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Ritualized practices among caregivers at meals in geriatric care.

The aim of this study was to examine the procedures of the caregivers in their daily work with meals in geriatric care, emphasizing ritualized practices, praxis and norms. An ethnographic approach was used. Registered nurses, enrolled nurses and nurse's assistants observed in the study responded to a questionnaire and, finally, were interviewed. The findings indicated that the meals mainly took the form of ritualized practices, and praxis depended on the ability and needs of the patients as well as on the working conditions. The guiding norms identified were 'to provide a home-like situation with fellowship for training purposes', 'to ensure each patient gets what he/she needs/wants by means of a fair method of serving', and 'to keep things in order and to be responsible'. These norms were transferred from the traditional family in the society, giving the caregivers the role of the parent when training patients. The enrolled nurses, responsible for the meal performance, strove to keep the eating milieu in order, and the meal as a whole was performed as a ritual. Its static form made it difficult to individualize the meal in accordance with the different needs of the patients.

Adult↗

The use of the kidneys in secular and ritual practices according to ancient Greek and Byzantine texts.

The use of kidneys in secular and spiritual practices was very common for centuries. In this article we present some references on their employment as sacrificial offers, as plain food or as a source for medicaments. Our material derives from Greek texts of the Classical, Hellenistic, Roman, and Byzantine eras. Relevant extracts from the Old Testament are also included, as they have become part of a common cultural heritage in that period of syncretism, when Jews were Hellenized and Greeks orientized. From the fragments cited in this article, it is obvious that the practical use of kidneys by priests, doctors, and lay persons in the periods under discussion was widespread. The sacrificial offering was based on the religious significance of the organ. The dietary consumption of the kidneys was limited by their function as urine producers. Their medicinal use was dictated first, by the abundance of the adipose tissue surrounding them, which was an ideal warming and binding substance. Second, it may be explained by the deeply rooted conviction that eating a particular organ led to the incorporation of its strength, thus protecting the corresponding eater's organs. Those practices should not surprise us in view of their corresponding modern use. Currently, kidney donors offer their organs in a sacrificial gesture, kidneys are consumed as a delicacy worldwide, and renal tissue is therapeutically used in transplantations and, until very recently, as a source for hormonal substances.

Animals↗

A randomized controlled trial of a nursery ritual: wearing cover gowns to care for healthy newborns.

The routine wearing of individual cover gowns by nurses and visitors for direct care of healthy newborns was usual practice on the maternity ward of a regional referral center. We conducted a randomized trial in which cover gowns were not provided for care of infants in the experimental group (n = 222), but were maintained for control infants (n = 230). The principal outcome measured was Staphylococcus aureus colonization of the newborn nares or umbilicus on day 3 or day of discharge. Twenty percent (n = 51) of the experimental group (no gown) had a positive culture compared with 21 percent (n = 47) of the controls. Of the infants with positive cultures, two in each group exhibited symptoms of overt S. aureus infection. Experimental infants were similar to controls with respect to feeding method, route of delivery, amount of time spent rooming-in, and average number of visitors per day. In the group of positively cultured infants, the mothers experienced longer labor, and more vaginal examinations in labor, and the number of males undergoing circumcision was higher. We concluded that routine use of cover gowns was unwarranted, and we have altered the ward policy accordingly. This also has had a positive economic effect.

Ceremonial Behavior↗

"You'll feel me touching you, sweetie": vaginal examinations during the second stage of labor.

Videotapes of women during the second stage of labor and their caregivers were examined in this descriptive study to determine how caregivers performed sterile vaginal examinations. Conversational analysis techniques were used to analyze the data. Results showed that the examinations were performed in a ritualistic manner by all caregivers, and the way the ritual was enacted repeatedly demonstrated the power of the caregivers over the women. The most common reason for performing the procedure, to help the woman push better, seems to be specific to the second stage of labor and is not described in the literature. The authors offer suggestions for better use of the examination, and recommend that it be performed far less frequently than is common.

Adolescent↗

Miscarriage: a historical perspective.

Ancient cultures have applied a variety of fascinating therapies to prevent the occurrence and reoccurrence of miscarriage. Ceremonies of ritual purification, special prayers, and a variety of medicinal therapies were employed throughout the ages to prevent this feared event. Rituals to memorialize and help mourn the lost pregnancy were developed in many cultures. These rituals reinforce how deeply men and women are affected by early pregnancy loss.

Abortion, Spontaneous↗

Alcoholism among four aboriginal groups in Taiwan: high prevalences and their implications.

An epidemiological study of alcohol use disorders was conducted on population samples from four aboriginal groups in Taiwan (a total of 993 subjects). The survey involved ethnographic observation and a semistructured psychiatric interview. The interview covered a detailed symptom profile that allowed diagnoses to be made according to different diagnostic criteria. The lifetime prevalences of alcoholism according to the ICD-10 (research criteria) and the DSM-III-R criteria were found to be 42.2-54.7% and 44.2-55.5%, respectively, much higher than the rates found in an earlier study (0.11-0.16%) conducted 40 years ago. Men in all groups were found to have higher prevalences, a lower mean age at onset, and a longer mean duration (except in one group) of alcoholism than women. Differences in the distribution of sociodemographic correlates (age, sex, marital status, education, and ethnicity) of ICD-10 harmful use of alcohol and alcohol dependence were examined by case-control analysis with logistic regression. The lifetime prevalences of alcohol use disorders were higher than in recent epidemiological surveys conducted elsewhere. Possible biological and sociocultural explanations for the high prevalence of alcoholism among the study populations are discussed.

Acculturation↗

Family rituals a powerful tool in family therapy.

The use of systemic models in family therapy obliged our team to devise therapeutic tasks involving the entire family. Among these, one was found to be extremely effective: the prescribing of a family ritual. This article gives details of on such example aimed at the destruction of a myth that had been created by three generations of a family. In order that the reader may have a adequate understanding of this ritual, were shall fully describe the story of the family and of the transgenerational evolution of this myth. In the description of the treatment of the family, certain errors were made by the therapists that will come to light-errors that, as usual, were far more instructive than the actual successes. Eventually, it was the very understanding of these errors and their repercussions that led us to the successful prescription of the ritual. Finally, detailed analysis of the substance and aim of the ritual will illustrate and explain exactly what we mean by the term ritual.

Adolescent↗

Material, myth, and magic: a cultural approach to family therapy.

This paper presents a model for a therapeutic approach to the cultural systems of families. Using anthropologically derived concepts of material and ideational planes of culture, magic, and ritualistic intervention, the inducement of culture change in frozen familial systems is framed in dialectical terms. Four brief case studies are presented describing the systems engaged, the material-ideational rituals employed, and the cultural transformations induced. The paper concludes with a brief discussion of some of the theoretical and practical implications of this cultural approach to the family in therapy.

Adolescent↗

Family rituals.

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Adult↗

Rites of passage in families with adolescents.

In previous generations society defined expectations and constructed events to promote individual development, a functional family organization, and cultural continuity. Culturally defined and accepted rites of passage that were previously observed in families with adolescents have given way to a more vague and meaningless set of adolescent expectations and affirmations. It is proposed that this change has interfered with the mission of the family to promote functional adolescent development and with the ability of the family during this life cycle stage to operate with a sense of community attachment. This paper addresses the importance of rites of passage as they pertain to family development and change and presents ideas about making them explicit in family therapy to change family interaction and structure. Prescribed family rituals that are straightforward, developmentally relevant, and interactional can be effective without consideration to whether they are paradoxical. Three clinical illustrations are presented to highlight this therapeutic approach.

Adolescent↗

Dimensions of family rituals across two generations: relation to adolescent identity.

Family rituals are considered part of a generational process that fosters a sense of identity for individual members and is reflective of the family's shared belief system. The symbolic significance attached to family rituals is considered central to the force of family rituals. Three questions were addressed in the study: (1) Are the dimensions of family rituals viewed similarly across generations?; (2) Is level of ritualization related to adolescent identity?; (3) If there is disagreement about the relative level of ritualization in a family, is there a negative relation to adolescent identity? A total of 77 families with an adolescent member completed the Family Ritual Questionnaire, and the adolescents completed a measure of self-esteem. Results of a factor analysis demonstrated shared representation of family rituals across two generations, with one factor loading on the symbolic qualities of family rituals and the second factor loading on the routine aspects of family rituals. Positive relations were found between adolescent identity and the family's report of symbolic significance and affect associated with family rituals. A negative relation was found between mother-adolescent disagreement about family rituals and adolescent feelings of belonging. Distinguishing between meaning and routine aspects of family rituals is discussed as well as clinical implications.

Adolescent↗

Graduation.

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Ceremonial Behavior↗

A couvade: a review.

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Ceremonial Behavior↗

Special needs of ritually circumcised women patients.

Female circumcision is a custom that affects many women who live north of the equator in Africa. Health-care practitioners in the United States may not have access to the information necessary to ensure that these women obtain optimum health care that is medically and culturally appropriate while they are in this country. This article describes the practice of female circumcision. It discusses urinary, gynecologic, and obstetric complications and includes a Sudanese physician's protocol recommended to avoid tearing during the delivery of a neonate. Health and social concerns are shared from the perspectives of circumcised women. The authors offer suggestions to assist health-care practitioners in providing culturally sensitive health-care services.

Africa, Northern↗