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1.
Clin Transplant ; 38(1): e15187, 2024 01.
Article in English | MEDLINE | ID: mdl-37933615

ABSTRACT

INTRODUCTION: We assessed differences in the post-transplant outcomes between COVID-19 vaccinated and unvaccinated Kidney transplant (KTx) recipients. METHODS: We conducted a retrospective, single-center study of 400 KTx from 2/1/2021 to 4/30/2022 with 6-21 months follow-up. Primary outcomes included differences in the incidence of post-transplant COVID-19, ICU admission for COVID-19, death, and graft failure between the two groups. Secondary outcomes were inpatient floor admission, outpatient-management, length of hospital stay during COVID-19 admission. We also reported rejection, DGF, CMV needing treatment, and BK PCR >10 000 in baseline characteristics. RESULT: 70.5% (282/400) were fully vaccinated, and 29.5% (118/400) were unvaccinated. 33% (92/282) of vaccinated and 39% (46/118) of unvaccinated patients developed COVID-19 (p-value .03). In both groups, 16% received outpatient treatments for COVID-19. 3% (12/282) of the vaccinated and 8% (11/118) unvaccinated were admitted to the general floors (p-value .06), and 1% (3/282) of the vaccinated and 3.3% (4/118) of the unvaccinated patients needed admission to the ICU (p-value .2). The length of stay was 12 days in both groups. 13/282 (4.6%) vaccinated patients and 7/118 (5.93%) unvaccinated patients died during the follow-up period (p-value = .3). COVID-19 was deemed the etiology of death in 5/13 cases in the vaccinated and 3/7 in the unvaccinated. DGF, rejection, CMV requiring treatment, and BK PCR >10 000 were comparable between groups. CONCLUSION: The incidence of COVID-19 was higher in unvaccinated than in vaccinated KTx. The two groups were not statistically different for other primary outcomes, including the need for hospital admissions (outpatient, general floor, ICU), length of hospital stay, death, and graft failure.


Subject(s)
COVID-19 , Cytomegalovirus Infections , Kidney Transplantation , Humans , Taboo , COVID-19/epidemiology , Retrospective Studies , Transplant Recipients
2.
Int J Legal Med ; 138(2): 639-649, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37934209

ABSTRACT

Forensic autopsy is an important tool for the proper management of non-natural deaths in minors. However, it seems that autopsy in minors is a practice which may not be performed routinely. In this framework, we conducted a study analyzing autopsies of minors (under 18 years of age in Italy) performed at the Institute of Forensic Medicine in Milan in the period 2001-2019. For the period 2015-2019, we extrapolated all deaths due to non-natural causes in minors to investigate how many and which of these deaths were not subjected to forensic autopsy. Of the total, 344 minors (235 males and 109 females) underwent autopsies, with an overall downward trend of about 80% since 2004. Most autopsies occurred between the ages of 0 and 1 year, and the fewest between the ages of 5 and 9 years. The place of death was home in most cases, and accidental death was most common, followed by natural death, suicide, and homicide, with prevalence varying by age group. Blunt force trauma predominated among accidental death in all age groups, followed by asphyxia. Similar findings were observed for suicides, although there was a more differentiated pattern for suicides between the ages of 15 and 17 years. Among homicides, blunt force trauma, asphyxia, and gunshot wounds were fairly evenly distributed across all age groups. Between 2015 and 2019, a total of 86 minors died of a non-natural cause, and a forensic autopsy was performed in only 33 cases (38%). Our data shows that fewer and fewer autopsies are being performed over the last years, which indicates a dangerous lack of forensic investigation of children and adolescent deaths, with enormous implications for prevention of child abuse.


Subject(s)
Suicide , Wounds, Gunshot , Wounds, Nonpenetrating , Child , Male , Adolescent , Female , Humans , Infant, Newborn , Infant , Retrospective Studies , Asphyxia , Taboo , Cause of Death , Autopsy , Homicide
3.
J Exp Child Psychol ; 242: 105894, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38493524

ABSTRACT

This research examines barriers to reporting academic dishonesty in early adulthood (Study 1; N = 92) and adolescence (Study 2; N = 137). Participants were asked to describe a recent time they observed a peer cheating and to reflect on their decision about whether to report the cheating. They also responded to hypothetical scenarios about observing typical cheating actions, and the presence of social motives (e.g., whether people who report tend to gain reputations for being snitches) was manipulated in each scenario. Even though participants judged reporting to be the morally right thing to do, doing so was rare and approval for it was low, especially in adolescence. Participants also tended to say they would rather be friends with people who do not report cheaters than with those who do. Participants reasoned about a variety of social concerns to support their judgments about reporting (e.g., concern about their relationship with the cheater, concerns for others' welfare), and the manipulated social motives in the hypothetical scenarios significantly influenced judgments about reporting. These findings inform our understanding of the social dynamics that contribute to decisions about policing academic honesty.


Subject(s)
Deception , Taboo , Adolescent , Humans , Animals , Rats , Adult , Students , Judgment , Motivation
4.
Ethn Health ; 29(2): 208-219, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38117236

ABSTRACT

BACKGROUND: The level of knowledge and comprehension surrounding puberty and menstruation. It can substantially impact women's overall health. This cross-sectional study is conducted to get insights about menstrual knowledge, attitudes and taboos among college and university female students in Haryana. METHODS: A survey was conducted to investigate the experiences of menstruation among female students from government universities and colleges. Respondents were categorized on the basis of age, education qualification, and background setting. Random sampling was used to ensure participation from six administrative zones. The chi-square test was used to determine statistical significance, and the analysis was built around the p-value. RESULTS: The data reveals that there is no significant association between the age of the participants and their awareness of menstruation, scientific knowledge related to menstruation, or their personal relationships with mother, father, or family members. Similarly, there is no significant association between the participants' scientific knowledge and their level of education. However, there is a significant association between participants' personal relationships and level of education (p = .025). Additionally, a significant association was observed between taboos and level of education (p = .025). CONCLUSION: Age, residential area, and educational levels do not seem to significantly impact participants' awareness and knowledge. This study highlights the influence of personal equations and education on attitudes and beliefs surrounding menstruation. The significant association between personal relationships and education underscores the importance of a supportive family. The persistence of menstrual taboos among undergraduates suggests that there is still a need for comprehensive and inclusive menstrual health education. This study also addressed the sustainable developmental goals for good health and well-being. Future studies should focus on exploring cultural factors such as religious beliefs and cultural norms in more detail to develop interventions that may help improve menstrual health outcomes among college and university students.


Subject(s)
Menstruation , Taboo , Female , Humans , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Mothers
5.
Health Commun ; 39(4): 685-696, 2024 Apr.
Article in English | MEDLINE | ID: mdl-36803354

ABSTRACT

Numerous women struggling with health issues dare not go to the hospital due to the stigmatization of obstetric and gynecological diseases in traditional Chinese culture. Social media provide a platform for women to access health information from experts easily. Guided by the doctor-patient communication model, attribution theory, and destigmatization framework, we sought to understand the topics/diseases covered by top OB/GYN influencers on Weibo and the prevalent functions, language style, responsibility attribution, and destigmatization cues used by them. We also examined how these communication strategies predicted followers' engagement behavior. The results showed that women's childbirth-related issues received the highest exposure in the leading OB/GYN influencers' Weibo posts. Influencers' emphasis on building psychological connectedness with their followers was exhibited in the following communication strategies: avoiding using complex medical terminology, drawing equivalences between the outgroup and ingroup, and providing health information. However, using everyday language, responding to emotions, and removing blame served as the three most influential predictors of followers' engagement. Theoretical and practical implications are also discussed.


Subject(s)
Reproductive Health , Social Media , Pregnancy , Female , Humans , Taboo , Communication , Language
6.
Behav Res Methods ; 56(4): 3794-3813, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38724878

ABSTRACT

The use of taboo words represents one of the most common and arguably universal linguistic behaviors, fulfilling a wide range of psychological and social functions. However, in the scientific literature, taboo language is poorly characterized, and how it is realized in different languages and populations remains largely unexplored. Here we provide a database of taboo words, collected from different linguistic communities (Study 1, N = 1046), along with their speaker-centered semantic characterization (Study 2, N = 455 for each of six rating dimensions), covering 13 languages and 17 countries from all five permanently inhabited continents. Our results show that, in all languages, taboo words are mainly characterized by extremely low valence and high arousal, and very low written frequency. However, a significant amount of cross-country variability in words' tabooness and offensiveness proves the importance of community-specific sociocultural knowledge in the study of taboo language.


Subject(s)
Language , Taboo , Humans , Semantics , Cross-Cultural Comparison
7.
Evol Anthropol ; 32(3): 144-153, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37172138

ABSTRACT

We hope to raise awareness of mental health and well-being among primatologists. With this aim in mind, we organized a workshop on mental health as part of the main program of the Winter meeting of the Primate Society of Great Britain in December 2021. The workshop was very well received. Here, we review the main issues raised in the workshop, and supplement them with our own observations, reflections, and reading. The information we gathered during the workshop reveals clear hazards to mental health and suggests that we must collectively acknowledge and better manage both the hazards themselves and our ability to cope with them if we are to avert disaster. We call on institutions and learned societies to lead in seeking solutions for the benefit of primatologists and primatology.


Subject(s)
Mental Health , Taboo , Animals , Primates , United Kingdom
8.
BMC Pregnancy Childbirth ; 23(1): 116, 2023 Feb 16.
Article in English | MEDLINE | ID: mdl-36797675

ABSTRACT

BACKGROUND: There are foods considered as taboo across different communities in the world and in Ethiopia in particular. Although food taboos exist across all ages or physiologic states, they are predominant among pregnant women and children. Identifying such foods among pregnant women is crucial in providing focused interventions and prevents their negative consequences. Therefore, the aim of this review was to review the available evidence on food taboos and their perceived reasons among pregnant women in Ethiopia to provide comprehensive and precise evidence for decision making. METHODS: Electronic search of the literature was made from Pub-Med, Google Scholar, Google Scopus, and Medline databases using search terms set based on the PICO/PS (Population, Intervention/exposure, Comparison, and Outcome) and PS (Population and Situation) search table. The search was made from December 05, 2020 - December, 29, 2021, and updated on January, 2022. All quantitative and qualitative studies published in English were included in the review. The systematic review protocol was registered at INPLASY (Registration number: INPLASY202310078). The outcome of interest was food taboo for pregnant women and its perceived reasons. The results of the review was narrated. RESULTS: After identifying eighty two articles, thirteen were found eligible for the review. Vegetables, fruits, and fatty foods like meat, and dairy products were considered as taboo for pregnant women in different parts of Ethiopia. The reasons stated for the food taboo vary from fear of having a big baby, obstructed labour, and abortion to evil eye and physical and aesthetic deformities in the newborn. CONCLUSIONS: Though not uniform across the country, there are foods considered as taboo for pregnant women in Ethiopia due to several perceived reasons, misconceptions, and societal influences. This could increase the risk of malnutrition and could have short and long term consequences on both the mother and her growing foetus. Therefore, context specific nutritional counseling with emphasis during ante-natal care and post-natal service is important.


Subject(s)
Malnutrition , Pregnant Women , Child , Infant, Newborn , Pregnancy , Female , Humans , Pregnant Women/psychology , Taboo , Ethiopia , Vegetables
9.
BMC Womens Health ; 23(1): 161, 2023 04 04.
Article in English | MEDLINE | ID: mdl-37016318

ABSTRACT

There is growing recognition of the important role menstrual health plays in achieving health, education, and gender equity. Yet, stigmatisation and taboo remain present and negative emotions like fear and shame dominate the narrative when speaking about periods. This paper analyses how formal and informal menstrual education is received in Spain, to understand the role of menstrual health literacy in the way menstruation is experienced, and to identify what information would be useful to integrate into formal menstrual education. An online survey with more than 4000 participants (aged between 14 and 80, both people who will/do/have previously menstruate/d and those who do not menstruate) was conducted. Data was gathered using the digital platform Typeform, descriptive and inferential statistical analyses were performed with SPSS software and qualitative data was thematically analysed using Nvivo. Many participants declared not having received sufficient information on menstruation prior to menarche, particularly about how to physically manage it. Furthermore, negative emotions like shame, worry, and fear were recurrently reported to describe menarche; this has not changed between generations. Interestingly, we saw an increase in stress and sadness with an increase in perceived knowledge of the reproductive role of menstruation. We did observe a reduction in negative emotions when people who menstruate perceived they had sufficient information on how to manage their first bleeding. It is recommended that menstrual education beyond reproductive biology, particularly including how to physically manage periods, is integrated into school curricula. Menstrual education of everyone - including those who do not menstruate-can improve how periods are experienced in Spain.


Subject(s)
Menarche , Menstruation , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Educational Status , Health Knowledge, Attitudes, Practice , Menstruation/psychology , Schools , Surveys and Questionnaires , Social Stigma , Taboo , Spain
10.
Proc Natl Acad Sci U S A ; 117(5): 2378-2384, 2020 02 04.
Article in English | MEDLINE | ID: mdl-31964846

ABSTRACT

The family unit and kinship structures form the basis of social relationships in indigenous societies. Families constitute a cultural group, a so-called clan, within which marriage is prohibited by the incest taboo. The clan attribution governs the mating preference and descent relationships by certain rules. Such rules form various kinship structures, including generalized exchange, an indirect exchange of brides among more than two clans, and restricted exchange, a direct exchange of brides with the flow of children to different clans. These structures are distributed in different areas and show different cultural consequences. However, it is still unknown how they emerge or what conditions determine different structures. Here, we build a model of communities consisting of lineages and family groups and introduce social cooperation among kin and mates and conflict over mating. Each lineage has parameters characterizing the trait and mate preference, which determines the possibility of marriage and the degree of cooperation and conflict among lineages. Lineages can cooperate with those having similar traits to their own or mates', whereas lineages with similar preferences compete for brides. In addition, we introduce community-level selection by eliminating communities with smaller fitness and follow the so-called hierarchical Moran process. We numerically demonstrate that lineages are clustered in the space of traits and preferences, resulting in the emergence of clans with the incest taboo. Generalized exchange emerges when cooperation is strongly needed, whereas restricted exchange emerges when the mating conflict is strict. This may explain the geographical distribution of kinship structures in indigenous societies.


Subject(s)
Family , Marriage , Anthropology, Cultural , Competitive Behavior , Cooperative Behavior , Family/ethnology , Family Characteristics , Female , Humans , Incest/ethnology , Male , Marriage/ethnology , Models, Theoretical , Population Groups , Taboo
11.
Health Commun ; 38(4): 695-704, 2023 04.
Article in English | MEDLINE | ID: mdl-34459348

ABSTRACT

Communication about menstrual health continues to be influenced by institutional and social practices which deem it to be unclean and impure. In a country such as India, several customs and traditions reinforce secrecy and shame about menstruation. As such, scholars advocate the need to generate knowledge that can open opportunities to converse on the topic of menstruation and understand issues related to bodily changes. Using a culture-centered approach, this study examined how college-going adult women from two cities in Northern India made sense of menstrual health. Data collection included 20 focus groups with 180 college-going women and interviews with 16 female family members. Participants discussed communication patterns surrounding menstrual health and how they uphold, challenge, and change social practices. Specifically, participants reflected on how they were communicated to about their menstrual health with underpinnings of secrecy and shame and how the influence of current opportunities for openness encourage them to anticipate positive change. Theoretical and practical implications for studying communication around menstruation in diverse cultural contexts are discussed.


Subject(s)
Menstruation , Taboo , Adult , Female , Humans , Focus Groups , Culture , India , Health Knowledge, Attitudes, Practice
12.
Cult Health Sex ; 25(9): 1198-1213, 2023 09.
Article in English | MEDLINE | ID: mdl-36409764

ABSTRACT

Pacific Sexual and reproductive health is influenced by cultural taboos and sensitivities. Although Pacific values are integral to family planning, open communication in the home is often difficult in the face of changing socio-cultural norms. This study explores the experiences of iTaukei Pacific women living in Fiji and Aotearoa New Zealand, and their discussion of family planning within the family setting. The study utilises talanoa methodology to understand women's realities and their navigation through shifting sexual and reproductive norms in both countries. The study found that although family may be seen as a place of 'truth' in which appropriate, culturally sensitive family planning communication should be available, this was challenged by cultural taboos or tabu which were persistent in family planning discussions. The study calls for greater reliance on holistic approaches to Pacific family planning perspectives and a greater examination of va or the spaces within which Pacific women's experiences are negotiated and informed.


Subject(s)
Culturally Competent Care , Family Planning Services , Sex Education , Female , Humans , Fiji , Sexual Behavior , New Zealand , Women's Health , Social Determinants of Health , Taboo , Health Knowledge, Attitudes, Practice
13.
Matern Child Nutr ; 19(3): e13517, 2023 07.
Article in English | MEDLINE | ID: mdl-37016926

ABSTRACT

Food taboos encompass food restrictions practiced by a group that go beyond individual preferences. During pregnancy and lactation, food taboos may contribute to inadequate nutrition and poor maternal and infant health. Restriction of specific fish, meat, fruits and vegetables is common among peripartum women in many Southeast Asian countries, but data from Cambodia are lacking. In this mixed-methods study, 335 Cambodian mothers were asked open-ended questions regarding dietary behaviours during pregnancy and up to 24 weeks postpartum. Descriptive statistics and content analysis were used to characterize food taboos and multiple logistic regression analyses were conducted to identify predictors of this practice. Participants were 18-44 years of age, all of Khmer ethnicity and 31% were primiparous. Sixty-six per cent of women followed food taboos during the first 2 weeks postpartum, whereas ~20% of women restricted foods during other peripartum periods. Pregnancy taboos were often beneficial, including avoidance of sugar-sweetened beverages, coffee and alcohol. Conversely, postpartum avoidances typically included nutrient-dense foods such as fish, raw vegetables and chicken. Food taboos were generally followed to support maternal and child health. No significant predictors of food taboos during pregnancy were identified. Postpartum, each additional live birth a woman had reduced her odds of following food taboos by 24% (odds ratio [95% confidence interval]: 0.76 [0.61-0.95]). Specific food taboo practices and rationales varied greatly between women, suggesting that food taboos are shaped less by a strict belief system within the Khmer culture and more by individual or household understandings of food and health during pregnancy and postpartum.


Subject(s)
Peripartum Period , Taboo , Pregnancy , Female , Humans , Cambodia , Diet , Meat , Health Status
14.
Rev Med Suisse ; 19(837): 1466-1469, 2023 Aug 16.
Article in French | MEDLINE | ID: mdl-37589581

ABSTRACT

In Switzerland, sex work has been legal under certain conditions since 1942, and the number of sex workers in 2011 was estimated at between 14'000 and 20'000 throughout the country, 96% of whom were migrants. These people are exposed to a wide range of vulnerabilities, both because of their profession and because of structural and institutional shortcomings. The complexity of their care has led over time to the creation of specialised structures and units, which are often unknown to healthcare professionals. The aim of this article is to shed light on these facilities and to offer healthcare professionals appropriate advice on how to improve the care provided to patients in the emergency department.


En Suisse, le travail du sexe est légal sous certaines conditions depuis 1942 et le nombre de travailleuses du sexe (TS) en 2011 était estimé entre 14 000 et 20 000 sur l'entier du territoire, dont 96 % de migrantes. Ces personnes sont exposées à de nombreuses vulnérabilités, de par leur métier mais également en raison de lacunes structurelles et institutionnelles. La complexité de leur prise en charge a mené au fil du temps à la création de structures et d'unités spécialisées, qui sont souvent méconnues des professionnels de la santé. L'objectif de cet article est de mettre en lumière ces lieux et de proposer aux soignants des conseils adaptés afin d'améliorer la prise en charge des TS au service d'urgences.


Subject(s)
Sex Workers , Humans , Taboo , Emergency Service, Hospital , Health Personnel , Switzerland
15.
Rev Infirm ; 72(296): 28-29, 2023 Dec.
Article in French | MEDLINE | ID: mdl-38071013

ABSTRACT

From the earliest stages of adolescence, the question of alcohol consumption should be addressed by health professionals (GPs, midwives, gynecologists, pediatricians, nurses) working in the field of perinatal care or public health. All alcohol consumption is prohibited during pregnancy. In fact, a 2022 study showed that even low exposure to alcohol in utero has measurable effects on the structure of children's brains.


Subject(s)
Ethanol , Taboo , Pregnancy , Female , Child , Adolescent , Humans , Alcohol Drinking/prevention & control , Health Personnel
16.
Cogn Affect Behav Neurosci ; 22(2): 362-382, 2022 04.
Article in English | MEDLINE | ID: mdl-34725787

ABSTRACT

This study examined whether the context of acquisition of a word influences its visual recognition and subsequent processing. We utilized taboo words, whose meanings are typically acquired socially, to ensure that differences in processing were based on learned social taboo, rather than proficiency. American English-speaking participants made word/non-word decisions on American taboo (native dialect), British taboo (non-native dialect), positive, neutral, and pseudo- words while EEG was recorded. Taboo words were verified as taboo by both American and British English speakers in an independent norming survey. American taboo words showed a more positive amplitude of the Late Positive Complex (LPC), a neural correlate of emotionality and social processing, compared with British taboo words and all other word categories. Moreover, in an item-wise analysis, LPC amplitudes of American taboo words were positively correlated with their taboo ratings. British taboo words did not show this effect. This indicates that American participants, who had very limited social contact with British English, did not have the same perception of social threat from British taboo words as they had from American taboo words. These results point to the importance of social context of acquisition in establishing social-affective meaning in language.


Subject(s)
Language , Taboo , Humans , Learning , Recognition, Psychology/physiology , Social Environment , Taboo/psychology , United States
17.
J Sex Med ; 19(3): 421-429, 2022 03.
Article in English | MEDLINE | ID: mdl-35105513

ABSTRACT

BACKGROUND: Young people who have psychiatric problems are more likely than their peers to endure difficulties during their sexual and gender identity development. AIM: This study aims to examine the communication between mental health care providers and their patients about the topics of relations, sexuality and gender identity, including a description of professionals' attitudes toward these topics and the factors that contribute to and inhibit communication. METHODS: Study participants (n = 242, response rate = 31%) were a representative sample of a large multicenter cohort of 768 mental health care professionals (eg, medical doctors, psychiatrists, psychologists, group counselors, parent counselors) of 7 institutions and 5 solo practices in the Netherlands, who completed a survey on communication about sexuality and gender identity with their young patients (age 12-21 years). OUTCOMES: Sexuality and gender identity are infrequently discussed by mental health care providers with their young patients or their patients' parents. RESULTS: Of the study sample, 99.5 % valued sexuality as an important topic to discuss with their patients. However, only 17.1% of the professionals reported that they discussed sexuality-related issues with the majority (>75%) of their patients (adolescents: 19.9%, parents: 14.4%) Additionally, only 2.3 % of the participants discussed gender nonconformity regularly with patients. Information about sexual side effects of prescribed medication was infrequently (20.3%) provided: antidepressants (40.0%), antipsychotics (34.0%), benzodiazepines (5.1%) and stimulants (2.4%). The most frequently cited reasons for not discussing these topics were a lack of awareness, own feelings of discomfort, and the patients' supposed feelings of shame. There was no gender differences observed. CLINICAL IMPLICATIONS: Recommendations for professionals include to be aware of these topics, initiating age-appropriate conversation and use inclusive language. STRENGTHS AND LIMITATIONS: The present study included a diverse and representative group of mental health care professionals. Frequency of sexual communication was based on self-report, which brings a risk of bias. CONCLUSION: Despite a recognized need to engage in age-appropriate communication about sexuality and gender identity in youth mental health care, mental health providers seem to remain hesitant to discuss such topics. Bungener SL, Post L, Berends I, et al. Talking About Sexuality With Youth: A Taboo in Psychiatry?. J Sex Med 2022;19:421-429.


Subject(s)
Psychiatry , Taboo , Adolescent , Adult , Child , Female , Gender Identity , Humans , Male , Sexual Behavior/psychology , Sexuality , Young Adult
18.
Br J Clin Psychol ; 61(4): 964-982, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35429005

ABSTRACT

OBJECTIVES: The current study evaluated the feasibility of an internet-delivered cognitive therapy (I-CT) in a self-help format with minimal therapist support for patients with obsessive-compulsive disorder (OCD) with primary taboo obsessions. Specifically, the aims were to investigate (1) whether participants were able to grasp and apply the internet-delivered cognitive framework to their own situation; (2) whether they had clinically meaningful reductions of OCD symptom severity; and (3) whether reduced negative appraisals (hypothesized mechanism of change in CT) preceded reductions in OCD symptom severity. METHOD: Nineteen OCD patients with primary taboo obsessions, recruited from an OCD clinic or self-referrals, received the I-CT intervention for 10 weeks. I-CT did not contain any systematic exposure or response prevention. RESULTS: Adherence and engagement with the intervention was high. Most participants (n = 13, 68%) understood and successfully applied the cognitive model to their own situation. Within-group analyses showed large reductions in OCD symptom severity at post-treatment (bootstrapped within group d = 1.67 [95% CI; 0.67 to 2.66]) measured with the Yale-Brown Obsessive-Compulsive Scale. The gains were maintained at the 6-month follow-up. Post-hoc analyses revealed that the large reductions in OCD symptom severity were driven by the participants who understood the cognitive model. Reductions in negative appraisals predicted subsequent reductions in OCD symptom severity during treatment. CONCLUSION: It is possible to adapt a purely cognitive intervention to a digital guided self-help format and to achieve both cognitive change and meaningful symptom reduction. The results require confirmation in a randomized clinical trial.


Subject(s)
Cognitive Behavioral Therapy , Obsessive-Compulsive Disorder , Cognitive Behavioral Therapy/methods , Humans , Obsessive Behavior , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/therapy , Taboo , Treatment Outcome
19.
Med Humanit ; 48(1): e2-e9, 2022 Mar.
Article in English | MEDLINE | ID: mdl-33199587

ABSTRACT

Contemporary society has grown seemingly detached from the realities of growing old and subsequently, dying. A consequence, perhaps, of death becoming increasingly overmedicalised, nearly one in two UK nationals die institutional deaths. In this article we, two architectural scholars engaged in teaching, research and practice and a nurse and healthcare scholar with a focus on end-of-life care and peoples' experiences, wish to draw attention to a controversy resulting from a paucity in current literature on the terms of reference of the dying 'patient' as we navigate the future implications of the COVID-19 pandemic. This contributes to a relative lack of touchstones for architects to refer to when designing person-centred palliative care environments. Unlike common building types, architects are extremely unlikely to have lived experience of palliative care environments as patients; and therefore, require the help of healthcare professionals to imagine and empathise with the requirements of a person dying away from home. This paper includes a review of ageing and dying literature to understand, and distil from an architectural perspective, who, design professionals, are designing for and to remember the nuanced characteristics of those we hold a duty of care toward. We ask readers to heed the importance of accurate terms of reference, especially when commissioning and/or designing environments of palliative care. Furthermore, we put forward an appeal for interdisciplinary collaboration to develop a framework for codesigning positive experiences of person-centred care and environments at the end of life.


Subject(s)
COVID-19 , Terminal Care , Humans , Palliative Care/methods , Pandemics , SARS-CoV-2 , Taboo
20.
Omega (Westport) ; 84(4): 1061-1080, 2022 Mar.
Article in English | MEDLINE | ID: mdl-32460672

ABSTRACT

Much of the scholarly literature sees death as a taboo topic for Chinese. To test this assumption, this study held seven focus groups in the Greater Toronto Area in 2017. It found that the majority of the older Chinese immigrant participants talked about death freely using either the word death or a euphemism. They talked about various issues including medical treatment and end-of-life care, medical assistance in dying, death preparation, and so on. A small number did not talk about death, but it seemed their reluctance was related to anxiety or discomfort or simply reflected a choice of words. The study concludes death as taboo could be a myth, at least for older Chinese immigrants.


Subject(s)
Emigrants and Immigrants , Terminal Care , Asian People , China , Humans , Taboo
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