Shared secrecy: teasing,attachment, and children's emotional management in rural southern Mongolia

In recent decades, anthropologists have scrutinized psychologists’ claim that humans process information about others by imputing mental states. The debate remains open whether cross-cultural variability in how people conceive of minds and inner states reflects differences in their folk theories only, or whether it engenders deep-grained psychological differences. In this article, I look at the very onset of children's apprenticeship in emotional management to examine its cognitive consequences. In the context of rural Mongolia in the late 2000s, questions about homesickness prompted by adults raised children's awareness of the existence of a private self and by the very same process discouraged verbalization or public display of personal feelings. I start by presenting interactions where children were routinely teased about homesickness, and invited to deny that they missed their family. I contextualize this teasing routine within local conceptions about emotional control and linguistic ideology to unveil how it introduced children to the performative power of words while also making them face moral dilemmas. The irreconcilable tension between behaving according to expectations of self-control and experiencing separation induced children's discovery of the possibility of disconnecting intimate feelings from public self-presentation, thus transforming the experience of separation into an experience of secret connection. I speculate that the secrecy that hallows homesickness contributed to making it all the more poignant. The way adults constantly checked on whether children were missing their home prompted children to actually identify some emotional state or aspect of their experience as ‘missing home’. It gave a name to a personal experience which thus became social and guaranteed that it became a shared feeling, albeit a secret one.     

Pet Loss and Grief: Identifying At-risk Pet Owners during the Euthanasia Process

Pet owners often experience complex and profound grief reactions when their animals are euthanized. Veterinary staff are increasingly being called upon to be aware of and to respond to the grief reactions of pet owners at this critical time. The objectives of this study were to identify pet owners who are most at risk of grief and to suggest veterinary interventions during the euthanasia process. A convenience sample of 409 pet owners whose animals had been euthanized in the past year took part in a survey. Variables of interest included pet and pet-owner demographics, pet-death characteristics, attachment to pet, and bereavement reactions. Stepwise multiple regression analyses were conducted to identify factors related to the three grief reaction subtypes: sorrow, anger, and guilt. Results indicated that attachment to pets was a strong predictor of feelings of grief/sorrow (p < 0.001) and anger (p < 0.001). Sudden death was also related to feelings of anger (p < 0.05). Cancer diagnosis was negatively related to feelings of anger (p < 0.05) and guilt (p < 0.01). The findings from this study provide additional insight into the complexity of grief following pet euthanasia. For veterinary staff, anticipating the needs of pet owners and supporting them through the grief process is an integral role. Understanding which pet owners are at greatest risk of grief is an important initial step, followed by empathic communications, sensitive interactions, and the provision of grief support.     

Human grief: Is its intensity related to the reproductive value of the deceased?

Thurstone's method of comparative judgement was used to measured the intensity of grief that parents of high-, moderate-, and low-reproductive value were expected to experience at the death of male and female children of different ages. The results were correlated with reproductive values for male and female British Columbians and for !Kung Bushwomen. Grief ratings were more highly correlated with reproductive value than with age and more highly correlated with reproductive values of !King Bushwomen than with those of British Columbians. The correlations were higher for male- than for female-stimulus children. The correlations of female ratings with reproductive value were higher than male ratings with reproductive value, although not as high as expected. However, the correlation between grief ratings and reproductive value did not increase as the reproductive value of the raters declined.     

The psychologic effects of spontaneous abortion.

Although 14% to 18% of pregnancies end in spontaneous abortion, miscarriage is often not recognized as a significant occurrence. Women may experience grief reactions similar to those after the loss of a neonate. If the woman is not given an opportunity to deal with her grief, there may be continuing feelings of sadness, inadequacy and fearfulness as well as impairment in the relationships with her spouse and children. Methods of helping the couple during this time include acknowledging the significance of the loss, providing information, permitting the couple to see the fetus, if desired, and suggesting a memorial service. Some women may require individual or group therapy to deal with their feelings.     

Cross-Cultural aspects of bereavement. II: Ethnic and cultural variations in the development of bereavement practices

Despite a growing interest in bereavement in cross-cultural perspective, few reports have described a comparative analysis of bereavement. By examining the social contexts in the transformations of Western bereavement practices, structures common to bereavement in a range of cultures can be identified. The paper compares the contemporary bereavement practices of several ethnic and cultural groups in North America: Blacks; ethnic Chinese; Southeast Asian refugees; Haitians; Italians; Greeks; and Spanish-speaking groups. Consideration is given to the state of widowhood in different cultural systems. The impact of modernization among traditional societies demonstrates that even though Western technologies are incorporated into the procedures followed by these modernizing societies, the deep cultural code remains intact. Five questions require further clarification: is bereavement an illness, or a rite de passage and a normal life event? How widespread and useful are protective factors, such as group support, that facilitate successful resolution of grief? How effective are mourning practices of various ethnic groups in preventing “bad grief”, and might some of these practices be beneficial if taken up by other ethnic groups? How can the Western health practitioner know that a bereaved person from an unfamiliar cultural group is suffering “bad grief”? How acceptable is Western grief counseling to non-Western clients?     

TAX-SUPPORTED MEDICAL CARE FOR CALIFORNIA'S CHILDREN—Where Should It Be Going?

The multiplication of separate governmental agencies providing health services to California''s children, the increasing difficulties in staffing tax-supported health agencies and the recent studies of the quality of care under these programs, have all pointed to an urgent need for prompt decisions on certain basic questions about the function of tax-supported medical care for children of dependent families.Fourteen separate kinds of health services are currently provided through public funds at an annual cost to California taxpayers of $52,000,000. These funds underwrite an uncoordinated, fragmented, patchwork quilt of medical care for some 500,000 children. Coordination and integration of these services through “one door” with uniform eligibility requirements and maximum utilization of private physicians'' services that meet appropriate standards is needed now. California physicians have an urgent responsibility to provide leadership in the development of more effective and more economical organization and distribution of higher quality medical care services for California''s children dependent on public support.     

Positive Behavioral Impact of Reptile-Assisted Support on the Internalizing and Externalizing Behaviors of Female Children with Emotional Disturbance

ABSTRACT

The effects of animal-assisted support were tested with children identified with emotional disturbance. Forty female children, aged 12 years old, participated in one of two treatments: animal-assisted support or control support. All participants had experienced the death of a parent in the preceding year. When offered animals for their support group, the participants chose reptiles. The reptile-assisted support group discussed death and grief along with training in animal care and identifying displays of emotions and grief. The control group discussed death and grief without reference to, or interactions with, reptiles. Primary caregivers completed the Child Behavior Checklist-Parent version (CBCL-P) before and after the 16-week support group sessions. A repeated measures ANOVA was used to examine the effects of reptile-assisted support on internalizing, externalizing, and other behaviors, as measured by the CBCL-P. The findings suggest that the use of reptile-assisted support improved internalizing behaviors such as withdrawal and somatic behaviors, externalizing behaviors such as aggression/delinquency behaviors, and other behaviors such as social, attention, and thought. Future work is suggested to identify why these children with emotional disturbance chose reptiles rather than pets such as dogs and horses, which are commonly used in animal-assisted programs with children with disabilities.     

The Association between Provider Practice and Knowledge of ORS and Zinc Supplementation for the Treatment of Childhood Diarrhea in Bihar,Gujarat and Uttar Pradesh,India: A Multi-Site Cross-Sectional Study

Introduction

Programs aimed at reducing the burden of diarrhea among children under-five in low-resource settings typically allocate resources to training community-level health workers, but studies have suggested that provider knowledge does not necessarily translate into adequate practice. A diarrhea management program implemented in Bihar, Gujarat and Uttar Pradesh, India trained private sector rural medical practitioners (RMPs) and public sector Accredited Social Health Activists (ASHAs) and Anganwadi workers (AWWs) in adequate treatment of childhood diarrhea with oral rehydration salts (ORS) and zinc. We used cross-sectional program evaluation data to determine the association between observed diarrhea treatment practices and reported knowledge of ORS and zinc among each provider cadre.

Methods

We conducted principal components analysis on providers’ responses to diarrhea treatment questions in order to generate a novel scale assessing ORS/zinc knowledge. We subsequently regressed a binary indicator of whether ORS/zinc was prescribed during direct observation onto the resulting knowledge scores, controlling for other relevant knowledge predictors.

Results

There was a positive association between ORS/zinc knowledge score and prescribing ORS and zinc to young children with diarrhea among private sector RMPs (aOR: 2.32; 95% CI: 1.29-4.17) and public sector ASHAs and AWWs (aOR 2.48; 95% CI: 1.90-3.24). Controlling for knowledge score, receipt of training in the preceding 6 months was a good predictor of adequate prescribing in the public but not the private sector. In the public sector, direct access to ORS and zinc supplies was also highly associated with prescribing.

Conclusions

To enhance the management of childhood diarrhea in India, programmatic activities should center on increasing knowledge of ORS and zinc among public and private sector providers through biannual trainings but should also focus on ensuring sustained access to an adequate supply chain.     

COVID-19 and children: medical impact and collateral damage

Children mostly experience mild SARS-CoV-2 infections, but the extent of paediatric COVID-19 disease differs between geographical regions and the distinct pandemic waves. Not all infections in children are mild, some children even show a strong inflammatory reaction resulting in a multisystem inflammatory syndrome. The assessments of paediatric vaccination depend on the efficacy of protection conferred by vaccination, the risk of adverse reactions and whether children contribute to herd immunity against COVID-19. Children were also the target of consequential public health actions such as school closure which caused substantial harm to children (educational deficits, sociopsychological problems) and working parents. It is, therefore, important to understand the transmission dynamics of SARS-CoV-2 infections by children to assess the efficacy of school closures and paediatric vaccination. The societal restrictions to contain the COVID-19 pandemic had additional negative effects on children’s health, such as missed routine vaccinations, nutritional deprivation and lesser mother–child medical care in developing countries causing increased child mortality as a collateral damage. In this complex epidemiological context, it is important to have an evidence-based approach to public health approaches. The present review summaries pertinent published data on the role of children in the pandemic, whether they are drivers or followers of the infection chains and whether they are (after elderlies) major sufferers or mere bystanders of the COVID-19 pandemic.     

The Role of Gender in Public Perception of Whether Animals Can Experience Grief and Other Emotions

Gender plays a significant role in influencing people's attitudes toward animals, however, little is known about how it influences their attribution of emotions to animals. To investigate the role that gender plays in public attitudes toward animals' experience of emotions and beliefs about whether animals can grieve, a face-to-face survey of 1,000 members of the general public was carried out in Brisbane, Australia. Potential respondents were asked to complete a 10-min “social attitudinal” survey. Males were significantly less likely than females to believe that animals experience complex emotions, including depression (p < 0.05), anxiety (p < 0.05), love (p < 0.01), and grief (p < 0.05), but did not differ in regard to basic emotions including distress, fear, happiness, anger, sadness, and fear. Males were also less likely to believe that animals show some behavioral (eating p < 0.05; vocalizing p < 0.01) changes when they experience grief (p < 0.05) and that animals grieve as a result of separation from a conspecific (p < 0.005). These results demonstrate a greater skepticism in males, compared with females, regarding the attribution of emotions to animals.     

Exploring the Grief Experience Among Callers to a Pet Loss Support Hotline

The present study explored the grief experience among callers to the Ontario Veterinary College Pet Loss Support Hotline (PLSH). Summary notes (n = 75) of the conversations between callers and PLSH volunteers were qualitatively analyzed using content analysis. Major content categories emerging from the analysis include personal pet narrative; perceived support sources; grief experiences; relationship with pet; memorialization; grief coping strategies; grief triggers; decision to euthanize; and veterinary interaction. Findings support that pet loss grief is a broad, complex construct, which can be complicated by a pet owner’s perceptions that they have minimal social support sources and negative veterinary interactions. Pet owners involved in the current study appeared comfortable sharing personal stories about their pet’s death when asked. In addition, memorialization appeared to be widely used by PLSH callers and may have helped them cope with their loss. Importantly, the interaction with veterinary staff was identified to potentially aggravate or alleviate a pet owner’s grief experience. Implications for mental health counselors and veterinary staff are that asking pet owners to tell their pet’s story and explore their support network may have value following the loss of a pet. Also, effectively communicating about memorialization and grief coping strategies may be beneficial when talking to owners experiencing grief. Finally, there continues to be a need for curricula and continuing professional training courses for veterinarians and mental health counselors to address topics such as the human–animal bond, grief, euthanasia, and memorialization practices.     

Human Grief Resulting from the Death of a Pet

Abstract

This study investigated antecedents of the human grief response which was associated with the death of a pet cat or dog. The sample included 207 voluntary subjects who experienced this type of loss within a one-year time period prior to participating in the study. Data for the predictor variables were obtained from two validated instruments and a questionnaire developed by the author. Data for grief outcome were obtained from another validated instrument on three clinical and three validity scales. The results indicated that level of attachment to the deceased pet, perceived understanding from others and other stressful events combined to have significant predictive ability in grief outcome. Other analyses indicated qualitative differences in grief outcome according to gender of owner and the presence of children and/or more than one other adult in the household. No significant difference was found between single and multiple pet ownership in grief outcome.     

The Politics of Pity: Domesticating Loss in a Russian Province

In this article, I explore how a group of women in a distant Russian province learned to live in the state of grief by creating a space for the traumatic experience in their daily order of things, their personal narratives, and public landscape. Using materials from my fieldwork in Siberia in 2001–03, I demonstrate how the Altai Regional Committee of the Soldiers' Mothers domesticated and privatized losses of their sons, which were caused by the Russian state's military politics of the last 20 years. By devising elaborate memorializating practices, the mothers managed to materialize evidence of their loss and suffering. It is precisely this collective and individual production of metonymies of death, I suggest, that not only became the main source of the Committee of the Soldiers' Mothers' new public identities but also acted as the principal vehicle of their politics of pity.     

Qualitative interview study of communication between parents and children about maternal breast cancer

Objective To examine parents'' communication with their children about the diagnosis and initial treatment of breast cancer in the mother. Design Qualitative interview study within a cross-sectional cohort. Setting Two breast cancer treatment centers. Participants 32 women with stage I or stage II breast cancer with 56 school-aged children. Main outcome measures Semistructured interview regarding timing and extent of communication with children about the diagnosis and initial treatment of the mother''s illness, reasons for talking to children or withholding information, and help available and requested from health professionals. Results Women were most likely to begin talking to their children after their diagnosis had been confirmed by biopsy, but a few waited until after surgery or said nothing at all. Family discussion did not necessarily include mention of cancer. There was considerable consistency in the reasons given for either discussing or not discussing the diagnosis. The most common reason for not communicating was to avoid children''s questions, particularly those about death. Although most women had helpful discussion with a physician concerning their illness, few were offered help with talking to their children; many would have liked help, particularly the opportunity for both parents to talk to a health professional with experience in understanding and talking to children. Conclusion Parents diagnosed with cancer or other serious illnesses should be offered help to think about whether, what, and how to tell their children and about what children can understand, especially as they may well be struggling themselves to come to terms with their illness.     

Qualitative interview study of communication between parents and children about maternal breast cancer

ObjectiveTo examine parents'' communication with their children about the diagnosis and initial treatment of breast cancer in the mother.DesignQualitative interview study within cross sectional cohort.SettingTwo breast cancer treatment centres.Participants32 women with stage I or stage II breast cancer with a total of 56 school aged children.ResultsWomen were most likely to begin talking to their children after their diagnosis had been confirmed by biopsy, but a minority waited until after surgery or said nothing at all. Family discussion did not necessarily include mention of cancer. There was considerable consistency in the reasons given for either discussing or not discussing the diagnosis. The most common reason for not communicating was avoidance of children''s questions and particularly those about death. While most mothers experienced helpful discussion with a doctor concerning their illness, few were offered help with talking to children; many would have liked help, particularly the opportunity for both parents to talk to a health professional with experience in understanding and talking to children.ConclusionsParents diagnosed with cancer or other serious illnesses should be offered help to think about whether, what, and how to tell their children and about what children can understand, especially as they may well be struggling themselves to come to terms with their illness.     

Premature singleton versus a twin or triplet infant death: parental adjustment studied through a personal interview.

Parental adjustment following the death of a premature singleton or multiple birth infant has hitherto been studied by mailed questionnaires or telephone survey. In the present study, using an in-depth personal interview, grief reactions and adjustment patterns of nine families who lost a singleton premature infant ('Single Group') were compared with those of nine families who lost one of a premature multiple birth cohort ('Multiple Group'). The interview was conducted 1-4 years after the death of the infant and evaluated specific areas or 'scales' of life adjustment, including individual feelings, relationship between husband and wife, and functioning at home and at work. There was no significant difference between the paternal and maternal level of adjustment of the two groups in any of the studied scales. A positive correlation was found between maternal and paternal grief reaction of the same family in the scales of individual feelings (r = 0.65), relationships between husband and wife (r = 0.70), and functioning at home (r = 0.57). Comparing the father's scale with the mother's scale revealed a significant difference only in the area of 'individual feelings'. The gestational age, maternal bonding during hospitalisation of the infant and the parental attendance at the event of death were significantly associated with the process of parental adjustment. The results of this study support previous reports of similar parental reactions following the demise of a premature singleton or multiple birth infant. Since societal environment may not recognise the need for consolation of these families, care, compassion, and sensitivity should be encouraged in dealing with these parents at the time of their infant' death, and for a long time thereafter.     

The sound of barking dogs: violence and terror among Salvadoran families in the postwar

This article examines the transgenerational transmission of trauma among campensino living in a rural, repopulated community in El Salvador. Research with Holocaust survivors and their children has shown that traumatic symptoms can be transmitted to children who did not directly experience the Holocaust. The mechanisms by which this transgenerational transmission occurs have not been fully explored and require an expansion of medical and anthropological conceptualizations of posttraumatic illness. Through their reactions to and interpretations of everyday events, campesino parents who lived in the guerrilla camps explicitly transmit trauma to children who did not experience the recent civil war. Illness narratives by sufferers of nervios transmit trauma and point to the basic immorality of the war, an immorality that continues today. In addition, the symptoms of nervios constitute a mechanism by which trauma is implicitly transmitted. Symptoms of nervios point to what generally is not and, indeed, cannot be voiced: the destruction of primary relationships in the family and unresolved grief and helplessness, which, through the responses of family members to the sufferer, are reproduced and reenacted in the present family context.     

Affordable assisted reproductive technologies in developing countries: pros and cons

¹ Correspondence address. E-mail: akandewole{at}yahoo.com Infertility in developing countries is pervasive and a seriousconcern. In addition to the personal grief and suffering itcauses, the inability to have children especially in poor communitiescan create broader problems, particularly for the woman. Infertilityservices in developing countries span the spectrum from preventionto treatment. From a societal and public health standpoint,prevention is cost–effective and is considered by manygovernments and public health care providers to be a priorityfor service delivery. While prevention remains paramount, takenalone it ignores the plight of infertile couples, includingthose with non-infectious causes of infertility. Two key argumentsare frequently used to challenge the development of new reproductivetechnologies in developing countries: overpopulation and limitedresources. Evidence supports the conclusion that there is acompelling need for infertility treatment beyond prevention.In many instances, assisted reproductive technologies (ART)are the last hope or the only means to achieve a child for couples.In an effort to make much needed ART to developing countriesaccessible and affordable, developing countries should lookto public–private partnerships. Governments have a responsibilityto ensure safe and effective services including the controlof standards for clinical procedures and the regulation of professionalpractice.     

The Correlates of Grief after Death of Pet

ABSTRACT

The correlates of degree of grief after death of dogs and cats were determined. With both animals, retrospectively reported grief was associated with present death depression and positive attitude toward pets. Grief after the death of a dog was associated with living alone at the time of death, higher death depression, and female gender. Grief after the death of a cat was associated with higher death depression, female gender, and was inversely correlated with the person's age at the time of the pet's death. These psychological and psychosocial variables were more associated with pet grief than behavioral variables such as amount of time spent with the pet.