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111-568: The name Mantua Creek is derived from a Native American word “Manta”, meaning frog , and was so named because of the remarkable chorus effect produced by abundant frogs in its watershed . Mantua Creek and its two major tributaries, Edwards Run and Chestnut Branch, drain over 50 square miles (130 km) of Gloucester County. Early human settlement along Mantua Creek dates back to the Lenni-Lenape Native Americans who exploited its abundance of fish and game and utilized

222-741: A Methodist church ". The landing is said to have been named either for a man named Carpenter who built boats at the site during its mercantile boom days, or Edward Carpenter (son of Thomas Carpenter and descendant of Samuel Carpenter of Philadelphia, Pennsylvania ) who owned the Heston & Carpenter Glass Works at nearby Glassboro, New Jersey in 1786 in partnership with Col. Thomas Heston, his wife's nephew. The bridge at 39°50′05″N 75°14′12″W  /  39.8346°N 75.23665°W  / 39.8346; -75.23665  ( railroad swing bridge ) has been cited for two freight train derailments, one in 2009 and one in 2012. On November 30, 2012

333-489: A collective noun (also describing First Nations, Inuit, and Métis) is a specific term of art used in some legal documents, including the Constitution Act, 1982 . Over time, as societal perceptions and government–indigenous relationships have shifted, many historical terms have changed definitions or been replaced as they have fallen out of favor. The use of the term "Indian" is frowned upon because it represents

444-505: A specialist , or watchful observation. A follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of " utilization review ", such as prior authorization of tests, may place barriers on accessing expensive services. The medical decision-making (MDM) process includes the analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain

555-667: A colonial state. The peopling of the Americas began when Paleolithic hunter-gatherers ( Paleo-Indians ) entered North America from the North Asian Mammoth steppe via the Beringia land bridge , which had formed between northeastern Siberia and western Alaska due to the lowering of sea level during the Last Glacial Maximum (26,000 to 19,000 years ago). These populations expanded south of

666-407: A combination of all three. Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those who can afford to pay for it, have self-insured it (either directly or as part of an employment contract), or may be covered by care financed directly by the government or tribe. Transparency of information is another factor defining

777-429: A combination of art and science (both basic and applied , under the umbrella of medical science ). For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine, now known as traditional medicine or folk medicine , remain commonly used in

888-640: A connection to residential schools. Additionally, Indigenous respondents with higher HLS and HLASS scores had one or more negative health outcomes. While there are many studies that found an association between IHT and adverse health outcomes, scholars continue to suggest that it remains difficult to understand the impact of IHT. IHT needs to be systematically measured. Indigenous people also need to be understood in separate categories based on similar experiences, location, and background as opposed to being categorized as one monolithic group. For thousands of years, Indigenous peoples domesticated, bred, and cultivated

999-500: A decade after medical school. Furthermore, surgical training can be very difficult and time-consuming. Surgical subspecialties include those a physician may specialize in after undergoing general surgery residency training as well as several surgical fields with separate residency training. Surgical subspecialties that one may pursue following general surgery residency training: Other surgical specialties within medicine with their own individual residency training: Internal medicine

1110-553: A definitive diagnosis that would explain the patient's problem. On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, lab or imaging results, or specialist consultations . Contemporary medicine is, in general, conducted within health care systems . Legal, credentialing , and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have

1221-494: A delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice of patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for its lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and

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1332-513: A few minutes or a few weeks, depending on the complexity of the issue. The components of the medical interview and encounter are: The physical examination is the examination of the patient for medical signs of disease that are objective and observable, in contrast to symptoms that are volunteered by the patient and are not necessarily objectively observable. The healthcare provider uses sight, hearing, touch, and sometimes smell (e.g., in infection, uremia , diabetic ketoacidosis ). Four actions are

1443-855: A few still considered uncontacted peoples . The Americas also host millions of individuals of mixed Indigenous, European, and sometimes African or Asian descent, historically referred to as mestizos in Spanish-speaking countries. In many Latin American nations, people of partial Indigenous descent constitute a majority or significant portion of the population, particularly in Central America , Mexico , Peru, Bolivia, Ecuador , Colombia , Venezuela , Chile , and Paraguay. Mestizos outnumber Indigenous peoples in most Spanish-speaking countries, according to estimates of ethnic cultural identification. However, since Indigenous communities in

1554-476: A large array of plant species. These species now constitute between 50% and 60% of all crops in cultivation worldwide. In certain cases, the Indigenous peoples developed entirely new species and strains through artificial selection , as with the domestication and breeding of maize from wild teosinte grasses in the valleys of southern Mexico. Numerous such agricultural products retain their native names in

1665-424: A large citizenry. Indigenous civilizations also displayed impressive accomplishments in astronomy and mathematics, including the most accurate calendar in the world. The domestication of maize or corn required thousands of years of selective breeding, and continued cultivation of multiple varieties was done with planning and selection, generally by women. Inuit, Yupik, Aleut, and Indigenous creation myths tell of

1776-551: A multitude of ways because the Indigenous community and their history are diverse. Many studies (such as Whitbeck et al., 2014; Brockie, 2012; Anastasio et al., 2016; Clark & Winterowd, 2012; Tucker et al., 2016) have evaluated the impact of IHT on health outcomes of Indigenous communities from the United States and Canada. IHT is a difficult term to standardize and measure because of the vast and variable diversity of Indigenous people and their communities. Therefore, it

1887-448: A patient to investigate or treat a pathological condition such as disease or injury , to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum ). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it

1998-417: A period of supervised practice or internship , or residency . This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to

2109-416: A pre-Columbian high of an estimated three million to some 300,000 in 1997. The Spanish Empire and other Europeans re-introduced horses to the Americas. Some of these animals escaped and began to breed and increase their numbers in the wild. The reintroduction of the horse , extinct in the Americas for over 7500 years, had a profound impact on Indigenous cultures in several regions, such as those of

2220-592: A second, more recent wave of migration several thousand years later and have much more recent genetic and cultural commonalities with the Indigenous peoples of Siberia . However, these groups are nonetheless considered "Indigenous peoples of the Americas". The term Amerindian , a portmanteau of "American Indian", was coined in 1902 by the American Anthropological Association . It has been controversial ever since its creation. It

2331-587: A secondary care setting. Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers , burn treatment centers, advanced neonatology unit services, organ transplants , high-risk pregnancy, radiation oncology , etc. Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means . In low-income countries, modern healthcare

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2442-593: A serious accident released vinyl chloride from rail cars that plunged into the creek. Coast Guard officials reported that the tidal flows of the creek seriously delayed cleanup. 39°51′14″N 75°13′52″W  /  39.85377°N 75.23111°W  / 39.85377; -75.23111 Indigenous peoples of the Americas In the Americas , indigenous peoples comprise the two continents' pre-Columbian inhabitants prior to European settlement in

2553-561: A significant impact on the way medical care is provided. From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals, and the Catholic Church today remains the largest non-government provider of medical services in the world. Advanced industrial countries (with the exception of the United States ) and many developing countries provide medical services through

2664-410: A system of universal health care that aims to guarantee care for all through a single-payer health care system or compulsory private or cooperative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices, state-owned hospitals and clinics, or charities, most commonly

2775-611: A threat to livestock. Several bird species, such as turkeys , Muscovy ducks , Puna ibis , and neotropic cormorants were domesticated by various peoples in Mesoamerica and South America to be used for poultry. In the Andean region, indigenous peoples domesticated llamas and alpacas to produce fiber and meat. The llama was the only beast of burden in the Americas before European colonization. Guinea pigs were domesticated from wild cavies to be raised for meat consumption in

2886-493: A variety of origins of their respective peoples. Some were "always there" or were created by gods or animals, some migrated from a specified compass point , and others came from "across the ocean". The European colonization of the Americas fundamentally changed the lives and cultures of the resident Indigenous peoples. Although the exact pre-colonization population count of the Americas is unknown, scholars estimate that Indigenous populations diminished by between 80% and 90% during

2997-666: A violent poison. Eventually, a Taíno Cacique named Enriquillo managed to hold out in the Baoruco Mountain Range for thirteen years, causing serious damage to the Spanish, Carib-held plantations and their Indian auxiliaries . Hearing of the seriousness of the revolt, Emperor Charles V (also King of Spain) sent Captain Francisco Barrionuevo to negotiate a peace treaty with the ever-increasing number of rebels. Two months later, after consultation with

3108-437: A whole, in general, most Indigenous peoples prefer to be identified by the name of their specific nation, tribe, or band. Early settlers often adopted terms that some tribes used for each other, not realizing these were derogatory terms used by enemies. When discussing broader subsets of peoples, naming has often been based on shared language, region, or historical relationship. Many English exonyms have been used to refer to

3219-534: A whole. Since the 1970s, the word "Indigenous", which is capitalized when referring to people, has gradually emerged as a favored umbrella term. The capitalization is to acknowledge that Indigenous peoples have cultures and societies that are equal to Europeans, Africans, and Asians. This has recently been acknowledged in the AP Stylebook . Some consider it improper to refer to Indigenous people as "Indigenous Americans" or to append any colonial nationality to

3330-533: Is a common term, though nativos or pueblos nativos ('native peoples') may also be heard; moreover, aborigen ('aborigine') is used in Argentina and pueblos originarios ('original peoples') is common in Chile . In Brazil, indígenas and povos originários ('Indigenous peoples') are common formal-sounding designations, while índio ('Indian') is still the more often heard term (the noun for

3441-416: Is an arduous task to assign an operational definition and systematically collect data when studying IHT. Many of the studies that incorporate IHT measure it in different ways, making it hard to compile data and review it holistically. This is an important point that provides context for the following studies that attempt to understand the relationship between IHT and potential adverse health impacts. Some of

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3552-450: Is classified into primary, secondary, and tertiary care categories. Primary care medical services are provided by physicians , physician assistants , nurse practitioners , or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics , nursing homes , schools, home visits, and other places close to patients. About 90% of medical visits can be treated by

3663-530: Is derived from Latin medicus , meaning "a physician". Medical availability and clinical practice vary across the world due to regional differences in culture and technology . Modern scientific medicine is highly developed in the Western world , while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners. In

3774-551: Is general agreement that the Americas were first settled from Asia, the pattern of migration and the place(s) of origin in Eurasia of the peoples who migrated to the Americas remain unclear. The traditional theory is that Ancient Beringians moved when sea levels were significantly lowered due to the Quaternary glaciation , following herds of now-extinct Pleistocene megafauna along ice-free corridors that stretched between

3885-595: Is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology , but are not considered surgical sub-specialties per se. Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than

3996-400: Is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain. Separation of prescribing and dispensing is a practice in medicine and pharmacy in which the physician who provides a medical prescription is independent from

4107-462: Is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in Commonwealth nations, such specialists are often called physicians . These terms, internist or physician (in

4218-570: The Archaic period of North American cultures. Technology had advanced to the point where pottery had started to become common and the small-scale felling of trees had become feasible. Concurrently, the Archaic Indigenous peoples began using fire in a controlled manner. They carried out the intentional burning of vegetation to mimic the effects of natural fires that tended to clear forest understories. It made travel easier and facilitated

4329-614: The Chiribaya to herd llamas . The vast majority of indigenous dog breeds in the Americas went extinct, due to being replaced by dogs of European origin. The Fuegian dog was a domesticated variation of the culpeo that was raised by several cultures in Tierra del Fuego , like the Selk'nam and the Yahgan . It was exterminated by Argentine and Chilean settlers, due to supposedly posing as

4440-771: The Great Plains , the Northwest Plateau , the Great Basin , Aridoamerica , the Gran Chaco and the Southern Cone . By domesticating horses, some tribes had great success: horses enabled them to expand their territories, exchange more goods with neighboring tribes, and more easily capture game , such as bison . According to Erin McKenna and Scott L. Pratt, the Indigenous population of the Americas

4551-503: The Inca Civil War of 1529–1532. Smallpox was only the first epidemic. Typhus (probably) in 1546, influenza and smallpox together in 1558, smallpox again in 1589, diphtheria in 1614, and measles in 1618—all ravaged the remains of Inca culture. Smallpox killed millions of native inhabitants of Mexico. Unintentionally introduced at Veracruz with the arrival of Pánfilo de Narváez on 23 April 1520, smallpox ravaged Mexico in

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4662-573: The Laurentide and Cordilleran ice sheets. Another route proposed is that, either on foot or using boats , they migrated down the Pacific coast to South America as far as Chile . Any archaeological evidence of coastal occupation during the last Ice Age would now have been covered by the sea level rise , up to a hundred metres since then. While technically referring to the era before Christopher Columbus ' voyages of 1492 to 1504, in practice

4773-549: The Laurentide Ice Sheet and spread rapidly southward, occupying both North and South America by 12,000 to 14,000 years ago. The earliest populations in the Americas, before roughly 10,000 years ago, are known as Paleo-Indians . Indigenous peoples of the Americas have been linked to Siberian populations by proposed linguistic factors , the distribution of blood types , and in genetic composition as reflected by molecular data, such as DNA . While there

4884-823: The Menominee of Wisconsin—suggest that longstanding "sacred values" may represent a summary of sustainable millennial traditions. Numerous Native American dog breeds have been used by the people of the Americas, such as the Canadian Eskimo dog , the Carolina dog , and the Chihuahua . Some indigenous peoples in the Great Plains used dogs for pulling travois , while others like the Tahltan bear dog were bred to hunt larger game. Some Andean cultures also bred

4995-517: The developed world , evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm. In modern clinical practice, physicians and physician assistants personally assess patients to diagnose , prognose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins with an interaction with an examination of

5106-485: The history and prehistory of the Americas before the appearance of significant European and African influences on the American continents, spanning the time of the original arrival in the Upper Paleolithic to European colonization during the early modern period . The Norte Chico civilization (in present-day Peru) is one of the defining six original civilizations of the world, arising independently around

5217-918: The pharmacist who provides the prescription drug . In the Western world there are centuries of tradition for separating pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide drugs. Working together as an interdisciplinary team , many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses , emergency medical technicians and paramedics , laboratory scientists, pharmacists , podiatrists , physiotherapists , respiratory therapists , speech therapists , occupational therapists , radiographers, dietitians , and bioengineers , medical physicists , surgeons , surgeon's assistant , surgical technologist . The scope and sciences underpinning human medicine overlap many other fields. A patient admitted to

5328-513: The prevention and treatment of illness . Contemporary medicine applies biomedical sciences , biomedical research , genetics , and medical technology to diagnose , treat, and prevent injury and disease, typically through pharmaceuticals or surgery , but also through therapies as diverse as psychotherapy , external splints and traction , medical devices , biologics , and ionizing radiation , amongst others. Medicine has been practiced since prehistoric times , and for most of this time it

5439-448: The residential school ancestry studies ask respondents if their parents, grandparents, great-grandparents, or "elders from their community" went to a residential school to understand if family or community history in residential schools is associated with negative health outcomes. In a comprehensive review of the research literature, Joseph Gone and colleagues compiled and compared outcomes for studies using these IHT measures relative to

5550-431: The " West Indies " (or " Antilles "), a name that is still used to describe the islands. This led to the blanket term "Indies" and "Indians" ( Spanish : indios ; Portuguese : índios ; French : indiens ; Dutch : indianen ) for the Indigenous inhabitants, which implied some kind of ethnic or cultural unity among the Indigenous peoples of the Americas. This unifying concept, codified in law, religion, and politics,

5661-621: The 1520s, possibly killing over 150,000 in Tenochtitlán (the heartland of the Aztec Empire) alone, and aiding in the victory of Hernán Cortés over the Aztec Empire at Tenochtitlan (present-day Mexico City) in 1521. There are many factors as to why Indigenous peoples suffered such immense losses from Afro-Eurasian diseases. Many Old World diseases, like cow pox, are acquired from domesticated animals that are not indigenous to

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5772-846: The 15th century, as well as the ethnic groups that identify with the pre-Columbian population of the Americas as such. These populations exhibit significant diversity; some Indigenous peoples were historically hunter-gatherers , while others practiced agriculture and aquaculture . Various Indigenous societies developed complex social structures , including pre-contact monumental architecture, organized cities , city-states , chiefdoms , states , kingdoms , republics , confederacies , and empires . These societies possessed varying levels of knowledge in fields such as engineering , architecture , mathematics , astronomy , writing , physics , medicine , agriculture , irrigation , geology , mining , metallurgy , art , sculpture , and goldsmithing . Indigenous peoples continue to inhabit many regions of

5883-587: The 16th century were Constantinople and Paris with 300,000 and 200,000 inhabitants respectively. The population in London, Madrid, and Rome hardly exceeded 50,000 people. In 1523, right around the time of the Spanish conquest, the entire population in the country of England was just under three million people. This fact speaks to the level of sophistication, agriculture, governmental procedure, and rule of law that existed in Tenochtitlan, needed to govern over such

5994-627: The 250,000 Taínos of Hispaniola , represented the dominant culture in the Greater Antilles and the Bahamas. Within thirty years about 70% of the Taínos had died. They had no immunity to European diseases, so outbreaks of measles and smallpox ravaged their population. One such outbreak occurred in a camp of enslaved Africans, where smallpox spread to the nearby Taíno population and reduced their numbers by 50%. Increasing punishment of

6105-462: The Americas are defined by cultural identification and kinship rather than ancestry or race , mestizos are typically not counted among the Indigenous population unless they speak an Indigenous language or identify with a specific Indigenous culture. Additionally, many individuals of wholly Indigenous descent who do not follow Indigenous traditions or speak an Indigenous language have been classified or self-identify as mestizo due to assimilation into

6216-468: The Americas have been more vocal about how they want to be addressed, pushing to suppress the use of terms widely considered to be obsolete, inaccurate, or racist . During the latter half of the 20th century and the rise of the Indian rights movement , the United States federal government responded by proposing the use of the term " Native American ", to recognize the primacy of Indigenous peoples' tenure in

6327-953: The Americas, with significant populations in countries such as Bolivia , Canada , Chile , Colombia , Ecuador , Guatemala , Mexico , Peru , and the United States . There are at least 1,000 different indigenous languages spoken across the Americas, with 574 federally recognized tribes in the US alone. Some languages, including Quechua , Arawak , Aymara , Guaraní , Mayan , and Nahuatl , have millions of speakers and are recognized as official by governments in Bolivia , Peru , Paraguay , and Greenland . Indigenous peoples, whether residing in rural or urban areas, often maintain aspects of their cultural practices, including religion , social organization , and subsistence practices. Over time, these cultures have evolved, preserving traditional customs while adapting to modern needs. Some Indigenous groups remain relatively isolated from Western culture , with

6438-456: The Americas. European populations had adapted to these diseases, and built up resistance, over many generations. Many of the Old World diseases that were brought over to the Americas were diseases, like yellow fever , that were relatively manageable if infected as a child, but were deadly if infected as an adult. Children could often survive the disease, resulting in immunity to the disease for

6549-473: The Andean region. Guinea pigs are now widely raised in Western society as household pets. Medicine This is an accepted version of this page Medicine is the science and practice of caring for patients, managing the diagnosis , prognosis , prevention , treatment , palliation of their injury or disease , and promoting their health . Medicine encompasses a variety of health care practices evolved to maintain and restore health by

6660-565: The Audencia of Santo Domingo, Enriquillo was offered any part of the island to live in peace. The Laws of Burgos, 1512–1513 , were the first codified set of laws governing the behavior of Spanish settlers in America, particularly concerning Indigenous peoples. The laws forbade the maltreatment of them and endorsed their conversion to Catholicism . The Spanish crown found it difficult to enforce these laws in distant colonies. Epidemic disease

6771-580: The English and Spanish lexicons. The South American highlands became a center of early agriculture. Genetic testing of the wide variety of cultivars and wild species suggests that the potato has a single origin in the area of southern Peru , from a species in the Solanum brevicaule complex. Over 99% of all modern cultivated potatoes worldwide are descendants of a subspecies indigenous to south-central Chile , Solanum tuberosum ssp. tuberosum , where it

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6882-538: The Europeans began the human trafficking of massive numbers of enslaved Western and Central African people to the Americas. Like Indigenous peoples, these African people, newly exposed to European diseases, lacked any inherited resistance to the diseases of Europe. In 1520, an African who had been infected with smallpox had arrived in Yucatán. By 1558, the disease had spread throughout South America and had arrived at

6993-401: The Indigenous peoples of the Americas. Some of these names were based on foreign language terms used by earlier explorers and colonists, while others resulted from the colonists' attempts to translate or transliterate endonyms from the native languages. Other terms arose during periods of conflict between the colonists and Indigenous peoples. Since the late 20th century, Indigenous peoples in

7104-611: The Indigenous population of North America in the first hundred years after the arrival of Europeans. Some 90 percent of the native population near Massachusetts Bay Colony died of smallpox in an epidemic in 1617–1619. In 1633, in Fort Orange (New Netherland) , the Native Americans there were exposed to smallpox because of contact with Europeans. As it had done elsewhere, the virus wiped out entire population groups of Native Americans. It reached Lake Ontario in 1636, and

7215-796: The Indigenous-European mixed-race mestizos (or caboclos in Brazil) of Hispanic America who, with their larger population (in most Latin American countries constituting either outright majorities, pluralities, or at the least large minorities), identify largely as a new ethnic group distinct from both Europeans and Indigenous, but still considering themselves a subset of the European-derived Hispanic or Brazilian peoplehood in culture and ethnicity ( cf. ladinos ). Among Spanish-speaking countries , indígenas or pueblos indígenas ('Indigenous peoples')

7326-665: The Plata basin. Colonist violence towards Indigenous peoples accelerated the loss of lives. European colonists perpetrated massacres on the Indigenous peoples and enslaved them. According to the U.S. Bureau of the Census (1894), the North American Indian Wars of the 19th century had a known death toll of about 19,000 Europeans and 30,000 Native Americans, and an estimated total death toll of 45,000 Native Americans. The first Indigenous group encountered by Columbus,

7437-748: The South-Asian nationality being indiano ), but for the past 10 years has been considered offensive and pejorative. Aborígene and nativo are rarely used in Brazil in Indigenous-specific contexts (e.g., aborígene is usually understood as the ethnonym for Indigenous Australians ). The Spanish and Portuguese equivalents to Indian , nevertheless, could be used to mean any hunter-gatherer or full-blooded Indigenous person, particularly to continents other than Europe or Africa—for example, indios filipinos . Indigenous peoples of

7548-421: The Taínos for revolting against forced labor, despite measures put in place by the encomienda , which included religious education and protection from warring tribes, eventually led to the last great Taíno rebellion (1511–1529). Following years of mistreatment, the Taínos began to adopt suicidal behaviors, with women aborting or killing their infants and men jumping from cliffs or ingesting untreated cassava ,

7659-470: The UK where all doctors are now required by law to work less than 48 hours per week on average. The following are some major medical specialties that do not directly fit into any of the above-mentioned groups: Some interdisciplinary sub-specialties of medicine include: Medical education and training varies around the world. It typically involves entry level education at a university medical school , followed by

7770-568: The United States are commonly known as Native Americans , Indians, as well as Alaska Natives . The term "Indian" is still used in some communities and remains in use in the official names of many institutions and businesses in Indian Country . The various nations, tribes, and bands of Indigenous peoples of the Americas have differing preferences in terminology for themselves. While there are regional and generational variations in which umbrella terms are preferred for Indigenous peoples as

7881-487: The United States, can be searched at http://data.medobjectives.marian.edu/ Archived 4 October 2018 at the Wayback Machine . In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts

7992-473: The United States, must be completed in and delivered from a recognized university. Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education . Medical practitioners upgrade their knowledge in various ways, including medical journals , seminars, conferences, and online programs. A database of objectives covering medical knowledge, as suggested by national societies across

8103-446: The absence of scientific medicine and are thus called alternative medicine . Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery . Medicine ( UK : / ˈ m ɛ d s ɪ n / , US : / ˈ m ɛ d ɪ s ɪ n / ) is the science and practice of the diagnosis , prognosis , treatment , and prevention of disease . The word "medicine"

8214-589: The basis of physical examination: inspection , palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order, although auscultation occurs prior to percussion and palpation for abdominal assessments. The clinical examination involves the study of: It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above. The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to

8325-509: The broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which has its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments);

8436-459: The considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health. In

8547-680: The contact and colonization period and were documented in historical accounts of the time. A few, such as the Mayan, Olmec, Mixtec, Aztec , and Nahua peoples , had their written languages and records. However, the European colonists of the time worked to eliminate non-Christian beliefs and burned many pre-Columbian written records. Only a few documents remained hidden and survived, leaving contemporary historians with glimpses of ancient culture and knowledge. According to both Indigenous and European accounts and documents, American civilizations before and at

8658-513: The creeks for transportation. Early European settlers also used the creek for transportation, and constructed saw mills and grist mills on the creek and its streams, encouraging flood plain development for agriculture . Carpenter's Landing was a 17th-century mercantile settlement located at the head of sloop navigation on Mantua Creek. In the 1860s, it was described as "a place of considerable trade in lumber , cordwood , etc., and contains one tavern , two stores, 30 dwellings and

8769-504: The dominant Hispanic culture . In recent years, the self-identified Indigenous population in many countries has increased as individuals reclaim their heritage amid rising Indigenous-led movements for self-determination and social justice . Application of the term " Indian " originated with Christopher Columbus , who, in his search for India , thought that he had arrived in the East Indies . The islands came to be known as

8880-788: The examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of

8991-417: The expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency departments , intensive care medicine , surgery services, physical therapy , labor and delivery , endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in

9102-630: The first centuries of European colonization. Most scholars estimate a pre-colonization population of around 50 million, with other scholars arguing for an estimate of 100 million. Estimates reach as high as 145 million. Epidemics ravaged the Americas with diseases, such as smallpox , measles , and cholera , which the early colonists brought from Europe. The spread of infectious diseases was slow initially, as most Europeans were not actively or visibly infected, due to inherited immunity from generations of exposure to these diseases in Europe. This changed when

9213-579: The growth of herbs and berry-producing plants, which were important both for food and for medicines. In the Mississippi River valley, Europeans noted that Native Americans managed groves of nut and fruit trees not far from villages and towns and their gardens and agricultural fields. They would have used prescribed burning farther away, in forest and prairie areas. Many crops first domesticated by Indigenous peoples are now produced and used globally, most notably maize (or "corn") arguably

9324-653: The gut and the kidneys. In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of primary care . There are many subspecialities (or subdisciplines) of internal medicine : Training in internal medicine (as opposed to surgical training), varies considerably across

9435-435: The health outcomes of Indigenous peoples. The study defined negative health outcomes to include such concepts as anxiety , suicidal ideation , suicide attempts , polysubstance abuse , PTSD , depression , binge eating , anger, and sexual abuse. The connection between IHT and health conditions is complicated because of the difficult nature of measuring IHT, the unknown directionality of IHT and health outcomes, and because

9546-553: The hospital is usually under the care of a specific team based on their main presenting problem, e.g., the cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments. Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in. The main branches of medicine are: In

9657-570: The imposition and restriction of Indigenous peoples and cultures by the Canadian Government. The terms "Native" and " Eskimo " are generally regarded as disrespectful (in Canada), and so are rarely used unless specifically required. While "Indigenous peoples" is the preferred term, many individuals or communities may choose to describe their identity using a different term. The Métis people of Canada can be contrasted, for instance, to

9768-434: The information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only

9879-707: The lands of the Iroquois by 1679. During the 1770s smallpox killed at least 30% of the West Coast Native Americans. The 1775–82 North American smallpox epidemic and the 1837 Great Plains smallpox epidemic brought devastation and drastic population depletion among the Plains Indians . In 1832 the federal government of the United States established a smallpox vaccination program for Native Americans ( The Indian Vaccination Act of 1832 ). The Indigenous peoples in Brazil declined from

9990-476: The methodologies to measure IHT include a "Historical Losses Scale" (HLS), "Historical Losses Associated Symptoms Scale" (HLASS), and residential school ancestry studies. HLS uses a survey format that includes "12 kinds of historical losses", such as loss of language and loss of land and asks participants how often they think about those losses. The HLASS includes 12 emotional reactions, and asks participants how they feel when they think about these losses. Lastly,

10101-887: The most important crop in the world. Other significant crops include cassava ; chia ; squash (pumpkins, zucchini, marrow , acorn squash , butternut squash ); the pinto bean , Phaseolus beans including most common beans , tepary beans , and lima beans ; tomatoes ; potatoes ; sweet potatoes ; avocados ; peanuts ; cocoa beans (used to make chocolate ); vanilla ; strawberries ; pineapples ; peppers (species and varieties of Capsicum , including bell peppers , jalapeños , paprika , and chili peppers ); sunflower seeds ; rubber ; brazilwood ; chicle ; tobacco ; coca ; blueberries , cranberries , and some species of cotton . Studies of contemporary Indigenous environmental management—including agro-forestry practices among Itza Maya in Guatemala and hunting and fishing among

10212-773: The narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities. Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of

10323-410: The nation. As may be expected among people of over 400 different cultures in the US alone, not all of the people intended to be described by this term have agreed on its use or adopted it. No single group naming convention has been accepted by all Indigenous peoples in the Americas. Most prefer to be addressed as people of their tribe or nations when not speaking about Native Americans/American Indians as

10434-504: The new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination. Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery". "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing

10545-477: The patient's medical history and medical record , followed by a medical interview and a physical examination . Basic diagnostic medical devices (e.g., stethoscope , tongue depressor ) are typically used. After examining for signs and interviewing for symptoms , the doctor may order medical tests (e.g., blood tests ), take a biopsy , or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on

10656-440: The possible exploitation of information for commercial gain on the other. The health professionals who provide care in medicine comprise multiple professions , such as medics , nurses , physiotherapists , and psychologists . These professions will have their own ethical standards , professional education, and bodies. The medical profession has been conceptualized from a sociological perspective . Provision of medical care

10767-432: The primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes. Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required

10878-774: The rest of their lives. But contact with adult populations without this childhood or inherited immunity would result in these diseases proving fatal. Colonization of the Caribbean led to the destruction of the Arawaks of the Lesser Antilles . Their culture was destroyed by 1650. Only 500 had survived by the year 1550, though the bloodlines continued through to the modern populace. In Amazonia, Indigenous societies weathered, and continue to suffer, centuries of colonization and genocide. Contact with European diseases such as smallpox and measles killed between 50 and 67 percent of

10989-540: The same time as that of Egypt . Many later pre-Columbian civilizations achieved great complexity, with hallmarks that included permanent or urban settlements, agriculture, engineering, astronomy, trade, civic and monumental architecture, and complex societal hierarchies . Some of these civilizations had long faded by the time of the first significant European and African arrivals (ca. late 15th–early 16th centuries), and are known only through oral history and through archaeological investigations. Others were contemporary with

11100-474: The term Indigenous people used in the various samples comprises a huge population of individuals with drastically different experiences and histories. That being said some studies such as Bombay, Matheson, and Anisman (2014), Elias et al. (2012), and Pearce et al. (2008) found that Indigenous respondents with a connection to residential schools have more negative health outcomes (e.g., suicide ideation, suicide attempts, and depression) than those who did not have

11211-497: The term because Indigenous cultures existed before European colonization. Indigenous groups have territorial claims that are different from modern national and international borders, and when labeled as part of a country, their traditional lands are not acknowledged. Some who have written guidelines consider it more appropriate to describe an Indigenous person as "living in" or "of" the Americas, rather than calling them "American"; or simply calling them "Indigenous" without any addition of

11322-569: The term usually includes the history of Indigenous cultures until Europeans either conquered or significantly influenced them. "Pre-Columbian" is used especially often in the context of discussing the pre-contact Mesoamerican Indigenous societies : Olmec ; Toltec ; Teotihuacano ' Zapotec ; Mixtec ; Aztec and Maya civilizations ; and the complex cultures of the Andes : Inca Empire , Moche culture , Muisca Confederation , and Cañari . The Pre-Columbian era refers to all period subdivisions in

11433-458: The time of European encounter had achieved great complexity and many accomplishments. For instance, the Aztecs built one of the largest cities in the world, Tenochtitlan (the historical site of what would become Mexico City ), with an estimated population of 200,000 for the city proper and a population of close to five million for the extended empire. By comparison, the largest European cities in

11544-568: The two camps above; for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA). Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on

11655-418: The world: see the articles on medical education for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the US. This difference does not apply in

11766-456: Was 145 million in the late 15th and by the late 17th century, had been reduced to 15 million due to epidemics , wars, massacres, mass rapes , starvation, and enslavement. Indigenous historical trauma (IHT) is the trauma that can accumulate across generations and develop as a result of the historical ramifications of colonization and is linked to mental and physical health hardships and population decline. IHT affects many different people in

11877-419: Was an art (an area of creativity and skill), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism . In recent centuries, since the advent of modern science , most medicine has become

11988-642: Was cultivated as long as 10,000 years ago. According to Linda Newson , "It is clear that in pre-Columbian times some groups struggled to survive and often suffered food shortages and famines , while others enjoyed a varied and substantial diet." Persistent drought around AD 850 coincided with the collapse of the Classic Maya civilization, and the famine of One Rabbit (AD 1454) was a major catastrophe in Mexico. Indigenous peoples of North America began practicing farming approximately 4,000 years ago, late in

12099-656: Was immediately rejected by some leading members of the Association, and, while adopted by many, it was never universally accepted. While never popular in Indigenous communities themselves, it remains a preferred term among some anthropologists, notably in some parts of Canada and the English-speaking Caribbean . " Indigenous peoples in Canada " is used as the collective name for First Nations , Inuit , and Métis . The term Aboriginal peoples as

12210-505: Was not originally accepted by the myriad groups of Indigenous peoples themselves but has since been embraced or tolerated by many over the last two centuries. The term "Indian" generally does not include the culturally and linguistically distinct Indigenous peoples of the Arctic regions of the Americas, including the Aleuts , Inuit , or Yupik peoples . These peoples entered the continent as

12321-517: Was the overwhelming cause of the population decline of the Indigenous peoples. After initial contact with Europeans and Africans, Old World diseases caused the deaths of 90 to 95% of the native population of the New World in the following 150 years. Smallpox killed from one-third to half of the native population of Hispaniola in 1518. By killing the Incan ruler Huayna Capac , smallpox caused

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