The Friar with the Crutch: A Pictorial Hint of the Stroke Suffered by Bernardino da Fossa (1420-1503).

BACKGROUND: Works of art may serve as a source of evidence of diseases and help to better understand their natural history. SUMMARY: Bernardino da Fossa was a 15th-century Italian Franciscan friar who wrote sermons and historical works. He described the events of the Observance Reformation movement since its dawn, but the last chapter is unexplainably interrupted. This has been considered suggestive for an acute and disabling illness. A painting dating back 12 years after his death depicts Bernardino holding a crutch with his left arm. This may represent an important clue to establish a gait disturbance, whereas the permanent interruption in drafting his writing may be ascribed to a serious writing impairment. KEY MESSAGES: The historical detail of the writing suspension and the crutch in this painting represent important hints of the stroke suffered by Bernardino da Fossa.

Study of medication use and effects of medication among hospitalized older Buddhist monks: An embedded mixed-method study.

AIM: The aim was to study medication use, effects of medication and perspective of participants involved in medication use among hospitalized older Buddhist monks. DESIGN: An embedded mixed-method study. METHODS: This study included 71 hospitalized older Buddhist monks and 23 participants involved in medication use. Quantitative data were collected from medical and medication records. Meanwhile, qualitative data were collected by using in-depth interviews. Data were analysed using descriptive statistics and content analysis. The study lasted from February to July 2021. RESULTS: Over 77% of the monks had chronic diseases. The median of medicine use was seven medicines/person and 6 days of use. Effects of the medication were as expected (52.04%), not as expected (2.22%) and unmeasurable results (45.74%). Unexpected results were hypo-hyperglycaemia, nausea/vomiting, high blood pressure and confusion. From the interview, participants perceived and did not perceive unique practices and medication use in Buddhist monks. In addition, the Buddhist monks received medication following standards and Buddhist doctrine. Finally, recommendations for medication use were adhering to the standard, following Buddhist doctrine and being flexible as deemed necessary. CONCLUSION: The results revealed medication use problems and medication effects among hospitalized older Buddhist monks. IMPACT: Older adults and Buddhist monks have specific needs and practices related to culture and religion, affecting typical treatment, especially medication use. Cultural diversity and sensitivity should be a concern for healthcare staff. The results can be utilized to promote an understanding of cultural diversity and increase the safety of medication administration for hospitalized older Buddhist monks. PATIENT AND PUBLIC CONTRIBUTION: Patient and public contributions were involved in this study. Participants involved in medication use were interviewed to answer the research objective. Moreover, a senior Buddhist monk at Wat Thai Washington D.C. reviewed content related to the Pali Canon for the final draft of the manuscript. CLINICAL TRIAL REGISTRATION NUMBER: https://osf.io/b6p3e.

Noncommunicable diseases and social determinants of health in Buddhist monks: An integrative review.

The prevalence of noncommunicable diseases (NCDs) is increasing worldwide. Buddhist monks in Thailand play a critical role in health as community leaders accounting for 0.3% of the population. However, some monks require treatment and hospitalization to alleviate the burden of NCDs due to religious beliefs and practices during ordainment. Risk factors for NCDs among Buddhist monks, and the relationship to social determinants of health (SDH) remain unclear. This integrative review examined the prevalence of NCDs and explored the relationship between SDH and health outcomes among Buddhist monks. Cohort, descriptive, and correlational studies published in both English and Thai languages were identified from the PubMed, Science Direct, CINAHL, and Thai journal databases. Keywords included "Thai Buddhist monks," "non-communicable diseases," and "prevalence". Twenty-two studies were selected. Obesity and hypertension were the most prevalent NCDs. Religious beliefs and practices influence SDH domains and play an important role in the lifestyle and health behaviors among Buddhist monks. Further understanding of the impact of the religious lifestyle is needed, particularly given the role and influence of monks in society.

Characterization of Bipolar Disorder in Anton Chekhov's The Black Monk.

Anton Chekhov (1860-1904) was a famous Russian author and physician known for his dramas and short stories. Many of his works also address mental health problems. Here, the present paper is investigating his novella The Black Monk that was published in 1894. Its main protagonist, Kovrin, likely suffered from bipolar disorder as he exhibited elevated mood, grandiosity, lack of sleep, and delusions. His symptoms are analyzed based on current DSM-5 criteria, and he appears to meet diagnostic criteria for bipolar I disorder. Chekhov himself suffered from a mood disorder, but we speculate that he himself exhibited some bipolar symptoms. Those were likely an inspiration for when he wrote The Black Monk.

Rules We Live by: How Religious Beliefs Relate to Compliance with Precautionary Measures Against COVID-19 in Tibetan Buddhists.

The present studies investigated how particular religious beliefs shape compliance with preventive measures in adherents of Gelug and Nyingma schools of Tibetan Buddhism. In Study 1, Gelug and Nyingma monks were asked to report their compliance with various infection prevention measures surrounding COVID-19. Results showed that the former group showed higher compliance with public health guidelines than the latter. Extending beyond self-report measures, Study 2 added a behavioral outcome measure and observed the same effect. Together, our results provide the first empirical evidence that various Tibetan Buddhist traditions are related to different degrees of compliance with precautionary measures against COVID-19.

Cetacean Morbillivirus and Toxoplasma gondii Co-infection in Mediterranean Monk Seal Pup, Italy.

A Mediterranean monk seal (Monachus monachus) pup from the southern Adriatic coast of Italy showed cetacean morbillivirus (CeMV) and disseminated Toxoplasma gondii co-infection, which probably resulted from CeMV-induced immunosuppression. These findings are of concern for the conservation of this critically endangered species.

Chronic conditions, multimorbidity, and quality of life among patients attending monk healers and primary care clinics in Thailand.

BACKGROUND: The study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand. METHODS: In all, 1409 attendees of three monk healer or three health centres were assessed with self-reported measures on chronic conditions and Quality of Life (QoL). RESULTS: Results indicate that the most common chronic conditions were common mental disorder (25.2%), followed by hypertension (22.8%), high blood cholesterol (18.0%), fatigue disorder (14.4%), diabetes (14.0%), migraine headaches (13.7%), sleeping problem (12.2%), and ulcer (11.0%). In all, 40.6% had multimorbidity (two or more chronic conditions) (42.4% in the monk healer and 38.9% in the primary care setting). In ANCOVA analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3). The overall QoL was poorer among monk healer clients (66.5) than primary care patients (68.8). In adjusted logistical regression analysis, being a monk healer attendee, older age (55-93 years), and high debt were positively, and being employed and better overall quality of life were negatively associated with multimorbidity, overall, for the monk healer and primary care setting. In adjusted linear regression analyses, primary health care attenders, older age, were employed and post-secondary education increased the odds of better overall QoL. CONCLUSION: Multimorbidity was higher among clients attending monk healers than those attending primary care facilities and QoL was poorer among clients seeking care from monk healers than those attending primary care. High multimorbidity was found and major chronic conditions were found to have poor QoL. Determinants of multimorbidity and QoL in two different treatment settings provide information to improve the management of chronic conditions.

The Dark Age of medieval surgery in France in the first part of Middle Age (500-1000): royal touch, wound suckers, bizarre medieval surgery, monk surgeons, Saint Healers, but foundation of the oldest worldwide still-operating hospital.

PURPOSE: During the Middle Ages, the Christian church established itself as the dominant force over all aspects of medieval life, including the practice of medicine. As the Church's influence expanded across Europe, the role of lay practitioners in medicine declined, and clerics gradually assumed the role of healers in surgical practice as the cure of the soul was felt to take precedence over cure of bodily ills. MATERIAL AND METHODS: A retrospective analysis of hospital foundation, old-school surgical techniques still used today was performed during the first part of the Middle Age. RESULTS: The Hospital Hotel Dieu in Paris was founded and remains the oldest worldwide still-operating hospital. The monastery became a resting place for travelers, as well as a place of refuge for the sick. As this role expanded, monks often developed considerable surgical expertise. This led to fierce competition for saintly relics and pilgrims. Among the myriad of saints to whom powers of healing were ascribed, the names of Damian and Cosmas figure prominently in medical history. Old-school medieval surgery was also performed with some bizarre techniques such as lip service by wound suckers, cautery, blood-letting, leech therapy, and maggot therapy. CONCLUSION: This account of surgery before it became scientific is based on a chronology that runs from the Clovis baptism to the reign of Charlemagne; much of the medicine in this period was based on ancient doctrines; indeed, much of the development of medicine in the period called as "Dark Age" was due to the slow and difficult business of recovering and trying to understand ancient medicine.

BrainAGE and regional volumetric analysis of a Buddhist monk: a longitudinal MRI case study.

Yongey Mingyur Rinpoche (YMR) is a Tibetan Buddhist monk, and renowned meditation practitioner and teacher who has spent an extraordinary number of hours of his life meditating. The brain-aging profile of this expert meditator in comparison to a control population was examined using a machine learning framework, which estimates "brain-age" from brain imaging. YMR's brain-aging rate appeared slower than that of controls suggesting early maturation and delayed aging. At 41 years, his brain resembled that of a 33-year-old. Specific regional changes did not differentiate YMR from controls, suggesting that the brain-aging differences may arise from coordinated changes spread throughout the gray matter.

Conversion and Self-Transformation in Christian Monasticism: A Cognitive Perspective.

Religious conversion involves changes in the convert's way of thinking and behaving. This paper focuses on the unique form that this transformative process took within the Christian monastic movement in late antiquity. Treating monastic conversion as a gradual process in which the convert is an active participant, it examines the ways in which monastic converts were able to intentionally promote such a change and influence its direction. This study draws on research in cognitive psychology and neuroscience on the cognitive underpinnings of self-transformation in order to reconstruct from the literary sources of Near Eastern monasticism the strategies and training methods that late antique monks employed in order to facilitate and sustain the transformation implicated in conversion.

Health-related quality of life of a very special population: monks of Holy Mountain Athos, Greece.

PURPOSE: The investigation of Health-Related Quality of Life (HRQOL) of Orthodox Christian monks who live at the Holy Mount Athos in Greece, and its correlation with demographic characteristics and Sense of Coherence (SOC-13). METHODS: A cross-sectional study was designed. The seven monasteries and five scetes with the largest number of monk population were invited to participate. Two monasteries and 1 scete gave their permission for the study. The final monks sample was formed by 166 monks from 215 who participated to the study. HRQOL was assessed using the SF-12 and Sense of Coherence the SOC-13 scales that were completed by monks from May to August 2012. Μultiple linear regression analyses were conducted to explore the association of the HRQOL subscales with the demographics and SOC-13. RESULTS: The mean age was 45.5 ± 13.0 years; 83.7% lived in communal monasteries, and the mean number of years in monasticism was 18.4 ± 12.1. The mean value of their Physical Component Summary (PCS) score was 47.3 ± 5.3, which is lower than in the general Greek men population, while their Mental Component Summary (MCS) score was 56.4 ± 5.8, which is higher than in the general Greek men population. The mean value of SOC-13 was 65.7 ± 6.5. Positive association for PCS appeared for place of living (ß = 5.43, SE = 1.27, p < 0.001) and negative association for age (ß = -0.16, SE = 0.03, p < 0.001) while for MCS for number of years in monasticism (ß = 0.07, SE = 0.06, p = 0.023) and sense of coherence (ß = 0.47, SE = 0.06, p < 0.001). CONCLUSIONS: The results indicated that monks had better mental health but worse physical health compared to the general Greek male population. More studies are required to validate the above findings.

Clinical and Laboratory Characteristics of a Tinea Capitis Outbreak Among Novice Buddhist Monks.

Sixty novice Buddhist monks with tinea capitis confirmed according to clinical presentation and mycological laboratory finding were included in this study. Mixed-type clinical presentation was observed in approximately half of all cases, together with scarring alopecia (95%) and superficial fungal skin infection at locations other than the scalp (43.3%). The major isolated organism was Trichophyton violaceum, and mixed-organism infection was found in 27 cases (45%). Slow-onset presentation and an extensive area of infection were significantly associated with mixed-type clinical presentation.

Sense of Coherence (SOC) in Christian Orthodox Monks and Nuns in Greece.

This paper aims to investigate the stress management skills of Christian Orthodox monks and nuns, as measured by Antonovsky's scale sense of coherence (SOC). A case-control study was designed to test the hypotheses whether monks and nuns have higher SOC than secular people. The study population consisted of 193 individuals, 96 monks and nuns (study group) and 97 secular men and women (control group). SOC score was higher in monks and nuns as compared to the secular population (p = 0.002), men as compared to women (p = 0.012) and persons of older age (p = 0.004) as compared to younger individuals.

Exploring Oral Health Beliefs and Behaviour Among Tibetan Immigrants of Bylakkupe.

PURPOSE: To explore the oral health beliefs and behaviour among Tibetan immigrants of Bylakkupe village. MATERIALS AND METHODS: A stratified random sampling technique involving 366 Tibetan monks in Bylakkupe monasteries was used in this study. The oral health beliefs were measured using a pre-tested questionnaire. RESULTS: The results showed that seriousness was higher compared to other domains in the health belief model. Further, as the duration of the stay increased, the perceived importance was also higher among the population studied. CONCLUSION: The results show that in general, although the seriousness of oral health was high among the participants, the perceived benefit of dental treatment was relatively low.

An Aspect of the History of Medicine in Ancient Korea as Examined through Silla Buddhist Monks'Annotations on the "Chapter on Eliminating Disease"in the Sutra of Golden Light (Suvarnabhasa-sutra).

Nearly nothing is known of medicine in ancient Korea due to insufficient materials. With several extant prescriptions and esoteric methods of treating diseases alone, it is impossible to gauge in depth the management of medicine during this period. If one exception were to be cited, that would be the fact that the annotations for understanding the contents on Indian medicine in the "Chapter on Eliminating Disease" in the Sutra of Golden Light, a Buddhist sutra originating from India, reflected the medical knowledge of Buddhist monks from Silla (57 BC-935 AD) who were active immediately after the nation's unification of the two other kingdoms on the Korean Peninsula (668 AD) such as Wonhyo (617-686 AD), Gyeongheung (620?-700? AD), and Seungjang (684-? AD). Along with those by other monks, these annotations are collected in the Mysterious Pivot of the Sutra of Golden Light, which was compiled by Gangyo(835-871 AD), a Japanese monk from the Heian era (794-1185 AD). Representative versions of the "Chapter on Eliminating Disease" in the Sutra of Golden Light include: a classical Chinese translation by the Indian monk Dharmaksema (385-433 AD); the eight-volume edition by Chinese monk Baogui, which differs little from the preceding work in terms of the contents of the "Chapter on Eliminating Disease"; and the ten-volume edition by Yijing (635-713 AD), who had full-fledged knowledge of Indian medicine. When the contents of the annotations thus collected are examined, it seems that Wonhyo had not been aware of the existence of the ten-volume edition, and Gyeongheung and Seungjang most certainly used the ten-volume edition in their annotations as well. Especially noteworthy are Wonhyo's annotations on the Indian medical knowledge found in the "Chapter on Eliminating Disease" in the Sutra of Golden Light. Here, he made a bold attempt to link and understand consistently even discussions on Indian and Buddhist medicine on the basis of the traditional East Asian medical theory centering on the yin-yang and five phases (wuxing). In accordance with East Asia's theory of the seasonal five phases, Wonhyo sought to explain aspects of Indian medicine, e.g., changes in the four great elements (catvari maha-bhutani) of earth, water, fire, and wind according to seasonal factors and their effect on the internal organs; patterns of diseases such as wind (vata)-induced disease, bile (pitta)-induced disease, phlegm (slesman)-induced disease, and a combination (samnipata) of these three types of diseases; pathogenesis due to the indigestion of food, as pathological mechanisms centering on the theory of the mutual overcoming (xiangke) of the five phases including the five viscera (wuzang), five flavors (wuwei), and five colors (wuse). They existed in the text contents on Indian medicine, which could not be explicated well with the existing medical knowledge based on the theory of the five phases. Consequently, he boldly modified the theory of the five phases in his own way for such passages, thus attempting a reconciliation, or harmonization of disputes (hwajaeng), of the two medical systems. Such an attempt was even bolder than those by earlier annotators, and Wonhyo's annotations came to be accepted by later annotators as one persuasive explanation as well. In the case of Gyeongheung and Seungjang, who obtained and examined the ten-volume edition, a new classical Chinese translation produced following Wonhyo's death, annotated the "Chapter on Eliminating Disease" based on their outstanding proficiency in Sanskrit and knowledge of new Indian and Buddhist medicine. This fact signifies that knowledge of the eight arts of Ayurvedic medicine in India was introduced into Silla around the early 8th century. The medical knowledge of Wonhyo, Gyeongheung, and Seungjang demonstrates that intellectual circles in contemporary Silla were arenas in which not only traditional East Asian medicine as represented by works such as the Inner Canon of the Yellow Emperor (Huangdi Neijing) but also Indian medicine of Buddhism coexisted in almost real time.

Monks on the move: Evaluating pilgrimage to Byzantine St. Stephen's monastery using strontium isotopes.

OBJECTIVES: Written and archaeological evidence indicates that migration, in the form of pilgrimage to Byzantine Palestine, was a major social phenomenon between the 5th and 7th centuries CE. Monasteries saw record growth at this time as pilgrims chose to stay in the region and take up religious life. A major influx of people to the region, with a corresponding growth in monastic vocations that led travelers to stay in the area, is not in question; however, the distant origins of pilgrims reflected in surviving texts may be an artifact of preservation, biased towards an elite minority. The Byzantine monastery of St. Stephen's provides an opportunity to study this question from a bioarchaeological perspective, given the excellent preservation of the human skeletal assemblage, a wealth of written works about the community as well as daily life in Byzantine Palestine, and a rich archaeological record for the site and region. MATERIALS AND METHODS: An analysis of radiogenic strontium isotope values from the third molars of 22 individuals recovered from the St. Stephen's crypt complex was conducted to test whether those interred at the monastery were of local origin. RESULTS: Of those examined ( x¯= 0.7084 ± 0.0007, 1σ), 8 out of 22 (36%) exhibited (87) Sr/(86) Sr ratios that fell outside of local ranges. DISCUSSION: These results confirmed the sizeable presence of nonlocals at St. Stephen's Monastery. While most of these migrants likely traveled to Jerusalem from different areas of the Levant as pilgrims, others may have hailed from further afield, including Europe.

Prevalence, awareness, treatment and control of hypertension in Tibetan monks from Gansu Province, Northwest China.

Tibetan monks are a special group in life style and diet customs. We have little information of hypertension about them. Therefore, the objective of this study was to investigate the information on the prevalence, awareness, treatment and control of hypertension in these populations. A cross-sectional study of hypertension was carried out in 984 monks and 1042 Tibetan residents' controls in the same area. All the subjects were selected for interview, and physical examination involved blood pressure (BP) measurement. The overall prevalence of hypertension in monks was significantly lower than those in local residents (19.3% versus 34.1%; p < 0.01). The rates of awareness, treatment and control in monks were also lower than those in local residents (9.5% versus 16.9%, 4.2% versus 13.2% and 1.6% versus 4.5%; p < 0.01 for each). These findings indicated that a low prevalence of hypertension among monks aged 18 years and over in Gannan Tibetan autonomous district of Gansu province in China. We concluded that the relatively healthy diet and ways of life in monks were the major contributing factors to the lower prevalence of hypertension. However, the awareness, treatment and control rates of hypertension were also low. The possible reasons were most likely due to the difficult access to quality medical care and poor health education.

Foot and ankle problems in Thai monks.

BACKGROUND: Foot and ankle problems in Thai monks have not been explored. This is an unshod population, and its members have a unique lifestyle living among others in our modern era. Beginning at their ordainment, they follow strict rules about barefoot walking, the amount of daily walking, and their sitting position, practices that theoretically can increase their risk of developing foot and ankle problems. OBJECTIVE: To evaluate the prevalence ofcommon foot and ankle problems in Thai monks. MATERIAL AND METHOD: A cross-sectional survey was conducted in combination with foot and ankle examinations of monks living in northern Thailand Foot morphology was examined using a Harris mat footprint. Results of the interviews and the foot and ankle examinations were evaluated. RESULTS: Two hundred and nine monks from 28 temples were included in this study. Common foot and ankle problems found included callosity (70.8%), toe deformities (18.2%), plantar fasciitis (13.4%), metatarsalgia (3.8%), and numbness (2.9%). Callosity and toe deformities were associated with prolonged barefoot walking over extended periods since ordainment (p < 0.05). The callosity was found on the forefoot (47.3%), lateral malleolus (40.7%), and heel (12%). Arch types were considered normal in 66.4% of cases, high in 21.6%, and low in 12%. No association was found between arch type and foot and ankle problems. CONCLUSION: Callosity and toe deformity were the most common foot and ankle problems found in Thai monks, especially those with prolonged period of barefoot walking and long-term duration ofordainment. The unique pattern of walking and sitting of Thai monks may have contributed to the development of those feet and ankle problems.