Doorways to the deathlands: The imaginal seeing of story

This chapter explore the places where therapist and client need to attend the witchy wise woman's lessons, by coming inside, moving beyond words, making good use of time and being ready to work in the currency of a 'magical logos' that is beyond what is known or fully understood. It will look at how story offers a doorway, through which one see into the silenced and paralyzed places one enters when mortality interrupts life, and dis-locate into the unvisited, imaginative realm called 'The Deathlands'. The chapter will be in a story form that starts by giving a context for story and ritual being vital soul-wise portals which guide during any process of death. It introduces the metaphor of a country, The Deathlands made up of four shires, each with an entry point or doorway through which people pass when they lose someone or become terminally ill. It looks at the kind of story that is played out in these days of Coronavirus, happening during the writing of this chapter. A traditional story will follow each description of The Deathland shires, intended to amplify imaginary, created story, with time-tested, magical wisdom of an ancient myth from tradition of different world cultures. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Socio-economic and clinical drivers of COVID-19 mortality: An empirical analysis of the supply-side and demand-side moderators

The COVID-19 pandemic has disrupted everyday life globally, with severe consequences in several countries and regions. A key concern related to the COVID-19 pandemic is the wide variation in mortality across nations and sub-national locations such as states and counties. Anecdotal evidence, as well as evidence from CDC, indicates that the risk of spread as well as the risk of mortality from the pandemic is higher for regions with a population characterized by disadvantaged economic (income) and racial (underserved communities) and demographic profiles (age). Multiple studies have indicated that the most crucial step toward reducing mortality is expanding critical care capacity through procuring personal protective equipment (PPE) and ventilators and training critical care frontline employees. It is projected that with exponential growth in the pandemic spread, many regions would fall short of critical care capacity, increasing mortality.Furthermore, the pandemic has imposed high levels of constraints on resource availability, even in developed nations. Under resource constraints in critical care delivery, mitigation strategies need to account for the variation in observed cases and the disparity in mortality across locations. In my dissertation, I make a concerted effort to contribute toward understanding the sources of variation in mortality and propose a framework that enables pandemic preparedness and mitigation strategies that encapsulate the spatial and temporal variation in risk of mortality from COVID-19. The mitigation strategies are divided into supply-side and demand-side moderators of mortality. Accordingly, I focus on two mitigation strategies: (i) ICU capacity as a supply-side moderator and (ii) Vaccination coverage as a demand-side moderator. The overarching objective of my dissertation is to understand the role of supply-side and demand-side moderators of mortality, independently and jointly, of the association between socio-economic, demographic (henceforth referred to as social), and clinical risk factors and COVID-19 mortality. Much of the epidemiological literature on COVID-19 has focused on reducing the spread. However, the ultimate goal is to reduce mortality. There is a necessity in both practice and academic literature to understand actionable policies that can reduce mortality in general and spatial variation of mortality in specific. This dissertation research primarily leverages empirical methodology combining matching procedures with fixed effect modeling of panel data to test the hypothesized relationships of interest. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The impact of individualism on the efficiency of epidemic control and the underlying computational and psychological mechanisms

Coronavirus disease 2019 (COVID-19) is a global health crisis, and some countries experience difficulties in controlling the infection and mortality of COVID-19. Based on previous findings, we argue that individualistic cultural values are not conducive to the control of the epidemic. The results of the cross-cultural analysis showed that the individualistic cultural values positively predicted the number of deaths, deaths per million, and mortality of COVID-19, and the independent self-construct negatively predicted the efficiency of epidemic control in the early phase. The evolutionary game model and cross-cultural experiment further suggested that individualistic culture reduced the efficiency of overall epidemic control by enhancing individuals' fear of death in the context of the epidemic and increased individuals' tendency to violate epidemic control. Our results support the natural-behavioral-cultural co-evolution model, suggesting the impact of culture on the control of virus transmission and deaths during COVID-19, and provide an important scientific reference for countries to respond to global public health crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Black death and mourning as pandemic

Black bodies have been the site of devastation for centuries. We who inhabit and love these bodies live in a state of perpetual mourning. We mourn the disproportionate dying in our families, communities and the dying in the black diaspora. We are yet to come to terms with the death that accompanied the AIDS pandemic. Tuberculosis breeds in the conditions within which most of us live. We die from hours spent in the belly of the earth where we dig for minerals to feed the unquenchable thirst of capital. Malaria targets our neighbors with deathly accuracy. Ebola stalks west Africa where it has established itself as a rapacious black disease. It kills us. In the black diaspora, African Americans are walking targets for American police who kill and imprison them at rates that have created a prison industrial complex. Africans die in the Mediterranean ocean and join the spirits of ancestors drowned centuries ago. With South Africa as the point of departure, this paper stages a transcontinental examination of black death. It is animated by the following questions. What are the dimensions of black death, what is its scale and how is it mourned? What does the COVID-19 pandemic mean for we who are so intimately familiar with death? (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Birth, death and isolation: Motherhood during a pandemic

This chapter draws out the existential themes that have emerged for mothers during the Covid-19 pandemic and how they have had an impact on their lives. Birth, death and motherhood are all corporeal events which ground people in the physical dimension. Whereas the physical dimension of maternity in the pandemic was dominated by the safety and risk pole of existence for mothers, in the social dimension the focus was on isolation and belonging;and these two dimensions became interconnected. The way in which the issues of mortality and natality, of life and death, were manifested in women during the pandemic was through a preoccupation with the safety and risk pole of existence, which in turn led to worry, anxiety and fear. For women, those wanting to conceive during the pandemic it became a mission of trying to plan for the unknown. For the majority of women, the thought of giving birth is often felt with trepidation and anxiety about what will happen and how the birth will proceed but at the same time excitement and anticipation of finally meeting their baby. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Association of income, education, employment and COVID-19 mortality in Brazil

The increased mortality rates from COVID-19 in Brazil have adversely affected vulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the theoretical framework, I evaluated the underlying influence of socioeconomic factors on COVID-19 mortality at different geographic levels (region, state, and capital). Therefore, the foci of these three manuscripts is the need to assess this influence to encourage governmental response through better planning, strategies, and actions toward socioeconomic equality in Brazil, which could promote a reduction in the COVID-19 mortality rate. Most findings do not agree with the theory tested, which can be explained by a series of other factors, such as population density and heterogeneity.Thus, there are still inconsistencies regarding how minority groups are at greater risk of disease contamination and death. The social change implications of this study include a potential increase in opportunities for socioeconomic equality. A decrease in the COVID19 mortality rate could also allow Brazilians to improve individual lives with healthier families and communities. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A Catholic Christian understanding of autism spectrum disorder and grief within the funeral setting

Attending the funeral of a loved one offers bereaved individuals the opportunity to say goodbye to the deceased, providing closure to the grieving loved one and concretizing the deceased's death. Within the Catholic-Christian tradition, the funeral rite is seen as an act of worship, a part of the more powerful story of salvation. Within this belief system, the funeral rite represents the deceased loved one's soul returning to God in the afterlife. It is a way to thank God for the endless mercy He has shown His children on Earth. Under the helpful guidance and expertise of funeral directors, funeral proceedings allow family and friends to grieve the loss of their loved one, surrounded by a community of prayer and support, which can provide a step toward healing. However, certain groups of individuals are commonly deprived of the opportunity to participate in or attend the funeral of a loved one. People in the autism community can fall into this category, as their grief is often disenfranchised. Their experience of disenfranchised grief can be problematic, as excluding these individuals from the funeral service may impact their grief and mourning process. Because grief reactions within people with autism are understudied, little is known as how to adequately address the needs of these individuals at the funeral of a loved one. Also, many funeral directors do not receive formal training on how to work with people with autism. Thus, they may not be aware of the extra support that individuals with autism may need when attending a funeral service.Therefore, through the lens of Catholic-Christian integration, this dissertation seeks to examine how grief manifests within people with autism more fully. Specifically, this dissertation examines the role that funeral attendance may play in their grief processes. Moreover, using archival data from a pilot study, a training program for funeral directors will be examined for its effectiveness. Furthermore, interview data from professionals in the field of autism and grief will be analyzed and discussed. Combining a thorough literature review of the topic with data from professionals in the field, this dissertation aims to better understand how grief manifests within this population, specifically as it relates to funeral attendance. Throughout the dissertation, the need for grief studies and interventions within the autism community will be highlighted, especially during this time of increased death and subsequent grief and mourning due to the COVID-19 pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Whither critical Management and Organization Studies? For a performative critique of capitalist flows in the wake of the COVID-19 pandemic

Over the last few months, COVID-19 has entered our own consciousness as a moment of profound disruption, leading in too many cases to misery and death, but also, forcing us more mundanely to reorganize our lives, work and social relations. The disruption of capitalist flows by the pandemic has exacerbated the cleavages and power inequalities. Addressing them can help critical MOS to reconnect the places and times of production and paid work to the circulation and consumption of goods and services and, more broadly, to social reproduction. This is necessary to identify the contradictions at the heart of capitalism, denaturalize it as a mode of organizing the economy and society, and envision more just flows and novel subjectivities. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Understanding daily psychological well-being in the context of the early COVID-19 environment

The onset of the COVID-19 pandemic led to a pervasive environment that was both novel and unescapable for people everywhere. This prolonged and massive event operated across multiple levels of influence with impacts ranging from the most distal global environment to the most proximal immediate environment of daily life. Individuals had to deal with wide-spread challenges and uncertainties, including coping with stay-at-home orders, adapting to new safety requirements and policies, and facing fear and risk of infection as well as symptoms from the virus itself. In order to investigate the impacts of this environment on daily psychological well-being, this dissertation identified innovative environmental measures of that COVID-19 environment and connected them to individuals' ecological momentary assessment outcomes, bridging community level indicators with person level experiences. This work addressed a critical gap in the COVID-19 literature, namely that COVID-19 pandemic was not a monolithic experience but a dynamic and complex environment. Specifically, Study 1 examined the role of daily changes in COVID-19 severity at the state level by using reported cases and deaths in February and March of 2020 to predict daily distress and distress variability in emerging adults. It also considered the differential effects of accumulated cases (or deaths) and daily new cases (or deaths). Study 2 examined relationships between community level COVID-19 information seeking and individual worry and coping self-efficacy. Internet search data was used as an indicator of community information seeking based on high interest search terms related to COVID-19 and critical lockdown material resources. Findings from both studies provide support for the role of the COVID-19 environment in daily well-being at multiple levels of influence. Distress, worry, and coping all showed evidence of environmental influences. Additionally, this work supports the critical need for investigating environments and their connections over time in models that allow both the environment and the individuals to change. This work has implications for understanding the complicated well-being effects of the COVID-19 environment and findings can be expanded to other crisis and chronic stress environments. It also provides a model for more precise within-person research that better models and measures environments and the impact of those environments on key individual health and well-being outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The experience of family members who have had a loved one in physical restraint in a critical care setting during the COVID-19 pandemic: A qualitative study using a phenomenological design

Limited accounts of family members' experiences with loved ones who have been physically restrained in ICU settings (Ones, 2020;Singer et al., 2020) have left a gap in providing respectful, responsive patient care. One study estimated that physical restraint was being used at the rate of 50 per 1,000 patient days. Currently, it is estimated that approximately 27,000 people are placed in physical restraints each day in U.S. hospitals. ICUs are responsible for 56% of all restraint days, despite accounting for only 16% of all patient days (Mion, 2008). According to Abdeljawad and Mrayyan (2016), patients may experience trauma with the use of these devices. In order to better comprehend the effects following physical restraint use, this dissertation explored the perceptions of family members with loved ones who have been physically restrained, with a focus on their application in critical care settings during the COVID-19 pandemic.While no scientific evidence of physical restraint efficacy is available, there is much evidence of its risk. Another study reported that in hospitals in the United States, the prevalence of using physical restraints is approximately with 53% of all patients. Further, the prevalence of using restraints on patients in critical care units is 75%. With the increased use of physical restraint, the mortality and morbidity rates are expected to increase, due to serious consequences of physical restraint that can result in confusion, deconditioning, pressure injuries, strangulation, death, and adverse psychological effects (Rakhmatullina et al., 2013). In the extant literature, limited studies have explored family members' experiences of loved ones being physically restrained (Ones, 2020). The findings from this study included the following themes: Theme 1: Having to Deal with Complications and Difficulties Encountered Preceding, During, and Post Hospitalization;Theme 2: Experiences That Are Identified as Negative;Theme 3: Understanding of Hospital Staff Intentions;Theme 4: The Need for Physical Restraint Intervention (PRI) May Be Justifiable but Stirs up Negative Emotions;and Theme 5: Feelings of Ambivalence Associated with PRI. The study provides an understanding of family members' perception of these experiences. These insights may help health care clinicians improve the experience of patient care, safety, and quality. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Supporting people with intellectual disability at end of life: Moral distress among staff caregivers during COVID-19

COVID-19 is likely to have compromised the management of end-of-life care. Disruptions include the inability to respect advanced care planning, offer support to the person dying, and the failure to celebrate the person's life within local customs. Where people work to deliver high-quality care, such disruption can lead to carers experiencing moral distress, which can have behavioural and physical consequences if unresolved. This chapter describes the leading theories of the causes, experiences, and prevention of moral distress for carers. We then utilise data from eight end-of-life interviews that supply evidence for carers experiencing moral conflict distress, moral constraint distress, moral uncertainty distress, retrospective moral distress, and moral residue to underpin three case stories about the disruptions to end-of-life care in the intellectual disability community. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Living and dying well with dementia

Many people with intellectual disability, particularly those with Down syndrome, are at increased risk for Alzheimer's disease. Recent findings suggest that while onset may be at an earlier age and more rapid in early dementia stages, there is often a long late stage where decisions about end-of-life care and dying well must be supported. For the individual and caregivers, later stages of dementia can be complicated by lack of understanding and preparedness by both generic palliative care and intellectual disability services. The COVID-19 pandemic has posed significant challenges for staff and family, and many have struggled with moral distress as they feel forced to act in a manner contrary to their own care beliefs. Three case studies with reflective questions about caring for people with Down syndrome and dementia are offered, one from the COVID-19 period. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Use of do-not-resuscitate orders

Use of patient/health proxy authorised do-not-resuscitate (DNR) or do-not-attempt-resuscitation (DNAR) orders is widespread in palliative, hospice and hospital-based chronic illness care. Such orders often reflect self-determination, avoidance of futile care and quality of dying principles. Reports during COVID-19 of physicians writing DNR/DNAR orders for people with intellectual disabilities at rates higher than the general population amplify past concerns about the value placed on their lives. Yet, absence of a DNR/DNAR or processes to permit one when someone cannot consent may result in painful and unnecessary prolongation of life. This chapter considers rationales for DNR/DNAR orders, use among people with intellectual disabilities, advance care planning, protocols when an individual is unable to consent and strategies for oversight of DNR/DNAR orders. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Essays on labor markets and health: Employment conditions and drug, suicide, and alcohol-related mortality among working-age adults in the United States

Americans in the twenty-first century are dying earlier in life and at higher rates from preventable causes than in nearly any other developed economy. Understanding of the root determinants of the recent reversal in life expectancy and identifying policy approaches to combat the rise in midlife mortality is a national public health and economic imperative. This dissertation focuses on the well-documented increase in fatal drug overdose, suicide, and alcohol-related mortality-a collection of causes of death often referred to as the "deaths of despair"-and examines the potential economic determinants of the acceleration in these causes of death over the past several decades. Building upon extensive literature examining macroeconomic and labor market conditions as upstream factors shaping population health, the following chapters consist of two empirical analyses intended to estimate the causal effect of short- to medium-term changes in local employment rates on these causes of death among working-age adults during the 2003-2017 period. These studies are of increasing importance as the United States continues to experience widespread employment uncertainty and prolonged economic distress in the wake of the COVID-19 pandemic.The first study presented in this dissertation focuses on the effects of county-level employment conditions on "deaths of despair" using a Bartik-style shift-share instrument to isolate demand-driven variation in county-level employment rates. In line with most existing studies that document countercyclical variation in suicide, I estimate that a one percentage point increase in the current-year employment-to-population ratio decreases non-drug suicide rates by one to two percent. On the other hand, my causal models suggest that rates of fatal drug overdose increase by a similar magnitude as the economy improves, and I find no evidence of changes in alcohol-related mortality in response to short-term employment shocks. I conduct a simulation exercise based on these point estimates to show that in general, and especially for accidental drug overdose, these estimated effects are small relative to the increases in cause-specific mortality over the 2003-2017 period.Motivated by the procyclical variation in accidental drug overdose uncovered in the first study, the second analysis examines the extent to which county employment rates affect the demand for prescription opioid medication among a population of commercially insured adults. This study draws on de-identified, individual-level pharmacy and medical claims from 2003-2017 aggregated to the county level to test the hypothesis that county-level employment fluctuations differentially affect the demand for prescription opioids that place individuals at higher (versus lower) risk for abuse and dependence. Unlike existing studies, I find no evidence of an effect of employment conditions on the demand for prescription opioids overall or differential effects between high- and low-risk prescriptions.The relatively small magnitude of the estimated effects, suggestive evidence of heterogeneity across demographic groups, and mixed findings on the cyclicality of these causes of death over various time horizons all point to a more complex set of factors underlying the rising rates of "deaths of despair" that is not explained by local employment rates alone. Developing a more nuanced understanding of these trends-particularly along key dimensions such as race/ethnicity and socioeconomic status-will be critically important in designing equitable policies to help the country recover from the COVID-19 pandemic and to reverse the disconcerting trends of increasing midlife mortality in the years to come. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Loss and grief: Personal stories of doctors and other healthcare professionals

This collection of personal narratives is just that: stories intended to chronicle the journeys of a small number of health clinicians and other professionals who have been struck by personal illness and/or loss. What these stories do not assume is that there are answers to the universal experiences of loss and grief, courage, and survival implicit in the telling. While the past is gone, the meaning of it, however, is forever in flux, forever being worked and reworked in our conscious and unconscious minds. Each memory is a redoing of what it represents and brings forth within our sense of ourselves and in our relationships with one another. Grief challenges us physically, emotionally, and psychologically to recast the loss again and again. And, in recasting the past and the passage of time, refashioning memory to meet the needs of the moment in which the lost object and our response to it either helps us to move forward in our life or keeps us stuck, unable to engage with a future that requires acceptance of giving up the life lived before. The COVID pandemic further highlighted the internalization of expectations. Drilled into us in training is the "prime directive", the ethical responsibility of patient care and that one should deal with personal things on one's one time. The stories written in this collection were a draft perhaps unending versions telling of the experience. Some stories were written in one setting, others over many weeks or months as the writer lost and regained footing along the tale's trail. The shame, the sadness and weeping, the anger and guilt, and the shame of feeling relief of the pain and suffering for ourselves or those we love(d) and the "weakness" of not being able to manage it all echo through these stories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

How political identity influences COVID-19 risk perception: A model of identity-based risk perception

Past research suggests that conservatives are usually more threat-sensitive than liberals are. Yet during the COVID-19 pandemic, conservatives consistently underestimated the risk from the virus. To reconcile this paradox, we introduce a model of identity-based risk perception (IRP). This model posits that risk perceptions depend not only on objective risk but also on people's political identity and whether the risk pertains to their group identity (group risk) versus individual identity (individual risk). When asked about the group risk posed by a threat ("How many Americans will die of COVID-19?"), conservatives focus on their national pride and underestimate the risk of contracting the virus compared to liberals. However, when asked about individual risk from the same threat ("What is the probability of an individual dying of COVID-19?"), conservatives focus on individual mortality threat and overestimate the risk of succumbing to the virus compared to liberals. Three national surveys support the IRP model. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Covid-19: Equal response and unequal interests

The greatest risks of Covid-19 are not arising from its direct effects on morbidity and mortality but from exaggerated aspirations to control such effects politically. A swift transformation from an epidemic to an endemic state of affairs may in case of a disease with comparatively low and unequally distributed mortality like covid-19 be an option, too. This needs to be laid out but it is not the task of science to plead for this or any other option. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 and health inequality: The nexus of race, income and mortality in New York City

Purpose: The purpose of this paper is to evaluate socioeconomic factors related to COVID-19 mortality rates in New York City (NYC) to understand the connections between socioeconomic variables, including race and income and the disease. Design/methodology/approach: Using multivariable negative binomial regression, the association between health and mortality disparities related to COVID-19 and socioeconomic conditions is evaluated. The authors obtained ZIP code-level data from the NYC Department of Health and Mental Hygiene and the US Census Bureau. Findings: This study concludes that the mortality rate rises in areas with a higher proportion of Hispanic and Black residents, whereas areas with higher income rates had lower mortality associated with COVID-19, among over 18,000 confirmed deaths in NYC. Originality/value: The paper highlights the impacts of social, racial and wealth disparities in mortality rates. It brings to focus the importance of targeted policies regarding these disparities to alleviate health inequality among marginalized communities and to reduce disease mortality. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Panel 19, Number 9, East: In Memoriam to Larry Insel

The author on his first trip to Washington, DC, in 1993, squeezed in a day of sightseeing between his meetings and conferences. When the author came upon the Vietnam War Memorial, he was suddenly seized with the urge to find the name of a long-lost high school friend, Larry. This poem came to him as he sat in the Metro train, making his way back to the hotel outside Baltimore. The author scribbled it on the back of an envelope. The Vietnam Era shaped the author's life. Because of the lottery, the author and his friends struggled to find ways to avoid fighting a war they didn't believe in. Larry's decision to join the armed forces early on stood in contrast to the angst and struggles the rest of our close friends experienced. The author's sense of loss during the Vietnam War years echoes today's COVID-19 era tragedy. Then and now, there are so many losses: not just relatives and friends, but also the loss of a unified voice of comfort in the face of profound polarities, the persistent lack of civility in public discourse, and the uncertainty-and at times terror-that we all collectively face. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Where is leisure when death is present?

For many, the COVID-19 pandemic is the overwhelming, ever-present reality of dying-of loved ones, close family members, dear friends, colleagues, or patients. Fear, avoidance of or lack of time for essential conversations, physical separation during final moments, and lack of rituals for these contingencies leave individuals alone with loss, mourning, and grieving. How is leisure relevant during such realities? Historically, leisure has been present across diverse cultural dying and death practices: art, music, dance, theater, play, contemplation, rituals, and somatic practices. These connect individuals with life forces even as some are absent in the flesh. In truth, we are all experiencing dying-death-mourning-beginning again during the COVID-19 pandemic. Josef Pieper's (2017, 2016, 2011, 1999, 1988) philosophy hints of leisure as context for the meaning, purpose, and comfort in such trying times: contemplating one's place in a changing world/universe and celebrating or affirming that relationship in community. (PsycInfo Database Record (c) 2023 APA, all rights reserved)