The institutional memorial service: a strategy to prevent burnout in HIV healthcare workers.
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Bereavement↗
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Kava dermopathy.
Kava is a psychoactive beverage used ceremonially for thousands of years by Pacific Islanders. Kava is made from the root of the pepper plant, Piper methysticum, found in Polynesia, Melanesia, and Micronesia. The beverage is a nonfermented depressant with complex neuropharmacologic properties that causes a tranquil state of intoxication. Kava also affects the skin, causing a peculiar scaly eruption. The cutaneous effects were first reported by members of Captain James Cook's Pacific expeditions, but they have never been described in dermatologic literature. Heavy kava drinkers acquire a reversible ichthyosiform eruption, kava dermopathy. The cause is unknown but may relate to interference with cholesterol metabolism. Today kava is used across the Pacific in both traditional ceremonies and informal social events. In Western nations, kava is sold as a relaxant by health food stores. This article explores the history of kava dermopathy from Cook's early reports to its presence today.
Beverages↗
[Blood, hemorrhage, hematuria, urology].
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Blood↗
Women's business: the challenge of childbirth.
This paper was delivered as the opening address at the First National Conference of Childbirth Educators held in Melbourne, Australia, November, 1988. It is published with permission and support from the organisers. This paper develops and links insights available from anthropology, sociology, feminism and economics to the challenge facing childbirth educators. This challenge needs illumination from a number of directions before it can be understood, explained and met. The challenge described in the paper is that of re-establishing the importance and value of 'women's business'. This phrase, developed further at the beginning of the work, is from Aboriginal culture. It conveys the uniqueness of matters belonging to women. Childbirth is currently big business. Its management, whilst masquerading as scientific or medical, is clearly socio-economic. Until this is understood big business will continue to dominate women's business. The paper sets out to develop and defend these assertions and establish a role and responsibility for childbirth educators in relation to them.
Anthropology, Cultural↗
Sociocultural factors and the promotion of exclusive breastfeeding in rural Yoruba communities of Osun State, Nigeria.
Child survival strategies include prolonged and intensive breastfeeding, together with its early initiation, and breastmilk only for the first six months of life. This paper reports on local knowledge and attitudes of breastfeeding and the sociocultural factors that shape its practice in poor rural Yoruba communities of Southwestern Nigeria. The study has conducted 10 focus group discussions among homogeneous groups of grandmothers, pregnant women, lactating mothers, husbands, and community health workers, and a questionnaire survey of 256 third trimester pregnant women. All women in these communities breastfeed their infants on demand, and for up to two years, because breastmilk is universally accepted as the best food for babies, and breastfeeding spaces births. Prelacteal feedings of water herbal infusions and ritual fluids are the norm, and breastmilk is supplemented, from birth, with water and teas. Exclusive breastfeeding is considered dangerous to the infant: the baby has an obligatory requirement for supplementary water to quench its thirst and promote its normal development, and for herbal teas which serve as food and medicine. Colostrum is discarded because it is dirty, "like pus", and therefore potentially harmful to the infant, although 24% of the survey sample would give it to their babies. Expressed breastmilk is suspect as it can get contaminated, poisoned or bewitched. Complementary foods are introduced as early as two months because of perceived lactation insufficiency. The commonest supplement is a watery maize porridge of low nutrient density. Breastfeeding can also be dangerous, as toxins and contaminants can be passed to the infant through breastmilk. The most serious conflict with the WHO/UNICEF recommendations is the lack of local credibility of exclusive breastfeeding. According to local knowledge, the early introduction of water, herbal teas, and of complementary foods is designed to enhance child survival, while these are supposed to do the exact opposite by the WHO/UNICEF rationale, by exposing the infant to contaminants early, thereby increasing diarrheal morbidity and mortality. Child survival interventions need to address this conflict.
Attitude to Health↗
Shabbes burn, a burn that occurs solely among Jewish orthodox children; due to accidental shower from overhead water heaters.
From January 1990 to January 2000, 35 children were treated in our department for Shabbes burn, a unique scald burn that occurred mainly among orthodox Jews during the Sabbath. A retrospective review was conducted to determine the extent of the problem, to understand the burn mechanism and to suggest a prevention program. A shower of hot water from the Sabbath heater is the cause of this burn. Among the Shabbes burn cases, 27 patients were female (77%) and 17 children (48%) were between 3 and 6 years old. It is suggested that this is a common burn that occurs among orthodox Jewish families and affects mainly females. Education programs using the media directed to the Jewish orthodox population have been conducted, this combined with redesigned of the heater, have reduced significantly the incidence of the burn as seen in our institute. However, even though efforts have been supported widely, there remains a need for educational and governmental regulations on a national level. This could aid orthodox Jews not only in Israel but globally, as well.
Accidents, Home↗
Burnt wives--a study of suicides.
Ritual self-immolation has long been practiced in India. Although in the past the practice has been related to the act of sati, it is currently more commonly associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 32 (21%) were immolation suicides and these cases were analyzed from both epidemiological and medicolegal aspects. Suicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from joint families (i.e. multigenerational groups of related individuals living under a single roof) and the suicides occurred 2-5 years after marriage. The majority of the affected wives were 21-25 years of age (69%) at the time of the suicide and sustained more than a 50% TBSA burn injury after dousing themselves with kerosene. Most died at the time of the incident or within the subsequent 24h, most commonly from shock.
Adolescent↗
Baby, souls, name and health: traditional customs for a newborn infant among the Hmong in Melbourne.
In this paper, I discuss childrearing beliefs and practices in Hmong culture. In particular I focus on issues related to souls and ceremonies for a newborn infant in Hmong society. The Hmong believe that each living body has three souls. For a newborn infant, the first soul enters his or her body when he or she is conceived in the mother's womb. The second soul enters when the baby has just emerged from the mother's body and taken its first breath. The third soul, however, will have to be called on the third morning after birth, as will be discussed in this paper. If all three souls are secured in the infant's body, he or she will be healthy and hence thrive well. On the contrary, the infant may become ill and eventually die if all three souls do not reside in his or her body. This, therefore, makes a soul calling ceremony on the third morning after birth essential in Hmong culture. I will show that for Hmong society to survive, the Hmong strongly adhere to their cultural beliefs and practices related to a newborn infant. These beliefs and practices tie the Hmong with not only their family and their society at large, but also the supernatural world.
Adult↗
Afrocentric treatment in residential substance abuse care. The Iwo San.
Alcohol and other drug treatment programs continue to report relatively low success rates among African-American participants. We propose that there is a need to consider treatment approaches that are more culturally competent. An Afrocentric paradigm is suggested and instituted as the central theme of a residential drug treatment program. Elements of an Afrocentric orientation and how these principles are used to guide the development of a treatment philosophy are discussed.
Black or African American↗
Handover: an ethnographic study of ritual in nursing practice.
Three times every day in most of the hospitals and nursing homes in the UK, the so-called ritual of handover takes place. This ethnographic study examines that practice. The handovers of one ward were observed to see if they warrant the label of ritual as described by Helman (1990). Further analysis was performed to examine the functions and meanings of this practice. The conclusion from the analysis is that this practice does merit the label of ritual. Ritual is examined in terms of its meaning and found to serve valuable psychological, social and protective functions for its unwitting participants. Ritual serves another function, it plays an important role in valuing and emphasising what comes to constitute working nursing knowledge. In conclusion, ritual should not be dismissed by a profession which claims a holistic approach as its espoused theory, but further investigated and utilised as a means for accessing nursing knowledge.
Ceremonial Behavior↗
Reflections on the differences between religion and culture.
Culture may be thought of as a causal agent that affects the evolutionary process by uniquely human means. Religion, on the other hand, is considered a process of revelation and contains the concept of the "faithful" who receive the message of revelation. Culture permits the "self-conscious evaluation of human possibilities" and therefore presents a device for increasing human control over species change. There are dangers, however, in accepting cultural relativism without any constraint, such as respect for human life and dignity. In this article, the author attempts to clarify the boundaries between religion and culture and acknowledges that further research is needed on the religion/culture dichotomy.
Attitude↗
Rituals: the 'soul' purpose.
Nursing has, perhaps unknowingly, given recognition to the importance of maintaining the client's normal rituals and patterns of day-to-day activity on admission to hospital. To make the client feel more at ease, comfortable and relaxed, care is aimed at adhering to their usual routine. To this end, the client's bedtime rituals, toileting habits and many other of their daily routines are explored during the hospital admission process or initiation ceremony to the ward. As nurses, we place great meaning on trying to maintain these rituals and routines for the client, recognizing that keeping a sense of normality may be of great importance. It seems almost paradoxical then, that it is we nurses who criticize ourselves for compulsively adhering to what are described as ritualistic ways of working; which it has been said, are of seemingly little value both to the client's own healing process and nursing itself. In a recent paper the notion that ritualized practice had no place in nursing and made a case for the defence of rituals was challenged. This paper expands this theme further, exploring the symbolic and ancestral necessity for rituals, drawing upon archetypal psychology to help illustrate the potential hazards for the nursing milieu of dismissing rituals without fully understanding their latent purpose.
Activities of Daily Living↗
Electroencephalographic measurement of possession trance in the field.
OBJECTIVES: To verify the utility of a portable electroencephalogram (EEG) measurement system developed for investigating spontaneous EEG from vigorously moving healthy subjects in a possession trance under a natural condition. METHODS: A portable multi-channel EEG telemetry system was developed to record the EEGs of 3 healthy male Balinese while they were performing a ritual dedicatory drama in the field. After reducing extraneous artifacts using a digital filter, the EEGs and their power spectra were analyzed in terms of evolution from one state to another. RESULTS: During the drama, one of the subjects became possessed while the others did not. The EEG of the possessed subject did not show any pathological findings including epileptic discharges, but indicated enhanced power in the theta and alpha frequency bands during the trance. This finding was not observed in the other two subjects, who did not go into trances, with no pathological EEG findings. CONCLUSIONS: The measurement system and data analysis methods we developed have allowed us, for the first time, to obtain an EEG from healthy subjects who are vigorously moving while in a possession trance. The present technique enables us to use a spontaneous EEG as a marker of the underlying physiology of a state of possession trance.
Adult↗
Abelam yam beliefs and sociorhythmicity: a study in chronoanthropology.
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Anthropology, Cultural↗
Social and psychosexual problems of African adolescents.
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Adolescent↗
Birth rights and rituals in rural south India: care seeking in the intrapartum period.
Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women's experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births with a lay attendant or dai. The proportion of women who planned for an ANM to assist was 49%, as compared with the actual occurrence, which was less than half of this proportion. Perceived quality of care was found to be an important factor in health seeking behaviour, as was wealth, caste, education and experience of previous problems in pregnancy. Actual care given by a range of practitioners was found to contain both beneficial and undesirable elements. As a response to serious morbidities experienced within the study period, many women were able to seek care although sometimes after a long delay. Those women who experienced inadequate progression of labour pains were most likely to proceed unexpectedly to a hospital delivery.
Adolescent↗
Religion's evolutionary landscape: counterintuition, commitment, compassion, communion.
Religion is not an evolutionary adaptation per se, but a recurring cultural by-product of the complex evolutionary landscape that sets cognitive, emotional, and material conditions for ordinary human interactions. Religion exploits only ordinary cognitive processes to passionately display costly devotion to counterintuitive worlds governed by supernatural agents. The conceptual foundations of religion are intuitively given by task-specific panhuman cognitive domains, including folkmechanics, folkbiology, and folkpsychology. Core religious beliefs minimally violate ordinary notions about how the world is, with all of its inescapable problems, thus enabling people to imagine minimally impossible supernatural worlds that solve existential problems, including death and deception. Here the focus is on folkpsychology and agency. A key feature of the supernatural agent concepts common to all religions is the triggering of an "Innate Releasing Mechanism," or "agency detector," whose proper (naturally selected) domain encompasses animate objects relevant to hominid survival--such as predators, protectors, and prey--but which actually extends to moving dots on computer screens, voices in wind, and faces on clouds. Folkpsychology also crucially involves metarepresentation, which makes deception possible and threatens any social order. However, these same metacognitive capacities provide the hope and promise of open-ended solutions through representations of counterfactual supernatural worlds that cannot be logically or empirically verified or falsified. Because religious beliefs cannot be deductively or inductively validated, validation occurs only by ritually addressing the very emotions motivating religion. Cross-cultural experimental evidence encourages these claims.
Anxiety↗
Alternative psychotherapeutic practice among middle class Americans: II: Some conceptual and practical comparisons.
This article will contextualize ethnographic and clinical features that distinguish one particular alternative healing method (Self-Acceptance Training) from 'main-stream' psychotherapeutic procedures. Factors common to many psychotherapies are listed and a series of contrasts and comparisons made by examining definitions of: (1) presenting problems, (2) inciting events, (3) phasic development, (4) taxonomic classifications, (5) therapeutic interventions, and (6) prognostic formulations. The alternative method of treatment described in a companion publication ('SAT') is used to make some specific comparisons (Zatzick and Johnson 1997). Basch's (1980) concise recording of a dynamic therapy is borrowed for purposes of a comparative hypothetical treatment of his patient through a Self-Acceptance Training session. Some directions for future work are suggested.
Adult↗