Death of a child following a superstitious ritual of exorcism.

INTRODUCTION: Diseases, especially those related to the psyche produced by demons, are an accepted belief in many communities. This paper elaborates on the death of a child, a victim of an exorcism ritual, and calls for adequate awareness and preventive measures. CASE REPORT: The deceased, a 9-year-old child, was taken by her mother to an exorcist to 'expel a demon from her body. The exorcist caned the child for two days while giving 'water' to drink. On the second day, the child lost consciousness and was pronounced dead on admission. On direct questioning, it was revealed that the child had been made to consume some medicinal syrups forcefully by the mother and the exorcist. The autopsy revealed multiple abrasions, tram-line contusions and burns on the body. There was mottling and consolidation in the lungs. Blood-stained secretions were found in the trachea, bronchi, and stomach. Musculoskeletal dissection revealed subcutaneous haemorrhages and muscular contusions over the buttocks and limbs. Histology revealed evidence of well-established aspiration pneumonia. There was no other significant pathology, especially no evidence of acute kidney injury due to rhabdomyolysis. Toxicological analysis was negative for common poisons, therapeutic drugs, and heavy metals. The cause of death was concluded as aspiration pneumonia in a child subjected to physical violence. CONCLUSION: With the forceful feeding of the syrup, the child can have aspiration, resulting in aspiration pneumonia. At the same time, it appears that even after the child became symptomatic, she had not been brought for medical treatment but had continued with the same exorcistic therapy. While the caregivers become responsible for the child's death, the lessons to be learnt are enormous. Thus, banning such practices against children is a need of the hour.

The school education, ritual customs, and reciprocity associated with self-regulating hand hygiene practices during COVID-19 in Japan.

BACKGROUND: The role of social ties, other-regarding preferences, and cultural traits in boosting community resilience and minimizing citizens' vulnerability to crises such as COVID-19 is increasingly being recognized. However, little is presently known about the possible routes through which such personal preferences and cultural norms pertinent to social behaviors are formulated. Thus, in this paper, factors that can be potentially associated with individuals to self-regulate strict hand hygiene practices before the pandemic, during the state of emergency, and after the state of emergency was lifted in Japan are investigated. Focus is given to the handwashing education in primary school, a cultural practice originating from the old Shinto tradition, and individuals' reciprocal inclinations. As people in Japan are known to be highly conscious of hygiene in all aspects of their daily life and are less likely to contract an infection, evidence obtained in this specific context could contribute to the better understanding of individuals' health-related behaviors in general, and during crises in particular. METHODS: Using the data derived from a four-wave nationwide longitudinal online survey, we examined the extent to which elementary school education, childhood cultural experiences at shrines, and individual other-regarding preferences are associated with self-regulating hand hygiene practices prior to the pandemic and people's efforts to comply with the government-imposed measures aimed at preventing the spread of COVID-19 infection during the state of emergency. We also investigated the long-term trends in the relationships among these factors (i.e., after the abolishment of the state of emergency) using panel data. RESULTS: Our findings reveal that childhood education and cultural experiences related to handwashing practices, as well as reciprocal inclinations, are significantly associated with Japanese attitudes toward personal hygiene (beyond handwashing practices) prior to, during, and after the state of emergency. In recognition of the possible effects of recall bias and measurement errors, several important attempts to mitigate these issues were made to strengthen the value of our findings. CONCLUSIONS: The importance of school education received during childhood, as well as culture and other-regarding preferences, in the individual attitudes toward hand hygiene in adulthood highlighted in this study contributes to the better understanding of the role that these factors play in the variations in voluntary compliance with strict hand hygiene practices before and during an uncertain and prolonged crisis.

Rituals of Contagion in Closed Religious Communities: A Case Study of Amish and Mennonite Communities in the USA During the Beginning of the COVID-19 Pandemic.

At the onset of the COVID-19 pandemic, government and medical guidelines emphasized social distancing to limit exposure. These guidelines significantly impacted closed religious communities, particularly those opposed to modern technologies, such as Amish and Mennonite communities. How did these religious communities respond to COVID-19 policies in the USA? We draw data from Ohio and Pennsylvania scribe entries published in an Amish/Mennonite correspondence newspaper. While some of these communities altered church rituals to comply with government directives, others maintained communal worship without disruption. Mennonite communities were more likely to conform to guidelines.

Future Directions on BIPOC Youth Mental Health: The Importance of Cultural Rituals in the COVID-19 Pandemic.

Culture plays an important role in the development of mental health, especially during childhood and adolescence. However, less is known about how participation in cultural rituals is related to the wellbeing of youth who are Black, Indigenous, and People of Color (BIPOC), and part of the Global Majority. This is crucial amid the COVID-19 pandemic, a global event that has disproportionally affected BIPOC youth and disrupted participation in rituals. The goal of this paper is to promote advances in clinical child and adolescent psychology focused on rituals. We begin by defining culture and rituals and examining their role on development. We illustrate these issues with the Lunar New Year in China, Maya rituals in México, Ramadan in Turkey, and Black graduations and Latinx funerals in the United States. We discuss how the pandemic has affected participation in these rituals and their potential impact on BIPOC children and adolescents' mental health. We propose future directions and recommendations for research.

Preventive behaviours during the pandemic: The role of collective rituals, emotional synchrony, social norms and moral obligation.

The present research focuses on the role of collective, social influence and intraindividual processes in shaping preventive behaviours during the COVID-19 pandemic. In two correlational studies conducted in Spain, we explored the impact of participation in the ritual of collective applause (carried out daily for over 70 days during the lockdown) and perceived social norms in fostering behavioural adherence to public health measures, as well as the mediating role of perceived emotional synchrony and a sense of moral obligation. The first study (general population, N = 528) was conducted in June 2020, just after the end of the lockdown, and the second study (students, N = 292) was carried out eight months later. The results of the structural equations modelling (SEM) consistently confirmed that active participation in collective applause was linked to more intense emotional synchrony and indirectly predicted self-reported preventive behaviour. Perceived social norms predicted self-reported behavioural compliance directly and also indirectly, via feelings of moral obligation. The discussion addresses some meaningful variations in the results and also focuses on the implications of the findings for both theory and psychosocial intervention.

Spiritual Health and the COVID-19 Pandemic: Impacts on Orthodox Christianity Devotion Practices, Rituals, and Religious Pilgrimages.

The impact of the COVID-19 pandemic on multiple aspects of physical and social health, including spiritual and religious dimensions, has been discussed not only by numerous theologians, scientists, and politicians, but also by millions of believers of all faiths worldwide. The pandemic seems to have exerted a significant impact on religious practices. Massive gatherings of devoted and faithful people have been strongly discouraged and even openly banned. Prominent religious festivals and pilgrimages that have been conflated by the media with other "mega-spreader events" are incessantly canceled to mitigate the pandemic and alleviate the burden of COVID-19 on the healthcare system. The impact of the pandemic on Catholic or Muslim religious tourism has been extensively described in peer-reviewed and gray literature. However, observant members of the Orthodox Christianity faith have also experienced the constrictive prohibitions for gathering at and worshiping in shrines, churches, and monasteries. Among the manifestations of devotion that the pandemic has interfered with are the attendance to public worship spaces for the celebration of rites and ceremonies, like the celebration of Orthodox Easter. Expressions of reverent devotion including the kissing of crosses and icons as well as the sacrament of Holy Communion may have also been considered a motive of concern as these holy objects and the spoon used might act as fomites in the dissemination of the virus. Visitation of holy places has been also hampered by the pandemic. The most important centers of pilgrimage for Orthodox Christianity are Mount Athos and Jerusalem, as well as the Shrine of Panagia Evangelistria in the Island of Tinos, Greece. Authorities have halted almost completely the arrival of visitors to these sites. This paper aims at elaborating on the impact that the COVID-19 pandemic has had on social manifestations of religiosity and therefore taking a toll on the spiritual health of believers who have deeply rooted religious convictions and are strongly attached to Church tradition. This analysis closes with the provision of specific suggestions for the care, support, and healing of the impacted or splintered spiritual health of the believers who cannot participate in expressions of devotion, such as pilgrimages and religious tourism because of personal and public health concern, such as the COVID-19 pandemic.

Take-home and digital Lenten filter ashes for Ash Wednesday: creative ritual practices of faith during COVID-19 pandemic.

Before the coronavirus disease 2019 (COVID-19) pandemic, previous research cautioned that complex and meaningful quotidian rituals involving intimate touch need re-evaluation as these pose a hygienic concern in pandemic culture. Faith-based practices entail human-to-human contact that could inevitably cause the virus infection contagion if not appropriately addressed. In a World Health Organization document, the crucial role of inter-faith collaboration and sharing of best practices to combat the spread of the virus are encouraged. In this correspondence, we assert that taking home ashes and launching digital Lenten ashes filter are non-traditional yet creative ways for the Catholic Church to perform the ritual practice in celebrating Ash Wednesday. We argued that such creative ritual practices changed the landscape of faith-based practices and implied trans-local participation of the Catholic community as witnesses of faith while upkeeping public health.

Grief: The Epidemic Within an Epidemic.

COVID-19 has not only dramatically changed the way we live, it has also impacted how we die and how we grieve. With more and more Americans dying in ICU settings, away from family, and more funerals being held virtually, the pandemic has seriously curtailed normal expressions of grief and cultural mourning. Given the CDC guidelines for funerals and social distancing, simple human touch is no longer a mitigating force against prolonged grief. So, while one epidemic has a face and a name, we point to a second, more silent yet potentially equally devastating one, unacknowledged grief, and emphasize how policy can be a current therapeutic. We can wait for a vaccine, but we can also act now through thoughtful policymaking that acknowledges this second epidemic.

COVID-19 Mitigation Plans During Hajj 2020: A Success Story of Zero Cases.

The Hajj pilgrimage, held in the Kingdom of Saudi Arabia, is among the largest mass gatherings in the world. More than 2.5 million Muslim pilgrims assemble from over 180 countries worldwide to perform Hajj. The Saudi government recognized the potential risks associated with this event since the first novel coronavirus disease 2019 (COVID-19) case was detected in the country on March 2, 2020. The return of possibly infected pilgrims to their countries after this huge mass gathering event could have turned Hajj into a superspreading event during the global COVID-19 pandemic. A multidisciplinary Saudi team from governmental sectors, including the Global Center for Mass Gatherings Medicine, shared in the assessment, planning, execution, and success of this holy event to prevent the spread of disease. The World Health Organization welcomed the Saudi government's decision to protect the wellbeing and safety of pilgrims and strengthen regional and global health security. A total of 1,000 pilgrims from 160 different countries were randomly selected to perform the rituals. Of all the pilgrims, healthcare personnel, and nonmedical employees facilitating the rituals, no confirmed cases of COVID-19 were identified during or after Hajj. This article highlights the success of the risk mitigation plan in place during the Hajj pilgrimage in 2020 (1441 Hijri year) during the COVID-19 pandemic and the efforts of the Saudi government to prevent associated outbreaks.

Understanding the ethical implications of the rituals of medicine.

Rituals may be understood broadly as stereotyped behaviours carrying symbolic meanings, which play a crucial role in defining relationships, legitimating authority, giving meaning to certain life events and stabilising social structures. Despite intense interest in the subject, and an extensive literature, relatively little attention has been given to the nature, role and function of ritual in contemporary medicine. Medicine is replete with ritualistic behaviours and imperatives, which play a crucial role in all aspects of clinical practice. Rituals play multiple, complex functions in clinical interactions and have an important role in shaping interactions, experiences and outcomes. Longstanding medical rituals have been disrupted in the wake of coronavirus disease 2019 (COVID-19). Medical rituals may be evident or invisible, often overlap with or operate alongside instrumentalised practices, and play crucial roles in establishing, maintaining and guaranteeing the efficacy of clinical practices. Rituals can also inhibit progress and change, by enforcing arbitrary authority. Physicians should consider when they are undertaking a ritual practice and recognise when the exigencies of contemporary practice are affecting that ritual with or without meaning or intention. Physicians should reflect on whether aspects of their ritual interactions are undertaken on the basis of sentiment, custom or evidence-based outcomes, and whether rituals should be defended, continued in a modified fashion or even abandoned in favour of new behaviours suitable for and salient with contemporary practice in the interests of patient care.

Rituals in the Time of COVID-19: Imagination, Responsiveness, and the Human Spirit.

Following the format put forth by Imber-Black and Roberts, I examine daily rituals, family traditions, holidays, and life cycle rituals during the pandemic of COVID-19. Marked by symbols capable of carrying multiple meanings, symbolic actions, special time and special place, and newly invented and adapted rituals are illustrated through stories of couples, families, and communities.

Siguiendo el formato presentado por Imber-Black, Roberts y Whiting (1988), analizo los rituales diarios, las tradiciones familiares, las festividades y los rituales del ciclo de vida durante la pandemia de la COVID-19. Los rituales recientemente inventados y adaptados -marcados por símbolos capaces de cargar varios significados, acciones simbólicas, un tiempo especial y un lugar especial- se ejemplifican mediante historias de parejas, familias y comunidades.

Hajj in the Time of COVID-19.

The recent outbreak of the novel COVID-19 is posing a severe public health risk across the globe. The Kingdom of Saudi Arabia (KSA) is one of the greatest destinations of religious congregations of Muslims. One of the largest religious gatherings is the Hajj that is anticipated to produce serious challenges of mass level exposures and spread to every corner of the world. Therefore, it is highly recommended that the Ministry of Hajj and Umrah (KSA), must regularly analyze the prevailing situation of COVID-19, and involve the religious scholars to make appropriate decisions about Hajj 2020. Although the Saudi government has been continuously taking all possible measures to contain the pandemic, people's cooperation is crucial in the fight against COVID-19.