(1/84) Family rituals as a protective factor for children with asthma.
OBJECTIVE: To examine how one aspect of family life, notably family rituals and routines, may protect children with asthma from anxiety-related symptoms. METHODS: Eighty-six families (43 children with asthma, 43 healthy comparison children) participated in the study. Children completed measures of anxiety (Revised Child Manifest Anxiety Scale) and health. Parents completed measures of stress (Parenting Stress Index), family rituals (Family Routines Questionnaire), and family health. RESULTS: Families that reported more meaning in their family routines had children who reported lower levels of anxiety. Mother endorsement of family ritual meaning and father endorsement of family ritual routine were most strongly related to lower levels of anxiety. Support for the protective function of meaningful family rituals was stronger when a general health stress model was used rather than the presence or absence of asthma alone. CONCLUSIONS: Family rituals may serve a protective function for children with asthma under conditions of heightened parenting stress. (+info)
(2/84) An exploration of the influence of family on cigarette smoking among American Indian adolescents.
American Indians have the highest smoking rate of all major racial/ethnic groups in the US, despite significant variation across tribes and regions of the country. Yet, little research has been conducted on smoking initiation among American Indian adolescents. In an effort to identify the mechanisms through which families influence teen smoking, both positively and negatively, 20 focus groups were conducted with 144 non-reservation American Indian teens in Oklahoma. Findings indicated that most of the antismoking messages from family members were given by parents and grandparents, and focused on the long-term health consequences of smoking and addiction. Parental responses to teen smoking varied widely, with some responses sending mixed messages to the teens. Many teens discussed obtaining their first cigarette in a family setting and the teens felt that having smokers in their families influenced them to try smoking. Teens were able to discuss the traditional role of tobacco in their culture and were aware of its presence at Indian events, but felt ceremonial and traditional use was distinct from recreational use. Additional research is necessary to assess whether these results are generalizable to other tribes and regions, and to other racial/ethnic groups. (+info)
(3/84) Assessing elemental mercury vapor exposure from cultural and religious practices.
Use of elemental mercury in certain cultural and religious practices can cause high exposures to mercury vapor. Uses include sprinkling mercury on the floor of a home or car, burning it in a candle, and mixing it with perfume. Some uses can produce indoor air mercury concentrations one or two orders of magnitude above occupational exposure limits. Exposures resulting from other uses, such as infrequent use of a small bead of mercury, could be well below currently recognized risk levels. Metallic mercury is available at almost all of the 15 botanicas visited in New York, New Jersey, and Pennsylvania, but botanica personnel often deny having mercury for sale when approached by outsiders to these religious and cultural traditions. Actions by public health authorities have driven the mercury trade underground in some locations. Interviews indicate that mercury users are aware that mercury is hazardous, but are not aware of the inhalation exposure risk. We argue against a crackdown by health authorities because it could drive the practices further underground, because high-risk practices may be rare, and because uninformed government intervention could have unfortunate political and civic side effects for some Caribbean and Latin American immigrant groups. We recommend an outreach and education program involving religious and community leaders, botanica personnel, and other mercury users. (+info)
(4/84) White coat ceremonies: a second opinion.
A "white coat" ceremony functions as a rite of passage for students entering medical school. This comment provides a second option in response to the earlier, more enthusiastic, discussion of the ceremony by Raanan Gillon. While these ceremonies may serve important sociological functions, they raise three serious problems: whether the professional oath or "affirmation of professional commitment" taken in this setting has any legitimacy, how a sponsor of such a ceremony would know which oath or affirmation to administer, and what the moral implications of this "bonding process" are. I argue that the initiation oath is morally meaningless if students are not aware of its content in advance, that different students ought to commit to different oaths, and that bonding of students to the medical profession necessarily separates them from identification with lay people who will be their patients. (+info)
(5/84) The 2003 anatomy ceremony: a service of gratitude.
In keeping with a long-standing tradition, Yale Medical and Physician Associate students gather at a ceremony each year after the completion of the anatomy course. The ceremony is a chance to reflect and to give thanks. It gives students the opportunity to articulate their gratitude to the selfless individuals who donated their bodies for the benefit of education. Many family members of the donors attend the ceremony. By reading poetry, performing musical pieces, and presenting works of art, the students and their teachers express some of the emotions and thoughts that the anatomy course has evoked. The following are some of the contributions presented at this year's ceremony. (+info)
(6/84) Personal view: cost and benefit of medical rituals in gastroenterology.
BACKGROUND: Unable to resolve a medical problem, gastroenterologists occasionally choose an ineffectual intervention instead. The elusive path to effectual management becomes substituted with an ineffectual but readily available medical ritual. The term 'ritual' refers to the utilization of an ineffectual intervention with little chances of achieving a medically relevant goal. AIM: The aim of the article is to analyse the cost-benefit relationship of rituals in gastroenterology and the reasons why gastroenterologists utilize them. METHODS: Ritualistic disease management is described in terms of medical decision and threshold analysis. RESULTS: If the perceived benefit of a ritual exceeds its cost, the ineffectual path becomes more attractive than expectant management or doing nothing. To engage in an ineffectual intervention, the threshold probability for success needs to exceed its cost-benefit difference divided by the benefit associated with success. In choosing an ineffectual intervention, doctors tend to underestimate the true costs of a ritual and overestimate its probability of success. The availability of an effectual path leads to more stringent conditions for the benefit associated with an ineffectual path. CONCLUSIONS: A better understanding of their economical underpinnings should lead to more restricted utilization of rituals in gastroenterology, especially, in situations where they drain scarce resources disproportionately to their perceived benefit. (+info)
(7/84) Complications of circumcision in Israel: a one year multicenter survey.
BACKGROUND: In Israel, virtually all children undergo circumcision in the neonatal period. Traditionally, it is commonly performed by a "Mohel" (ritual circumciser) but lately there is an increasing tendency among the educated secular population to prefer a medical procedure performed by a physician and with local anesthetic injection. OBJECTIVES: To evaluate the outcome of this procedure and to compare the complication rate following circumcisions performed by ritual circumcisers and by physicians. METHODS: In 2001, of the 19,478 males born in four major medical centers in Israel 66 had circumcision-related complications. All the children were circumcised in non-medical settings within the community. The patients were medically evaluated either urgently due to immediate complications or electively in outpatient clinics later on. Upon the initial assessment a detailed questionnaire was filled to obtain data regarding the procedure, the performer, and the subsequent complications. RESULTS: All the circumcisions were performed during the early neonatal period, usually on day 8 of life (according to Jewish law). in 55 cases (83%) it was part of a ritual ceremony conducted by a ritual circumciser (Mohel), while in 11 babies (17%) physicians were involved. Acute bleeding after circumcision was encountered in 16 cases (24%), which required suturing in 8. In addition, we found two cases of wound infection and one case of partial amputation of glans penis in which the circumcision was performed by a ritual circumciser. Among the late complications, the most common was excess of skin in 38 cases (57%); 5 children (7.5%) had penile torsion and 4 children (6%) had shortages of skin, phimosis and inclusion cyst. The overall estimated complication rate of circumcision was 0.34%. CONCLUSIONS: Complications of circumcision are rare in Israel and in most cases are mild and correctable. There appears to be no significant difference in the type of complications between medical and ritual circumcisions. (+info)
(8/84) Grief revisited.
The article serves to examine the cultural influences on attitudes towards the deceased and bereaved, as well as on the practice of mourning, and to revisit normal and pathological variants of grief. Grief is a subjective state of psychological and physiological reaction to the loss of a loved one. Reaction to the loss is experienced internally in a uniform manner across cultures. However, mourning, the voluntary social expression of the loss, varies from culture to culture. Rituals provide a standardised mode of behaviour, which helps to relieve the sense of uncertainty or loss. There were reports of ghost sightings involving foreign tourists in the 6 worst-hit southern provinces in Thailand following the tsunami tragedy. This phenomenon of "mass hallucinations" is understandable from the cultural perspective. New models of grief have been developed to account for the individuality and diversity of grief and to encompass the social, behavioural and spiritual dimensions of loss as well as those of the psychological and physical. Clinically, the duration of grief reactions varies widely, depending on the nature of the loss and the connection to the deceased. In the case of the tsunami tragedy, with relatives missing, homes swept away and familiar neighbourhoods turned into wastelands, many victims are likely to have complicated grief. Traumatic grief, which includes a prominent component of separation distress characterised by yearning and searching and frequent "bittersweet" recollections of the deceased, has been associated with long-term dysfunction. Grief work utilising the traumatic grief treatment protocol appears to be a promising intervention. (+info)