Bioethics for clinicians: 19. Hinduism and Sikhism.
Hindus and Sikhs constitute important minority communities in Canada. Although their cultural and religious traditions have profound differences, they both traditionally take a duty-based rather than rights-based approach to ethical decision-making. These traditions also share a belief in rebirth, a concept of karma (in which experiences in one life influence experiences in future lives), an emphasis on the value of purity, and a holistic view of the person that affirms the importance of family, culture, environment and the spiritual dimension of experience. Physicians with Hindu and Sikh patients need to be sensitive to and respectful of the diversity of their cultural and religious assumptions regarding human nature, purity, health and illness, life and death, and the status of the individual. (+info)
Community based retrospective study of sex in infant mortality in India.
OBJECTIVE: To determine whether the imbalance in the sex ratio in India can be explained by less favourable treatment of girls in infancy. DESIGN: Analysis of results of verbal autopsy reports over a five year period. SETTING: Community health project in urban India. MAIN OUTCOME MEASURES: Deaths from all causes in infants aged less than 1 year. RESULTS: The sex ratio at birth was 869 females per 1000 males. The mean infant mortality was 1.3 times higher in females than in males (72 v 55 per 1000). Diarrhoea was responsible for 22% of deaths overall, though twice as many girls died from diarrhoea. There were no significant differences in the numbers of deaths from causes such as birth asphyxia, septicaemia, prematurity, and congenital anomalies. In 10% of deaths there was no preceding illness and no satisfactory cause was found. Three out of every four such deaths were in girls. CONCLUSIONS: The excess number of unexplained deaths and deaths due to treatable conditions such as diarrhoeal disease in girls may be because girls are regarded and treated less favourably in India. (+info)
Dhaga syndrome: a previously undescribed entity.
Three children between the ages of 18 months and four years presented with a discharging sinus or sinuses at the wrist due to a 'sacred' thread (the Moli Dhaga) which had been tied around it. This thread had been forgotten by the parents and had become embedded in the soft tissues of the wrist. Plain radiographs showed a circumferential constriction in the soft tissue shadow in all three. In two, there was a periosteal reaction in the distal radius or ulna with an indentation which we have called the constriction sign. Surgical removal of the buried thread was successful in all cases. (+info)
Female sterilisation in rural Bihar: what are the acceptor characteristics?
OBJECTIVE: The National Population Policy aims to expand voluntary and informed use of contraceptive services. This paper examines the determinants of use of female sterilisation versus other contraceptive methods in rural Bihar, one of the most socially and economically deprived states in India. METHODS: Data for 1378 ever-married women aged 15-49 years in rural Bihar, who are currently using contraception, were abstracted from the Second National Family Health Survey. A logistic regression model was developed to understand the determinants of use of female sterilisation versus other contraceptive methods. RESULTS: Maternal age, the number of living sons, religion, scheduled caste/tribe/backward class status, exposure to mass media and household standard of living are statistically significant determinants of the choice between sterilisation and other contraceptive methods. CONCLUSION: The study underscores the need to significantly broaden the contraceptive choice for women in rural Bihar. (+info)
International public health research involving interpreters: a case study from Bangladesh.
BACKGROUND: Cross-cultural and international research are important components of public health research, but the challenges of language barriers and working with interpreters are often overlooked, particularly in the case of qualitative research. METHODS: A case-study approach was used to explore experiences of working with an interpreter in Bangladesh as part of a research project investigating women's experiences of emergency obstetric care. THE CASE STUDY: Data from the researcher's field notes provided evidence of experiences in working with an interpreter and show how the model of interviewing was adapted over time to give a more active role to the interpreter. The advantages of a more active role were increased rapport and "flow" in interviews. The disadvantages included reduced control from the researcher's perspective. Some tensions between the researcher and interpreter remained hard to overcome, irrespective of the model used. Independent transcription and translation of the interviews also raised questions around accuracy in translation. CONCLUSION: The issues examined in this case study have broader implications for public health research. Further work is needed in three areas: 1) developing effective relationships with interpreters; 2) the impact of the interpreter on the research process; and 3) the accuracy of the translation and level of analysis needed in any specific public health research. Finally, this paper highlights the importance to authors of reflecting on the potential impact of translation and interpretation on the research process when disseminating their research. (+info)
Reconstructing recent human phylogenies with forensic STR loci: a statistical approach.
BACKGROUND: Forensic Short Tandem Repeat (STR) loci are effective for the purpose of individual identification, and other forensic applications. Most of these markers have high allelic variability and mutation rate because of which they have limited use in the phylogenetic reconstruction. In the present study, we have carried out a meta-analysis to explore the possibility of using only five STR loci (TPOX, FES, vWA, F13A and Tho1) to carry out phylogenetic assessment based on the allele frequency profile of 20 world population and north Indian Hindus analyzed in the present study. RESULTS: Phylogenetic analysis based on two different approaches - genetic distance and maximum likelihood along with statistical bootstrapping procedure involving 1000 replicates was carried out. The ensuing tree topologies and PC plots were further compared with those obtained in earlier phylogenetic investigations. The compiled database of 21 populations got segregated and finely resolved into three basal clusters with very high bootstrap values corresponding to three geo-ethnic groups of African, Orientals, and Caucasians. CONCLUSION: Based on this study we conclude that if appropriate and logistic statistical approaches are followed then even lesser number of forensic STR loci are powerful enough to reconstruct the recent human phylogenies despite of their relatively high mutation rates. (+info)
Chinese and South Asian religious institutions and HIV prevention in New York City.
Religious institutions in Asian immigrant communities are in a unique position to confront the challenges of the HIV epidemic for the populations they serve. However, there has been little research on whether these institutions are willing or able to take a role in HIV prevention. This article reports on findings from a qualitative study of three Asian immigrant religious institutions in New York City (a Buddhist temple, a Hindu temple, an Islamic center/mosque) that are part of a larger study of Asian immigrant community institutions and their response to the HIV epidemic. Several prominent themes arose that formed the basis of a preliminary theoretical framework describing the way Asian immigrant religious institutions may evaluate their role in HIV prevention. The interview data indicate that the institutions take a stance of "conservative innovation," weighing their role as keepers of morality and religious tradition against the changing needs of their communities and then adjusting their practices or positions incrementally (to varying degrees) to stay responsive and relevant. (+info)
Response of religious groups to HIV/AIDS as a sexually transmitted infection in Trinidad.
BACKGROUND: HIV/AIDS-related stigma and discrimination are significant determinants of HIV transmission in the Caribbean island nation of Trinidad and Tobago (T&T), where the adult HIV/AIDS prevalence is 2.5%. T&T is a spiritually-aware society and over 104 religious groups are represented. This religious diversity creates a complex social environment for the transmission of a sexually transmitted infection like HIV/AIDS. Religious leaders are esteemed in T&T's society and may use their position and frequent interactions with the public to promote HIV/AIDS awareness, fight stigma and discrimination, and exercise compassion for people living with HIV/AIDS (PWHA). Some religious groups have initiated HIV/AIDS education programs within their membership, but previous studies suggest that HIV/AIDS remains a stigmatized infection in many religious organizations. The present study investigates how the perception of HIV/AIDS as a sexually transmitted infection impacts religious representatives' incentives to respond to HIV/AIDS in their congregations and communities. In correlation, the study explores how the experiences of PWHA in religious gatherings impact healing and coping with HIV/AIDS. METHODS: Between November 2002 and April 2003, in-depth interviews were conducted with 11 religious representatives from 10 Christian, Hindu and Muslim denominations. The majority of respondents were leaders of religious services, while two were active congregation members. Religious groups were selected based upon the methods of Brathwaite. Briefly, 26 religious groups with the largest followings according to 2000 census data were identified in Trinidad and Tobago. From this original list, 10 religious groups in Northwest Trinidad were selected to comprise a representative sample of the island's main denominations. In-depth interviews with PWHA were conducted during the same study period, 2002-2003. Four individuals were selected from a care and support group located in Port of Spain based upon their perceived willingness to discuss religious affiliation and describe how living with a terminal infection has affected their spiritual lives. The interviewer, a United States Fulbright Scholar, explained the nature and purpose of the study to all participants. Relevant ethical procedures associated with the collection of interview data were adopted: interviews were conducted in a non-coercive manner and confidentiality was assured. All participants provided verbal consent, and agreed to be interviewed without financial or other incentive. Ethics approval was granted on behalf of the Caribbean Conference of Churches Ethics Committee. Interview questions followed a guideline, and employed an open-ended format to facilitate discussion. All interviews were recorded and transcribed by the interviewer. RESULTS: Religious representatives' opinions were grouped into the following categories: rationale for the spread of HIV/AIDS, abstinence, condom use, sexuality and homosexuality, compassion, experiences with PWHA, recommendations and current approach to addressing HIV/AIDS in congregations. Religious representatives expressed a measure of acceptance of HIV/AIDS and overwhelmingly upheld compassion for PWHA. Some statements, however, suggested that HIV/AIDS stigma pervades Trinidad's religious organizations. For many representatives, HIV/AIDS was associated with a promiscuous lifestyle and/or homosexuality. Representatives had varying levels of interaction with PWHA, but personal experiences were positively associated with current involvement in HIV/AIDS initiatives. All 4 PWHA interviewed identified themselves as belonging to Christian denominations. Three out of the 4 PWHA described discriminatory experiences with pastors or congregation members during gatherings for religious services. Nonetheless, PWHA expressed an important role for faith and religion in coping with HIV. CONCLUSION: Religious groups in Trinidad are being challenged to promote a clear and consistent response to the HIV/AIDS epidemic; a response that may reflect personal experiences and respect religious doctrine in the context of sex and sexuality. The study suggests that (1) religious leaders could improve their role in the fight against HIV/AIDS with education and sensitization-specifically aimed at dismantling the myths about HIV transmission, and the stereotyping of susceptible sub-populations, and (2) a consultative dialogue between PWHAs and religious leaders is pivotal to a successful faith-based HIV intervention in Trinidad. (+info)