A Long-Term Study of Young Children's Rapport, Social Emulation, and Language Learning With a Peer-Like Robot Playmate in Preschool

Prior research has demonstrated the importance of children's peers for their learning and development. In particular, peer interaction, especially with more advanced peers, can enhance preschool children's language growth. In this paper, we explore one factor that may modulate children's language learning with a peer-like social robot: rapport. We explore connections between preschool children's learning, rapport, and emulation of the robot's language during a storytelling intervention. We performed a long-term field study in a preschool with 17 children aged 4-6 years. Children played a storytelling game with a social robot for 8 sessions over two months. For some children, the robot matched the level of its stories to the children's language ability, acting as a slightly more advanced peer (Matched condition); for the others, the robot did not match the story level (Unmatched condition). We examined children's use of target vocabulary words and key phrases used by the robot, children's emulation of the robot's stories during their own storytelling, and children's language style matching (LSM-a measure of overlap in function word use and speaking style associated with rapport and relationship) to see whether they mirrored the robot more over time. We found that not only did children emulate the robot more over time, but also, children who emulated more of the robot's phrases during storytelling scored higher on the vocabulary posttest. Children with higher LSM scores were more likely to emulate the robot's content words in their stories. Furthermore, the robot's personalization in the Matched condition led to increases in both children's emulation and their LSM scores. Together, these results suggest first, that interacting with a more advanced peer is beneficial for children, and second, that children's emulation of the robot's language may be related to their rapport and their learning. This is the first study to empirically support that rapport may be a modulating factor in children's peer learning, and furthermore, that a social robot can serve as an effective intervention for language development by leveraging this insight.

Interactive Elaborative Storytelling: Engaging Children as Storytellers to Foster Vocabulary

Positive effects of shared reading for children’s language development are boosted by including instruction of word meanings and by increasing interactivity. The effects of engaging children as storytellers on vocabulary development have been less well studied. We developed an approach termed Interactive Elaborative Storytelling (IES), which employs both word-learning techniques and children’s storytelling in a shared-reading setting. To systematically investigate potential benefits of children as storytellers, we contrasted this approach to two experimental groups, an Elaborative Storytelling group employing word-learning techniques but no storytelling by children and a Read-Aloud group, excluding any additional techniques. The study was a 3 × 2 pre-posttest randomized design with 126 preschoolers spanning 1 week. Measured outcomes were receptive and expressive target vocabulary, story memory, and children’s behavior during story sessions. All three experimental groups made comparable gains on target words from pre- to posttest and there was no difference between groups in story memory. However, in the Elaborative Storytelling group, children were the least restless. Findings are discussed in terms of their contribution to optimizing shared reading as a method of fostering language.

The effect of storytelling on anxiety and behavioral disorders in children undergoing surgery: a randomized controlled trial

Background

One of the most frightening procedures for children is surgery. This study aimed to assess the effect of animated illustrated stories on anxiety and behavioral disorders in children after surgery.

Methods

In this randomized controlled clinical trial (RCT), 60 children between 4 and 8 years who went through adenotonsillectomy were divided into two groups based on random numbers. In the intervention group, animated illustrated books were read for the children by the researcher, for 30 mins, on the night before surgery. Child’s anxiety was measured using the Revised Children’s Manifest Anxiety Scale (RCMAS) and Behavioral Disorder questionnaire (a researcher-made tool) before and 10 days after the book reading. Data were analyzed using descriptive statistics and the non-parametric Mann–Whitney U test and Wilcoxon signed-rank test.

Results

The results showed that mean scores of physiological anxiety (P-value<0.001), social concerns/concentration (P-value=0.012), and total anxiety (P-value<0.001), except worry/oversensitivity (P-value=0.140), statistically significantly decreased in the intervention group after book reading, but mean total anxiety and its three dimensions did not show statistically significant differences before and after treatment in the control group (P-value>0.05). Mean scores of the Behavioral Disorder questionnaire significantly decreased in the intervention group after book reading (P-value=0.001), but significantly increased in the control group (P-value<0.001).

Conclusion

The results showed that reading animated illustrated books could be effective in reducing anxiety and behavioral disorders in children after surgery. It seems that these books could be a new and creative way to distract children and can be used as supportive care.

Exploring the Effects of a Social Robot's Speech Entrainment and Backstory on Young Children's Emotion, Rapport, Relationship, and Learning

In positive human-human relationships, people frequently mirror or mimic each other's behavior. This mimicry, also called entrainment, is associated with rapport and smoother social interaction. Because rapport in learning scenarios has been shown to lead to improved learning outcomes, we examined whether enabling a social robotic learning companion to perform rapport-building behaviors could improve children's learning and engagement during a storytelling activity. We enabled the social robot to perform two specific rapport and relationship-building behaviors: speech entrainment and self-disclosure (shared personal information in the form of a backstory about the robot's poor speech and hearing abilities). We recruited 86 children aged 3–8 years to interact with the robot in a 2 × 2 between-subjects experimental study testing the effects of robot entrainment Entrainment vs. No entrainment and backstory about abilities Backstory vs. No Backstory. The robot engaged the children one-on-one in conversation, told a story embedded with key vocabulary words, and asked children to retell the story. We measured children's recall of the key words and their emotions during the interaction, examined their story retellings, and asked children questions about their relationship with the robot. We found that the robot's entrainment led children to show more positive emotions and fewer negative emotions. Children who heard the robot's backstory were more likely to accept the robot's poor hearing abilities. Entrainment paired with backstory led children to use more of the key words and match more of the robot's phrases in their story retells. Furthermore, these children were more likely to consider the robot more human-like and were more likely to comply with one of the robot's requests. These results suggest that the robot's speech entrainment and backstory increased children's engagement and enjoyment in the interaction, improved their perception of the relationship, and contributed to children's success at retelling the story.

'This is our liver patient…': use of narratives during resident and nurse handoff conversations

OBJECTIVE

Handoffs are often framed as the co-construction of a shared understanding relying on narrative storytelling. We investigated how narratives are constructed and used during resident and nurse handoff conversations.

METHOD

We audio-recorded resident (n=149) and nurse (n=126) handoffs in an inpatient medicine unit. Qualitative analysis using grounded theory was conducted to identify and characterise the structure of resident and nursing handoff narratives.

RESULTS

Handoff conversations among both residents and nurses used three types of narratives: narratives on creating clinical imagery, narratives on coordinating care continuity and narratives on integrating contextual aspects of care. Clinical imagery narratives were common during patient introductions: residents used a top-down approach relying on overarching patient clinical situations (eg, 'a liver patient'), whereas nurses used a bottom-up approach using patient-specific identifying information. Narratives on the coordination of care continuity for residents focused on managing internal and external coordination activities, whereas nurse narratives focused on internal coordination, emphasising their role as an interface between patients and their physicians. Both resident and nurse narratives on the contextual aspects of care had considerable focus on highlighting 'heads up' anticipatory information and personal patient information; such information was often not present in patient charts, but was important for ensuring effective care management.

DISCUSSION

The presence of narrative structures highlights the need for new perspectives for the design of handoff tools that allow for both informational and cognitive support and shared awareness among conversational partners during handoff conversations. We discuss the implications of the use of narratives for patient safety and describe specific design considerations for supporting narrative interactions during handoffs.

Judging Domestic Violence From the Bench: A Narrative Analysis of Judicial Anecdotes About Domestic Violence Protective Order Cases

Interview participants sometimes share anecdotes (stories about past events), to illustrate a point or discuss their perspectives. When sharing these stories, participants may imbue the events with their own personal meaning-making, selective memory, and biases. We conducted a narrative analysis of anecdotes shared by judges ( n = 20) who preside over Domestic Violence Protective Order (DVPO) hearings to examine how biases and misperceptions shape decisions in DVPO cases. We found that judges rely on biases to sort cases as "true domestic violence" compared with "frivolous cases." In the anecdotes they shared, judges often used gendered stereotypes to depict litigants, and many judges felt that DVPOs had limited efficacy in preventing violence. We argue that important cognitive insights are revealed by interview participants during the spontaneous act of storytelling. In the case of judges, their biases could lead to DVPOs being denied in situations when they are warranted.

Rewriting stories of trauma through peer-to-peer mentoring for and by at-risk young people

Adverse childhood experiences are strongly associated with the development of mental health disorders during the life span. When mental health issues are not effectively dealt with during the adolescent period, young people can become long-term consumers in the mental health system. A widely accepted method of intervention is the provision of mentoring. More recently, young people have been fulfilling the role of mentor to their peers and mentoring has played a large role in supporting young people who are considered at-risk of not achieving the expected psychosocial, educational, and/or developmental goals. What is not known is why young people, previously identified as being at-risk, are motivated to mentor their at-risk peers. The study aim was to examine what motivates previously recognized at-risk young people to provide mentoring to their at-risk peers. Participants were twelve previously recognized at-risk young people recruited through a formal peer-to-peer mentoring programme. Semi-structured interviews were conducted, and the data analysed through narrative inquiry and reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ). Results indicate that young people are motivated by their own lived experiences of trauma(s) to provide at-risk peer mentoring. The experience of mentoring afforded opportunities to rewrite individual personal journeys of trauma through mentoring their at-risk peers, thus constructing a more positive self-identity. Outcomes of developing positive peer relationships and prosocial behaviours could significantly assist mental health clinicians in providing more acceptable care to clients in an age group known to be reluctant to accept traditional mental health intervention.

How narratives influence colorectal cancer screening decision making and uptake: A realist review

BACKGROUND

Although narratives have been found to affect decisions about preventive behaviours, including participation in cancer screening, the underlying mechanisms of narratives remain unclear.

OBJECTIVE

The purpose of this study was to summarize and synthesize existing literature on narrative interventions in the context of colorectal cancer screening. Our main research question was as follows: How, when and for whom do narratives work context of decision making about colorectal cancer screening participation?

METHODS

We undertook a realist review to collect evidence on narratives in the context of colorectal cancer screening. A search of the literature was performed in Embase, MEDLINE/PubMed, Cinahl and PsycINFO. We included empirical evaluations (qualitative or quantitative) of narrative interventions. In total, 15 studies met the inclusion criteria. A content-based taxonomy of patient narrative types in decision aids formed the basis for our initial programme theory.

MAIN RESULT

We identified four mechanisms: (a) process narratives that address perceived barriers towards screening lead to improved affective forecasting, (b) experience narratives that demonstrate the screening procedure lead to increased self-efficacy, (c) experience narratives that depict experiences from similar others lead to more engagement and (d) outcome narratives that focus on outcomes of colorectal cancer (CRC) screening decision decrease or increase fear of colorectal cancer. The evidence was limited on which narrative type may facilitate or bias informed decision making in colorectal cancer screening.

DISCUSSION AND CONCLUSION

The findings indicate the importance of more detailed descriptions of narrative interventions in order to understand how mechanisms may facilitate or bias informed decision making in colorectal cancer screening.

Attuning to laboratory animals and telling stories: Learning animal geography research skills from animal technologists

Posthumanism has challenged the social sciences and humanities to rethink anthopocentricism within the cultures and societies they study and to take account of more-than-human agencies and perspectives. This poses key methodological challenges, including a tendency for animal geographies to focus very much on the human side of human-animal relations and to fail to acknowledge animals as embodied, lively, articulate political subjects. In this paper, we draw on recent ethnographic work, observing and participating in the care of research animals and interviewing the animal technologists, to contribute to the understandings of life within the animal house. In so doing, the paper makes three key arguments. Firstly, that studying how animal technologists perform everyday care and make sense of their relationships with animals offers useful insights into the specific skills, expertise and relationships required in order to study human-animal relations. Secondly, that animal technologists are keenly aware of the contested moralities which emerge in animal research environments and can offer an important position from which to understand this. Thirdly, that storytelling (exemplified by the stories told by animal technologists) is a useful resource for animal geographers to engage with complexity in human-animal relations.

Syntax of Testimony: Indexical Objects, Syntax, and Language or How to Tell a Story Without Words

Language-often said to set human beings apart from other animals-has resisted explanation in terms of evolution. Language has-among others-two fundamental and distinctive features: syntax and the ability to express non-present actions and events. We suggest that the relation between this representation (of non-present action) and syntax can be analyzed as a relation between a function and a structure to fulfill this function. The strategy of the paper is to ask if there is any evidence of pre-linguistic communication that fulfills the function of communicating an absent action. We identify a structural similarity between understanding indexes of past actions of conspecifics (who did what to whom) and one of the simplest and most paradigmatic linguistic syntactic patterns - that of the simple transitive sentence. When a human being infers past events from an index (i.e., a trace, the conditions of a conspecifics or an animal, a constellation or an object) the interpreters' comprehension must rely on concepts similar in structure and function to the 'thematic roles' believed to underpin the comprehension of linguistic syntax: in his or her mind the idea of a past action or event emerges along with thematic role-like concepts; in the case of the presentation of, e.g., a hunting trophy, the presenter could be understood to be an agent (subject) and the trophy a patient (direct object), while the past action killed is implied by the condition of the object and its possession by the presenter. We discuss whether both the presentation of a trophy and linguistic syntax might have emerged independently while having the same function (to represent a past action) or whether the presentation of an index of a deed could constitute a precursor of language. Both possibilities shed new light on early, and maybe first, language use.

« Imaginaire et sensibilités » : la mise en récit de la déshospitalisation psychiatrique en Ontario

This paper proposes a historiographical discussion based on the article « Les contrecoups de la déshospitalisation psychiatrique. L'exemple du parcours transinstitutionel de Françoise ». Françoise's transinstitutional journey presented in the collective publication La fin de l'asile ? Histoire de la déshospitalisation psychiatrique dans l'espace francophone au XX^e siècle, gives me the opportunity to reveal the subtext of this article, and to describe the method and the historical reasoning that gave life to the psychiatric journey of an anonymous person named Françoise. This process is organized around three main points: my positioning as a researcher, the issues related to my narrative approach, and a statement on my historical reasoning in an interdisciplinary perspective. Influenced and inspired by the work of Alain Corbin, George Duby, Roy Porter, Natalie Zemon Davis and Arlette Farge, my approach focusses on the feelings and emotions hidden in historical sources. I remain connected to a subjective intuition, and stay away from positivist reflexes. Based on my research experience with psychiatric records, my conclusion explores the renewal of historical writing , in which I suggest that it is possible to write the history of ordinary people while telling stories with sensitivity.

Using narratives to impact health policy-making: a systematic review

BACKGROUND

There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to impact the health policy-making process.

METHODS

Eligible study designs included randomised studies, non-randomised studies, process evaluation studies, economic studies, qualitative studies, stakeholder analyses, policy analyses, and case studies. The MEDLINE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Global Health Library, Communication and Mass Media Complete, and Google Scholar databases were searched. We followed standard systematic review methodology for study selection, data abstraction and risk of bias assessment. We synthesised the findings narratively and presented the results stratified according to the following stages of the policy cycle: (1) agenda-setting, (2) policy formulation, (3) policy adoption, (4) policy implementation and (5) policy evaluation. Additionally, we presented the knowledge gaps relevant to using narrative to impact health policy-making.

RESULTS

Eighteen studies met the eligibility criteria, and included case studies (n = 15), participatory action research (n = 1), documentary analysis (n = 1) and biographical method (n = 1). The majority were of very low methodological quality. In addition, none of the studies formally evaluated the effectiveness of the narrative-based interventions. Findings suggest that narratives may have a positive influence when used as inspiration and empowerment tools to stimulate policy inquiries, as educational and awareness tools to initiate policy discussions and gain public support, and as advocacy and lobbying tools to formulate, adopt or implement policy. There is also evidence of undesirable effects of using narratives. In one case study, narrative use led to widespread insurance reimbursement of a therapy for breast cancer that was later proven to be ineffective. Another case study described how the use of narrative inappropriately exaggerated the perceived risk of a procedure, which led to limiting its use and preventing a large number of patients from its benefits. A third case study described how optimistic 'cure' or 'hope' stories of children with cancer were selectively used to raise money for cancer research that ignored the negative realities. The majority of included studies did not provide information on the definition or content of narratives, the theoretical framework underlying the narrative intervention or the possible predictors of the success of narrative interventions.

CONCLUSION

The existing evidence base precludes any robust inferences about the impact of narrative interventions on health policy-making. We discuss the implications of the findings for research and policy.

TRIAL REGISTRATION

The review protocol is registered in PROSPERO International prospective register of systematic reviews (ID =  CRD42018085011 ).

Storytelling: How We Learn

The best conference presentations tell a story with an interesting introduction, details in the middle, and a conclusion that leads to new research, questions or answers about practice, and perhaps further research on the topic. So, too, do journal articles, and this publication is dependent on the rigors of quality research to tell stories about our patients and their experiences and make suggestions on how we can effect change.

Stories of Identity from High Performance Male Boxers in Their Training and Competition Environments

The current submission was conceived to broaden the discussion around male athletic identities by exploring the stories told by four members of the Canadian National Boxing Team. The athletes' stories were elicited through an arts-based method followed by a conversational interview. Stories were then analyzed using an interpretive thematic analysis. Three salient themes were found-fluid masculinity, ethnicity brings an edge to boxing, and expressing identity through language. These themes present accounts that highlight how socially, culturally, and historically dominant narratives can allow athletes to feel comfortable in presenting the identities they might reveal or feel constrained from doing so due to factors outside of their control. The need to develop training and competition contexts that allow for the empowerment of athletes' individually distinct identities is highlighted as a method to ensuring the positive mental health of elite level athletes.

Digital Storytelling in Early Childhood: Student Illustrations Shaping Social Interactions

This study tests an instructional model designed to empower students in an early childhood classroom as emerging digital storytellers. Educators can use digital storytelling to support students' learning by encouraging them to organize and express their ideas and knowledge in an individual and meaningful way while developing voice and facility in child-computer interactions. This work also helps develop traditional communication skills, fosters collaboration, and strengthens emergent literacy practices. Students develop enhanced communication skills by learning to organize their ideas, ask questions, express opinions, and construct narratives as they interact with others and computers in the creation of digital stories. The "Emerging Digital Storytellers" instructional model focuses on social-emotional development and finding student voice through writing and digital content construction in the early childhood educational context.

Narrative Assessment: A new approach to evaluation of advocacy for development

This article proposes an approach to monitoring and evaluating advocacy that integrates theory of change and storytelling. This approach, called Narrative Assessment, addresses the feasibility of objectivity and evidence in the complex context of advocacy and proposes an evaluation methodology rooted in alternative conceptualizations of rigour and of evaluator roles. The approach centres on practical judgment and the construction and examination of stories through interaction between advocates and monitoring and evaluation specialists. The article discusses how Narrative Assessment can be useful in the evaluation of advocacy in terms of (1) monitoring and evaluation specialists' orientation toward programmes; (2) the interpretation of outcomes; (3) the assessment of outcome relevance; (4) reflection and learning and (5) the communication of programme results. The approach builds on lessons drawn from evaluation of eight advocacy programmes in international development.

Colonized Silence: Confronting the Colonial Link in Rural Alaska Native Survivors' Non-Disclosure of Child Sexual Abuse

Though there is evidence linking the history of colonialism and oppression of Indigenous people to the high rates of rape and child sexual abuse experienced by this population today, it is less understood how colonial processes, past and present, condition the decision to disclose or report victimization. Drawing on a survivorship storytelling study of rural Alaska Native survivors of child sexual abuse, this paper underscores the importance of centering colonialism in understanding the culture of silence surrounding sexual victimization among Indigenous people. Results show that reasons for non-disclosure are quite embedded within larger social, historical and political themes of colonialism, oppression, and marginalization. Implications for policy and praxes are discussed, as well as a broader mandate of social change to remove barriers to disclosure.

Enabling Analysis of Big, Thick, Long, and Wide Data: Data Management for the Analysis of a Large Longitudinal and Cross-National Narrative Data Set

Distinctive longitudinal narrative data, collected during a critical 18-year period in the history of the HIV epidemic, offer a unique opportunity to examine how young Africans are making sense of evolving developments in HIV prevention and treatment. More than 200,000 young people from across sub-Saharan Africa took part in HIV-themed scriptwriting contests held at eight discrete time points between 1997 and 2014, creating more than 75,000 narratives. This article describes the data reduction and management strategies developed for our cross-national and longitudinal study of these qualitative data. The study aims to inform HIV communication practice by identifying cultural meanings and contextual factors that inform sexual behaviors and social practices, and also to help increase understanding of processes of sociocultural change. We describe our sampling strategies and our triangulating methodologies, combining in-depth narrative analysis, thematic qualitative analysis, and quantitative analysis, which are designed to enable systematic comparison without sacrificing ethnographic richness.

Storytelling to Support Disease Self-Management by Adults With Type 2 Diabetes

OBJECTIVES

This pilot project aimed to examine the acceptability and feasibility of a group storytelling intervention to support self-management among adults living with type 2 diabetes.

METHODS

Two waves of a single-arm storytelling intervention, consisting of 8 sessions at a community health centre, were delivered to 8 adults with type 2 diabetes. Diabetes educators facilitated each session, in which patients shared stories about diabetes-self-management topics of their choice. Focus groups with both patients and facilitators explored the feasibility and acceptability of the sessions. External raters assessed the fidelity of the intervention's implementation.

RESULTS

Overarching themes describe the acceptability and feasibility of the intervention: 1) the facilitation of patient self-direction, group cohesion, collective learning and support; 2) roles of facilitator educator, and peer learner; 3) the intervention's customization to patients' preferences. The sessions were delivered with high fidelity (averaging 84.4%).

CONCLUSIONS

Informal group storytelling enables patients to discuss, understand and give personal meaning to the information that was exchanged, and facilitates educators' better understanding of patients' concerns and gaps in knowledge and how-to strategies that can inform their practice. The group storytelling intervention is acceptable to patients and educators and can be delivered with high fidelity. Further research into effective patient recruitment methods and evaluation of the intervention's impact on diabetes self-management is required.

Faces of Shame

The author in this article explores the humanbecoming dignity tenet of shame. Shame is examined through an extensive literature review, through storytelling, and through surveying humanbecoming inquiries of sadness, feeling fear, feeling overwhelmed, and feeling disrespected.

An inquiry into the effectiveness of bibliotherapy for children with intellectual disability

BACKGROUND

The present study was aimed at developing a grounded theory on how bibliotherapy influences children with intellectual disabilities.

METHOD

Participants were selected among the students of four primary schools in Tehran. They received, for 3 years, a special bibliotherapy intervention provided by the public library in cooperation with a team of experts; The bibliotherapy sessions were held once a week during the academic year. 10 teachers, 4 mothers, and 4 agents (librarians) were selected using a purposeful sampling method, and were interviewed using in-depth interviews.

RESULT

Data analysis was performed using the grounded theory. 'Improvement of skills necessary for adjustment to disability' was identified at the core of grounded theory.

CONCLUSION

Bibliotherapy, as a guided learning method and an add-on therapy, based on an accurate identification of intellectually disabled children's needs and behaviors, providing them with supplemental education materials, empathy, and cooperation among experts from different fields.

Kindergarteners' Narrative Competence Across Tasks and Time

The authors investigated children's narrative competence by analyzing the development of the reciprocal relationship between storytelling and story retelling performances over a school year through a cross-lagged panel design. The participants in this study were 170 Italian kindergarten pupils (M age = 4.98 ± 0.31 years). Children were asked to produce oral narratives in two different tasks: a storytelling and a story retelling task. Narrative competence was assessed in terms of structure and coherence. The cross-lagged panel analyses showed that both storytelling and story retelling tasks are stable constructs, but they differ in the emphasis on coherence. Data confirmed the pivotal role played by storytelling as a task, and structure as a component in fostering the development of children's narrative competence. Overall, results from this study suggest that storytelling and story retelling are tasks that involve interrelated but not overlapping processes, and trigger different aspects of narrative competence.

Referential Choices in a Collaborative Storytelling Task: Discourse Stages and Referential Complexity Matter

During a narrative discourse, accessibility of the referents is rarely fixed once and for all. Rather, each referent varies in accessibility as the discourse unfolds, depending on the presence and prominence of the other referents. This leads the speaker to use various referential expressions to refer to the main protagonists of the story at different moments in the narrative. This study relies on a new, collaborative storytelling in sequence task designed to assess how speakers adjust their referential choices when they refer to different characters at specific discourse stages corresponding to the introduction, maintaining, or shift of the character in focus, in increasingly complex referential contexts. Referential complexity of the stories was manipulated through variations in the number of characters (1 vs. 2) and, for stories in which there were two characters, in their ambiguity in gender (different vs. same gender). Data were coded for the type of reference markers as well as the type of reference content (i.e., the extent of the information provided in the referential expression). Results showed that, beyond the expected effects of discourse stages on reference markers (more indefinite markers at the introduction stage, more pronouns at the maintaining stage, and more definite markers at the shift stage), the number of characters and their ambiguity in gender also modulated speakers' referential choices at specific discourse stages, For the maintaining stage, an effect of the number of characters was observed for the use of pronouns and of definite markers, with more pronouns when there was a single character, sometimes replaced by definite expressions when two characters were present in the story. For the shift stage, an effect of gender ambiguity was specifically noted for the reference content with more specific information provided in the referential expression when there was referential ambiguity. Reference content is an aspect of referential marking that is rarely addressed in a narrative context, yet it revealed a quite flexible referential behavior by the speakers.

Cancer Storytelling: A Study of Well-Being Expressions Made by Patients

Many cancer patients tell their story to help others. This paper reports a study of 160 such stories, which were processed using a grounded theory methodology. The stories were rich in emotional words and in metaphors and these, along with self-talk and meaning-for-life, provided the commonest indications of the patients' well-being. Cancer patients, through the process of telling their story, help themselves and enhance their well-being. The method of active listening is described, with associated risks for professionals.