The Evil Eye--an ancient superstition

Carers’ and health workers’ perspectives on malnutrition in infants aged under six months in rural Ethiopia: A qualitative study

Objectives

Supporting small and nutritionally at-risk (potentially malnourished) infants under six months is a global health priority, albeit with a weak evidence-base. To inform policy and research in this area, we aimed to assess the perceptions and understanding of infant malnutrition and its management among carers, communities, and healthcare workers in rural Ethiopia.

Methods

We conducted in-depth and key-informant interviews, from May-August 2020 in Jimma Zone and Deder District, Ethiopia. We used purposive sampling to recruit the participants. Interviews were transcribed into Amharic or Afaan Oromo and then translated into English. Atlas ti-7 was used to support data analysis. Findings were narrated based on the different themes arising from the interviews.

Results

Carers/community members and healthcare workers reported on five different themes: 1) Perceptions about health and well-being: an ‘ideal infant’ slept well, fed well, was active and looked ‘fat’; 2)Perceptions of feeding: overall knowledge of key recommendations like exclusive breastfeeding was good but practices were suboptimal, notably a cultural practice to give water to young infants; 3)Awareness about malnutrition: a key limitation was knowledge of exactly how to identify small and nutritionally at-risk infants; 4) Reasons for malnutrition: levels of understanding varied and included feeding problems and caregiver’s work pressures resulting in the premature introduction of complementary feeds; 5) Perceptions about identification & treatment: carers prefer treatment close to home but were concerned about the quality of community-based services.

Conclusion

To succeed, research projects that investigate programes that manage small and nutritionally at-risk infants under six months should understand and be responsive to the culture and context in which they operate. They should build on community strengths and tackle misunderstandings and barriers. Interventions beyond just focusing on knowledge and attitude of the carers and health workers are necessary to tackle the challenges around infants under 6 months of age at risk of malnutrition. Moreover, stakeholders beyond the health sector should also be involved in order to support the infants under 6 months and their mothers as some of the key reasons behind the at-risk infants are just beyond the capacity of the health sector or health system. Our list of themes could be used to inform infant nutrition work not just in Ethiopia but also in many others.

Belief in Brua among psychiatric patients from Aruba, Bonaire, and Curaçao: Results from an explorative study in the Netherlands

Brua is an Afro-Caribbean religion and healing tradition predominantly practised on the ABC islands of the former Netherlands Antilles. It is grounded in oral tradition and shrouded in strict social taboos. Existing literature suggests that the majority of people on and from the islands are familiar with Brua and that it plays a substantial role in shaping their illness conception and idioms of distress. A lack of knowledge of Brua may therefore lead biomedically trained health professionals to misdiagnose these patients. This article discusses how religious beliefs related to Brua influence the illness concepts and idioms of distress of psychiatric patients originating from the ABC Islands, based on semi-structured interviews with former islanders receiving treatment at a psychiatric institute in the Netherlands. We found that of the 29 interviewees, 93.1% knew what Brua involved, 72.4% believed in it, 48.2% had first-hand experience with Brua practices, and 34.5% attributed their mental illness to Brua with greater or lesser certainty. However, only one patient had previously discussed her belief in Brua with her psychiatrist and only when asked to do so. The role of psychoactive substances in the context of Brua practices was negligible. Thus, the present study indicates that the majority of psychiatric patients from the ABC islands are familiar with Brua, but feel reluctant to discuss their concerns in this area with mental health professionals. Recommendations for clinical practice and further research are provided, including the need for a culture-sensitive approach and integrative care.

Religion, Spirituality and Folk Medicine/Superstition in a Neonatal Unit

Beliefs and practices surrounding religion and spirituality (RS) feature in neonatal units, although healthcare professionals and families hold different views on their role in neonatal care. Descriptive study performed at the Neonatology Unit of Santa Lucía University Hospital, Cartagena. Separate forms concerning spirituality, religion and folk medicine were administered to professionals ascribed to the unit (n = 70) and parents (n = 93). 70% of professionals and 60.2% of parents perceive RS as playing a relevant role in neonatal care; however, 45% of professionals prefer that parents do not express their RS beliefs. Actual use of prayer by parents while in the unit was 55.9%, compared to the staff's estimation of 20.8% (p < 0.001); parents believe that RS affects outcomes indirectly, mediating through caregivers, contrary to the staff perception that parents turn to RS for a direct effect on outcomes (p < 0.001); professionals, unlike parents, found RS to be of little benefit to children (p < 0.001) or in reducing parental anxiety (p < 0.001). Amulets were found alongside 26.6% of children. Up to 40% of parents believe in magic concepts such as evil eye. Many families express RS while a member is hospitalized and, while staff recognize its importance, they often fail to respond correctly. The use of amulets and ritual objects is still common and can express the need for emotional and psychological support. Caregivers need to be aware of the medical, psychological and emotional implications of these practices.

Culture-Bound Syndromes of a Brazilian Amazon Riverine population: Tentative correspondence between traditional and conventional medicine terms and possible ethnopharmacological implications

ETHNOPHARMACOLOGICAL RELEVANCE

It is not always possible to correlate the "emic" terms to the "etic" ones during ethnopharmacological surveys, especially regarding those related to Culture-Bound Syndromes (CBS). Nevertheless, it is the role of ethnopharmacology to address these correlations, since they are the basis for the understanding of potential bioactives.

AIM AND OBJECTIVES

This study reports the clinical manifestations and therapeutic resources used for the treatment of CBS among some riverine inhabitants of Brazilian Amazonia. An effort was made to establish a correspondence between the local "emic" terms of traditional medicine and the symptoms or diseases known by conventional medicine ("etic" terms). The ultimate goal was to gain insights to suggest further pharmacological studies with the local resources.

MATERIAL AND METHODS

Fieldwork was guided by methods of anthropology, botany and zoology-with the assistance of a doctor-among the traditional healing experts in Jaú National Park (during 199 days in 1995) and Unini River Extractive Reserve (210 days from 2008 to 2012).

RESULTS

Fifty-nine healers of different kinds were interviewed: a prayer-maker, medium, natural resource expert, massage therapist, midwife and snakebite healer. The clinical manifestations and healing resources of the following CBS were collected: "mau olhado" (evil eye), "quebrante" (chipping); "espante" (fright or susto); "doença do ar" (air diseases); "vento caído" (fallen wind); "derrame" (leakage); "mãe do corpo" (mother of the body) and "panema" (unlucky). The first three seem to be local variations of other CBSs already described in Latin America. "doença do ar", "vento caído", "derrame" and "mãe do corpo" seem to be folk terms for known conventional medical disorders, while "panema" is a yet undescribed Brazilian CBS that is possibly related to dysthymic disorder or depression and deserves further investigation. Treatments included prayer rituals, fumigation, baths and oral remedies using 25 plants and 10 animals.

CONCLUSION

It was possible to establish hypothetical correlations between CBS as described by the riverine population studied and some "etic" terms. The main importance of this is to help the proposition of target-oriented pharmacological studies of the natural resources used by these communities. Accordingly, the following plants are suggested to be submitted to further studies for antidepressant and anxiolytic activities: Siparuna guianensis, Mansoa alliacea, Leucas martinicensis, Petiveria alliacea, Annona montana and Alpinia nutans; for anti-seizure activity: Protium amazonicum, Protium aracouchini and Protium heptaphyllum; finally for antispasmodic activity: Leucas martinicensis.

Russians Inhibit the Expression of Happiness to Strangers: Testing a Display Rule Model

Cultural stereotypes and considerable psychological research suggest that Russians are less happy and more stoic than Americans and Westerners. However, a second possibility is simply that cultural norms deter Russians from displaying happiness that they actually feel. To test this second possibility, three studies compared the emotional inhibition tendencies in U.S. and Russian student samples. Although Russians and Americans were no different on subjective well-being (SWB), a consistent three-way interaction was found such that Russians (compared with Americans) reported greater inhibition of the expression of happiness (vs. unhappiness), but mainly to strangers (vs. friends/family). Russians also viewed their peers and countrymen as behaving similarly. Furthermore, a consistent interaction was found such that the degree of happiness inhibition with strangers was negatively correlated with SWB in the U.S. samples but was unrelated to SWB in the Russian samples. Given the equivalent levels of SWB observed in these data, we suggest that Russians may not be less happy than Americans, as this would illogically entail that they exaggerate their SWB reports while also claiming to inhibit their expression of happiness. Implications for emotion researchers and international relations are considered.

Decoding facial blends of emotion: visual field, attentional and hemispheric biases

Most clinical research assumes that modulation of facial expressions is lateralized predominantly across the right-left hemiface. However, social psychological research suggests that facial expressions are organized predominantly across the upper-lower face. Because humans learn to cognitively control facial expression for social purposes, the lower face may display a false emotion, typically a smile, to enable approach behavior. In contrast, the upper face may leak a person's true feeling state by producing a brief facial blend of emotion, i.e. a different emotion on the upper versus lower face. Previous studies from our laboratory have shown that upper facial emotions are processed preferentially by the right hemisphere under conditions of directed attention if facial blends of emotion are presented tachistoscopically to the mid left and right visual fields. This paper explores how facial blends are processed within the four visual quadrants. The results, combined with our previous research, demonstrate that lower more so than upper facial emotions are perceived best when presented to the viewer's left and right visual fields just above the horizontal axis. Upper facial emotions are perceived best when presented to the viewer's left visual field just above the horizontal axis under conditions of directed attention. Thus, by gazing at a person's left ear, which also avoids the social stigma of eye-to-eye contact, one's ability to decode facial expressions should be enhanced.