Western Medical Systems Research Articles

Western versus African Medical Knowledge Systems

Epistemička osnova zbilje, naročito znanje Zapada, često se opisuje kao opće i time kao dano, dok se oblici koji ne odgovaraju paradigmi Zapada izazivaju i odbacuju kao inferiorni i nevrijedni znanstvene analize. Retoriku zapadnog vs. ne¬zapadnog znanja, naročito u okviru afričke tradicije, čini se da karakterizira patronistička sugestija da je ne-zapadno znanje inferiorno sistemima zapadne racionalnosti. Ta je retorika i ideološka orijentacija duboko ukorijenjena u akademski diskurs kada je u pitanju proizvodnja znanja i alata. Nastanila se u zapadnjačko obrazovanje i ostala dominantna stoljećima. Podtekstualna pretpostavka takvog diskursa nepotkrijepljena je jer se zasniva na znanstvenoj tradiciji koja je antagonistička prema drugačijim oblicima znanja. U ovom radu argumentiramo da je prava razlika između zapadnog i afričkog sustava medicinskog znanja ne toliko u rezultatima, koliko u epistemičkoj osnovi koja ih oblikuje. Tvrdimo da su svi oblici znanja kontingentni prema specifičnim kontekstima te evaluacijski kriterij dizajniran da vrednuje njihovu univerzalnu istinu nema korisnu funkciju osim promicanja lažnog hegemonijskog narativa s jedinom svrhom da dominira i eksploatira. Zaključujemo tako što zagovaramo proširenje glavnog medicinskog znanja istraživanjem drugih oblika epistemologije, bez predrasuda

History and Future of the Korean Medical Education System

Western medicine was first introduced to Korea by Christian missionaries and then by the Japanese in the late 19th century without its historical, philosophical, cultural, social, political, and economic values being communicated. Specifically, during the Japanese colonial era, only ideologically ‘degenerated’ medicine was taught to Koreans and the main orthodox stream of medicine was inaccessible. Hence, Korean medical education not only focuses on basic and clinical medicine, but also inherited hierarchical discrimination and structural violence. After Korea’s liberation from Japan and the Korean war, the Korean medical education system was predominantly influenced by Americans and the Western medical education system was adopted by Korea beginning in the 1980s. During this time, ethical problems arose in Korean medical society and highlighted a need for medical humanities education to address them. For Korean medical students who are notably lacking humanistic and social culture, medical humanities education should be emphasized in the curriculum. In the Fourth Industrial Revolution, human physicians may only be distinguishable from robot physicians by ethical consciousness; consequentially, the Korean government should invest more of its public funds to develop and establish a medical humanities program in medical colleges. Such an improved medical education system in Korea is expected to foster talented physicians who are also respectable people.

Beyond the rational choice: The social dynamics of the changing nature of the rural people's health concept

Culture creates an exclusive prototype of the beliefs and perceptions as to what “health” or “illness” actually means. Health culture is the basis for health-seeking and health-promoting behavior. There are institutional arrangements within which heath behavior occurs and the impacts of socioeconomic, political, and physical background for their specific health beliefs and health institutions counts a lot. Further, this prototype of beliefs mainly influences how symptoms are documented, to what they are accredited, and how they are interpreted and how it also affects how and when modern traditional health services are sought by the people. Cultural differences in the recognition and interpretation of symptoms and in the use of health services are the topic of wealthy literature. This paper is based on the author's fieldwork experiences in different occasions about the various cultural aspects of the rural health-care issues in southern Karnataka, India. The fieldwork was done in certain rural parts of Karnataka, South India, using participant observation and data also synthesized using content analysis technique. It concludes that cultural differences among the rural people seeking health care are related to the social structures and relationships and the quantity of belief/disbelief in concerning traditional or Western medical care system. We found that the impediment in seeking suitable and timely health care were indifferently found among the individuals belonging to the various sociocultural groups characterized by the cultural exceptionality and customary and family authority.

How Do New Immigrant Families (African Continent) with a Child with Sickle Cell Disease (SCD) Experience the Western Medical System?

INTRODUCTIONNew immigrant families from continental Africa account for an increasing proportion of pediatric patients with Sickle Cell Disease (SCD) in Canada and North America. As families enter the western medical system they face a myriad of tests and medications as well they encounter language barriers, endless forms and large teams. Previous experiences with healthcare also influence families' expectations and adjustment.There is no published data exploring the experiences of these families to help guide practice. Resources such as the Canadian Pediatric Society guide on immigrant health are not specific to SCD. We set out to examine cultural sensitivity methodologically in order to improve delivery of care. Research QuestionsWhat are newcomer families' experiences with SCD in Canada and their home country?What are the prevailing values and beliefs related to SCD that shape the attitude and behaviors of newcomer families?How do newcomer families perceivethe current delivery of medical care (the barriers and the facilitators)? METHODSFocused ethnography was used to understand the socio-cultural context in which newcomer families from Africa experience their child's SCD; to explore their perspectives, beliefs, how they manage daily life and experience the western medical system. A sample size of12-15 participants was selected to reach saturation.Participants were selected using purposeful and convenience sampling and semi-structured interviews were held with the primary caregiver(s) with use of aninterpreter if needed. Research Ethics Board approved. RESULTSSaturation was reached at 10 families and 12 were interviewed due to recruiting methods.Demographics:12 caregivers (N=8 females; N=4 males); most were in their forties and from Congo, Nigeria or Liberia. The majority had 3 or more children, were married and employed. The majority did not have extended family within the region. Languages spoken at home were English, French, Yoruba, Swahili orMoorie. They immigrated to Canada between 2002 and 2015For themes see table 1. CONCLUSIONSParticipants' attitude, perception and knowledge about SCD were profoundly affected by their experiences in their countries of origin. These mostly negative experiences (seeing children suffering without appropriate medical care; observing social stigma, etc.) were deeply embedded and determined their response to SCD in their children.1. Practice guideline: Allow for sufficient time and provision oftranslation services to explore the families' experience with stigma within country of residence and origin as well as embedded in the healthcare system and the community.Despite the prevalence of SCD in their home countries the diagnosis was a surprise. The path towards acceptance was slow, emotionally convoluted and not linear. Acceptance of the diagnosis is a process and devastating in the context of previous experiences.2. Practice guideline: Review diagnostic information early and have easily accessible information about SCD available for parents/family network. This information will also need to be reviewed with the child at key developmental time periods. SCD has a dominant impact on life causing renegotiation of all relationshipsspousal, family, community, co-workers and school staff. Managing SCD influenced daily routines imposing structure which was disrupted for hospitalizations. Families were reluctant to leave children unattended in the hospital and thus sacrificed personal and employment goals. Social support is limited and families cope alone.Families tend to seek practical support and deny the desire for emotional support.3. Practice guideline: 3a)Screen for potential isolation and explore whether other caretakers are aware of diagnosis and disease specific care 3b) Given the tendency to deny emotional support needs, lack of nearby extended family and the stigma in the community setting up networks that provide both practical and instrumental support could be meaningful and more likely utilized resources.The life-long complexity of SCD creates anxiety for the child's life expectancy. Families trust in medical expertise, improvements in medical treatments and their faith/religious beliefs are foundations for hope.4. Practice guideline: HCP working with families should ensure awareness of clinical advances and develop means to easily share knowledge as it will strengthen hope for the future. [Display omitted] DisclosuresBruce:Novartis: Consultancy, Honoraria; Apopharma: Consultancy.

Precision medicine: Towards complexity science age.

Precision medicine (PM) refers to the tailoring of the prevention and treatment strategies to the individual characteristics of each patient. Following the vigorous advocacy of the U.S. President Obama and China's President Xi, PM has now become a hot topic of common concern worldwide. PM does not merely refer to the skill set level but rather a comprehensive medical methodology. Hence, there is PM that builds on the analytical methodology of Western medical system as well as PM that builds on Chinese medicine (CM). The differences between the two systems, fundamentally speaking, are the differences in methodology to describe the body constitution that based on reductionism and holism. Today, as science advances to complex systems, the mainstream analytical reductionism advances to the holistic synthesis era, it is imperative to introduce CM's holistic body constitution to the modern medical system in order to progress to PM. PM with its foundation on holistic body constitution, is a medical system that integrates Western medicine and CM, is the highest attainment of "PM" in the future.

Dialectical Construction and Deconstruction of Contemporary African Medicine

African medicine is an important component of the cultural adaptive system. The system has been evolving interminably in response to changing environmental vulnerabilities and health care needs since primordial times. Flexibility of indigenous African ethnomedicine and its associated customs has since time immemorial incorporated new techniques and knowledge. The resulting textual and discourse heritage on African medicine has often depicted its dialectical interrelationship with western biomedicine and other medical systems. The oral and documentary records on the authenticity of African medicine either conceal or condescend to its contributions to overall healthseeking and illness behaviour. Tensions in conceptualisation of African medicine relate to its pragmatic borrowing from non-African medical systems that are compatible with local pluralistic systems and indigenous ontology. The advent of colonial and post-colonial health care paradigms further define the emergence of dialectics in the documentation and appraisal of African medicine against western standards of science and health care practices.

Yoruba Indigenous Medical Knowledge: A Study of the Nature, Dynamisms, and Resilience of Yoruba Medicine

The Yoruba people, whose major homeland is southwestern Nigeria, are one of the major ethnic groups in Africa. They have a long history of highly sophisticated sociocultural and political systems. Like other ethnic groups in Africa, the Yoruba have an impressive system of indigenous medicine. The Yoruba indigenous forms of medical practices are still in existence up until today in spite of the influence of colonization, westernization, and modernization. The Yoruba medicine has its distinct nature, forms, and methods, and it has been very resilient to the imposed western medical system since the colonial period. Against this background, this paper examines the nature, forms, and methods of the traditional Yoruba medicine. The paper discovers that the traditional Yoruba medicine is typified by the use of herbs, roots, concoction, verbal incantations, and so on. It is also found out that among the Yoruba, health and religion are intertwined and therefore, the efficacy of Yoruba medicine is dependent on the approval of the Yoruba gods and goddesses (Orisha). In other words, important aspects of Yoruba medicine are belief system and spirituality. The paper concludes that, in spite of the great influence of modern western medicine, the Yoruba indigenous medicine is very resilient and it continues to play a vital role in the health management system among the Yoruba in contemporary Nigeria.

How Much Culture is there in the ‘Health Culture’ of Rural Community?

Background In a wider meaning given by the World heal organization, health culture means a set of cultural beliefs about health and illness that forms. It is the basis for the health seeking and health promoting behaviour; the institutional arrangements within which that behaviour occurs; and the impacts of socio-economic, political and physical context for their beliefs and institutions. It is opined that even though western medicines are having a high rate of success, it has not been accepted by the majority of the Indian rural people because of their unique and historical health culture. However, some of the western epidemiologists have proved how countryside (rural) people can be convinced to adopt the western medical system, without affecting their inherited health culture and beliefs. Methodology This paper is prepared reviewing various related literatures and field work experiences of this author. Conclusion Cultural response to different health problems forms an interacting sub-system within the overall general cultural system. Health culture is an invariable determining factor of the communities� understanding of health and illness.

Pibyongwon Construction Campaign and Influence on the Korean Society in 1920’s - Traditional Inertia and the Circumstances on Colonial Period

Although it was impossible, Japanese colonialists tried to establish westernized medical system in colonial Korea. There were no substitutions for medical labor force, and Koerans are not accustomed to it. Japanese colonialists cheapened Korean tradiotional doctor, but they had to educate some of them about preventing cholera. They even made a suggestion to them to build Pibyongwon, which is Korean style isolation hospital. Strictly speaking, encouraging and inducing to discuss about korean friendly agenda in korean society is a trick to shift burdens of health care onto themselves, justified using public interest. But Korean tradiotional doctors and entrepreneurs responded actively on this proposal. Because prevention and treatment of cholera were a critical issue to Korean society.<BR> There were some logical arguments required to Park, Younghyo to speak out about Pibyongwon campaign toward Korean society in Seoul, although it was induced. In the process of motion the first man on the initiator list was Kim, Yunsik. Park tried to use symbolic features of Kim, who was a representative of Confucian scholars. Kim treated people who make a huge effort to solve local problems by themselves as iconic figure. From the perspective of autonomist Park, ‘traditional literati’s way of solving problems by leading in autonomic area’ is the strongest logical argument to support his stance as the one of the leaders of Pibyongwon campaign. Although critical mind about leader’s autonomic role had been succeeded to literati of late Chosun period, those Chosun style inertia was spoiled by Kim and spoiled inertia was reused by Park.<BR> The inertia and the condition of reinterpreting can be identified in the discussion about the location. The designation to construct public hospital in the center of the city was completely different from perspectives in Chosun period, which was to build an isolation hospital in the outside of the city wall. Koreans’ disharmony to the public hospital was because of not only hygiene police system and western medical system, but also the location of it which invaded Korean citizens’ life-world. As the campaign went into orbit, the location of it became an issue again. Leaders of the campaign tried to find some suitable places based on the traditional perspective, they encounter opposition every time. Oppositions were severe from outer city wall. As demands about improving residential environment increased dramatically in Korean society, old locational inertia disappeared from the sights of urban citizens.

Insights of Chinese medicine syndrome study: from current status to future prospects.

Syndrome differentiation is a key feature of Chinese medicine (CM) system. With CM receiving more and more attention from the mainstream medical systems, researchers from both traditional medical systems and the Western medical system are putting more effort into studying why and how the CM system works, particularly about CM syndromes. This paper reviews the current status of syndrome study and its future development. The major aspects include: (1) Usage of syndrome differentiation in clinical practice; (2) Formalization of syndrome diagnostic criteria; (3) Evidence-based determination of the common syndrome(s) of a disease; (4) Systems biology study of syndromes; and (5) Usage of syndrome in randomized controlled trials. It is expected to integrate the syndrome concept into the main stream medical system, in terms of diagnosis, treatment and prevention.

Role of Vaidyas and Ayurveda and Its Impact on Human Health

Nowadays medicine is an essential part of daily life and it was also used in traditional life style. There are a huge number of pharmaceutical products available in the market at the present time. Among them 80% of all such pharmaceutical products derived from plant source. In the developing country viz. India, Africa, Sri Lanka, Nepal, etc. 70% of the world population are directly and indirectly depending on herbal drugs and products. Although advanced Western medicine has gained popularity in the current market, expensive cost, bacterial resistance and side effect on human body are some crucial factors, which make the western medical system less attractive for long periods. Through modern bio-technology approach, Good Manufacturing Practices (GMP) could improve the effectiveness, low cost, stability of the drug. The aim of this study is to focus on the traditional medicinal system and there is a strong need to change the scenario of the modern medical system for better health care for the long-lasting future.

Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers

BackgroundAboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA).MethodsA qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis.ResultsCSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs, cancer education for Aboriginal stakeholders, continuity of care, avoiding use of medical jargon, accommodating patients’ psychosocial and logistical needs, and in-service coordination.ConclusionIndividual CSPs identified challenges in cross-cultural communication and their willingness to accommodate culture-specific needs within the wider health care system including better communication with Aboriginal patients. However, participants’ comments indicated a lack of concerted effort at the system level to address Aboriginal disadvantage in cancer outcomes.

Textual research on the Han yao xin jue (New Recognition of Chinese Medicines), a representative book of amalgamation of Chinese and western medicines in the Republican period

Guo Ruo-ding's Han yao xin jue (New Recognition of Chinese Medicines) was the representative work of amalgamating Chinese and western pharmacy of the Republican period. Its first volume was published in Medicine Tomorrow in Peiping in installments, also with offprints; while the second volume was collected by his relatives. The whole book was published by the Shanghai Press of Science and Technology, carrying 208 kinds of Chinese materia medica mainly with individual drug descriptions, some compound prescriptions, and some western medicines. The amalgamating idea was expressed in three points: collection of both Chinese and western drugs; inheritance and creation with new idea of amalgamating Chinese and western medical systems; mutual consultation of Chinese and western medicine aiming at their amalgamation.

Roles Traditional Healers Play in Cancer Treatment in Malaysia: Implications for Health Promotion and Education

For a number of reasons from cultural compatibility, to accessibility, to cost, traditional healers are a major source of health care in developing countries. In Malaysia, 'en estimated that upwards of 80% of the population consult traditional healers even if simultaneously seeking treatment from the Western medical system. Partially as a result of the widespread practice of visiting traditional healers, cancer diagnosis and treatment in Malaysia is often delayed or interrupted resulting in late presentation, advanced stage diagnosis, and a higher mortality rate than in Western countries. However, there is very little research on the role of traditional healers in cancer treatment in Malaysia. This qualitative study was designed to identify the roles traditional healers play in cancer diagnosis and treatment, with an eye to alleviating the cancer burden through educational responses with four publics in mind-policy makers, Western medical personnel, traditional healers, and the general public. In-depth interviews were conducted with 14 Malay traditional healers, 13 cancer survivors who had seen both traditional healers and Western doctors, and 12 cancer medical specialists. Analysis of the data from these 39 participants revealed four roles traditional healers play in cancer treatment-medicinal healer, emotional comforter, spiritual guide, and palliative caregiver. Three roles (emotional, spiritual, palliative) can be seen as complementary to the allopathic system. Emotional and spiritual roles may augment the effectiveness of biomedical treatment. Cancer awareness and education programs need to position traditional healers as complementary, rather than an alternative to Western medical treatment; Validating the roles Traditional Healers can play in cancer treatment in MY through health promotion and education will contribute to alleviating the nation's cancer burden.

Phytochemicals of Ayurvedic medicine in the treatment of rheumatoid arthritis

The Ayurvedic system of medicine is generally known for its potential to treat rheumatic diseases. However, documentations in international literature are scarce due to several reasons: Western and Ayurvedic medical systems are based on different conceptual frameworks and have no common disease entities. Ayurvedic treatments are often individualized treatments with complex phytochemical compositions. To address these challenges we analysed the Ayurvedic disease entities related to rheumatoid arthritis (RA) by literature [1]. Further, in an open observational pilot study, a team of Indian Western and Ayurvedic physicians diagnosed patients as RA (ARA-criteria 1987) [2] followed by the Ayurvedic diagnosis [1, 2].

Confronting the Elephant in the Room: Can We Transcend Medical Graduate Stereotypes?

As a US medical graduate, I was not exposed to the travails of international medical graduates until 1993. That year, having just completed critical care training at the University of Chicago, I joined the faculty of a program where international medical graduates made up most of the trainees. I made this choice because I sensed an opportunity to have a positive impact on education and a community's health outcomes. At the time, some admonished me that I would be throwing away my career on “missionary work.” While this elitist comment sealed the deal, my choice was also prescient. My impact in a place that had not had formal critical care education and team coordination was instant and substantial.1 Eventually, I became program director of internal medicine and was charged with the task of building a top-tier residency. This journey has been simultaneously edifying, frustrating, and inspiring. Demographics of 21st Century Graduate Medical Education Data compiled by the National Resident Matching Program (NRMP)2 show that the percentage of international medical graduate (IMG) residents has remained relatively stable during the past decade at 17% to 20% overall and 28% to 36% for internal medicine programs (figure). While the NRMP publishes national specialty-specific match results, it excludes positions offered outside the match, which are often filled by IMGs. Thus, the number of IMGs in residency programs is unknown. Despite the sizeable proportion of IMGs who fill training programs, relatively little scholarly work has examined their demographics, distribution, and performance compared to US medical graduates (USMGs). A few studies and anecdotal data suggest that university programs train a greater percentage of USMGs, and community hospitals may have a higher percentage IMGs.3,4 A single large study of internal medicine residents examined aggregate examination scores over time finding that medical knowledge scores of IMGs compared favorably to those of USMGs.5 Between 1995 and 2000, IMGs “scored higher than graduates of US medical schools on every internal medicine in-training examination at every PGY level.”5 Although overall rates of internal medicine board certification are less in US-born international medical graduates (US-IMGs) than in non–US-IMGs and USMGs,6 no study has reported pass rates for first-time test takers in medicine or other disciplines. FIGURE NRMP Statistics Describing Percentage of IMGs Matching to All Residencies and Internal Medicine Residencies.

Individualized medicine, health medicine, and constitutional theory in Chinese medicine

The patterns of modern science and changes in the medical model can result in the transformation of the current state of individualized and health medicines into being the primary trend in medical development. Chinese and Western medical systems are dissimilar in terms of value orientations, thinking style, and research directions because of their different historical and cultural backgrounds. Individualized treatment in modern medicine is mainly established based on individual genome information and the differences in mononucleotide polymorphisms. However, such treatment method is expensive, creates an uncertain genetic marker, and leads to different result interpretations, among other problems. The Chinese constitutional theory developed in the 1970s expresses the principle behind Chinese health medicine and individual treatment and provides the corresponding methods. The Chinese constitutional theory divides the constitution of the Chinese population into nine categories based on established classification criteria. It promotes the study of the relationship of each constitution to diseases and Chinese medicine preparation toward adjusting the constitution and preventing diseases. The theory also provides methods and tools for individualized treatment. Constitution identification shows the direction and provides the core technology for the evaluation of the health status. By combining the developments in modern biotechnology, new diagnostic techniques and treatment models of constitution-differentiation, disease-differentiation, and syndrome-differentiation can be established for the development of individualized Chinese medicine treatment and health medicine for the international medical community.

Traditional Healers and Western Medicine: The Challenge of Addressing Malaysia’s Cancer Burden through Collaboration

Abstract Developing countries share a disproportionate burden of late-stage cancer presentation and cancer-related deaths. This burden is often a function of an inadequately resourced healthcare system along with easier access to and preference for traditional healers. In Malaysia, traditional healers are so embedded in the culture that they are often the first and sometimes only source of cancer information and treatment. The purpose of this qualitative study was to assess the willingness and the means by which Malay traditional healers and Western cancer specialists might work collaboratively in addressing the country’s cancer burden. Interviews were conducted in urban and rural areas of Peninsular Malaysia with 14 Malay traditional healers known for treating cancer and with 12 cancer specialists. Findings from traditional healers suggest that there is a range of receptiveness for working with the Western medical system, with Islamic healers being the most receptive. Medical doctors readily acknowledged the presence of traditional healers and their personal willingness to cooperate; however, cooperation was conditional depending on the nature of the healer’s practice, the timing of the healer’s intervention, and the instituting of government oversight/regulation. Suggestions for fostering interaction and implications for healthcare policy are discussed.

Abstract LB-67: From Patient to Advocate

Abstract Peg Ford is a living example of two causes that have become her passion: early detection of ovarian cancer and timely referral of patients into the care of a gynecologic oncologist. Before Ms. Ford's experience with ovarian cancer, she had mostly chosen alternative healing methods. Impressed and appreciative of the diversity of care the western medical system now offers, she was directed toward advocacy to spread awareness of the benefits of interweaving both types of care. She chose to pursue advocacy for many reasons, but most importantly to put ovarian cancer at the forefront of medical doctors' minds. Early diagnosis is crucial to saving more women's lives. The overall survival rate for ovarian cancer for five years is only 45 percent, but when the cancer is diagnosed early, survival rates greatly improve to over 90 percent. Until there is a screening test for ovarian cancer, women must rely on the awareness of medical doctors in all fields. She strives to ensure that all women have a great understanding of their bodies and act as their own advocates to get care in a timely fashion. Ms. Ford's poster outlines her journey to becoming an advocate. After discovering an innovative educational program, “Survivors Teaching Students: Saving Women's Lives,” created by the Ovarian Cancer National Alliance, she successfully launched the program at UCSD School of Medicine for Third Year Medical Students. The course brings ovarian cancer survivors right into the classroom to share their stories with the goal of increasing awareness of the symptoms and risk factors needed for the early detection of ovarian cancer. Her poster reflects the outstanding success of the program in two short years. Seeing the need and opportunity to reach practicing medical doctors, she teamed up with the esteemed Dr. Afshin Bahador, Gynecologic Oncologist, to participate in his grand rounds at major hospital campuses. Her commitment to tell her story whenever the opportunity presents itself: as a guest speaker, facilitator, or writer for community outreach efforts, blossoms into a voice for the ovarian cancer community on a local, state, national, and international level. Her poster outlines her diverse advocacy efforts from DoD Funding, a Research Advocacy Network's 2010 Scholar at ASCO, as a member of the Core Planning Group of COCAP, as a consumer reviewer for The Cochrane Collaboration, and as an attendee of the Salzburg Global Seminar in Salzburg, Austria. With her appreciation for the advances in research, her poster highlight's patient advocates' roles as the bridge between the scientific/medical world to the patient community and to work hand-in-hand to advance research and impact change to better serve both communities. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-67. doi:10.1158/1538-7445.AM2011-LB-67

Negotiating Health and Identity: Lay Healing, Medicinal Plants, and Indigenous Healthscapes in Highland Peru

Global health-care models for developing countries urge integration of tradi- tional medicine with Western biomedicine. This article shows how residents of a remote Peruvian village negotiate among biomedicine, traditional medicine, lay indigenous medicine, and local knowledge of medicinal plants. Villagers' health-care choices reveal that they often resort to medicinal plants before modern pharmaceuticals. Their dis- courses show that these choices refl ect social and cultural processes beyond the medical: the revitalization of Andean identity, the confl ictual relationship that villagers have with modernity, and the desire to evade or subvert the power that Western medicine has over them. This article elaborates the concept of the healthscape as an individual's subjective vision of a landscape's medical resources and institutions, limited by cost and accessibil- ity and shaped by the uneasy coexistence of Western and indigenous medical systems.