[Physicians' talks with patients have been analyzed. Three different types of images in physician-patient relations].
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OBJECTIVE: To explore whether contemporary women use good luck rites in the infertility situation. STUDY DESIGN: Prospective study in a tertiary infertility center where women were asked to describe any type of good luck act performed on the day of critical medical intervention (either intrauterine insemination or embryo transfer) to achieve pregnancy. RESULTS: Four hundred thirty-eight consecutive infertile women participated. Good luck rituals, as defined by patients, included prayer, wearing of objects, fantasies and other acts performed specifically on the day of the medical intervention. While 40% of the study population reported engaging in a good luck act prior to intrauterine insemination of embryo transfer, there was no significant difference in pregnancy rates observed in women reporting utilization versus nonutilization of fertility rituals. CONCLUSION: This study indicated that good luck rites are commonly performed by women undergoing infertility procedures on the day of a critical intervention. The fact of their common presence attests to their importance for the well-being of the individual; however, there is no evidence of direct benefit in terms of higher pregnancy rates. The possibility of secondary benefits needs to be explored further.
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Although the "social relationship" between care givers and care recipients should be one of the distinguishing features of care giving--in contradiction to medicine--there is in fact a clear need in practice and on a theoretical level for the professional to distance him-/herself from a physically or psychologically "other" person. In order to avoid this destructive situation whereby people are divided into categories such as healthy and ill, helping and in need of help, powerful and weak, knowledgeable and ignorant, a self-reflective process on the part of the caring profession needs to be set in motion. This would inevitably lead care givers to question their roles and behaviour as professionals which is a necessary step towards establishing a "social relationship" between care givers and care recipients. Only then can the experience of the care recipients and the professional knowledge of the care givers be regarded as of equal importance. No longer would care recipients be perceived as somehow different and needed to be kept at a distance by numerous rituals.
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Southern Africa has a long history of dental mutilation in the form of dental chipping and of intentional removal of anterior teeth. The first evidence is found in the skeletons of Early Iron Age populations (ca. 1500 years before present), but the incidence decreases in archaeological sites of more recent origin. In modern times, dental mutilation appears to have been limited to the people of the countries further north in Africa, but the one exception is the presence of deliberate incisor removal amongst the communities of the Western Cape. It is hypothesised in this paper that the modern practice in the Cape is associated with youthful gangs in the poorer communities, and acts as part of a rite of passage into adulthood. The "socio-sexual" theory, as reflected in such names as the "passion gap", is shown to be both wrong and insulting. The name "Cape Flats Smile" is recommended as a more appropriate and respectful term for the phenomenon.
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Drawing from Hindu and Buddhist Tantric traditions, central themes reflecting Asian approaches to sexuality are described and contrasted with contemporary values, assumptions, and objectives implicit in both sexual experience and in the clinical practice of sexual counseling. The Tantric ceremonial sex ritual provides a fertile source for several innovative behavioral assignments useful in sexual counseling. Five exercises in intimacy derived from the ancient Tantric sex ritual are presented and suggested as home assignments for couples: the creation of a ritual, synchronized breathing, sustained eye contact, motionless intercourse, and sexual exchange without orgasm. Applications to intimacy development, sexual enhancement, and sexual counseling for couples are described, creating a broad and meaningful context for responding to clients' sexual concerns.
The paper briefly discusses the way different disciplines have approached the study of illness and healing crossculturally. The theoretical advantages and difficulties of using a behavioural perspective are then outlined. This is then applied to the Sanni Demon ritual of the Sinhalese Buddhists; this ceremony is used to end demonic possession. It is acknowledge that the anthropological and psychoanalytic analyses are useful but it is also shown that the ritual constitutes behavioral treatment. The implications of this in relation to universalistic ideas of normal and abnormal are discussed.
This paper explores the meaning of Kimam (Irian Jaya) male ritualized homosexual behavior by placing the behavior within a broad cultural context. It demonstrates that males claim to foster the growth of yams and to make men from boys by manipulating the processes of fertilization. One aspect of this manipulation involves the transfer of sperm from older males to boys. Exploration of Kimam ideas of death and burial rituals suggests that members of one village sector see their fertility as under attack by males of the opposite sector. At the conclusion of mortuary ceremonies, the two sectors engage in competitive feasts in which the successful control of fertility is symbolized by the presentation of finished products of male vitality: yams and children, especially boys. The analysis indicates that an understanding of homosexual behavior requires that attention not be restricted to the sexual behavior itself, but rather include various domains of meaning associated with it.
PURPOSE: To examine the symbolism of the white coat and the nature of authority as employed in the White Coat Ceremony for incoming first-year medical students. Little has been written concerning the rapid spread, bioethical implications or theoretical underpinnings of this ceremony despite adoption by over 100 medical schools in the United States, international recognition by medical schools in Israel and as the subject of recent editorial opinion in the United Kingdom. SUMMARY: The short white coat can be a highly useful tool allowing patients to identify practitioners in a liminal state. However, by officially sanctioning the white coat as a sign of the psychological contract of professionalism and empathy, the medical establishment may be responding to abrogations of its own authority and is teaching students that they are respected for their sartorial behavior separate from their behavior as individuals. CONCLUSION: The White Coat Ceremony fosters a sense of entitlement whereby authority based on title and uniform, and authority based on trust, are poorly distinguished.
A sacred relationship exists between tobacco and American Indian ceremonial activities and beliefs. This ancient connection continues to play an important role in American Indian communities including the Anishinabe (Ojibwe). Six Ojibwe traditional healers and spiritual leaders described the sacred use of tobacco during interviews. The research provides information on key-informant smoking behaviors, influence of tobacco-industry media, and 3 essential themes: the origin of sacred traditional tobacco; contemporary use and abuse of tobacco; and cultural strengths and meaning of tobacco in Anishinabe (Ojibwe) communities. Health professionals must recognize, be amenable to learn, and understand that sacred tobacco use and smoking commercial cigarette tobacco have separate purposes and functions. The challenge for health professionals, including nurses, is to retain the cultural use and value of tobacco while addressing the abuse and chronic effects of cigarette smoking when providing health care to American Indian clients.
These remarks were presented at the opening ceremony of the American Academy of Health Behavior (AAHB) annual scientific conference held in Charleston, SC, in February 2005 by the outgoing president of the Academy.
OBJECTIVE: Like many other medical schools, the University of California, Irvine annually conducts a White Coat ceremony in which incoming students take a professional oath of ethical conduct.(1) We report a new educational activity to connect the values expressed in the oath taken to the Ethics and Professionalism (EP) curriculum for first-year medical students(2) and its potential impact on physician training. DESCRIPTION: Following the White Coat ceremony, students participated in the Patient Doctor Society course that integrates diverse curricular topics centered on physician-patient communication. During this course, the students were introduced to EP content through a collaborative peer exercise. With the assistance of background readings on professional values and ethics concepts, small groups of students were asked to construct their own codes of ethics. The process of working in a group became part of the learning. After developing a code of ethics, each group was asked to identify primary values embodied in its code; primary obligations to patients and their families, other members of the health care team, and the community; key factors influencing code development; and likely effects of the code on the conduct of medical students and physicians. The goals of the session were to recognize formally both individual values and the values to which students commit themselves during the White Coat ceremony, to facilitate understanding of those values, and to begin to reconcile differences between personal and professional values. The small groups convened to report their findings in a three-hour session. Common values expressed by the students included patient autonomy, respect, beneficence, and professionalism. The delivery of quality health care, communication, education, and the equitable distribution of health care were among the most often listed obligations. The students reported that culture, societal values, family, experience, religion, education, and assigned readings were the key sources of the values in their codes. Most of the students enjoyed and learned from the exercise, believing that a code of ethics will serve as a helpful educational guide while they are students and as an action guide in their future practices. Student evaluations, narrative feedback, and faculty observation indicated that the students appreciated the opportunity to work in teams and to explore professional values. The students' most common suggestion for improvement involved incorporating analysis of clinical cases in which questions about professional values arise. DISCUSSION: Medical educators suggest that students' values and professional behaviors change throughout medical school, but such change is difficult to assess. The code-development exercise established a baseline of values at entry to medical school. We plan to track this cohort of students by reintroducing this exercise in their fourth year and will compare the codes developed in their first and fourth years to identify changes in values and to suggest what the students have learned about values during medical school. The comparison will be used to inform further development of the EP curriculum toward the goal of shaping and supporting the positive professional growth of our student-physicians.
The Papago people in the Tohono village have a repertoire of culturally stylized patterns of behavior to help them maintain their health. The use of foods and ceremonies for preventing illness and maintaning health are emphasized in the styles of the people as well as the concept of taking care of self and others. Comfort and discomfort, fatigue, aches, thirst, hunger, and sadness are daily experiences of the people. Laughter, crying, "taking care of self and others", walking slowly, eating beans and tortillas, maintaining calm thoughts, and so on, are all culturally defined patterns for coping with alterations in feeling. When professional healers are needed, they will be consulted according to how helpful people perceive these healers to be by their sensitive attitudes and actions. The medicine man, nurses, medicine ladies, the ladies-who-pray, physicians, and St. Francis are perceived to be members of the health care team for the Papago people. The meaningful patterning of culturally defined behavior must be understood within the context of the Papago cultural system. As illustrated by the Tohono, "taking care of self and others" is highly valued, but it is only meaningful as we understand the rules of the Papago society, particularly the religious and kinship systems. These systems tell us that family members are important in taking care of themselves and others. Thus, the description in this paper of culturally patterned health practices with their rituals, ceremonies, and ways to help maintain health and heal the sick help the reader to understand the importance of health and healing behaviors within a designated cultural context. In this study, it is the Papago community and their specialty life ways of maintaining health and preventing illnesses.
Olfaction is crucial to spotted hyenas (Crocuta crocuta), yet there are no controlled studies of their reactions to odors. In Experiment 1, the authors examined responses of captive hyenas to various environmental (prey, nonprey animal, and plant) odors. Subjects approached and sniffed all odors equally but preferentially licked prey odors, scent marked next to odors, and rolled in animal-based odors. In Experiment 2, the authors examined the function of rolling by applying odors to the pelts of captive hyenas. When hyenas wore carrion, they gained positive social attention (increased investigation and allogrooming) from pen mates, but when they wore camphor, the normal social greeting ceremony was curtailed. Thus, olfactory stimuli elicit specific responses, influence where behavior is directed, and can be used to affect social interaction.
Many gay American Indian (GAI) men feel alienated from their tribal, ceremonial and social communities because of homophobia and heterosexism. As a result, they often turn to their local gay community for social participation and sex opportunities. It is no secret that a significant aspect of some gay communities is socializing in local bars and clubs. The gay bar scene makes healthy living difficult for Native American gay men. This is especially the case for those who are in alcohol or drug recovery. In response, gay Native men's support groups are attempting to make available a cultural alternative to the double bind of alienation from one's Native community and exposure to substance abuse by providing alcohol and substance free opportunities for ceremonial and social involvement. The hope is that the men will go to bars less frequently and instead turn to Native cultural activities in men's groups for social, spiritual and emotional support. The logic of this approach assumes that individuals who are culturally invested in a community will gain a level of self and social acceptance, making them less likely to abuse substances and put themselves at risk for HIV infection. The information presented in this article comes from over six years of ethnographic research among GAI men concerning self and social acceptance, HIV/AIDS and American Indian GLBT identity.
These remarks by the incoming president of the Academy were presented at the closing ceremonies of the 5 annual scientific meeting of the American Academy of Health Behavior in Charleston, SC, February 23, 2005.