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Lessons from child of water.

This chapter examines the perceptions and treatment of psychological combat reactions by American Indians. My goal is to provide the reader with an introduction to the clinical implications of these perceptions and treatment in order to encourage a closer examination of what American Indian healers have to offer mental health professionals trained in the mainstream (what I will refer to as Anglo) psychological tradition. To do this we shall briefly examine how American Indians regard war and the role of warriors, for this cultural perception influences how combat reactions such as posttraumatic stress disorder symptoms are perceived and treated. Regardless of the value of what we might learn from American Indian culture, it does not matter what they say if we will not hear. It is necessary to consider attitudes typically held toward the concepts and techniques of American Indian healing practices if we wish for this examination to be more than an anthropological exposition, and have clinical value for Anglo mental health professionals.

Adaptation, Psychological↗

"When I am lonely the mountains call me": the impact of sacred geography on Navajo psychological well being.

As we approach the twenty-first century, sacred geography continues to have a profound impact on Navajo psychological well being. This article explores the extent of the Navajo's bond with their homeland through an emphasis on orderly conditions in their world view, myths, and ceremonies. When traditional Navajos leave their homeland to pursue educational and professional endeavors or to seek biomedical treatment, a sense of emotional dislocation can undermine their success. The emotional trauma goes far beyond mere homesickness because it is based on an often unconscious sense of having violated the moral order of the universe. It is essential that mental health professionals respond with sensitivity to this issue by understanding the extent to which the sacred mountains and other landforms serve as a vital source of spiritual strength.

Adaptation, Psychological↗

On white coats and professional development: the formal and the hidden curricula.

White coat ceremonies are a recent phenomenon in medical education. Selected as a symbol by the Arnold P. Gold Foundation to impress upon medical students the importance of compassion and humility, the white coat has had a long association with all things medical, scientific, and healing. It is also associated with the attributes of purity and goodness traditionally symbolized by the color white. Thus, its selection as the material focus of the white coat ceremony seems natural. This article situates the white coat ceremony as a curricular event and suggests that, in addition to having the meanings cited above, the white coat has other meanings that fall into the realm of the hidden curriculum--it can symbolize caregiving hierarchies and spheres of practice, the social and economic privilege of physicians, and medicine's well-established practices of determining membership in the profession. Finally, this paper suggests several other ceremonies or rituals that may be better than the white coat ceremony for encouraging compassion and humility in medical students.

Ceremonial Behavior↗

Plastic apron wear during direct patient care.

AIM: To identify factors that influence nurses' practice in apron use during direct patient care. METHOD: A small-scale documentary analysis of a purposive sample of 15 journal articles relating to nurses' apron use during patient care was undertaken. The analysis sought to address what factors affect nurses' decisions in relation to apron use. FINDINGS: Nurses' decisions regarding apron use during patient care tend to be ritualistic rather than evidence-based. Their knowledge of infection control is limited. CONCLUSION: Although there is current literature available on infection control, as well as health and safety regulations, if local policy regarding apron use in nursing care is scant this can result in inconsistent and, perhaps, less desirable practices.

Ceremonial Behavior↗

Safe placement of nasogastric tubes in children.

Insertion of nasogastric tubes is a common nursing procedure but practice rituals and unfounded assumptions can compromise safety. Current methods for checking the position of nasogastric tubes are not always suitable in children but there is limited guidance on how to proceed when gastric placement cannot be determined. As a result of a local adverse incident, a working party challenged the assumptions and rituals of practice using an evidence-based framework. A nasogastric tube algorithm was developed using a risk assessment approach to improve the safety of children in hospital and community settings.

Algorithms↗

Aspects of male circumcision in sub-equatorial African culture history.

This paper describes the general cultural background of male circumcision for the Bantu speaking peoples of sub-equatorial Africa. Where the contemporary cultural context of male circumcision is now variable and often transformed amongst groups who continue the practice, traditional practices were commonly of a particular and rather narrow profile linked to the toughening, training and initiation of male adolescents into warrior status. For those groups the normal social context of circumcision was in the adolescent rites of passage typically called 'initiation schools' in the ethnographic literature. These in turn were highly associated with 'age-grades', age ranked male cohorts whose membership was defined by participation in the same initiation schools in the same year. Linguistic evidence suggests the schools and circumcision are very ancient and typological arguments suggest that those Bantu groups which do not circumcise males have abandoned a once more widespread practice. In the main, the Bantu groups which do not circumcise males belong to certain contiguous linguistic groups and their neighbours from amongst bordering Bantu subgroups. Almost all groups which have abandoned male circumcision have also abandoned initiation schools and age-grades. This constitutes a culture area in terms of those dimensions of those societies. Circumcising and non-circumcising groups are suggested to have their distribution due to diffusion of loss and it cannot be expected that differential risk behaviours in relation to HIV infection will be found to sort similarly amongst Bantu-speaking or other African peoples. But such mapping, for those who would do it, can now take place with the knowledge that a cluster of cultural traits typify the non-circumcising Bantu groups.

Adolescent↗

Rituals.

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Ceremonial Behavior↗

[Female rituals: preceding maternity].

Throughout our lives, we pass through important stages of change, from the moment of our births until the moment of our deaths. These experiences entail social rituals. Pregnancy and childbirth are one of these changes in which women will encounter multiple rites, defined mainly by medical practices and beliefs. Every society has its rites which work to maintain an ideology. With a rite, we recognize all that a society considers correct. A woman during pregnancy will undergo those actions and interventions considered normal in this ritual process, with the final objective being to achieve motherhood.

Adult↗

Injuries to the skin of the male external genitalia in Southern Africa.

The more common injuries to the skin of the male external genital organs are described; some of these mutilations are unique to the African continent. The extent of trauma ranges from small penile skin defects after circumcision to complete avulsion of the skin of the penis and scrotum. The techniques of reconstruction are described.

Adolescent↗