THE CHRISTIAN NURSE: A NURSE'S SPECIAL PROBLEMS. 2. CARING FOR THE DYING.
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METHOD: We describe the cases of four patients with eating disorders in whom complex interactions occurred among religious faith, pathogenesis of the eating disorder, and clinical management. RESULTS: In some of the cases, religious beliefs seemed to provide a containment of maladaptive behaviors, partly through prayer and through a sense of belonging to the religious community. In other cases, it proved difficult to separate the concept of a punitive God from the illness process. DISCUSSION: The cases are discussed with reference to a limited empirical literature. Similarities are noted between some religious institutions and eating disorder treatment regimes. This paper explores management issues, including the use of pastoral counseling and the ethics of addressing religious beliefs in therapy. We note the benefits of a rapprochement between psychiatry and religion.
Previous analysis of cribra orbitalia in the medieval populations of Kulubnarti focused only on the presence or absence of the lesion relative to age, sex, and cultural period. Demographic consideration of the lesion was limited to a gross comparison of lesion frequencies and probabilities of dying by age group. The scope of the earlier work has been expanded in the present research to include the consideration of cribra orbitalia from a developmental, demographic, and diachronic perspective. The sample consisted of the same 334 crania analyzed by Van Gerven et al. ([1981] J. Hum. Evol. 10:395-408). All skulls showing the lesion were dichotomized as active or healing, and separate life tables were constructed for those with lesions and those without. The results demonstrate that active lesions are confined entirely to infancy and childhood with formation beginning as early as six months and ending by the twelfth year. This childhood pattern is consistent with the iron deficiency anemia hypothesis proposed by Carlson et al. ([1974] J. Hum. Evol. 3:405-410). Among young adults (16-40), healing lesions occur more frequently in males than females. In the older age categories, however, females exhibit a higher frequency of partially healed lesions than males. A life table comparison of those with and those without cribra orbitalia reveals a dramatic reduction in mean life expectancy for those with the lesion across the formative childhood years (birth-16). This reduction peaks at age 5 where 78% of the children exhibit lesions and where they, as a group, have a mean life expectancy 15.5 years below those without the lesion.
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