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["When the soul is depleted, the body dies". Dying and death on the island Nias/Indonesia].

In our society death and dying are largely displaced from everyday experiences. Since old rites and traditions seem antiquated and new behavioral patterns haven't yet developed, interaction with dying persons is ruled by helplessness and speechlessness. This article describes death and dying on the islands of Nias/Indonesia, where a big celebration is held before someone is dying. Relatives keep close physical contact to the dying person. Rites and Customs finally help the bereaved to structure their time of mourning and to express their grief in a socially accepted way. Thus the adat (custom, tradition) is not only supporting the dying person, but also helps the survivors to cope with their loss.

Adaptation, Psychological↗

The Wheat Valley assisted living culture: rituals and rules.

This ethnographic study describes the cultural knowledge individuals use to organize their behaviors at one assisted living facility, Wheat Valley. Data were comprised of transcribed interviews with residents, family members, and staff; field notes of observations and informal interviews; and abstracted information from facility documents. The Wheat Valley culture is described as having six cultural categories, a single theme, a threat to the culture, and a conceptualization of resident decision-making. The cultural description provides the basis for a discussion of practice implications.

Activities of Daily Living↗

Hunting for sacred cows.

"Sacred cows" are behavioral patterns that we continue to use even though they may no longer be effective. Their continued use tramples creativity, reduces innovative thought, limits the ability to respond quickly to change, and ultimately becomes costly to individuals and organizations. In less turbulent times, sacred cows were a source of irritation that managers worked around. There is no longer time available for managers to "work around" sacred cows. They must be rounded up and dealt with. It is only by confronting their own sacred cows that nurse managers will find the energy to maintain a caring environment for patients' families and staff.

Attitude of Health Personnel↗

Anxiety disorders and control related beliefs: the exemplar of Obsessive-Compulsive Disorder (OCD).

Beliefs about control have been postulated to be important to anxiety and mood disorders. In particular, the phenomenology of Obsessive-Compulsive Disorder (OCD) suggests that it may be an exemplar of an anxiety disorder where control issues related to the self (behavior and thoughts) and world (the external environment) are particularly important. However, only beliefs concerning the need to control thoughts have been incorporated into contemporary theories of OCD. This article summarizes the theoretical and empirical research relevant to control-related beliefs in OCD. It is suggested that discrepancies between an individual's desired level of control and their perceived level of control could contribute to OCD symptoms, and exacerbate the tendency for individuals with OCD to engage in magical ideation and superstitious rituals. Overall, this review demonstrates how consideration of control cognitions could enhance our understanding of OCD and further improve its treatment.

Anxiety Disorders↗

Family context in pediatric psychology from a transactional perspective: family rituals and stories as examples.

Reviewed the transactional model as applied to the family context of pediatric psychology. A three-part sequence of child behavior, parent behavior, and family interpretation was used to describe developmental adaptation and transitions. It was proposed that families are regulated by practices that are proximal to the child's experience and representations that are more distal to the child's experience. Family practices are examined through family routines and rituals. Family representations are examined through family stories. Case examples of low birth weight premature infants and an adolescent referred for repeated hospitalizations due to diabetic ketoacidosis were presented to illustrate the model. Guidelines for the practicing pediatric psychologist are presented to assess family organization through family rituals and family meaning-making in the telling of family stories.

Adolescent↗

Incorporating ethnographic methods in multidisciplinary approaches to risk assessment and communication: cultural and religious uses of mercury in Latino and Caribbean communities.

The potential risk from cultural and religious practices involving mercury in Latino and Caribbean communities raises central methodological and ethical questions for risk assessment and risk communication. Here, specific cultural practices unfamiliar to most risk professionals carry significant inherent risks in the eyes of those professionals but not necessarily in the eyes of practitioners. Practitioners' past experience and history as targets of religious suppression and anti-immigrant sentiment create a reluctance to engage with researchers or public health officials in risk assessment or preventive risk communication efforts. The potential for the risk--in this case mercury contamination in dwellings--to extend beyond the practicing community to future occupants adds to public health concern. Understanding the risks of these practices requires both an understanding of the cultural and political context, beliefs, and behaviors of mercury users and an understanding of the fate and transport of mercury in typical use scenarios. In this study, we employed ethnographic methods (interviews and participant observation) to understand beliefs and behavior about mercury use as well as quantitative modeling and measurement to estimate and assess potential exposures. This represents a new methodology tailored to situations in which traditional activities or observances that are integral components of cultural identity pose risks in and of themselves. Our findings indicate that there are different types of mercury use stemming from different cultural and religious traditions that result in different levels of exposure. Many of the mercury uses that can result in the highest exposures to mercury vapors have previously been attributed to the religious tradition of Santeria, but appear instead to have their roots outside of the religion.

Caribbean Region↗

Event- and context-specific normative misperceptions and high-risk drinking: 21st birthday celebrations and football tailgating.

OBJECTIVE: Negative alcohol-related consequences often occur during specific events and in specific contexts (e.g., 21st birthday celebrations and tailgating parties). A lack of available event- and context-specific interventions suggests the need to better understand factors associated with heavy drinking in these contexts, with an eye toward developing specific interventions. The purpose of this research was to lay the foundation for developing personalized normative feedback interventions for 21st birthday celebratory drinking and tailgating drinking by evaluating whether students overestimate norms in these specific contexts, as they do more generally. METHOD: Perceived descriptive norms and alcohol consumption were assessed at event- and context-specific levels in two studies. Study 1 included 119 students turning 21 years old who reported their 21st birthday drinking behavior and estimated the typical number of drinks consumed by students celebrating their 21st birthday. Study 2 included 140 undergraduates drawn from a stratified random sample who reported their behavior regarding drinking and tailgating and their perceived norms for typical drinking and tailgating behavior. RESULTS: Results from Study 1 revealed that students overestimated peer drinking during 21 st birthday celebrations, and this overestimation was associated with heavier drinking on one's own 21st birthday. In Study 2, students underestimated the percentage of tailgaters who drank but overestimated typical consumption. Overestimation was consistently associated with heavier drinking during tailgating. CONCLUSIONS: Successful correction of general normative misperceptions has been shown to reduce drinking in other research. Documentation of normative misperceptions for specific events and contexts provided by these results represents an important step in developing event- and context-specific interventions utilizing specific normative feedback.

Adult↗

The shadow of life: psychosocial explanations for placenta rituals.

Culturally determined patterns of behavior associated with placenta disposal are characteristic of many modern and ancient societies. This paper defines this type of placenta disposal as a ritual event that delimits a "portion of reality"; explanations are provided leading to the conclusion that placenta rituals operate as anxiety releasing mechanisms that provide a means of control over the future health and welfare of mother, child, and community. The question of why the placenta figures so prominently in folk beliefs and practices has previously been attributed to its morphological and physiological properties; this paper argues that attributes associated with it from a psychosocial model are equally important. The data for this study were drawn from a compilation of ethnographic reports of post-partum practices in African, Asian, European, and Latin American societies. Additional information on placenta disposal was derived from interviews with 1,859 Peruvian informants. Analysis of the data obtained from the Peruvian studies show a significant difference between rural and semi-urban patterns of placenta disposal.

Ceremonial Behavior↗

Nursing rituals: doing ethnography.

Types of nursing rituals identified in this study include therapeutic and occupational rituals. Therapeutic rituals (Douglas, 1963, 1966, 1975; Turner, 1957, 1967, 1969) are identified as symbolic healing actions that improve the condition of patients. Occupational rituals or rituals of socialization include symbolic actions that facilitate the transition of professional neophytes into their professional role (Bosk, 1980; Fox, 1979; Zerubavel, 1979). Nursing rituals fulfill an important although not highly visible function in a nursing unit of a modern American hospital. They enable nurses to carry out caring activities for patients who are acutely or chronically ill, old, and dying. Rituals help to reaffirm values and beliefs of nurses. Explication of the implicit meanings of nursing rituals illuminates nursing for nurses and others who seek to understand nursing services. Descriptive analyses of nursing rituals direct attention to the hidden work of the hospital staff nurse, work sometimes taken for granted by professionals and the public who fail to see the many difficult, intimate, and risky aspects of nursing work and how certain ritual behavior promotes its accomplishment. Other studies on nursing ritual are needed to expand the theory of nursing ritual in this descriptive analysis, and to move it from descriptive to explanatory theory. For example, the transmission of the beliefs, rules of conduct, and customs that take place during change-of-shift report has not been extensively investigated. Neither have the more practical aspects of shift report been studied, including the types of information exchanged or the influence of shift report on planning and priority setting for the nurses who work during the ensuing shift. Also, few empirical studies examine the effects of bathing on patient outcomes, such as skin integrity, cardiac function, and comfort levels, and patient bathing preferences. This is surprising, because the bath is such an essential ritual for the nursing profession and is thought to help patients. Nursing's close association with profane materials, including excretions and secretions, has most likely affected society's perception of the role of nurse. Investigations about these influences may reveal valuable insights into some of the status problems that nurses have encountered for many years. Equally important is the association of nurses with death. Although nurses are frustrated with the intrusion of hospital technology on patients' deaths, they have not yet established themselves as standard setters for helping patients achieve tranquil deaths.(ABSTRACT TRUNCATED AT 400 WORDS)

Anthropology, Cultural↗

Kuru with incubation periods exceeding two decades.

The clinical characteristics of kuru in 15 patients are described. All the patients had a history of joint pains preceding difficulty walking. The severity of the neurological dysfunction varied from mild truncal and limb ataxia necessitating the use of a stick for walking to terminal illness accompanied by marked ataxia, rigidity, spasticity, and dementia. All the patients with kuru in this study had a apprehensive, frightened facial expression. Most of the patients examined showed diminished or absent optokinetic nystagmus bilaterally. Apprehensive facies and diminished optokinetic nystagmus have not previously been described in kuru. The other clinical features of the current patients with kuru are similar to those recorded twenty years ago. Epidemiological surveillance, anamnesis, and missionary reports strongly suggest that all the patients described in this study were exposed to the kuru agent more than two decades ago through ritualistic cannibalism. Thus the incubation period or time interval from exposure to the onset of clinical illness exceeds two decades, while the duration of illness is two years or less. The cause of these extraordinarily long incubation periods is unknown but may result in part from exposure to small doses of the kuru agent through an inefficient oral route.

Adult↗

Ritual use of plants with possible action on the central nervous system by the Kraho Indians, Brazil.

The aim of the present study was to document the use of plants, probably acting on the central nervous system (CNS), in rituals carried out by the Kraho Indians, who occupy the cerrado biome in the central region of Brazil. The 2 years of fieldwork were guided by methods of anthropology and botany. The local shamans have indicated 286 formulas, consisting of 138 plant species in 50 uses that could be associated with some type of action on the CNS; of which 98 formulas, 87 plants and 25 uses, appear to involve psychoactive properties, such as: 'to get slow', 'stimulant effect', 'to calm down', 'to enhance memory', 'to reduce anxiety' and 'to induce sleep'. Phytochemical and pharmacological literature data were queried to establish any correlation between indigenous knowledge and scientific indications, for each one of the 138 plant species. Studies were available for 11 of these plants; and for two of them, scientific data coincided with indigenous information.

Brazil↗