Incorporation of spiritual care as a component of healthcare and medical education: comparison of viewpoints of healthcare providers from a rural community hospital in Uganda with those of medical students from United Kingdrom

This study addresses cultural differences regarding views on the place for spirituality within healthcare training and delivery. A questionnaire was devised using a 5-point ordinal scale, with additional free text comments assessed by thematic analysis, to compare the views of Ugandan healthcare staff and students with those of (1) visiting international colleagues at the same hospital; (2) medical faculty and students in United Kingdom. Ugandan healthcare personnel were more favourably disposed towards addressing spiritual issues, their incorporation within compulsory healthcare training, and were more willing to contribute themselves to delivery than their European counterparts. Those from a nursing background also attached a greater importance to spiritual health and provision of spiritual care than their medical colleagues. Although those from a medical background recognised that a patient’s religiosity and spirituality can affect their response to their diagnosis and prognosis, they were more reticent to become directly involved in provision of such care, preferring to delegate this to others with greater expertise. Thus, differences in background, culture and healthcare organisation are important, and indicate that the wide range of views expressed in the current literature, the majority of which has originated in North America, are not necessarily transferable between locations; assessment of these issues locally may be the best way to plan such training and incorporation of spiritual care into clinical practice.

Remedios Varo's Feminine, Spiritual Quest

Remedios Varo occupies a marginal position in the Surrealist canon, despite her direct involvement with Breton’s circle and in spite of the fact that her work is attributed a universal significance. It has been interpreted as representing a journey towards identity and freedom, a search for female empowerment, and as a spiritual quest. Moreover, critical focus on the mythic/exoteric ‘female’ quest has been to the detriment of the mystical/esoteric significance of the paintings. This article argues that it is in the combination of these strands that Varo’s radicalism might be found. It shows that by presenting a female, spiritual quest for enlightenment—which exists apart from a traditionally male-dominated, western religious schema—Varo circumvented her ordained role within the artistic, spiritual, and political communities of which she was a part.

Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-differences Study in Rural KwaZulu-Natal, South Africa

Background Despite the importance of HIV testing for controlling the HIV epidemic, testing rates remain low. Efforts to scale-up testing coverage and frequency in hard-to-reach and at-risk populations commonly focus on home-based HIV testing. This study evaluates the effect of a gift (a food voucher for families, worth US$ 5) on consent rates for home-based HIV testing.
Methods We use data on 18,478 men and women who participated in the 2009 and 2010 population-based HIV surveillance carried out by the Wellcome Trust Africa Centre for Health and Population Studies in rural KwaZulu-Natal, South Africa. Our quasi-experimental difference-in-differences approach controls for unobserved confounding in estimating the causal effect of the intervention on HIV testing consent rates.
Results Allocation of the gift to a family in 2010 increased the probability of family members consenting to test in 2010 by 25 percentage points (95% CI 21-30; p<0.001). The intervention effect persisted, slightly attenuated, in the year following the intervention (2011), further increasing intervention value for money.
Conclusions In HIV hyperendemic settings a gift can be highly effective at increasing consent rates for home-based HIV testing. Given the importance of HIV testing for treatment uptake and individual health, as well as for HIV treatment-and-prevention strategies and for monitoring the population impact of the HIV response, gifts should be considered as a supportive intervention for HIV testing initiatives where consent rates have been low.

Turning the categories inside-out: Complex identifications and multiple interactions in religious ethnography

This paper challenges the fixed boundaries that ethnographers have often constructed between religious insiders and outsiders. Drawing on Neitz's observations, it argues that the main task of reflexive fieldwork is locating the self in relation to ambiguous and shifting boundaries. We offer a comparative analysis of the experiences of two differently socially located researchers to illustrate how religious identity emerges as a continuum, on which one's place is negotiated with one's research participants. We also examine the importance of intersecting multiple identities. Finally, the paper questions whether social identity categories are the primary way that we relate with our respondents. It explores the spiritual and emotional dimensions of research relationships and argues that these may transform, reinforce and generally interact with social identities. Comparing our experiences, we outline the consequences of these reflections for data gathering and analysis.

Metaphor and Maltese Art: Explorations in the Temple Period

Temple Period Malta in the 3rd millennium BC saw the production of a range of figurative and decorative art and architecture that implies a richly populated spiritual and cognitive world associated with ritual practice in life and death. The paper explores the potential to categorize the figurative art into distinct groups, and how these various images might represent aspects of the cosmology and social concerns of a prehistoric island society.

Devotional Culture in Late Medieval England and Europe: Diverse Imaginations of Christ’s Life

Christ’s life, as related through the Gospel narratives and early Apocrypha, was subject to a riot of literary-devotional adaptation in the medieval period. This collection provides a series of groundbreaking studies centring on the devotional and cultural significance of Christianity’s pivotal story during the Middle Ages.

The collection represents an important milestone in terms of mapping the meditative modes of piety that characterize a number of Christological traditions, including the Meditationes vitae Christi and the numerous versions it spawned in both Latin and the vernacular. A number of chapters in the volume track how and why meditative piety grew in popularity to become a mode of spiritual activity advised not only to recluses and cenobites as in the writings of Aelred of Rievaulx, but also reached out to diverse lay audiences through the pastoral regimens prescribed by devotional authors such as the Carthusian prior Nicholas Love in England and the Parisian theologian and chancellor of the University of Paris, Jean Gerson.

Through exploring these texts from a variety of perspectives — theoretical, codicological, theological — and through tracing their complex lines of dissemination in ideological and material terms, this collection promises to be invaluable to students and scholars of medieval religious and literary culture.

Covenanter Politics: Evangelicalism, Political Liberalism and Ulster Presbyterians, 1798-1914

Historians of Ireland have devoted considerable attention to the Presbyterian origins of modern Irish republicanism in the 1790s and their overwhelming support for the Union with Great Britain in the 1880s. On the one hand, it has been argued that conservative politics came to dominate nineteenth-century Presbyterianism in the form of Henry Cooke who combined conservative evangelical religion with support for the established order. On the other hand, historians have long acknowledged the continued importance of liberal and radical impulses amongst Presbyterians. Few historians of the nineteenth century have attempted to bring these two stories together and to describe the relationship between the religion and politics of Presbyterians along the lines suggested by scholars of Presbyterian radicalism in the last quarter of the eighteenth century. This article argues that a distinctive form of Presbyterian evangelicalism developed in the nineteenth century that sought to bring the denomination back to the theological and spiritual priorities of seventeenth-century Scottish and Irish Presbyterianism. By doing so, it encouraged many Presbyterians to get involved in movements for reform and liberal politics. Supporters of ‘Covenanter Politics’ utilised their denominational principles and traditions as the basis for political involvement and as a rhetoric of opposition to Anglican privilege and Catholic tyranny. These could be the prime cause of Presbyterian opposition to the infringement of their rights, such as the marriage controversy and the Disruption of the Church of Scotland in the early 1840s, and they could also be employed as a language of opposition in response to broader social and political developments, such as the demands for land reform stimulated by the agricultural depression that accompanied the Famine. Despite their opposition to ascendancy, however, the Covenanter Politics of Presbyterian Liberals predisposed them towards pan-protestant unionism against the threat of ‘Rome Rule’.

The Role of Identity in Adjustment among Survivors of Oesophageal Cancer.

The study sought to contextualize the physical, social and emotional adjustments that are faced by oesophageal cancer patients following surgery. Semi-structured interviews were conducted with five survivors, guided by the principles of Interpretative Phenomenological Analysis (IPA). Participants’ accounts encompassed descriptions of personal, social and medical relationships, illness and treatment experiences, eating behaviours, and spiritual and religious perspectives, representing myriad challenges to the self-concept. Surviving patients may have a role in addressing patient expectations about eating. The importance of attempts to nurture and maintain a sense of self should be recognized by those providing care.

Learning Not to Curse: Swearing, Testimony, and Truth in Olaudah Equiano’s The Interesting Narrative

This article addresses swearing and testimony in Olaudah Equiano’s The Interesting Narrative (1789) by reading the work in the context of a broader contemporary discourse concerning profane swearing and cursing. Acts of profane enunciation inform a number of key episodes in Equiano’s life, and bear particular significance for his spiritual development and abolitionist witnessing. Within the Narrative, swearing is cast as a failure of piety, civility, and humanity, and shown to be actively avenged by a retributive deity. In Britain, profane swearing was also thought to undermine the validity of legal testimony; while, in the British West Indies, slaves were denied recourse to such testimony against their oppressors. By disavowing profane swearing and cursing, the essay argues, Equiano sought to assert both the validity of his oath and the truth of his testimony against the iniquities of the British slave trade.

Writing the Dark Side of Travel

The travel experience filled with personal trauma; the pilgrimage through a war-torn place; the journey with those suffering: these represent the darker sides of travel. What is their allure and how are they represented? This volume takes an ethnographic and interdisciplinary approach to explore the writings and texts of dark journeys and travels. In traveling over the dead, amongst the dying, and alongside the suffering, the authors give us a tour of humanity’s violence and misery. And yet, from this dark side, there comes great beauty and poignancy in the characterization of plight; creativity in the comic, graphic, and graffiti sketches and comments on life; and the sense of profound and spiritual journeys being undertaken, recorded, and memorialized.

Reflexology for symptom relief in patients with cancer

Complementary therapies are increasingly being used in hospices and hospitals alongside orthodox treatments in an attempt to improve patients' emotional, spiritual, psychological, and physical well-being. An average of 31% of UK patients with cancer use some form of complementary therapy. Many UK cancer centers, out-patient units, and hospices are providing complementary services. There is strong anecdotal evidence that complementary therapies assist in the palliation of physical and psychological symptoms. This systematic review examines the research evidence base for the effectiveness of reflexology in cancer care. The study reports the results of a systematic review following the Cochrane principles of systematic reviewing. No meta-analysis was possible. Studies were retrieved from a comprehensive search of electronic databases from their start dates. An initial search was carried out in 2003 and updated in 2005 to 2006. Eligible studies were randomized controlled trials, controlled before and after studies, and interrupted time-series studies. Participants were adults with a diagnosis of cancer, receiving care in any healthcare setting. Interventions were limited to reflexology carried out by a qualified therapist as distinguished from another healthcare professional carrying out a reflexology intervention. Outcome measures were patient-reported levels of physical and psychological indices of symptom distress and quality of life (measured using validated assessment tools). Copyright © 2008 Lippincott Williams & Wilkins

“ Humanitarian Competition: An Intellectual History in Perspective”.

Competition has become the mantra for survival in a globalised world where meaningful existence is fraught with demands, which go beyond the material to the immaterial ‘byte-size’. This has been exemplified by our obsession with illusions of immediate fame and fortune. This paper contextualises and extends the debate about the role of competition in general. Here the four major myths of competition are explored and deconstructed, from a Darwinian perspective to a more demonstrably engaged perspective on ‘capabilities’ (Sen, 1999). The second section deals particularly with the key debates, theories that influenced Tsunesaburo Makiguchi’s seminal ideas of ‘humanitarian competition’ in 1903. The final part of the paper seeks to decipher the relevance of the key ideas of ‘humanitarian competition’ as proposed by Dr Daisaku Ikeda in his 2009 peace proposal. Here the transition from competition to cooperation is explored by tying together the key principles of global coexistence enunciated by both Makiguchi and Ikeda in the context of expanding spiritual influence by the forces of culture, morality and virtue. To engage with humanitarian competition calls for a major shift from hard power to soft power, from subordination to one of engagement. In other words this concept advances the Buddhist principle of peaceful co-existence, or Panchsheel, as a norm for human behaviour of love, kindness, sacrifice and peace through cooperation, where equality and mutual benefit are critical. Humanitarian competition provides the essential framework to establish a new world order as highlighted by both Makiguchi and Ikeda.