Rituelles Handeln verstehen:Soziale Morphologie und ritueller Zyklus der Person bei den Hmong in Laos und Thailand

In dieser Studie werden die Beziehungen zwischen Sozialstruktur, Kosmologie und Austauschsystemen der Hmong in Laos und Thailand untersucht. Die Analyse der Sozialstruktur fokussiert auf die Kategorien von Abstammung, Affinität und Haushalt sowie von "Fremden", v.a. "Chinesen". Die Kategorien des kosmologischen Systems umfassen Repräsentationen der Toten, der konstituierenden Teile der Person sowie der Geister inner- und außerhalb der sozialen Sphäre des Dorfes. Die Beziehungen zwischen sozialen und kosmologischen Kategorien werden in Bezug auf Legitimationsansprüche auf Land und messianische Reinkarnation analysiert. Schließlich wird das System ritueller und nicht-ritueller Austauschhandlungen untersucht. Die Analyse der Rituale des Lebenszyklus legt einen kontinuierlichen Fluss von materiellen und immateriellen Ressourcen nahe, die soziale und kosmologische Domäne in Austauschbeziehungen miteinander verbinden und für die Reproduktion der sozialen Ordnung der Hmong unerlässlich sind

Implementing psychiatric day treatment for infants, toddlers, preschoolers and their families: a study from a clinical and organizational perspective

Background: An increasing number of empirical studies indicate that infants, toddlers and preschoolers may suffer from non-transient mental illnesses featuring developmental psychopathology. A few innovative child psychiatric approaches have been developed to treat infants, toddlers and preschoolers and their families, but have not yet been conceptually presented and discussed in the framework of different healthcare systems. The organizational and clinical experience gained while developing specific approaches may be important across disciplines and guide future developments in psychiatric treatment of infants, toddlers, preschoolers and their families. Results: This article introduces the Preschool Family Day Hospital for Infants, Toddlers and Preschoolers and their Families at Münster University Hospital, Germany. This hospital is unique in the German healthcare system with regard to its social-service institution division of labor. Specifically, it uses an intermittent treatment approach and an integrated interactional family psychiatric approach to treat children and their parents as separate patients. This multidisciplinary, developmentally and family-oriented approach includes components of group treatments with children and separate treatments with parents. Specific techniques include video-assisted treatments of the parent–child interaction, psychiatric and psychotherapeutic treatments for parents, and conjoint family therapies that include both parents and siblings. Conclusions: The Family Day Hospital for infants, toddlers and preschoolers and their families offers innovative family-oriented treatments for those who suffer from a wide range of severe child psychiatric disorders that cannot be sufficiently treated in outpatient settings. Treatment is based on the need for family-oriented approaches to the early psychiatric treatment of infants, toddlers and preschoolers. Family day hospitals are an innovative approach to preschool child psychiatry that requires further evaluation.<br

Inter-rater reliability and aspects of validity of the parent-infant relationship global assessment scale (PIR-GAS)

Background: The Parent-Infant Relationship Global Assessment Scale (PIR-GAS) signifies a conceptually relevant development in the multi-axial, developmentally sensitive classification system DC:0-3R for preschool children. However, information about the reliability and validity of the PIR-GAS is rare. A review of the available empirical studies suggests that in research, PIR-GAS ratings can be based on a ten-minute videotaped interaction sequence. The qualification of raters may be very heterogeneous across studies. Methods: To test whether the use of the PIR-GAS still allows for a reliable assessment of the parent-infant relationship, our study compared a PIR-GAS ratings based on a full-information procedure across multiple settings with ratings based on a ten-minute video by two doctoral candidates of medicine. For each mother-child dyad at a family day hospital (N = 48), we obtained two video ratings and one full-information rating at admission to therapy and at discharge. This pre-post design allowed for a replication of our findings across the two measurement points. We focused on the inter-rater reliability between the video coders, as well as between the video and full-information procedure, including mean differences and correlations between the raters. Additionally, we examined aspects of the validity of video and full-information ratings based on their correlation with measures of child and maternal psychopathology. Results: Our results showed that a ten-minute video and full-information PIR-GAS ratings were not interchangeable. Most results at admission could be replicated by the data obtained at discharge. We concluded that a higher degree of standardization of the assessment procedure should increase the reliability of the PIR-GAS, and a more thorough theoretical foundation of the manual should increase its validity. <br

Das medizinische System der Hmong zwischen Schamanismus und Biomedizin:eine interkulturelle Studie zur Rationalität des Heilens

Aufbauend auf Cassirers Philosophie der Symbolischen Formen und Ansätzen aus der französischen Ethnologie wird einleitend ein methodologischer Ansatz entwickelt, der die Untersuchung fremdkultureller Heilsysteme als Bildung der spezifischen Differenz zwischen Begriffen der eigenen und der fremden Gesellschaft versteht. Nach einer Darstellung grundlegender Wertideen werden Krankheitskonzepte, diagnostische und therapeutische Systeme der Hmong in Laos ausführlich vorgestellt, analysiert und an einem Fallbeispiel exemplifiziert. Anhand des Phänomens der tödlichen Träume bei den Hmong in den USA, das als Sudden Unexpected Nocturnal Death Syndrome (SUNDS) bekannt wurde, werden biomedizinisch und ethnologisch geprägte Zugangsweisen zu fremdkulturellen Phänomenen verglichen und bewertet. Aufbauend auf diesen Ergebnissen und auf Überlegungen von Kurt Hübner wird abschließend für einen Rationalitätsbegriff plädiert, der seinen analytischen Wert auch im Rahmen interkultureller Vergleiche behält

Rituelles Handeln verstehen:Soziale Morphologie und ritueller Zyklus der Person bei den Hmong in Laos und Thailand

In dieser Studie werden die Beziehungen zwischen Sozialstruktur, Kosmologie und Austauschsystemen der Hmong in Laos und Thailand untersucht. Die Analyse der Sozialstruktur fokussiert auf die Kategorien von Abstammung, Affinität und Haushalt sowie von "Fremden", v.a. "Chinesen". Die Kategorien des kosmologischen Systems umfassen Repräsentationen der Toten, der konstituierenden Teile der Person sowie der Geister inner- und außerhalb der sozialen Sphäre des Dorfes. Die Beziehungen zwischen sozialen und kosmologischen Kategorien werden in Bezug auf Legitimationsansprüche auf Land und messianische Reinkarnation analysiert. Schließlich wird das System ritueller und nicht-ritueller Austauschhandlungen untersucht. Die Analyse der Rituale des Lebenszyklus legt einen kontinuierlichen Fluss von materiellen und immateriellen Ressourcen nahe, die soziale und kosmologische Domäne in Austauschbeziehungen miteinander verbinden und für die Reproduktion der sozialen Ordnung der Hmong unerlässlich sind

Efficacy of a children’s procedural preparation and distraction device on healing in acute burn wound care procedures: study protocol for a randomized controlled trial

The intense pain and anxiety triggered by burns and their associated wound care procedures are well established in the literature. Non-pharmacological intervention is a critical component of total pain management protocols and is used as an adjunct to pharmacological analgesia. An example is virtual reality, which has been used effectively to dampen pain intensity and unpleasantness. Possible links or causal relationships between pain/anxiety/stress and burn wound healing have previously not been investigated. The purpose of this study is to investigate these relationships, specifically by determining if a newly developed multi-modal procedural preparation and distraction device (Ditto™) used during acute burn wound care procedures will reduce the pain and anxiety of a child and increase the rate of re-epithelialization.Children (4 to 12 years) with acute burn injuries presenting for their first dressing change will be randomly assigned to either the (1) Control group (standard distraction) or (2) Ditto™ intervention group (receiving Ditto™, procedural preparation and Ditto™ distraction). It is intended that a minimum of 29 participants will be recruited for each treatment group. Repeated measures of pain intensity, anxiety, stress and healing will be taken at every dressing change until complete wound re-epithelialization. Further data collection will aid in determining patient satisfaction and cost effectiveness of the Ditto™ intervention, as well as its effect on speed of wound re-epithelialization.Results of this study will provide data on whether the disease process can be altered by reducing stress, pain and anxiety in the context of acute burn wounds.ACTRN12611000913976