confidentiality, and though the informant granted express permission to use his words and his story, I could not ask him to waive his rights under the Health Insurance Portability and Accountability Act (1996). I felt that the limitation was not an undue hardship, and the benefits of gaining such a random perspective far outweighed the benefits of identification of the informant.

The informant that I interviewed was a 70-something year-old gentleman who was more than eager to share his story with someone so interested in listening. The most important discovery of the entire interview was that we all have interesting life lessons to share. If only more people would stop to listen, important lessons could be taught.

It is very important to note that this interview was conducted during a time when the informants mortality was in question. I feel that this opportunity is unique in the honesty and conviction of the responses to my questions. We started the interview by talking about religion.

The informant and I feel that we have quite the same religious background and beliefs (personal communication, June 2010). When I approached the topic of religious tolerance, he seemed to be more cognizant of character and overall morals separate from specific religious practices. This thought reinforced some of my core beliefs about the human condition, about how we are moral creatures.

Discussing politics gave me some real insight into how earlier Americans might have viewed the progressive versus conservative debate originally (Anonymous, personal communication, June 2010). I am sure that the informant is not an exemplar of all twentieth century American political thought, but he was able to draw some parallels with the current political environment. Tough times arise and people tend to get nervous about economic survival. It is easy to conceive that an incomplete understanding of politics and economics fuels the debate on both sides of the issues.

From politics, we moved on to discuss his view of race relations in the United States. Interestingly, it seems as though my informant might have been resigned to accept that he might have some racist tendencies until I asked him his thoughts and understanding of race (personal communication, June 2010). It turns out that he was slightly mistaken. My informant realized, during our conversation, that it was not racial differences that he was upset about but a general lack of motivation seen in many people over the years. It is just an unfortunate twist that he associated this laziness with racial stereotypes. Though we changed the subject quite abruptly, I could sense a rebuilding of his understanding of racial differences. It was good to see such a thing take place.

Family was strong throughout my informants life (personal communication, June 2010). Whether we were speaking of being raised by post-depression era parents or farm life with his own family, there was always cooperation to make the family structure work. I took exceptional notice during this portion of the interview. In the contemporary United States, I have noticed a disintegration of family and community. In childhood, I recognized the meaningfulness of family bonds and community spirit. I wonder how this changed. My informant describes a time that was not particularly easy on him or his wife, but they remained loyal to each other and to the family, specifically. Today, it outwardly appears to makes more sense for some to seek a better alternative at the first hint of difficulty or trouble. This is not what family means to either of us, and I am glad to see an example of how things work out pleasantly in the end.

Our interview ended with a particularly entertaining joke about him protecting his wife from any irresponsible comments that I might make (Anonymous, personal communication, June 2010). I am sure that he did not feel that he had to actually protect her from me, but I think he felt that he needed to make me understand how much he cared for his wife. Man to man, an idle threat seems to convey a universal understanding between men, whether serious or joking. I am glad to have witnessed this show of strength. I am sure that he is contemplating the fact that he will not be around much longer. I hope that he understands that he would leave his wife with good people in the world. I believe that this discussion was the impetus for my patient to realize that the world outside of [his neighborhood] is not a hostile or unfriendly world. I also think he realized that he will not be here forever, and his wife will be taken care of by the community that he supported for so long. I am glad to be a part of that community.


Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, §1177, 110 Stat. 2029 (1996).

Creation (Revelations of Genesis)

Beginning the week anew, I still search for the meaning of indigenous identity and how it might apply to me. This week allows me to search, not only my ancestry, but my cultural beliefs in the Creation. If only I believed in the Creation as taught to me in my childhood, the biblical teachings, I could describe the wondrous event that first saw mankind on Earth. Alas, I have grown an independent and scientific mind, and I not only question the existence of a god, but with boldness I question my own existence. This is a very philosophical question for me, and while it is not so important to the comparison of cultural beliefs, per se, that I describe my unwillingness to believe the story that I was told as a child, it is important to me that this distinction be made.

As a child, I was taught a simplistic variation of the Book of Genesis from the King James version of the Christian Bible. The allegory tells of a god, personified, who creates a man, Adam, from dust and a woman, Eve, from Adam’s rib. Unfortunately, after being told this story, I spent a great amount of time and energy convincing my fellow disciples that, in deed, men and women have the same number of ribs. Further reading reveals the story describes a human ascent into an age of agriculture where respect of and responsibility to the land are of great import (Dalley, 1998; Langdon, 1915). I fear that the oversimplification of such a beautiful tale of our coming of age led to its diminished significance.

The Jewish faithful, who share the Genesis story with Christians, celebrate Rosh Hashanah, a feast to celebrate the creation of Adam and his female companion on the sixth day (Leviticus 23:24). Christians, on the other hand, celebrate Easter at about the same time; some with the fervor of the pagan civilizations that celebrated Easter originally before the indoctrination of the Catholic Church. Many of the same traditions and rituals used to celebrate fertility are done during the vernal equinox. This is seen widely during the Spring season. Pardoe (2006) tells of the origins of one of the most peculiar traditions of a Christian celebration: the Easter bunny. Carried to the United States by the German and Dutch immigrants involved a bunny delivering eggs to boys and girls. The story tells of the goddess granting the easter bunny the ability to lay eggs once a year because the bunny was upset after being transformed from a bird. The Easter bunny particularly missed laying eggs and flying, so during the vernal celebrations of the creation of life, The Easter bunny laid colored eggs and hid them in nests designed by children. The Easter bunny was also granted flight as the constellation Lepus through Autumn and Winter.

However, as my family is a fair-minded and clever clan, the biblical description of our origins was juxtaposed with the tellings of science. It is this scientific belief that I will present in comparison to the religious tale.

The theory of evolution and natural selection as researched and published by Darwin (1859) was presented to me at a very early age. Darwin’s theory, in conjunction with many others before and during his time, believed that we as humans exist in the contemporary manner solely on the basis of a series of changes and adaptations that promoted our growth and dominance of our environment. Arguably, no one can say with any certainty how life came to exist from non-life, but Darwin’s research offers a path from just beyond that singularity to the present explaining all life on Earth.

The biblical story of the Creation seems to disagree with science if read without understanding. A closer look, though, tells of man entering into an era when he can use intelligence above cunning and strength over force. Darwin (1859) tells of a process of biological adaptation while the biblical Genesis story imparts the importance of using the mind and body to promote mankind while considering our place on the Earth. Science, however, is not celebrated with grand ritual in the likes of religion. As I was brought up with both stories, I am impartial to neither. Both stories, I feel, are valuable contributions to contemporary life (in the grander scheme of our existence).


Dalley, S. (1998). Myths from Mesopotamia: Creation, the flood, Gilgamesh, and others. New York, NY: Oxford.

Darwin, C. (1859). On the origin of species (Sixth ed.) [Adobe Portable Document Format version]. Retrieved from http://www.netlibrary.com/Reader/

Langdon, S. (1915). Sumerian epic of paradise, the flood and the fall of man. Philadelphia, PA: The University of Philadelphia Museum.

Pardoe, E. (2006, April 11). A look at Easter symbolism and the holiday’s pagan roots. Retrieved from http://www.associatedcontent.com/article/27142/a_look_at_easter_symbolism_ and_the.html?cat=74

Making the Strange Familiar – A Cultural Identity

Scouring the literature in an attempt to define indigenous identity as it relates to me has been futile. Weaver (2001) describes the difficulty of obtaining a consensus on the definition of indigenous identity and how to apply the term. She continues to outline her frustration and finally gives in to using less exact terms. Corntassel (2003) shows how a multitude of definitions has arisen that are both incomplete and politicized. Neither Weaver nor Corntassel nor any of the other scholars that I have read in the past two weeks would agree, based on their writings, that I would have some indigenous identity. It seems that this would otherwise offend them. It is obvious, however, that I have a cultural identity as do all people, but I fail to see myself as indigenous, so I will concentrate on this cultural identity using the fieldwork methods outlined by Omohundro (2008).

My cultural identity is, in part, related to my ancestry, or genealogy. As far as I can tell, my ancestry is a combination of Italian, French, English, German, Irish, Scottish, and Portuguese, though living New England, specifically around Boston, Providence, and New York, I have more of an affinity to my Irish and Italian heritage. However, it does appear that I share my English heritage with nobility of Queen Catherine’s privy court, Sir John Alexander Webb, and William Shakespeare.

Developing as a child in my household, I have learned a few ideals that have more import and others: loyalty, character, and resolution. Honesty, temperance, and justice I have learned on my own, or more evidently from my environment growing up. Much of this wisdom of our forefathers is still evident in and around Rhode Island, thankfully. Understanding why my ancestors migrated as they did certainly underscores the importance of freedom, liberty, and tolerance.

The ethnosemantics of Rhode Islanders can be quite intriguing to outsiders. I am not sure that I have ever met anyone who enjoyed the dandle as much as my cousins and I. Others, though, would have used a see-saw or teeter-totter. Likewise, I remember looking forward to enjoying a cabinet on a hot summer day with my grinder. Others might have enjoyed a milkshake with their submarine sandwich, hoagie, or hero. It seems that we stole the terms bubbler and soda from Wisconsinites as they moved to the area as my ancestors did. A bubbler being a water fountain and soda refers to any carbonated beverage.

Even more interesting than our vocabulary, though, is our pronunciation. Traveling around the country, I have noticed that when residents of other States hear an accent, they usually just comment on it. For the typical Rhode Islander, we are made to repeat ourselves often. Sometimes people truly do not understand our vernacular, but mostly it is for the novelty of it all. Rhode Islanders seem to remove the letter ‘r’ from words and place them in words that do not have any. Additionally, we run many words together unnecessarily. For example, “A Rhod’aylindah would flip a breakah if the lights’n out an’ say suntin’ like ‘I’ve an idear… let’s getindacah’n go fe’ bananar splits wit vanillar ice cream,’” or my favorite, “Immunna gessin gaggahs, djeetjet?” This question would usually be replied with, “No, joo?” More obvious, the first set of statements refers to resetting a circuit breaker after losing power then taking a ride in the car to get a banana split. The second, more cryptic, phrasing simply translates, “I am going to get some gaggers (or, hot weiners; see also http://www.olneyvillenewyorksystem.com), did you eat yet?” The reply being, “No, did you?” We tend to ask even if we know the answer.

As our strange vocabulary and pronunciation are very colloquial, I think I might understand how it has developed. Rhode Island has always been known for tolerance, both religious and political; therefore, the heritage has always been a rich mixture of various cultures attempting to flee from various types of oppression. My assumption is that much of the dialect and vocabulary is simply based on misunderstanding and ethnosemantic distortions of the multiple cultures residing at any given time in Rhode Island, a pidgin. I may be mistaken, but the thesis seems viable.

Understanding my cultural identity allows me to view the world and other cultures with temperance and acceptance. My heritage is rich with both culture and despotism. Likely, many other people have a similar story. Most important in understanding cultural identity is the ability to benchmark one’s self against society. Doing so allows me the ability to focus on the moral strengths that I have learned while attempting to temper the weaknesses. With a more complete understanding, I am able to justify the life lessons that I might pass on to others.


Corntassel, J. J. (2003). Who is indigenous? ‘Peoplehood’ and ethnonationalist approaches to rearticulating indigenous identity. Nationalism and Ethnic Politics, 9(1), 75-100. doi:10.1080/13537110412331301365

Omohundro, J. T. (2008). Thinking like an anthropologist: A practical introduction to cultural anthropology. New York, NY: McGraw Hill.

Weaver, H. N. (2001). Indigenous identity: What is it and who really has it? The American Indian Quarterly, 25(2), 240-255. doi:10.1353/aiq.2001.0030

Patient Safety Considerations for EMS

 In the out-of-hospital emergency care setting, patient safety is paramount. Initially, victims of trauma or illness are already suffering in an uncontrolled environment. It is this same environment where first responders, emergency medical technicians, and paramedics must operate to stabilize and transport the victim to the hospital, a more controlled environment. Unfortunately, there is little research in the area of patient safety in this setting (Meisel, Hargarten, & Vernick, 2008; Paris & O’Conner, 2008).


Focusing on patient safety and developing processes to ensure optimal safety would allow the study of inherently dangerous, yet potentially beneficial therapies, such as rapid sequence intubation where the clinician uses a series of medications to rapidly sedate and paralyze a critical patient for ease of inserting a breathing tube. Focusing on safety, an EMS department in Maryland successfully instituted such a program (Sullivan, King, Rosenbaum, & Smith, 2010).

With more research in this area, the Emergency Medical Services (EMS) can improve the care they seek to deliver to their patients.


There are many challenges facing EMS as they seek to deliver safe and effective care to their patients. Motor vehicle accidents (including air transportation accidents), dropped patients, medication and dosage errors, other inappropriate care, and assessment errors all contribute to the number of adverse events in the EMS out-of-hospital care setting (Meisel et al., 2008). Unfortunately, it has proved difficult to identify both the existence and the cause of each event (Meisel et al., 2008; Paris et al., 2008). Additionally, there are adverse events that are impossible to track, such as the iatrogenic exposure to a pathogen. It would be very difficult to distinguish how and when a patient was first exposed to the infecting pathogen without considering community-acquired infections and hospital-acquired infections, which are both equally difficult to ascertain (Taigman, 2007).

Strategies for improvement

As EMS seeks to increase the professionalism among its ranks, the stakeholders must acknowledge responsibility for providing evidence-based processes to ensure patient safety.


Meisel, Z. F., Hargarten, S., & Vernick, J. (2008, October). Addressing prehospital patient safety using the science of injury prevention and control.Prehospital Emergency Care, 12(4), 4-14.

Paris, P. M. & O’Connor, R. E. (2008, January). A national center for EMS provider and patient safety: helping EMS providers help us. Prehospital Emergency Care, 12(1), 92-94.

Sullivan, R. J., King, B. D., Rosenbaum, R. A., & Shiuh, T. (2010, January). RSI: the first two years. One agency’s experience implementing an RSI protocol. EMS Magazine, 39(1), 34-51.

Taigman, M. (2007, July). We don’t mean to hurt patients. EMS Magazine, 52(4), 36-42.

Freedom vs. Health Care Reform

In the United States, we believe in individual rights, some of which are enumerated in the U. S. Constitution. The right to health care is not one of these. As our country prospers or declines, we may amend our Constitution to ensure more rights or take them away. The question, now, is can we afford health care for all? At this moment, I believe we cannot. Other countries have attempted to provide health care for all of its citizens but are facing economic troubles in spite of 70% tax rates (Clark & Dilnot, 2002). I believe that high tax rates are dangerous to the economy because the people and the government compete in mobilizing the economy; whereas with lower tax rates, the small businesses can drive the economy (U.S. Small Business Administration, Office of Advocacy, 2006).

It is my experience that those who overutilize health care are those who are under-insured (e.g. Medicare and Medicaid) and uneducated about the health care system. Further, it seems that the underpayment of costs by the Medicare and Medicaid programs are driving up the recoverable costs to other payors (Brennan & Mello, 2009). This is why I believe that our health care system is as expensive and inefficient as it is. “The U.S. health care system also spends more on administrative or overhead costs related to health care,” says Garber and Skinner (2008, p. 32), but they attribute this to administrative waste where I conclude that the over-administration is needed to meet the demands of an over-regulated and inefficient payment system.

In conclusion, our health care system is linked to our economy, and improving the economy is the only way to ensure that our health care system improves. By adding entitlements, we are forcing the American people to minimize their financial growth and, thereby, their financial freedom to choose affordable health care.


Brennan, T. A. & Mello, M. M. (2009). Incremental health care reform. Journal of the American Medical Association, 301(17), 1814-1816. doi:10.1001/jama.2009.610

Clark, T. & Dilnot, A. (2002). Long-term trends in British taxation and spending (IFS Briefing Note No. 25). London, UK: The Institute for Fiscal Studies. Retrieved from http://www.ifs.org.uk/bns/bn25.pdf

Garber, A. M. & Skinner, J. (2008). Is American health care uniquely inefficient? Journal of Economic Perspective, 22(4), 27–50. doi:10.1257/jep.22.4.27.

U.S. Small Business Administration, Office of Advocacy. (2006, September 28). Small business drives the U.S. economy — represent 99.7 percent of all businesses, employ 57.4 million (SBA No. 06-17 ADVO). Retrieved from http://www.sba.gov/advo/press/06-17.html