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Saturday, October 22, 2022

Rite of passage

From Wikipedia, the free encyclopedia

A rite of passage is a ceremony or ritual of the passage which occurs when an individual leaves one group to enter another. It involves a significant change of status in society. In cultural anthropology the term is the Anglicisation of rite de passage, a French term innovated by the ethnographer Arnold van Gennep in his work Les rites de passage, The Rites of Passage. The term is now fully adopted into anthropology as well as into the literature and popular cultures of many modern languages.

Original conception

In English, Van Gennep's first sentence of his first chapter begins:

"Each larger society contains within it several distinctly separate groupings. ... In addition, all these groups break down into still smaller societies in subgroups."

The population of a society belongs to multiple groups, some more important to the individual than others. Van Gennep uses the metaphor, "as a kind of house divided into rooms and corridors." A passage occurs when an individual leaves one group to enter another; in the metaphor, he changes rooms.

Van Gennep further distinguishes between "the secular" and "the sacred sphere." Theorizing that civilizations are arranged on a scale, implying that the lower levels represent "the simplest level of development," he hypothesizes that "social groups in such a society likewise have magico-religious foundations." Many groups in modern industrial society practice customs that can be traced to an earlier sacred phase. Passage between these groups requires a ceremony, or ritual rite of passage.

The rest of Van Gennep's book presents a description of rites of passage and an organization into types, although in the end he despairs of ever capturing them all: "It is but a rough sketch of an immense picture ...." He is able to find some universals, mainly two: "the sexual separation between men and women, and the magico-religious separation between the profane and the sacred." (Earlier the translators used secular for profane.) He refuses credit for being the first to recognize type of rites. In the work he concentrates on groups and rites individuals might normally encounter progressively: pregnancy, childbirth, initiation, betrothal, marriage, funerals and the like. He mentions some others, such as the territorial passage, a crossing of borders into a culturally different region, such as one where a different religion prevails.

Stages

Rites of passage have three phases: separation, liminality, and incorporation, as van Gennep described. "I propose to call the rites of separation from a previous world, preliminal rites, those executed during the transitional stage liminal (or threshold) rites, and the ceremonies of incorporation into the new world postliminal rites."

In the first phase, people withdraw from their current status and prepare to move from one place or status to another. "The first phase (of separation) comprises symbolic behavior signifying the detachment of the individual or group ... from an earlier fixed point in the social structure." There is often a detachment or "cutting away" from the former self in this phase, which is signified in symbolic actions and rituals. For example, the cutting of the hair for a person who has just joined the army. He or she is "cutting away" the former self: the civilian.

The transition (liminal) phase is the period between stages, during which one has left one place or state but has not yet entered or joined the next. "The attributes of liminality or of liminal personae ("threshold people") are necessarily ambiguous."

In the third phase (reaggregation or incorporation) the passage is consummated [by] the ritual subject." Having completed the rite and assumed their "new" identity, one re-enters society with one's new status. Re-incorporation is characterized by elaborate rituals and ceremonies, like debutant balls and college graduation, and by outward symbols of new ties: thus "in rites of incorporation there is widespread use of the 'sacred bond', the 'sacred cord', the knot, and of analogous forms such as the belt, the ring, the bracelet and the crown."

Psychological effects

Laboratory experiments have shown that severe initiations produce cognitive dissonance. It is theorized that such dissonance heightens group attraction among initiates after the experience, arising from internal justification of the effort used. Rewards during initiations have important consequences in that initiates who feel more rewarded express stronger group identity. As well as group attraction, initiations can also produce conformity among new members. Psychology experiments have also shown that initiations increase feelings of affiliation.

Aronson and Mills tested the Festinger's (1957) theory of cognitive dissonance by having three groups read either embarrassing material, not very embarrassing material, or nothing at all to a group. Aronson and Mills summarized Festinger's theory of cognitive dissonance as such when discussing the rationale for their study: "No matter how attractive a group is to a person it is rarely completely positive, i.e., usually there are some aspects of the group that the individual does not like. If he has undergone an unpleasant initiation to gain admission to the group, his cognition that he has gone through an unpleasant experience for the sake of membership is dissonant with his cognition that there are things about the group that he does not like. He can reduce this dissonance in two ways. He can convince himself that the initiation was not very unpleasant, or he can exaggerate the positive characteristics of the group and minimize its negative aspects. With increasing severity of initiation it becomes more and more difficult to believe that the initiation was not very bad. Thus, a person who has gone through a painful initiation to become a member of a group should tend to reduce his dissonance by over estimating the attractiveness of the group." Those who read the severely embarrassing material perceived the group as more attractive than those who read the mildly embarrassing material or nothing at all. Another study using mathematical subtraction tasks reached the opposite conclusion but research using electrical shocks supported the concept that suffering increased the degree to which participants liked the group.

Cultural

The Hamar are known for their custom of "bull jumping", which initiates a boy into manhood.

Initiation rites are seen as fundamental to human growth and development as well as socialization in many African communities. These rites function by ritually marking the transition of someone to full group membership. It also links individuals to the community and the community to the broader and more potent spiritual world. Initiation rites are "a natural and necessary part of a community, just as arms and legs are natural and necessary extension of the human body". These rites are linked to individual and community development. Dr. Manu Ampim identifies five stages; rite to birth, rite to adulthood, rite to marriage, rite to eldership and rite to ancestorship. In Zulu culture, entering womanhood is celebrated by the Umhlanga.

Types and examples

Rites of passage are diverse, and are found throughout many cultures around the world. Many western societal rituals may look like rites of passage but miss some of the important structural and functional components. However, in many Native and African-American communities, traditional rites of passage programs are conducted by community-based organizations such as Man Up Global. Typically the missing piece is the societal recognition and reincorporation phase. Adventure education programs, such as Outward Bound, have often been described as potential rites of passage. Pamela Cushing researched the rites of passage impact upon adolescent youth at the Canadian Outward Bound School and found the rite of passage impact was lessened by the missing reincorporation phase. Bell (2003) presented more evidence of this lacking third stage and described the "Contemporary Adventure Model of a Rites of Passage" as a modern and weaker version of the rites of passage typically used by outdoor adventure programs.

Coming of age

Jewish boy reading a Torah scroll at his Bar Mitzvah, using a Yad
 
Land diving is a rite of passage for boys of the South Pacific island of Pentecost
 
Karajà statuettes
 

In various tribal and developed societies, entry into an age grade—generally gender-separated—(unlike an age set) is marked by an initiation rite, which may be the crowning of a long and complex preparation, sometimes in retreat.

Religious

Jesus underwent Jewish circumcision, here depicted in a Catholic cathedral; a liturgical feast commemorates this on New Year's Day

Military

Academic

  • The first day of school, whether the first overall or the first in a specific phase prior to postsecondary education
  • Graduation
  • Matura

Some academic circles such as dorms, fraternities, teams and other clubs practice hazing, ragging and fagging. Szecskáztatás, a mild form of hazing (usually without physical and sexual abuse), is practiced in some Hungarian secondary schools. First-year junior students are publicly humiliated through embarrassing clothing and senior students branding their faces with marker pens; it is sometimes also a contest, with the winners usually earning the right to organize the next event. Fraternities and sororities, like other private societies, often have codified initiation ceremonies as ritual separating candidates from members.

Vocational/professional

Sports

Other

  • Castration in some sects and special castes
  • Dental evulsion, among various cultures of Africa, Asia and Oceania.
  • Earlier seasons of the television series Survivor typically include a rite of passage prior to the final immunity challenge. Though the specifics of this rite of passage vary based on the customs and traditions of the host country, most rites of passage include a lengthy walk to the final challenge along which the remaining castaways pass the torches of every eliminated contestant from that season. There have been variations on this walk, such as seasons in which the remaining contestants paddle a boat to the final challenge and drop the torches into the ocean along the way.

Hazing

From Wikipedia, the free encyclopedia
 
Hazing of French military pilot at 1,000 hours flight time

Hazing (American English), initiation, beasting (British English), bastardisation (Australian English), ragging (South Asian English) or deposition refers to any activity expected of someone in joining or participating in a group that humiliates, degrades, abuses, or endangers them regardless of a person's willingness to participate.

Hazing is seen in many different types of social groups, including gangs, sports teams, schools, cliques, universities, military units, prisons and fraternities and sororities. The initiation rites can range from relatively benign pranks to protracted patterns of behavior that rise to the level of abuse or criminal misconduct. Hazing is often prohibited by law or institutions such as colleges and universities because it may include either physical or psychological abuse, such as humiliation, nudity, or sexual abuse.

Terms

In some languages, terms with a religious theme or etymology are preferred, such as baptism or purgatory (e.g. baptême in Belgian French, doop in Belgian Dutch, chrzciny in Polish) or variations on a theme of naïveté and the rite of passage such as a derivation from a term for freshman, for example bizutage in European French, ontgroening ("de-green[horn]ing") in Dutch and Afrikaans (South Africa and Namibia), novatada in Spanish, from novato, meaning newcomer or rookie or a combination of both, such as in the Finnish mopokaste (literally "moped baptism"). In Latvian, the word iesvētības, which literally means "in-blessings", is used, also standing for religious rites of passage, especially confirmation. In Swedish, the term used is nollning, literally "zeroing". In Portugal, the term praxe, which literally means "practice" or "habit", is used for initiation. In Brazil, it is called trote and is usually practiced at universities by older students (doutores and veteranos) against newcomers (calouros) in the first week of their first semester. In the Italian military, instead, the term used was nonnismo, from nonno (literally "grandfather"), a jargon term used for the soldiers who had already served for most of their draft period. A similar equivalent term exists in the Russian military, where a hazing phenomenon known as dedovshchina (дедовщи́на) exists, meaning roughly "grandfather" or the slang term "gramps" (referring to the senior corps of soldiers in their final year of conscription). At education establishments in India, Pakistan, Bangladesh and Sri Lanka, this practice involves existing students baiting new students and is called ragging. In Polish schools, hazing is known as kocenie (literally catting, coming from the noun kot cat)[citation needed]. It often features cat-related activities, like competitive milk drinking. Other popular tasks include measuring a long distance (i.e. hallways) with matches. Less loaded names for hazing are otrzęsiny (related to the verb otrząsać get over, rally but also shake off/out—as being a novice is a negative state that should be quit) and chrzciny mentioned above.

Hazings are sometimes concentrated in a single session, which may be called a hell night, prolonged to a hell week, or over a long period, resembling fagging. When done on a persons birthday, it can be called birthday spanking.

Methods

One way of initiating a new member into a street gang is for multiple other members of the gang to assault the new member with a beating.

Hazing activities can involve forms of ridicule and humiliation within the group or in public, while other hazing incidents are akin to pranks. A snipe hunt is such a prank, when a newcomer or credulous person is given an impossible task. Examples of snipe hunts include being sent to find a tin of Tartan paint, or a "dough repair kit" in a bakery, while in the early 1900s rookies in the Canadian military were ordered to obtain a "brass magnet" when brass is not magnetic.

Spanking is done mainly in the form of paddling among fraternities, sororities and similar clubs, sometimes over a lap, a knee, furniture or a pillow, but mostly with the victim "assuming the position", i.e., simply bending over forward. A variation of this (also as punishment) is trading licks. This practice is also used in the military. Alternative modes (including bare-buttock paddling, strapping and switching, as well as mock forms of antiquated forms of physical punishments such as stocks, walking the plank and running the gauntlet) have been reported.

Paddling depicted on 1922 cover of College Humor magazine.

The hazee may be humiliated by being hosed or by sprinkler or buckets; covered with dirt or with (sometimes rotten) food, even urinated upon. Olive or baby oil may be used to "show off" the bare skin, for wrestling or just slipperiness, e.g., to complicate pole climbing. Cleaning may be limited to a dive into water, hosing down or even paddling the worst off. They may have to do tedious cleaning including swabbing the decks or cleaning the toilets with a toothbrush. In fraternities, pledges often must clean up a mess intentionally made by brothers which can include fecal matter, urine, and dead animals.

Servitude such as waiting on others (as at fraternity parties) or various other forms of housework may be involved, often with tests of obedience. In some cases, the hazee may be made to eat raw eggs, peppers, hot sauce, or drink too much alcohol. Some hazing even includes eating or drinking vile things such as bugs or rotting food.

Native American okipa ceremony as witnessed by George Catlin, circa 1835

The hazee may have to wear an imposed piece of clothing, outfit, item or something else worn by the victim in a way that would bring negative attention to the wearer. Examples include a uniform (e.g. toga); a leash or collar (also associated with bondage); infantile and other humiliating dress and attire.

Markings may also be made on clothing or bare skin. They are painted, written, tattooed or shaved on, sometimes collectively forming a message (one letter, syllable or word on each pledge) or may receive tarring and feathering (or rather a mock version using some glue) or branding.

Submission to senior members of the group is common. Abject "etiquette" required of pledges or subordinates may include prostration, kneeling, literal groveling, and kissing body parts.

Other physical feats may be required, such as calisthenics and other physical tests, such as mud wrestling, forming a human pyramid, or climbing a greased pole. Exposure to the elements may be required, such as swimming or diving in cold water or snow.

Orientation tests may be held, such as abandoning pledges without transport. Dares include jumping from some height, stealing from police or rival teams and obedience. Blood pinning among military aviators (and many other elite groups) to celebrate becoming new pilots is done by piercing their chests with the sharp pins of aviator wings.

On a pilot's first solo flight, they are often drenched with water, as well as having the back of their shirt cut off to celebrate the achievement. Cutting off the back of the shirt originates from the days of tandem trainers, where the instructor sat behind the student and tugged on the back of their shirt in order to get their attention. Cutting off the back of the shirt symbolizes that the instructor has no need to do that anymore.

On their first crossing the equator in military and commercial navigation, each "pollywog" is subjected to a series of tests usually including running or crawling a gauntlet of abuse and various scenes supposedly situated at King Neptune's court. A pledge auction is a variation on the slave auction, where people bid on the paraded pledges.

Hazing also occurs for apprentices in some trades. In printing, it consists of applying bronze blue to the apprentice's penis and testicles, a color made by mixing black printers ink and dark blue printers ink, which takes a long time to wash off. Similarly, mechanics get their groins smeared with old dirty grease.

Hazing by women of their suitors, often assisted by the women's friends, can also play a role in budding romantic relationships, usually taking mental and psychological rather than physical forms, and apparently for the same basic purposes as other hazing.

Psychology, sociology, purpose and effects

Hazing supposedly serves a deliberate purpose of building solidarity. Psychologist Robert Cialdini uses the framework of consistency and commitment to explain the phenomenon of hazing and the vigor and zeal to which practitioners of hazing persist in and defend these activities even when they are made illegal. Cialdini cites a 1959 study in which the researchers observed that "persons who go through a great deal of trouble or pain to attain something tend to value it more highly than persons who attain the same thing with a minimum of effort". The 1959 study shaped the development of cognitive dissonance theory by Leon Festinger.

There are several psychological effects that both the hazer and hazee endure throughout the hazing process. In an article published by Raalte, Cornelius, Linder, and Brewer, the researchers used sports teams as the subject of their study. The authors suggest that hazing can result in some positive outcomes. During the hazing process, a bond between the two parties (the hazer and the hazee) grew. Many people view hazing as an effective way to teach respect and develop discipline and loyalty within the group, and believe that hazing is a necessary component of initiation rites. Hazing can be used as a way to engender conformity within a social group, something that can be seen in many sociological studies. Moreover, initiation rituals when managed effectively can serve to build team cohesion and improve team performance, while negative and detrimental forms of hazing alienate and disparage individuals.

Dissonance can produce feelings of group attraction or social identity among initiates after the hazing experience because they want to justify the effort used. Rewards during initiations or hazing rituals matter in that initiates who feel more rewarded express stronger group identity. As well as increasing group attraction, hazing can produce conformity among new members. Hazing could also increase feelings of affiliation because of the stressful nature of the hazing experience. Also, hazing has a hard time of being extinguished by those who saw it to be potentially dangerous like administration in education or law enforcement. In an article published by Linda Wilson, she and the National Pan-Hellenic Council Leaders at North Carolina Agricultural and Technical State University gave their perspectives and opinions on hazing at their institution, and she discussed why hazing is so hard to discontinue. The reason why is because the act of hazing is deeply rooted traditionally, so it becomes hard to break those traditional actions. For example, York College in Pennsylvania tried to solve this issue with suspending students who partake in the act. However, it is hard to dismantle not only because of tradition, but also because it is meant to be done in private spaces. It is not meant to be public which makes getting rid of it even harder.

A 2014 paper by Harvey Whitehouse discusses theories that hazing can cause social cohesion though group identification and identity fusion. A 2017 study published in Scientific Reports found that groups that share painful or strong negative experiences can cause visceral bonding, and pro-group behavior. Students of Brazilian Jiu Jitsu who had experienced painful belt-whipping gauntlets had a higher willingness to donate time or risk their lives for the club.

Scope

Tied and blindfolded first-year students from Universidad de Talca, Chile

United States

According to one of the largest US National Surveys regarding hazing including over 60,000 student athletes from 2,400 colleges and universities:

Over 325,000 athletes at more than 1,000 National Collegiate Athletic Association schools in the US participated in intercollegiate sports during 1998–99. Of these athletes:

  • More than a quarter of a million experienced some form of hazing to join a college athletic team.
  • One in five was subjected to unacceptable and potentially illegal hazing. They were kidnapped, beaten or tied up and abandoned. They were also forced to commit crimes – destroying property, making prank phone calls or harassing others.
  • Half were required to participate in drinking contests or alcohol-related hazing.
  • Two in five consumed alcohol on recruitment visits even before enrolling.
  • Two-thirds were subjected to humiliating hazing, such as being yelled or sworn at, forced to wear embarrassing clothing (if any clothing at all) or forced to deprive themselves of sleep, food or personal hygiene.
  • One in five participated exclusively in positive initiations, such as team trips or ropes courses.

The survey found that 79% of college athletes experienced some form of hazing to join their team, yet 60% of the student-athletes respondents indicated that they would not report incidents of hazing.

A 2007 survey at American colleges found 55% of students in "clubs, teams, and organizations" experienced behavior the survey defined as hazing, including in varsity athletics and Greek-letter organizations. This survey found 47% of respondents experienced hazing before college, and in 25% of hazing cases, school staff were aware of the activity. 90% of students who experienced behavior the researchers defined as hazing did not consider themselves to have been hazed, and 95% of those who experienced what they themselves defined as hazing did not report it. The most common hazing-related activities reported in student groups included alcohol consumption, humiliation, isolation, sleep deprivation, and sex acts.

Police forces, especially those with a paramilitary tradition, or sub-units of police forces such as tactical teams, may also have hazing rituals. Rescue services, such as lifeguards or air-sea rescue teams may have hazing rituals.

Belgium

Hazing rituals are a common practice in student clubs (fraternities and sororities, called studentenclubs) and student societies (called studentenverenigingen, studentenkringen or faculteitskringen). The latter is attached to the faculty of the university, while the first ones are privately operated. Hazing rituals in student societies have generally been safer than those in student clubs, precisely because they are to some extent regulated by universities.

For example, KU Leuven drew up a hazing charter in 2013 following an animal cruelty incident in the hazing ritual of student club Reuzegom. The charter was to be signed by student societies, fraternities and sororities. Signing the charter would have been a pledge to notify the city of the place and time of the hazing ceremony, and to abstain from violence, racism, extortion, bullying, sexual assault, discrimination, and the use of vertebrate animals. Reuzegom, as well as the other fraternities and sororities of the Antwerp Guild, refused. In 2018, twenty-year-old student Sanda Dia died from multiple organ failure in the Reuzegom hazing ritual as a result of racially motivated abuse by fellow Reuzegom members. As of 2019, a few sororities have signed the charter, as well as all student societies. In April 2019, the 28 remaining fraternities in Leuven signed the charter.

Netherlands

In the Netherlands, the so-called 'traditional fraternities' have an introduction time which includes hazing rituals. The pledges go for a few days to a camp during which they undergo hazing rituals but are meanwhile introduced in the traditions of the fraternity. After camp, there are usually evenings or whole days in which the pledges have to be present at the fraternity, although slowly the pressure is released and the relations become somewhat more equal. Often, pledges collect or perform chores to raise funds for charity. At the end of the hazing period, the inauguration of the new members take place.

Incidents have occurred resulting in injuries and death. Often these incidents occur when members wish to join a house, (prestigious) sub-structure or commission for which they undergo a second (and usually heavier) hazing ritual. Incidents mostly occur during hazing rituals for these sub-structures, since there is less or no control from the fraternity board. Also, these sub-structure hazing rituals involve often excessive alcohol abuse, even when alcohol has become a taboo in hazing of the fraternity itself. Other situations causing additional risks for incidents are members (often joining the hazing camp but not designated with any responsibility) separating pledges and taking them away from the main group to 'amuse themselves' with them.

In 1965 a student at Utrecht University choked to death during a hazing ritual (Roetkapaffaire). There was public outrage when the perpetrators were convicted to light conditional sentences while left-wing Provo demonstrators were given unconditional prison sentences for order disturbances. The fact that the magistrates handling the case were all alumni of the same fraternity gave rise to accusions of nepotism and class justice. Two incidents in 1997, leading to one heavy injury and one death, lead to sharpened scrutiny over hazing. Hazing incidents have nevertheless occurred since, but justice is becoming keener in persecuting perpetrators.

The Netherlands has no anti-hazing legislation. Hazing incidents can be handled by internal resolution by the fraternity itself (the lightest cases), and via the criminal justice system as assault or in case of death negligent homicide or manslaughter. Universities as a rule support student unions (financially and by granting board members of such union a discount on the required number of ECTS credits) but can in the most extreme case suspend or withdraw recognition and support for such union.

Philippines

According to R. Dayao, hazing, usually in initiation rites of fraternities, has a long history in the Philippines, and has been a source of public controversy after many cases that resulted to death of the neophyte. The first recorded death due to hazing in the Philippines was recorded in 1954, with the death of Gonzalo Mariano Albert. Hazing was regulated under the Anti-Hazing Act of 1995, after the death of Leonardo Villa in 1991, but many cases, usually causing severe injury or death, continued even after it was enacted, the latest involving Darwin Dormitorio, a 20-year old Cadet 4th Class from the Philippine Military Academy.

Republic of Ireland

Hazing incidents are rare in the Republic of Ireland, but are known at certain elite educational institutions.

At Trinity College Dublin, an all-male society, Knights of the Campanile, was implicated in a hazing incident in 2019, where initiates were required to eat large amounts of butter. Campus newspaper The University Times was criticised for using secret recording devices to record the event. Dublin University Boat Club are also known for hazing, with rituals including consumption of alcohol, stripping to ones underwear, caning with bamboo rods, push-ups, being shouted at, standing in the rain, being tied together by shoelaces and crawling a maze while being hit with pillows. Hazing is common at Trinity sports societies and teams. Zeta Psi fraternity has a presence at Trinity as well, and some hazing has been reported.

Hazing also took place at Dublin City University's Accounting & Finance Society in 2018, where first-years standing for committee positions had to complete a variety of sexualised games. The club was suspended for a year as a result.

A report on Gaelic games county players noted that 6% of players reported were aware of forced binge drinking as a form of hazing.

Ragging in South Asia

Ragging is a practice similar to hazing in educational institutions in the Indo subcontinent. The word is mainly used in India, Pakistan, Bangladesh and Sri Lanka. Ragging involves existing students baiting or bullying new students. It often takes a malignant form wherein the newcomers may be subjected to psychological or physical torture. In 2009 the University Grants Commission of India imposed regulations upon Indian universities to help curb ragging, and launched a toll-free 'anti ragging helpline'. The effectiveness of these measures are unknown; many accused of ragging freshmen are either let out with a warning or saved from legal action by political or caste lobbyists.

Although ragging is a criminal offense in Sri Lanka under the Prohibition of Ragging and other Forms of Violence in Educational institutions Act, No. 20 of 1998 and carries a severe punishment, several variations of ragging can be observed in universities around the country. Through the years this practice has worsened to all types of violence including sexual violence, harassment and has also claimed the lives of several students. The university grants commission of Sri Lanka, have set up several pathways to report ragging incidents, including a special office, helpline and a mobile app where students can make a complaint anonymously or seek help.

Controversy

The "Scenes of Hazing", as portrayed in an early student yearbook of the Massachusetts Agricultural College. Circa 1879.

The practice of ritual abuse among social groups is not clearly understood. This is partly due to the secretive nature of the activities, especially within collegiate fraternities and sororities, and in part a result of long-term acceptance of hazing. Thus, it has been difficult for researchers to agree on the underlying social and psychological mechanisms that perpetuate hazing. In military circles hazing is sometimes assumed to test recruits under situations of stress and hostility. Although in no way a recreation of combat, hazing does put people into stressful situations that they are unable to control, which allegedly should weed out the weaker members before being put in situations where failure to perform will cost lives. A portion of the military training course known as Survival, Evasion, Resistance and Escape (SERE) simulates as closely as is feasible the physical and psychological conditions of a POW camp.

The problem with this approach, according to opponents, is that the stress and hostility comes from inside the group, and not from outside as in actual combat situation, creating suspicion and distrust towards the superiors and comrades-in-arms. Willing participants may be motivated by a desire to prove to senior soldiers their stability in future combat situations, making the unit more secure, but blatantly brutal hazing can in fact produce negative results, making the units more prone to break, desert or mutiny than those without hazing traditions, as observed in the Russian army in Chechnya, where units with the strongest traditions of dedovschina were the first to break and desert under enemy fire. At worst, hazing may lead into fragging incidents. Colleges and universities sometimes avoid publicizing hazing incidents for fear of damaging institutional reputations or incurring financial liability to victims.

In a 1999 study, a survey of 3,293 collegiate athletes, coaches, athletic directors and deans found a variety of approaches to prevent hazing, including strong disciplinary and corrective measures for known cases, implementation of athletic, behavioral, and academic standards guiding recruitment; provisions for alternative bonding and recognition events for teams to prevent hazing; and law enforcement involvement in monitoring, investigating, and prosecuting hazing incidents. Hoover's research suggested half of all college athletes are involved in alcohol-related hazing incidents, while one in five are involved in potentially illegal hazing incidents. Only another one in five was involved in what Hoover described as positive initiation events, such as taking team trips or running obstacle courses.

Hoover wrote: "Athletes most at risk for any kind of hazing for college sports were men; non-Greek members; and either swimmers, divers, soccer players, or lacrosse players. The campuses where hazing was most likely to occur were primarily in eastern or southern states with no anti-hazing laws. The campuses were rural, residential, and had Greek systems." (Hoover uses the term "Greek" to refer to U.S.-style fraternities and sororities.) Hoover found that non-fraternity members were most at risk of hazing, and that football players are most at risk of potentially dangerous or illegal hazing. In the May issue of the American Journal of Emergency Medicine, Michelle Finkel reported that hazing injuries are often not recognized for their true cause in emergency medical centers. The doctor said hazing victims sometimes hide the real cause of injuries out of shame or to protect those who caused the harm. In protecting their abusers, hazing victims can be compared with victims of domestic violence, Finkel wrote.

Finkel cites hazing incidents including "beating or kicking to the point of traumatic injury or death, burning or branding, excessive calisthenics, being forced to eat unpleasant substances, and psychological or sexual abuse of both males and females". Reported coerced sexual activity is sometimes considered "horseplay" rather than rape, she wrote. Finkel quoted from Hank Nuwer's book "Wrongs of Passage" which counted 56 hazing deaths between 1970 and 1999.

In November 2005, controversy arose over a video showing Royal Marines fighting naked and intoxicated as part of a hazing ritual. The fight culminated with one soldier receiving a kick to the face, rendering him unconscious. The victim, according to the BBC, said "It's just Marine humour". The Marine who leaked the video said "The guy laid out was inches from being dead." Under further investigation, the Marines had just returned from a six-month tour of Iraq, and were in their "cooling down" period, in which they spend two weeks at a naval base before they are allowed back into society. The man who suffered the kick to the head did not press charges.

In 2008, a national hazing study was conducted by Dr Elizabeth Allan and Dr Mary Madden from the University of Maine. This investigation is the most comprehensive study of hazing to date and includes survey responses from more than 11,000 undergraduate students at 53 colleges and universities in different regions of the U.S. and interviews with more than 300 students and staff at 18 of these campuses. Through the vision and efforts of many, this study fills a major gap in the research and extends the breadth and depth of knowledge and understanding about hazing. Ten initial findings are described in the report, Hazing in View: College Students at Risk. These include:

  1. More than half of college students involved in clubs, teams, and organizations experience hazing.
  2. Nearly half (47%) of students have experienced hazing before coming to college.
  3. Alcohol consumption, humiliation, isolation, sleep deprivation, and sex acts are hazing practices common across student groups.

Disability-adjusted life year

From Wikipedia, the free encyclopedia
 
Disability-adjusted life years out of 100,000 lost due to any cause in 2004.
  no data
  fewer than 9,250
  9,250–16,000
  16,000–22,750
  22,750–29,500
  29,500–36,250
  36,250–43,000
  43,000–49,750
  49,750–56,500
  56,500–63,250
  63,250–70,000
  70,000–80,000
  more than 80,000

The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.

The DALY has become more common in the field of public health and health impact assessment (HIA). It not only includes the potential years of life lost due to premature death, but also includes equivalent years of 'healthy' life lost by virtue of being in states of poor health or disability. In so doing, mortality and morbidity are combined into a single, common metric.

Calculation

adjusted life year

The disability-adjusted life year is a societal measure of the disease or disability burden in populations. DALYs are calculated by combining measures of life expectancy as well as the adjusted quality of life during a burdensome disease or disability for a population. DALYs are related to the quality-adjusted life year (QALY) measure; however, QALYs only measure the benefit with and without medical intervention and therefore do not measure the total burden. Also, QALYs tend to be an individual measure, and not a societal measure.

Traditionally, health liabilities were expressed using one measure, the years of life lost (YLL) due to dying early. A medical condition that did not result in dying younger than expected was not counted. The burden of living with a disease or disability is measured by the years lost due to disability (YLD) component, sometimes also known as years lost due to disease or years lived with disability/disease.

DALYs are calculated by taking the sum of these two components:

DALY = YLL + YLD

The DALY relies on an acceptance that the most appropriate measure of the effects of chronic illness is time, both time lost due to premature death and time spent disabled by disease. One DALY, therefore, is equal to one year of healthy life lost.

How much a medical condition affects a person is called the disability weight (DW). This is determined by disease or disability and does not vary with age. Tables have been created of thousands of diseases and disabilities, ranging from Alzheimer's disease to loss of finger, with the disability weight meant to indicate the level of disability that results from the specific condition.

Examples of disability weight
Condition DW 2004 DW 2010
Alzheimer's and other dementias 0.666 0.666
Blindness 0.594 0.195
Schizophrenia 0.528 0.576
AIDS, not on ART 0.505 0.547
Burns 20%–60% of body 0.441 0.438
Fractured femur 0.372 0.308
Moderate depression episode 0.350 0.406
Amputation of foot 0.300 0.021–0.1674
Deafness 0.229 0.167–0.281
Infertility 0.180 0.026–0.056
Amputation of finger 0.102 0.030
Lower back pain 0.061 0.0322–0.0374

Examples of the disability weight are shown on the right. Some of these are "short term", and the long-term weights may be different.

The most noticeable change between the 2004 and 2010 figures for disability weights above are for blindness as it was considered the weights are a measure of health rather than well-being (or welfare) and a blind person is not considered to be ill. "In the GBD terminology, the term disability is used broadly to refer to departures from optimal health in any of the important domains of health."

At the population level, the disease burden as measured by DALYs is calculated by adding YLL to YLD. YLL uses the life expectancy at the time of death. YLD is determined by the number of years disabled weighted by level of disability caused by a disability or disease using the formula:

YLD = I × DW × L

In this formula, I = number of incident cases in the population, DW = disability weight of specific condition, and L = average duration of the case until remission or death (years). There is also a prevalence (as opposed to incidence) based calculation for YLD. Number of years lost due to premature death is calculated by

YLL = N × L

where N = number of deaths due to condition, L = standard life expectancy at age of death. Note that life expectancies are not the same at different ages. For example, in Paleolithic era, life expectancy at birth was 33 years, but life expectancy at the age of 15 was an additional 39 years (total 54).

Historically Japanese life expectancy statistics have been used as the standard for measuring premature death, as the Japanese have the longest life expectancies. Other approaches have since emerged, include using national life tables for YLL calculations, or using the reference life table derived by the GBD study.

Age weighting

Some studies use DALYs calculated to place greater value on a year lived as a young adult. This formula produces average values around age 10 and age 55, a peak around age 25, and lowest values among very young children and very old people.

The World Health Organization (WHO) used age weighting and time discounting at 3 percent in DALYs prior to 2010 but discontinued using them starting in 2010.

There are two components to this differential accounting of time: age-weighting and time-discounting. Age-weighting is based on the theory of human capital. Commonly, years lived as a young adult are valued more highly than years spent as a young child or older adult, as these are years of peak productivity. Age-weighting receives considerable criticism for valuing young adults at the expense of children and the old. Some criticize, while others rationalize, this as reflecting society's interest in productivity and receiving a return on its investment in raising children. This age-weighting system means that somebody disabled at 30 years of age, for ten years, would be measured as having a higher loss of DALYs (a greater burden of disease), than somebody disabled by the same disease or injury at the age of 70 for ten years.

This age-weighting function is by no means a universal methodology in HALY studies, but is common when using DALYs. Cost-effectiveness studies using QALYs, for example, do not discount time at different ages differently. This age-weighting function applies only to the calculation of DALYs lost due to disability. Years lost to premature death are determined from the age at death and life expectancy.

The Global Burden of Disease Study (GBD) 2001–2002 counted disability adjusted life years equally for all ages, but the GBD 1990 and GBD 2004 studies used the formula

where is the age at which the year is lived and is the value assigned to it relative to an average value of 1.

In these studies, future years were also discounted at a 3% rate to account for future health care losses. Time discounting, which is separate from the age-weighting function, describes preferences in time as used in economic models.

The effects of the interplay between life expectancy and years lost, discounting, and social weighting are complex, depending on the severity and duration of illness. For example, the parameters used in the GBD 1990 study generally give greater weight to deaths at any year prior to age 39 than afterward, with the death of a newborn weighted at 33 DALYs and the death of someone aged 5–20 weighted at approximately 36 DALYs.

As a result of numerous discussions, by 2010 the World Health Organization had abandoned the ideas of age weighting and time discounting. They had also substituted the idea of prevalence for incidence (when a condition started) because this is what surveys measure.

Economic applications

The methodology is not an economic measure. It measures how much healthy life is lost. It does not assign a monetary value to any person or condition, and it does not measure how much productive work or money is lost as a result of death and disease. However, HALYs, including DALYs and QALYs, are especially useful in guiding the allocation of health resources as they provide a common numerator, allowing for the expression of utility in terms of dollar/DALY, or dollar/QALY. For example, in Gambia, provision of the pneumococcal conjugate vaccine costs $670 per DALY saved. This number can then be compared to other treatments for other diseases, to determine whether investing resources in preventing or treating a different disease would be more efficient in terms of overall health.

Examples

Schizophrenia has a 0.53 weighting and a broken femur a 0.37 weighting in the latest WHO weightings.

Australia

Cancer (25.1/1,000), cardiovascular (23.8/1,000), mental problems (17.6/1,000), neurological (15.7/1,000), chronic respiratory (9.4/1,000) and diabetes (7.2/1,000) are the main causes of good years of expected life lost to disease or premature death. Despite this, Australia has one of the longest life expectancies in the world.

Africa

These illustrate the problematic diseases and outbreaks occurring in 2013 in Zimbabwe, shown to have the greatest impact on health disability were typhoid, anthrax, malaria, common diarrhea, and dysentery.

PTSD rates

Posttraumatic stress disorder (PTSD) DALY estimates from 2004 for the world's 25 most populous countries give Asian/Pacific countries and the United States as the places where PTSD impact is most concentrated (as shown here).

Noise-induced hearing loss

The disability-adjusted life years attributable to hearing impairment for noise-exposed U.S. workers across all industries was calculated to be 2.53 healthy years lost annually per 1,000 noise-exposed workers. Workers in the mining and construction sectors lost 3.45 and 3.09 healthy years per 1,000 workers, respectively. Overall, 66% of the sample worked in the manufacturing sector and represented 70% of healthy years lost by all workers.

History and usage

Originally developed by Harvard University for the World Bank in 1990, the World Health Organization subsequently adopted the method in 1996 as part of the Ad hoc Committee on Health Research "Investing in Health Research & Development" report. The DALY was first conceptualized by Christopher J. L. Murray and Lopez in work carried out with the World Health Organization and the World Bank known as the Global Burden of Disease Study, which was published in 1990. It is now a key measure employed by the United Nations World Health Organization in such publications as its Global Burden of Disease.

The DALY was also used in the 1993 World Development Report.

Criticism

Both DALYs and QALYs are forms of HALYs, health-adjusted life years.

Some critics have alleged that DALYs are essentially an economic measure of human productive capacity for the affected individual. In response, defenders of DALYs have argued that while DALYs have an age-weighting function that has been rationalized based on the economic productivity of persons at that age, health-related quality of life measures are used to determine the disability weights, which range from 0 to 1 (no disability to 100% disabled) for all disease. These defenders emphasize that disability weights are based not on a person's ability to work, but rather on the effects of the disability on the person's life in general. Hence, mental illness is one of the leading diseases as measured by global burden of disease studies, with depression accounting for 51.84 million DALYs. Perinatal conditions, which affect infants with a very low age-weight function, are the leading cause of lost DALYs at 90.48 million. Measles is fifteenth at 23.11 million.

Some commentators have expressed doubt over whether the disease burden surveys (such as EQ-5D) fully capture the impacts of mental illness, due to factors including ceiling effects.

According to Pliskin et al., the QALY model requires utility independent, risk neutral, and constant proportional tradeoff behaviour. Because of these theoretical assumptions, the meaning and usefulness of the QALY is debated. Perfect health is difficult, if not impossible, to define. Some argue that there are health states worse than being dead, and that therefore there should be negative values possible on the health spectrum (indeed, some health economists have incorporated negative values into calculations). Determining the level of health depends on measures that some argue place disproportionate importance on physical pain or disability over mental health.

The method of ranking interventions on grounds of their cost per QALY gained ratio (or ICER) is controversial because it implies a quasi-utilitarian calculus to determine who will or will not receive treatment. However, its supporters argue that since health care resources are inevitably limited, this method enables them to be allocated in the way that is approximately optimal for society, including most patients. Another concern is that it does not take into account equity issues such as the overall distribution of health states – particularly since younger, healthier cohorts have many times more QALYs than older or sicker individuals. As a result, QALY analysis may undervalue treatments which benefit the elderly or others with a lower life expectancy. Also, many would argue that all else being equal, patients with more severe illness should be prioritised over patients with less severe illness if both would get the same absolute increase in utility.

As early as 1989, Loomes and McKenzie recommended that research be conducted concerning the validity of QALYs. In 2010, with funding from the European Commission, the European Consortium in Healthcare Outcomes and Cost-Benefit Research (ECHOUTCOME) began a major study on QALYs as used in health technology assessment. Ariel Beresniak, the study's lead author, was quoted as saying that it was the "largest-ever study specifically dedicated to testing the assumptions of the QALY". In January 2013, at its final conference, ECHOUTCOME released preliminary results of its study which surveyed 1361 people "from academia" in Belgium, France, Italy and the UK. The researchers asked the subjects to respond to 14 questions concerning their preferences for various health states and durations of those states (e.g., 15 years limping versus 5 years in a wheelchair). They concluded that "preferences expressed by the respondents were not consistent with the QALY theoretical assumptions" that quality of life can be measured in consistent intervals, that life-years and quality of life are independent of each other, that people are neutral about risk, and that willingness to gain or lose life-years is constant over time. ECHOUTCOME also released "European Guidelines for Cost-Effectiveness Assessments of Health Technologies", which recommended not using QALYs in healthcare decision making. Instead, the guidelines recommended that cost-effectiveness analyses focus on "costs per relevant clinical outcome".

In response to the ECHOUTCOME study, representatives of the National Institute for Health and Care Excellence, the Scottish Medicines Consortium, and the Organisation for Economic Co-operation and Development made the following points. First, QALYs are better than alternative measures. Second, the study was "limited". Third, problems with QALYs were already widely acknowledged. Fourth, the researchers did not take budgetary constraints into consideration. Fifth, the UK's National Institute for Health and Care Excellence uses QALYs that are based on 3395 interviews with residents of the UK, as opposed to residents of several European countries. Finally, people who call for the elimination of QALYs may have "vested interests".

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