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Durrant M, Oliver C, Gottlieb L, Frechette J, Lavoie-Tremblay M, Cyr G. Facilitated engagement approach: A novel approach to guide mentor conversations. Nurse Education Today 2024; 137:106152. [PMID: 38513303 DOI: 10.1016/j.nedt.2024.106152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/14/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Mentorship has been recognized as a strategy to develop leadership competencies in clinical leaders and has been integrated into leadership programs. However, there are few published frameworks to guide mentor conversations with mentees training to assume nursing leadership roles. OBJECTIVE This study explores mentors' perceptions of 6-month mentorship, a component of the Strengths-Based Nursing Leadership program, the effectiveness of the Facilitated Engagement Approach, a pedagogical strategy developed to facilitate conversation between the mentor and mentee, and the impact of mentorship on leadership practice of mentees. METHODS A mixed method qualitative and quantitative approach was used with semi-structured interviews and bi-weekly survey among mentors. Data were thematically analyzed. RESULTS Mentors described the use of the Facilitated Engagement Approach to guide their mentorship conversations and found it to be effective in mentoring program participants. Mentors described techniques used and the process of deepening a reflective mentorship conversation. The Spiraling Process (58 %) and the Story Sharing Process (74 %) were integral aspects of the Facilitated Engagement Approach used. Mentorship was found to be impactful in that mentors reported a change in their mentee. CONCLUSIONS The Facilitated Engagement Approach was an effective tool for mentees and mentors to develop leadership capacities.
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Affiliation(s)
- M Durrant
- Ingram School of Nursing/ École des sciences infirmières Ingram, Canada; Ingram School of Nursing, McGill University, 680 Sherbrooke West, Suite 1800, Montreal, QC H3A 2M7, Canada; Seneca Nanji Foundation School of Nursing, Seneca Polytechnic,13990 Dufferin Street, King City, Ontario L7B 1B3, Canada.
| | - C Oliver
- Ingram School of Nursing/ École des sciences infirmières Ingram, Canada; Ingram School of Nursing, McGill University, 680 Sherbrooke West, Suite 1800, Montreal, QC H3A 2M7, Canada
| | - Laurie Gottlieb
- Ingram School of Nursing/ École des sciences infirmières Ingram, Canada; Ingram School of Nursing, McGill University, 680 Sherbrooke West, Suite 1800, Montreal, QC H3A 2M7, Canada
| | | | - Melanie Lavoie-Tremblay
- Faculty of Nursing, Researcher Centre de recherche de l'institut universitaire en santé mentale de Montréal, University of Montreal, Pavillon Marguerite-d'Youville, 2375, chemin de la Côte Sainte-Catherine, Bureau 2089, Montréal, QC H3T 1A8, Canada
| | - Guyaline Cyr
- Ingram School of Nursing, McGill University, 680 Sherbrooke Ouest, 19e étage, bureau 1818, Montréal, Québec H3A 2M7, Canada
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Chrysouli K, Theodorakopoulos C, Saratsiotis A, Kakosimou C, Tsami C, Vrettakos P, Kokolakis G, Gounari A. Allergic Rhinitis in Children: An Underestimated Disease. Indian J Otolaryngol Head Neck Surg 2024; 76:1759-1764. [PMID: 38566743 PMCID: PMC10982218 DOI: 10.1007/s12070-023-04402-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/22/2023] [Indexed: 04/04/2024] Open
Abstract
Allergic rhinitis affects approximately 40% of children. This study aimed at determining the prevalence, sociodemographic features, comorbid illnesses, complications and quality of life in children referred to the outpatient clinic of "Allergic Rhinitis" in Penteli Children Hospital, Athens, Greece. We analyzed 590 pediatric patients referred to the outpatient clinic of "Allergic Rhinitis" in Penteli Children Hospital, Athens, Greece from 26/01/2012 to 20/11/2022. Allergic rhinitis was recorded as the one and only allergic disease in 59% of the children diagnosed with allergic rhinitis, concomitant asthma in 16% of them, atopic dermatitis in 8% and allergic conjunctivitis in 5%. 54% of asthmatic children was diagnosed allergic rhinitis, while 16% of allergic rhinitis children was diagnosed asthma. Skin tests were important diagnostic tools, not being necessary the measurement of total IgE in plasma. Eosinophils from nasal secretions were increased in 19% of the children with non-diagnostic cases and the diagnosis was local allergic rhinitis (LAR). Clinical presentations of allergic rhinitis were mainly nasal blockage, runny nose, recurrent sneezing and nasal itching. The most common complication was acute or chronic sinusitis 35%. Major associated comorbid illnesses among were tonsils hypertrophy, adenoid hypertrophy and inferior turbinate hypertrophy. Allergic rhinitis was reported in 78% of studied children and was frequently characterized by significant morbidity. Allergic rhinitis affected all paediatric age group and was peaked at age group 11-14 years and 5-7 years. There were associated epidemiological features, clinical manifestations, comorbid illnesses, complications and affectation of the quality of life in children.
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Affiliation(s)
- Konstantina Chrysouli
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Christos Theodorakopoulos
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Angelos Saratsiotis
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Chara Kakosimou
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Charalampia Tsami
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Petros Vrettakos
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Georgios Kokolakis
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
| | - Anastasia Gounari
- Department of Otorhinolaryngology, Penteli Children Hospital, Hippocratous 8, 152 36, Athens, Greece
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Bilodeau K, Henriksen C, Aloisio Alves C, Piché L, Pepin J, Lee V, Vachon MF, Folch N, Pomey MP, Fernandez N. Learning to provide humanistic care and support in the context of chronic illness: Insights from the narratives of healthcare professionals in hemato-oncology. Eur J Oncol Nurs 2024; 69:102522. [PMID: 38382155 DOI: 10.1016/j.ejon.2024.102522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/11/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To document the process by which healthcare professionals (HCPs) support people living with and beyond hematological cancer and detail how they learned from their personal and clinical experience. METHOD Using a narrative approach, we conducted nine semi-structured interviews with HCPs, including nurses, from a specialized care centre who support patients with hematological cancer. Interviews aimed to capture experiential learning gained from their practice. We performed a hybrid inductive/deductive content analysis on data using a framework based on sociological and educational models of experiential learning. RESULTS Among healthcare professionals, analysis revealed the need to provide care and support that is 'humane' and adapted to each patient. Learning to provide this type of care proved to be challenging. Over the course of their clinical experience, healthcare professionals learned to adapt the support they provided by straddling a boundary between sympathy and empathy. Learning outcomes were associated with personal-professional development among participants. CONCLUSION Our findings bring to light an overlooked facet of patient support in the context of cancer care, which is the acquisition of the soft skills required to deliver humanistic care and support. This learning process requires time and involves navigating between the realms of sympathy and empathy. Experiential learning is intertwined with the complexity of the often long-term patient-professional relationship that characterizes hemato-oncology. This unique relationship offers rewards for healthcare professionals on both personal and professional fronts.
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Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, Quebec, H3C 3J7, Canada; Maisonneuve-Rosemont Hospital Research Center, 5415 Assomption Blvd, Montreal, Quebec, H1T 2M4, Canada.
| | - Cynthia Henriksen
- Maisonneuve-Rosemont Hospital Research Center, 5415 Assomption Blvd, Montreal, Quebec, H1T 2M4, Canada.
| | - Camila Aloisio Alves
- Petrópolis Medical College (FMP/UNIFASE), Av. Barão do Rio Branco, 1003 - Centro, Petrópolis, Rio de Janeiro, 25680-120, Brazil.
| | - Lynda Piché
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada.
| | - Jacinthe Pepin
- Faculty of Nursing, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, Quebec, H3C 3J7, Canada.
| | - Virginia Lee
- McGill University Health Center (Glen site), 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.
| | - Marie-France Vachon
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada.
| | - Nathalie Folch
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada.
| | - Marie-Pascale Pomey
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada; Department of Management, Evaluation and Health Policy of the School of Public Health, University of Montreal, 7101 Av du Parc, Montréal, Quebec, H3N 1X9, Canada.
| | - Nicolas Fernandez
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, Quebec, H3T 1J4, Canada.
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Leggat FJ, Heaton-Shrestha C, Fish J, Siriwardena AN, Domeney A, Rowe C, Patel I, Parsons J, Blair J, Jones F. An exploration of the experiences and self-generated strategies used when navigating everyday life with Long Covid. BMC Public Health 2024; 24:789. [PMID: 38481230 PMCID: PMC10938753 DOI: 10.1186/s12889-024-18267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Around one in ten people who contract Covid-19 report ongoing symptoms or 'Long Covid'. Without any known interventions to cure the condition, forms of self-management are routinely prescribed by healthcare professionals and described by people with the condition. However, there is limited research exploring what strategies are used to navigate everyday life with Long Covid, and experiences that initiate development of these strategies. Our study aimed to explore the range and influence of self-generated strategies used by people with Long Covid to navigate everyday life within the context of their own condition. METHODS Forming part of the Long Covid Personalised Self-managemenT support co-design and EvaluatioN (LISTEN) project, we conducted a qualitative study using narrative interviews with adults who were not hospitalised with Covid-19. Participants aged over 18 years, who self-identified with Long Covid, were recruited from England and Wales. Data were analysed with patient contributors using a reflexive thematic analysis. RESULTS Eighteen participants (mean age = 44 years, SD = 13 years) took part in interviews held between December 2021 and February 2022. Themes were constructed which depicted 1) the landscape behind the Long Covid experience and 2) the everyday experience of participants' Long Covid. The everyday experience comprised a combination of physical, emotional, and social factors, forming three sub-themes: centrality of physical symptoms, navigating 'experts' and the 'true colour' of personal communities, and a rollercoaster of psychological ambiguity). The third theme, personal strategies to manage everyday life was constructed from participants' unique presentations and self-generated solutions to manage everyday life. This comprised five sub-themes: seeking reassurance and knowledge, developing greater self-awareness through monitoring, trial and error of 'safe' ideas, building in pleasure and comfort, and prioritising 'me'. CONCLUSIONS Among this sample of adults with Long Covid, their experiences highlighted the unpredictable nature of the condition but also the use of creative and wide ranging self-generated strategies. The results offer people with Long Covid, and healthcare professionals supporting them, an overview of the collective evidence relating to individuals' self-management which can enable ways to live 'better' and regain some sense of identity whilst facing the impact of a debilitating, episodic condition. TRIAL REGISTRATION LISTEN ISRCTN36407216.
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Affiliation(s)
- Fiona J Leggat
- Population Health Research Institute, St George's, University of London, London, England, UK
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, England, UK
| | - Celayne Heaton-Shrestha
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, England, UK
| | - Jessica Fish
- Department of Clinical Neuropsychology & Clinical Health Psychology, St George's University Hospitals NHS Foundation Trust, London, England, UK
- Mental Health & Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | | | - Anne Domeney
- LISTEN Lived Experience Advisory Group, London, UK
- Bridges Self-Management, London, England, UK
| | - Carol Rowe
- LISTEN Lived Experience Advisory Group, London, UK
| | - Ian Patel
- LISTEN Lived Experience Advisory Group, London, UK
| | | | - John Blair
- LISTEN Lived Experience Advisory Group, London, UK
| | - Fiona Jones
- Population Health Research Institute, St George's, University of London, London, England, UK.
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, England, UK.
- Bridges Self-Management, London, England, UK.
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Atout M, Hasan AAH, Alkharabsheh AAH, Al-Tobasi AM, Ali AM. A narrative inquiry into the communication experiences of mothers caring for children with cancer in Jordan. J Pediatr Nurs 2024:S0882-5963(24)00064-2. [PMID: 38453545 DOI: 10.1016/j.pedn.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND This study aims to investigate the parenting experiences of mothers who care for children with cancer in Jordan and specifically focuses on the communication experiences of mothers who care for children with cancer. METHODOLOGY A qualitative research design employing a narrative inquiry methodology was adopted; it employed the implementation of twenty semi-structured interviews with the mothers of children with cancer recruited from one pediatric hospital located in Amman, Jordan. FINDINGS The findings of this study reveal that the majority of mothers attempted to conceal or delay any discussion regarding the diagnosis with their child, particularly during the immediate post-diagnosis period. Additionally, the mothers expressed that their relationships with the parents of children diagnosed with the same illness contain positive and negative aspects. Finally, most mothers participating in this study praised the role of hope in helping them cope with the challenging health condition of their children. CONCLUSIONS The findings of this study reveal that mothers would withhold diagnostic information from their children for several reasons: firstly, they wished to safeguard their children from feelings of distress; secondly, they perceived that their children were too immature to fully comprehend the seriousness of their diagnosis; and, finally, they desired to protect their children from unnecessary fear and negative emotions. PRACTICAL IMPLICATIONS Pediatric cancer care requires effective communication between physicians, pediatric nurses, caregivers, and children; clear and accurate communication between healthcare providers and parents of children with cancer ensures that they fully understand the diagnosis and can make values-based decisions.
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Affiliation(s)
- Maha Atout
- Faculty of Nursing, Philadelphia University, Jarash Road, P.O. Box 19392, Amman, Jordan.
| | - Abd Al-Hadi Hasan
- Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia.
| | | | - Adnan Mahmmoud Al-Tobasi
- Faculty of Arts, Department of Counseling Psychology, Philadelphia University, Jarash Road, P.O. Box 19392, Amman, Jordan.
| | - Amira M Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt.
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Lin N, Zhang X, Wang X, Wang S. The organization of the semantic network as reflected by the neural correlates of six semantic dimensions. Brain Lang 2024; 250:105388. [PMID: 38295716 DOI: 10.1016/j.bandl.2024.105388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/03/2024]
Abstract
Multiple sensory-motor and non-sensory-motor dimensions have been proposed for semantic representation, but it remains unclear how the semantic system is organized along them in the human brain. Using naturalistic fMRI data and large-scale semantic ratings, we investigated the overlaps and dissociations between the neural correlates of six semantic dimensions: vision, motor, socialness, emotion, space, and time. Our findings revealed a more complex semantic atlas than what is predicted by current neurobiological models of semantic representation. Brain regions that are selectively sensitive to specific semantic dimensions were found both within and outside the brain networks assumed to represent multimodal general and/or abstract semantics. Overlaps between the neural correlates of different semantic dimensions were mainly found inside the default mode network, concentrated in the left anterior superior temporal gyrus and angular gyrus, which have been proposed as two connector hubs that bridge the multimodal experiential semantic system and the language-supported semantic system.
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Affiliation(s)
- Nan Lin
- CAS Key Laboratory of Behavioural Sciences, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiaohan Zhang
- State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, CAS, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Xiuyi Wang
- CAS Key Laboratory of Behavioural Sciences, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Shaonan Wang
- State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, CAS, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
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Shimizu H. Explaining depression in the language of burnout: Normative reasons for depression in place of deterministic causes. Soc Sci Med 2024; 345:116703. [PMID: 38422685 DOI: 10.1016/j.socscimed.2024.116703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/27/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
In recent years, there has been renewed interest in diversifying the understanding and discussion about the causes of depression to move beyond biomedical determinism-a view that biomedical factors are the ultimate cause of an individual's depression. There is increasing emphasis on diversity in how people seek to articulate the causes of depression to incorporate non-biomedical dimensions. Furthermore, the biomedical understanding of depression has been increasingly questioned due especially to emerging limitations in pharmacotherapy. These shifts encourage social analyses that explore what narratives as to the causes of depression are constructed and presented with relative plausibility in different contexts and why and how. By analysing published memoirs of individuals diagnosed with depression in Japan, this study aims to provide fresh insights into narratives around the causes of depression. It illustrates how memoirs portray depression and its perceived causes in characteristic ways in a nation that adopts Western diagnostic systems, biomedical therapeutics and other relevant technologies. I will show that 'burnout' is the dominant theme in the Japanese data, diverging from the predominantly biomedical narrative in Western societies. This burnout narrative depicts depression as the somewhat unfortunate but unsurprising result of overwork arising from individual active adaptations to structural features of the Japanese work culture. I argue that reasons, rather than causes, articulate the making of the burnout narrative by revealing the interplay between the structural and individual and ultimately enrich the understanding of depression. The paper concludes with a call for exploring the shifting relationship between illness and normalcy that the burnout narrative implies. I suggest that further studies could explore how the boundaries between normalcy and illness are enacted and re-enacted and to what avail through public discourse and through shifting diagnostic schemata in the context of different national norms and practices.
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Affiliation(s)
- Hiroto Shimizu
- Centre for Biomedicine, Self and Society, Usher Institute, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK.
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Cohn N, van Middelaar L, Foulsham T, Schilperoord J. Anaphoric distance dependencies in visual narrative structure and processing. Cogn Psychol 2024; 149:101639. [PMID: 38306880 DOI: 10.1016/j.cogpsych.2024.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/03/2024] [Accepted: 01/20/2024] [Indexed: 02/04/2024]
Abstract
Linguistic syntax has often been claimed as uniquely complex due to features like anaphoric relations and distance dependencies. However, visual narratives of sequential images, like those in comics, have been argued to use sequencing mechanisms analogous to those in language. These narrative structures include "refiner" panels that "zoom in" on the contents of another panel. Similar to anaphora in language, refiners indexically connect inexplicit referential information in one unit (refiner, pronoun) to a more informative "antecedent" elsewhere in the discourse. Also like in language, refiners can follow their antecedents (anaphoric) or precede them (cataphoric), along with having either proximal or distant connections. We here explore the constraints on visual narrative refiners created by modulating these features of order and distance. Experiment 1 examined participants' preferences for where refiners are placed in a sequence using a force-choice test, which revealed that refiners are preferred to follow their antecedents and have proximal distances from them. Experiment 2 then showed that distance dependencies lead to slower self-paced viewing times. Finally, measurements of event-related brain potentials (ERPs) in Experiment 3 revealed that these patterns evoke similar brain responses as referential dependencies in language (i.e., N400, LAN, Nref). Across all three studies, the constraints and (neuro)cognitive responses to refiners parallel those shown to anaphora in language, suggesting domain-general constraints on the sequencing of referential dependencies.
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Affiliation(s)
- Neil Cohn
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Netherlands.
| | - Lincy van Middelaar
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Netherlands
| | - Tom Foulsham
- Department of Psychology, University of Essex, UK
| | - Joost Schilperoord
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Netherlands
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Egalité N. Our Newspaper as Care: Narrative Approaches in Fanon's Psychiatry Clinic. J Med Humanit 2024:10.1007/s10912-023-09834-w. [PMID: 38407741 DOI: 10.1007/s10912-023-09834-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 02/27/2024]
Abstract
This paper argues that the newspaper Notre Journal enshrined the importance of narrative in the revolutionary psychiatry of its founder and editor, Frantz Fanon. Anchoring my analysis in the interdisciplinarity of the medical humanities, I demonstrate how care at Hôpital Blida-Joinville in colonial Algeria was mediated by the written word. I examine Fanon's physician writing and editorial texts detailing the use of narrative approaches in the clinic. As an object of care, Notre Journal's promotion of psychic healing, social actions, and engaged professional practice shaped the interactions and experiences of patients and staff. Printed and distributed to the wider institution, the newspaper created community-during an oppressive French Occupation and at the outset of the War of Independence-in addition to nurturing creativity, curiosity, solidarity, and accountability. Still, Fanon would come to recognize the limits of narrative methods amidst cultural oral traditions, illiteracy, and divergent attitudes about narrating the self.
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Affiliation(s)
- Nathalie Egalité
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
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Surapaneni KM. Livogena: The Ikteros Curse-A Jaundice Narrative Card and Board Game for Medical Students. MedEdPORTAL 2024; 20:11381. [PMID: 38322827 PMCID: PMC10844581 DOI: 10.15766/mep_2374-8265.11381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/14/2023] [Indexed: 02/08/2024]
Abstract
Introduction Jaundice is a common condition that requires integrating knowledge of biochemistry, physiology, pathology, and general medicine. However, medical students face difficulty in learning with passive teaching methods. To enhance their learning, an educational story game that promotes active learning and assessment with immediate feedback was implemented. Methods This jaundice game was named Livogena: The Ikteros Curse-denoting the liver as the principal organ and jaundice (icterus) as a problem. One hundred fifty first-year medical students were divided into small groups to play using a game board and cards. The players moved ahead on the game board by providing the correct answer and completing the activities. The first team to reach the end was the winner. Perceptions and feedback questionnaires were distributed to students at the end of the game. Individual views about the game were recorded for qualitative analysis. Also, to analyze the effectiveness of this intervention, pre- and posttests on jaundice were conducted. Results Livogena: The Ikteros Curse resulted in a highly significant improvement in students' knowledge and application skills in jaundice, from 5.5 (SD = 2.4) in the pretest to 11.2 (SD = 7.6) in the posttest for 20 marks (p < .001). Students perceived and rated the game exceptionally positively. Discussion This educational game significantly increased learners' understanding of the concepts of jaundice. Highly positive perceptions from students further affirm this to be a creative innovation to enhance their learning and application of knowledge in an active and team-based learning environment.
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Affiliation(s)
- Krishna Mohan Surapaneni
- Professor, Department of Biochemistry, and Head, Department of Medical Education, Panimalar Medical College Hospital & Research Institute
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Bose A, Ahmed S, Cheng Y, Suárez-Gonzalez A. Connected speech features in non-English speakers with Alzheimer's disease: protocol for scoping review. Syst Rev 2024; 13:40. [PMID: 38273377 PMCID: PMC10809489 DOI: 10.1186/s13643-023-02379-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/26/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND A large body of literature indicates that connected speech profiles in patients with Alzheimer's disease (AD) can be utilized for diagnosis, disease monitoring, and for developing communication strategies for patients. Most connected speech research has been conducted in English, with little work in some European languages. Therefore, significant drawback remains with respect to the diversity of languages studied, and how the fragmentation of linguistic features differs across languages in AD. Accordingly, existing reviews on connected speech in AD have focused on findings from English-speaking patients; none have specifically focused on the linguistic diversity of AD populations. This scoping review is undertaken to provide the currently reported characteristics of connected speech in AD in languages other than English. It also seeks to identify the type of assessments, methods to elicit speech samples, type of analysis and linguistic frameworks used, and micro- and macro-linguistic features of speech reported in non-English speakers with AD. METHOD We will conduct a scoping review of published studies that have quantitively assessed connected speech in AD in languages other than English. The inclusion criteria for the studies would be subject/s with a clinical diagnosis of AD. The search will include the electronic databases PubMed, Ovid-Embase, PsycINFO, Linguistic and Language Behaviour Abstracts (LLBA), and Web of Science up until March 2023. Findings will be mapped and described according to the languages studied, the methodology employed (e.g., patient characteristics, tasks used, linguistic analysis framework utilized), and connected speech profiles derived (e.g., micro- and macro-linguistic reported). DISCUSSION The scoping review will provide an overview of languages studied in connected speech research in AD with variation in linguistic features across languages, thus allowing comparison with the established key features that distinguish AD patients from healthy controls. The findings will inform future research in connected speech in different languages to facilitate robust connected speech research in linguistically and ethnically diverse populations.
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Affiliation(s)
- Arpita Bose
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
| | - Samrah Ahmed
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Yesi Cheng
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Wexham Park Hospital, NHS Frimley Health Foundation Trust, Slough, UK
| | - Aida Suárez-Gonzalez
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
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12
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Brisbois B, Plamondon K, Walugembe D, Pereira RC, Edet C, Dixon J, Habibi R, Karamouzian M, Labonté R, Murthy S, Ravitsky V. Pandemics, intellectual property and 'our economy': A worldview analysis of Canada's role in compromising global access to COVID-19 vaccines. Glob Public Health 2024; 19:2335360. [PMID: 38626321 DOI: 10.1080/17441692.2024.2335360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 03/21/2024] [Indexed: 04/18/2024]
Abstract
Despite self-congratulatory rhetoric, Canada compromised COVID-19 vaccine equity with policies impeding a proposed global waiver of vaccine intellectual property (IP) rules. To learn from Canada's vaccine nationalism we explore the worldview - a coherent textual picture of the world - in a sample of Government of Canada communications regarding global COVID-19 vaccine sharing. Analysed documents portray risks and disparities as unrelated to the dynamics and power relations of the Canadian and international economies. Against this depoliticised backdrop, economic growth fueled by strict IP rules and free trade is advanced as the solution to inequities. Global vaccine access and distribution are pursued via a charity-focused public-private-partnership approach, with proposals to relax international IP rules dismissed as unhelpful. Rather than a puzzling lapse by a good faith 'middle power', Canada's obstruction of global COVID-19 vaccine equity is a logical and deliberate extension of dominant neoliberal economic policy models. Health sector challenges to such models must prioritise equity in global pandemic governance via politically assertive and less conciliatory stances towards national governments and multilateral organisations. Mobilisation for health equity should transform the overall health-damaging macroeconomic model, complementing efforts based on specific individual health determinants or medical technologies.
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Affiliation(s)
- Ben Brisbois
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - Katrina Plamondon
- School of Nursing, University of British Columbia - Okanagan, Kelowna, Canada
| | - David Walugembe
- School of Nursing, University of British Columbia - Okanagan, Kelowna, Canada
| | - Rodrigo Curty Pereira
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, Canada
| | - Christine Edet
- School of Nursing, University of British Columbia - Okanagan, Kelowna, Canada
| | - Jenna Dixon
- School of Nursing, University of British Columbia - Okanagan, Kelowna, Canada
| | - Roojin Habibi
- Faculty of Law, University of Ottawa, Ottawa, Canada
| | - Mohammad Karamouzian
- Centre on Drug Policy Evaluation, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
- BC Children's Hospital Research Institute, Vancouver, Canada
| | - Vardit Ravitsky
- School of Public Health, Université de Montréal, Montréal, Canada
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13
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Zelvin LB. Wait for Me: Chronic Mental Illness and Experiences of Time During the Pandemic. J Med Humanit 2023:10.1007/s10912-023-09829-7. [PMID: 38146014 DOI: 10.1007/s10912-023-09829-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/27/2023]
Abstract
As someone diagnosed with severe chronic mental illness early in my adolescence, I have spent over half of my life feeling out of step with the rest of the world due to hospitalizations, treatment programs, and the disruptions caused by anxiety, anorexia, depression, and obsessive-compulsive disorder. The effect of my mental health conditions compounded by these treatment environments means I often feel that I experience time passing differently, which results in sensations of removal and isolation from those around me. The global shutdown caused by the COVID-19 pandemic seemed a way for normative bodies to experience the passing of time the way I always have. In this paper, I extend Dr. Sara Wasson's analysis of the ways in which chronic pain resists narrative coherence to my own temporal experience of chronic mental illness, specifically my embodied experience of the pandemic. I use that embodied experience as a case study for examining how the reciprocal nature of time and narrativity, as outlined by Dr. Paul Ricoeur, can create isolation for those struggling with their temporality due to chronic mental illness. To acknowledge and grapple with the ramifications of discursive and material privilege involved in such situations, I include an analysis of Robert Desjarlais's 1994 article "Struggling Along: The Possibilities for Experience among the Homeless Mentally Ill," in which he investigates a similar phenomenon of being outside of structured sequential narrative time in the residents of a Boston shelter for the mentally ill.
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Affiliation(s)
- Lindsey Beth Zelvin
- School of English, Division of Arts and Humanities, University of Kent in Canterbury, Canterbury, UK.
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14
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Kloester J, Brand G, Willey S. How midwives facilitate informed decisions in the third stage of labour - an exploration through portraiture. Midwifery 2023; 127:103868. [PMID: 37931464 DOI: 10.1016/j.midw.2023.103868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
PROBLEM Midwifery philosophy promotes informed decision-making. Despite this, midwives report a lack of informed decision-making in standard maternity care systems. BACKGROUND Previous research has shown a woman's ability to make informed decisions within her maternity care significantly impacts her childbearing experience. When informed decision-making is facilitated, women report positive experiences, whereas when lacking, there is an increased potential for birth trauma. AIM To explore midwives' experiences of facilitating informed decision-making, using third-stage management as context. METHODS Five midwives from Victoria, Australia, were interviewed about their experiences with informed decision-making. These interviews were guided by portraiture methodology whereby individual narrative portraits were created. This paper explores the shared themes among these five portraits. FINDINGS Five individual narrative portraits tell the stories of each midwife, providing rich insight into their philosophies, practices, barriers and enablers of informed decision-making. These are then examined as a whole dataset to explore shared themes, and include; 'informed decision-making is fundamental to midwifery practice' 'the system', and 'navigating the system'. The system contained the sub-themes; hierarchy in hospitals, the medicalisation of birth, and the impact on midwifery practice, and 'navigating the system' - contained; safety of the woman and safety of the midwife, and the gold-standard of midwifery. DISCUSSION AND CONCLUSION Midwives in this study valued informed decision-making as fundamental to their philosophy but also faced barriers in their ability to facilitate it. Barriers to informed decision-making included: power-imbalances; de-skilling in physiological birth; fear of blame, and interdisciplinary disparities. Conversely enablers included continuity models of midwifery care, quality antenatal education, respectful interdisciplinary collaboration and an aim toward a resurgence of fundamental midwifery skills.
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Affiliation(s)
- Joy Kloester
- Monash Nursing and Midwifery, Monash University, Melbourne Victoria, Australia.
| | - Gabrielle Brand
- Monash Nursing and Midwifery, Monash University, Melbourne Victoria, Australia. https://twitter.com/https://twitter.com/GabbyBrand6
| | - Suzanne Willey
- Monash Nursing and Midwifery, Monash University, Melbourne Victoria, Australia. https://twitter.com/https://twitter.com/SueWilley5
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15
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Defenbaugh N, Dickey LA, Foulke VC, Orlando JP. Storied reflections: Development of a longitudinal interdisciplinary curriculum to improve patient-provider communication. PEC Innov 2023; 2:100170. [PMID: 37384161 PMCID: PMC10294085 DOI: 10.1016/j.pecinn.2023.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/08/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023]
Abstract
Objective This article details the development of an interdisciplinary graduate medical education (GME) narrative curriculum. Methods Descriptive statistics were conducted for the narrative session surveys. Two separate qualitative analyses were conducted. First, content and thematic analyses of the open-ended questions in the survey using NVIVO software occurred. Second, an inductive analysis of the participants' 54 stories was performed to identify unique themes not related to the prompt topics. Results Quantitative survey results demonstrated that 84% of learners' felt the session benefited their personal or professional sense of wellbeing and resilience, 90% of learners believed the sessions aided in their ability to listen more effectively, and 86% of learners could apply what they practiced or witnessed. Qualitative analysis of survey data showed learners focused on patient care and listening. Thematic analysis of participants' narratives revealed strong feelings and emotions, struggles with time management, increase in self- and other-awareness, and challenges managing job-life balance. Conclusion The longitudinal interdisciplinary Write-Read-Reflect narrative exchange curriculum is cost-effective, sustainable, and demonstrably valuable to learners and their program directors across multiple disciplines. Innovation The program was designed for 4 graduate programs' learners to simultaneously experience a narrative exchange model to improve patient-provider communication, support professional resilience, and deepen relationship-centered care skills.
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Affiliation(s)
- Nicole Defenbaugh
- University of Health Sciences and Pharmacy, 1 Pharmacy Place, St. Louis, Missouri 63110, United States of America
| | | | - Vivian C. Foulke
- Lehigh Valley Hospital, 1200 South Cedar Crest Blvd, Allentown, PA 18103, United States of America
| | - James P. Orlando
- St Luke's University Health Network, 801 Ostrum Street, Bethlehem, PA 18015, United States of America
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16
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Jackson D, Brady J, Dawkins D. Positioning, power and agency in postgraduate primary care supervision: a study of trainee narratives. BMC Med Educ 2023; 23:880. [PMID: 37978527 PMCID: PMC10656937 DOI: 10.1186/s12909-023-04826-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Postgraduate supervision takes place within complex training environments, where experiences are shaped by the socio-cultural context and wider profession, and where tensions permeate. Bordin's working alliance-based model of supervision suggests that quality relationships encompass agreement on the goals and tasks of supervision, in the context of an emotional bond. However, as trainees and their supervisors navigate the demands of providing safe clinical care, alongside educational support, disagreement on expectations for supervision may emerge. By applying a critical lens, this research draws on positioning theory to explore General Practice trainees' experiences of supervision. METHODS In 2017-2019 a series of narrative interviews were undertaken with 13 General Practice trainees in the United Kingdom (UK). Participants were purposively sampled based on end-of-year performance, gender, training location and training status. Interviews were analysed using Brown and Gilligan's Listening Guide, which was adapted to incorporate an exploration of positioning, power and agency. RESULTS Trainees appeared to hold variable positions, such as 'insiders', 'outsiders', 'peers' and 'problem trainees'. Supervisors, through talk and the degree of access afforded, contributed to this positioning. Some trainees viewed their supervisors as brokers and guides as they navigated their training, whilst others were suspicious of the supervisor role. For trainees who raised concerns about their supervisor through formal channels, results were not often satisfactory. Others chose to navigate difficulty in supervision through informal means. This typically involved mastery of artefacts of training, such as the electronic appointment book or training portfolio. CONCLUSIONS This paper builds on Bordin's model of supervision to encourage greater clarity in supervisory discussions, exploring assumptions, and recognising the influences of environment, power, positioning, and agency. We have developed a Model of the Supervisory Alliance in Postgraduate GP Training (MSA-GP) to serve as a springboard for discussion for trainees and their supervisors.
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Affiliation(s)
- Dawn Jackson
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Josephine Brady
- Mary Immaculate College, South Circular Road, Limerick, V94 VN26, Ireland
| | - Donna Dawkins
- School of Education, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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17
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Jangraw DC, Finn ES, Bandettini PA, Landi N, Sun H, Hoeft F, Chen G, Pugh KR, Molfese PJ. Inter-subject correlation during long narratives reveals widespread neural correlates of reading ability. Neuroimage 2023; 282:120390. [PMID: 37751811 PMCID: PMC10783814 DOI: 10.1016/j.neuroimage.2023.120390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 09/28/2023] Open
Abstract
Recent work using fMRI inter-subject correlation analysis has provided new information about the brain's response to video and audio narratives, particularly in frontal regions not typically activated by single words. This approach is very well suited to the study of reading, where narrative is central to natural experience. But since past reading paradigms have primarily presented single words or phrases, the influence of narrative on semantic processing in the brain - and how that influence might change with reading ability - remains largely unexplored. In this study, we presented coherent stories to adolescents and young adults with a wide range of reading abilities. The stories were presented in alternating visual and auditory blocks. We used a dimensional inter-subject correlation analysis to identify regions in which better and worse readers had varying levels of consistency with other readers. This analysis identified a widespread set of brain regions in which activity timecourses were more similar among better readers than among worse readers. These differences were not detected with standard block activation analyses. Worse readers had higher correlation with better readers than with other worse readers, suggesting that the worse readers had "idiosyncratic" responses rather than using a single compensatory mechanism. Close inspection confirmed that these differences were not explained by differences in IQ or motion. These results suggest an expansion of the current view of where and how reading ability is reflected in the brain, and in doing so, they establish inter-subject correlation as a sensitive tool for future studies of reading disorders.
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Affiliation(s)
- David C Jangraw
- Section on Functional Imaging Methods, NIMH, Bethesda, MD, United States; Emotion and Development Branch, NIMH, Bethesda, MD, United States; Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, United States.
| | - Emily S Finn
- Section on Functional Imaging Methods, NIMH, Bethesda, MD, United States; Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Peter A Bandettini
- Section on Functional Imaging Methods, NIMH, Bethesda, MD, United States; Center for Multimodal Neuroimaging, NIMH, Bethesda, MD, United States
| | - Nicole Landi
- Haskins Laboratories, New Haven, CT, United States
| | - Haorui Sun
- Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, United States
| | - Fumiko Hoeft
- Haskins Laboratories, New Haven, CT, United States; Department of Psychological Sciences, University of Connecticut, Hartford, CT, United States
| | - Gang Chen
- Statistical Computing Core, NIMH, Bethesda, MD, United States
| | - Kenneth R Pugh
- Haskins Laboratories, New Haven, CT, United States; Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States
| | - Peter J Molfese
- Center for Multimodal Neuroimaging, NIMH, Bethesda, MD, United States; Haskins Laboratories, New Haven, CT, United States
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18
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Baldassano C. Studying waves of prediction in the brain using narratives. Neuropsychologia 2023; 189:108664. [PMID: 37604332 DOI: 10.1016/j.neuropsychologia.2023.108664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/04/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023]
Abstract
Narrative stimuli offer a unique opportunity for research in cognitive neuroscience because they evoke cognitive processes that are difficult or impossible to study with traditional paradigms. An especially compelling feature of narratives is their temporal structure, which allows for meaningful predictions about upcoming events. As we proceed through a narrative, we can maintain a complex set of short- and long-term guesses about the future and continually refine our predictions as the story unfolds. Experiments using narratives can allow researchers to probe the ways in which memory systems are flexibly used during perception, including the mechanisms by which continuous experiences are segmented into discrete events. Despite the challenges of using narratives and other naturalistic stimuli in experimental research, these approaches offer a new window into critical components of real-world cognition.
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Affiliation(s)
- Christopher Baldassano
- Department of Psychology, Columbia University, 1190 Amsterdam Ave., New York, NY, 10027, USA.
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19
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Miyamae F, Sugiyama M, Taga T, Okamura T. Peer support meeting of people with dementia: a qualitative descriptive analysis of the discussions. BMC Geriatr 2023; 23:637. [PMID: 37814249 PMCID: PMC10563253 DOI: 10.1186/s12877-023-04329-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Dementia cafés for people with dementia and their caregivers are promoted in national dementia policies. The effect of dementia cafés on people with dementia has been reported through narratives of caregivers who participated the dementia cafés. However, evidence derived from the data, which included only people with dementia, is sparse. The aim of this study is to analyze the narratives of people with dementia in peer support meetings in Tokyo where only people with dementia participate, i.e., caregivers were not present. METHODS People with dementia and older people with subjective cognitive impairment were recruited in our community-based participatory research centre. Based on the qualitative descriptive approach, we conducted a thematic analysis of the field notes, which was made through ethnographical observation of the meetings. RESULTS Twenty-five meetings were held from November 2018 to March 2020. The cumulative total number of participants was 196. First, the symptomatic problems related to living with dementia were mentioned, which were collectively named under the overarching category of 'Experience of living with dementia.' Second, questions and solutions to the various symptoms were discussed, which were named the 'Quest of Symptoms.' Third, we noted the narrative that reflected on daily life, feelings, and the life that one has led, which were named 'Life story.' Fourth, we noted narratives of how symptoms have improved and their world has expanded, which were named 'Hope.' Fifth and most importantly, narratives about compassion for people with dementia in the past and future, as well as for people of the same generation, were discussed, which were named 'Compassion.' CONCLUSIONS The lived experiences of people with dementia were revealed. Participants noted they were not just being cared for but exchanging information and exploring the symptoms; in other words, they were resilient. Furthermore, more positive aspects concerning living with dementia were discussed, such as 'Hope' and 'Compassion.' Further research concerning the discourse of people around the participants is necessary to evaluate the situation from multiple perspectives.
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Affiliation(s)
- Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan.
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Tsutomu Taga
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
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20
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Nikitović T, Vuletić T, Ignjatović N, Ninković M, Grujić K, Krnjaić Z, Krstić K. Crisis as Opportunity, Risk, or Turmoil: Qualitative Study of Youth Narratives About the COVID-19 Pandemic. J Adolesc Health 2023; 73:686-692. [PMID: 37410006 DOI: 10.1016/j.jadohealth.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/02/2023] [Accepted: 05/14/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE The present study employed a narrative approach in order to explore how young people constructed meanings regarding their sense of self in the context of COVID-19 experiences. Adolescents have been identified as a particularly vulnerable group, as the developmental challenges they face are superimposed and amplified by the accidental crisis caused by the pandemic. METHODS An in-depth narrative analysis was conducted on written accounts of 13 females aged 17-23 years from Serbia. We selected these narratives from a larger sample of 70 responses (M = 20.1; SD = 2.9; 85.7% female) collected via an online form. We used reflexive thematic analysis as a tool for the selection process of the narratives subjected to in-depth narrative analysis. RESULTS Young people told stories that differ significantly in coherence, affective tone, personal agency, and depth of self-exploration. Narrative analysis of the selected accounts identified three distinct types of stories: (1) crisis as an opportunity for personal growth, (2) crisis as a risk for the sense of self, and (3) crisis as inner turmoil. DISCUSSION Narrative analysis enabled us to recognize three distinct processes of youth meaning-making related to the sense of self in times of crisis, all reflecting a significant impact on their core developmental task. Personal narratives served different functions; for some, the pandemic was framed as a challenge one could grow from, while others were left devastated or overwhelmed. Narrative coherence reflected youths' capacities for integrating experiences not necessarily connected to their psychological well-being.
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Affiliation(s)
- Tijana Nikitović
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia.
| | - Teodora Vuletić
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Natalija Ignjatović
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Milica Ninković
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Kristina Grujić
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Zora Krnjaić
- Institute of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Ksenija Krstić
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
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21
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Smart E, Nalder E, Trentham B, King G. "What their expectations could be": a narrative study of mothers and service providers in paediatric rehabilitation. Disabil Rehabil 2023; 45:3238-3251. [PMID: 36191330 DOI: 10.1080/09638288.2022.2127935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To better understand and visualise how and why mothers' and service providers' expectations for therapy can change over time spanning their journeys and careers in the paediatric rehabilitation system. METHODS Narrative analysis was used to construct two parallel collective stories that illustrate and explain phases and turning points of developing expectations. Five mothers and nine service providers participated in interviews discussing their expectations when new and more experienced with therapy. RESULTS Each collective story had five chapters illustrating how expectations became more relational, controllable, and informed. For mothers, the chapters were: (1) expecting therapy to be a saviour; (2) being turned away and alone; (3) expecting to advocate from necessity; (4) finding new solutions in the environment; and (5) expecting to combine mother and service provider expertise. For service providers, the chapters were: (1) expecting to rescue and fix; (2) searching for an alternative sense of professional worth; (3) expecting to lose control; (4) being the authentic self before expected self; and (5) expecting the unexpected. CONCLUSIONS Mothers' experiences with feeling alone and learning ways to modify their child's environments, and service providers' experiences with feeling inadequate and embracing authenticity, were essential to the developmental trajectories of expectations.Implications for Rehabilitation:Mapping expectations for therapy on a line graph shaped as a wave shows promise in reflecting the developmental trajectory of mothers' and service providers' expectations over time.Service providers should become aware of how to work with three distinct groups of mothers as determined by the phase of expectations for therapy they are currently experiencing (i.e., hyped, disillusioned, or enlightened).Therapy programmes can optimise expectations for therapy through redesigns that emphasise elements of networking, self-compassion, ethics, and authenticity.
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Affiliation(s)
- Eric Smart
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Barry Trentham
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Gillian King
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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22
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Adornetti I, Chiera A, Altavilla D, Deriu V, Marini A, Gobbo M, Valeri G, Magni R, Ferretti F. Defining the Characteristics of Story Production of Autistic Children: A Multilevel Analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06096-2. [PMID: 37653117 DOI: 10.1007/s10803-023-06096-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
Several studies suggest that a valuable tool to examine linguistic skills in communication disorders is offered by procedures of narrative discourse assessment. Following this line of research, we present an exploratory study aimed to investigate storytelling abilities of autistic children to better define the characteristics of their story production. Participants included 41 autistic children and 41 children with typical development aged between 7.02 and 11.03 years matched on age, gender, level of formal education, intelligence quotient, working memory, attention skills, theory of mind, and phonological short-term memory. Narrative production was assessed by analysing the language samples obtained through the "Nest Story" description task. A multilevel analysis including micro- and macro-linguistic variables was adopted for narrative assessment. Group differences emerged on both micro- and macro-linguistic dimensions: autistic children produced narratives with more phonological errors and semantic paraphasias (microlinguistic variables) as well as more errors of global coherence and a fewer number of visible events and inferred events (macrolinguistic variables) than the control group.This study shows that even autistic children with adequate cognitive skills display several limitations in their narrative competence and that such weaknesses affect both micro- and macrolinguistic aspects of story production.
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Affiliation(s)
- Ines Adornetti
- Cosmic Lab, Department of Philosophy, Communication and Performing Arts, Roma Tre University, Via Ostiense 234-236, 00146, Rome, Italy.
| | - Alessandra Chiera
- Cosmic Lab, Department of Philosophy, Communication and Performing Arts, Roma Tre University, Via Ostiense 234-236, 00146, Rome, Italy
| | - Daniela Altavilla
- Cosmic Lab, Department of Philosophy, Communication and Performing Arts, Roma Tre University, Via Ostiense 234-236, 00146, Rome, Italy
| | - Valentina Deriu
- Cosmic Lab, Department of Philosophy, Communication and Performing Arts, Roma Tre University, Via Ostiense 234-236, 00146, Rome, Italy
| | - Andrea Marini
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, Via Margreth, 3, 33100, Udine, Italy
- Claudiana - Landesfachhochschule Für Gesundheitsberufe, Bozen, Italy
| | - Marika Gobbo
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, Via Margreth, 3, 33100, Udine, Italy
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy
| | - Giovanni Valeri
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, The Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio 4, 00165, Rome, Italy
| | - Rita Magni
- Studio Polispecialistico Evò, Viale Pier Luigi Nervi 164, 04100, Latina, Italy
| | - Francesco Ferretti
- Cosmic Lab, Department of Philosophy, Communication and Performing Arts, Roma Tre University, Via Ostiense 234-236, 00146, Rome, Italy
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23
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Valtonen J, Lewis B. The Brain Disorders Debate, Chekhov, and Mental Health Humanities. J Med Humanit 2023; 44:291-309. [PMID: 36961674 PMCID: PMC10491527 DOI: 10.1007/s10912-023-09786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The contemporary brain disorders debate echoes a century-long conflict between two different approaches to mental suffering: one that relies on natural sciences and another drawing from the arts and humanities. We review contemporary neuroimaging studies and find that neither side has won. The study of mental differences needs both the sciences and the arts and humanities. To help develop an approach mindful of both, we turn to physician-writer Anton Chekhov's story "A Nervous Breakdown." We review the value of the arts and humanities as a coequal partner with natural sciences in the creation of a robust mental health humanities.
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Affiliation(s)
- Jussi Valtonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, 00014, Finland.
- Theatre Academy, University of the Arts Helsinki, Helsinki, Finland.
| | - Bradley Lewis
- Gallatin School of Individualized Study, New York University, New York, NY, USA
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24
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Lundin NB, Cowan HR, Singh DK, Moe AM. Lower cohesion and altered first-person pronoun usage in the spoken life narratives of individuals with schizophrenia. Schizophr Res 2023; 259:140-149. [PMID: 37127466 PMCID: PMC10524354 DOI: 10.1016/j.schres.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/17/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
Abstract
Usage of computational tools to quantify language disturbances among individuals with psychosis is increasing, improving measurement efficiency and access to fine-grained constructs. However, few studies apply automated linguistic analysis to life narratives in this population. Such research could facilitate the measurement of psychosis-relevant constructs such as sense of agency, capacity to organize one's personal history, narrative richness, and perceptions of the roles that others play in one's life. Furthermore, research is needed to understand how narrative linguistic features relate to cognitive and social functioning. In the present study, individuals with schizophrenia (n = 32) and individuals without a psychotic disorder (n = 15) produced personal life narratives within the Indiana Psychiatric Illness Interview. Narratives were analyzed using the Coh-Metrix computational tool. Linguistic variables analyzed were indices of connections within causal and goal-driven speech (deep cohesion), unique word usage (lexical diversity), and pronoun usage. Individuals with schizophrenia compared to control participants produced narratives that were lower in deep cohesion, contained more first-person singular pronouns, and contained fewer first-person plural pronouns. Narratives did not significantly differ between groups in lexical diversity, third-person pronoun usage, or total word count. Cognitive-linguistic relationships emerged in the full sample, including significant correlations between greater working memory capacity and greater deep cohesion and lexical diversity. In the schizophrenia group, social problem-solving abilities did not correlate with linguistic variables but were associated with cognition. Findings highlight the relevance of psychotherapies which aim to promote recovery among individuals with psychosis through the construction of coherent life narratives and increasing agency and social connectedness.
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Affiliation(s)
- Nancy B Lundin
- Department of Psychiatry and Behavioral Health, The Ohio State University, 1670 Upham Drive, Suite 460, Columbus, OH 43210, USA.
| | - Henry R Cowan
- Department of Psychiatry and Behavioral Health, The Ohio State University, 1670 Upham Drive, Suite 460, Columbus, OH 43210, USA.
| | - Divnoor K Singh
- Department of Neuroscience, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA.
| | - Aubrey M Moe
- Department of Psychiatry and Behavioral Health, The Ohio State University, 1670 Upham Drive, Suite 460, Columbus, OH 43210, USA; Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, USA.
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25
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Kim SW, Langer S, Ahern M, Larkey L, Todd M, Martin D, Weihs K, Khera N. Hematopoietic Cell Transplantation Patient-Caregiver Dyad Perspectives on Participation in a Digital Storytelling Intervention: A Qualitative Approach. Transplant Cell Ther 2023; 29:520.e1-520.e7. [PMID: 37137443 PMCID: PMC10526713 DOI: 10.1016/j.jtct.2023.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/05/2023]
Abstract
Storytelling has long been considered an effective means of communication, allowing the teller to process their emotions in light of particular life challenges. Effects on the listener also have been demonstrated to be beneficial, especially if the listener is faced with a similar life challenge. Less is known regarding the potential effects of storytelling on listening dyads and opportunities for joint processing following exposure to relevant stories. We sought to study these phenomena in the context of hematopoietic cell transplantation (HCT), a demanding medical procedure requiring intensive informal caregiving and thus great patient-caregiver entwinement. The purpose of this qualitative descriptive study was to explore participants' perceptions of a 4-week web-based digital storytelling (DST) intervention using both quantitative ratings of acceptability and qualitative coding of interviews conducted after intervention completion. A total of 202 participants (101 HCT patient-caregiver dyads) were recruited from the Mayo Clinic Arizona and randomized into either a DST arm or an Information Control (IC) arm. Participants in the DST arm rated the acceptability of the intervention and were asked to participate in a 30-minute phone interview to discuss their experience with the DST intervention. All interviews were recorded and transcribed verbatim and imported into NVivo 12 for coding and analysis, using a combination of deductive and inductive approaches to organize the data, create categories, and develop themes and subthemes. A total of 38 participants (19 HCT patient-caregiver dyads) completed the post-intervention interviews. Patients were 63% male and 82% White, 68% received allogeneic HCT, and their mean age was 55 years. The median time from HCT was 25 days (range, 6 to 56 days). Caregivers were mostly patients' spouses (73%) and female (69%), with a mean age of 56 years. In general, the 4-week web-based DST intervention was well accepted and liked by both patients and caregivers regarding the duration, dyadic participation, and convenience of participating in the intervention at home. Patients and caregivers who completed the DST intervention indicated that they were satisfied with the intervention (mean score, 4.5 of 5), were likely to recommend it to others (mean score, 4.4), would watch more stories (mean score, 4.1), and that the experience was worth their time (mean score, 4.6). Major themes that emerged from the qualitative analysis included (1) building communal connection through engaging with the stories; (2) positive emotional growth after HCT; (3) value of gaining the other's perspective; and (4) impact of open communication on the patient-caregiver relationship. A web-based DST intervention provides an attractive format through which to deliver a nonpharmacologic psychosocial intervention to HCT patient-caregiver dyads. Watching the emotional content in digital stories may help patients and caregivers cope with psychoemotional challenges together and provide an opportunity for emotional disclosure. Further work on determining optimal paths to disclosure is warranted.
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Affiliation(s)
- Sunny Wonsun Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona.
| | - Shelby Langer
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Mary Ahern
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Danielle Martin
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Karen Weihs
- Department of Psychiatry, College of Medicine, Tucson, Arizona
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Dudley MZ, Squires GK, Petroske TM, Dawson S, Brewer J. The Use of Narrative in Science and Health Communication: A Scoping Review. Patient Educ Couns 2023; 112:107752. [PMID: 37068426 DOI: 10.1016/j.pec.2023.107752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many people deny science and reject health recommendations despite widely distributed facts and statistics. Didactic science and health communication is often dry, and relies on the false assumption that people make purely evidence-based decisions. Stories can be a powerful teaching tool by capturing attention and evoking emotion. OBJECTIVE We explore the impact and appeal of, and describe best practices for, using narrative (storytelling) versus didactic methods in science and health communication. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS We searched PubMed and Web of Science for articles either: assessing effectiveness of narrative science/health communication; assessing acceptability of (or preference for) narrative science/health communication; giving advice on how best to use narrative; and/or providing science-based explanations for how/why narrative succeeds. RESULTS Narrative science/health communication is effective and appealing for audiences across a variety of topics and mediums, with supporting evidence across fields such as epidemiology, neuroscience, and psychology. Whether narrative or didactic messaging is most effective depends on the topic, audience, and objective, as well as message quality. However, combining narrative with didactic methods is likely to be more effective than using either strategy alone. DISCUSSION Narrative science/health communication merits wider implementation and further research. Narrative communication creates openness to information by delaying the formulation of counterarguments. PRACTICAL VALUE Science and health communicators should collaborate with cultural and storytelling experts, work directly with their target audiences throughout the message development and testing processes, and rely on popular story elements (e.g., first-person point of view, relatable protagonists) to improve the comprehension, engagement, and thoughtful consideration of their intended audience. FUNDING This work was funded by Thirty Meter Telescope, with which two authors (GKS and SD) were affiliated. Otherwise, the funding organization had no role in the study and/or submission.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA.
| | - Gordon K Squires
- California Institute of Technology / IPAC, 1200 E California Blvd, 315 Keith Spalding, Pasadena, CA 91125, USA
| | | | - Sandra Dawson
- Thirty Meter Telescope International Observatory, Pasadena, CA, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA
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27
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Okuhara T, Kagawa Y, Furukawa E, Okada H, Yokota R, Kiuchi T. Realism and length of narrative for further research in health communication. Patient Educ Couns 2023; 114:107859. [PMID: 37348311 DOI: 10.1016/j.pec.2023.107859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Yumi Kagawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Emi Furukawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Rie Yokota
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
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28
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Cahill JM, Moyse AJ, Dugdale LS. "Ruptured selves: moral injury and wounded identity". Med Health Care Philos 2023; 26:225-231. [PMID: 36780060 DOI: 10.1007/s11019-023-10138-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 05/13/2023]
Abstract
Moral injury is the trauma caused by violations of deeply held values and beliefs. This paper draws on relational philosophical anthropologies to develop the connection between moral injury and moral identity and to offer implications for moral repair, focusing particularly on healthcare professionals. We expound on the notion of moral identity as the relational and narrative constitution of the self. Moral identity is formed and forged in the context of communities and narrative and is necessary for providing a moral horizon against which to act. We then explore the relationship between moral injury and damaged moral identities. We describe how moral injury ruptures one's sense of self leading to moral disorientation. The article concludes with implications for moral repair. Since moral identity is relationally formed, moral repair is not primarily an individual task but requires the involvement of others to heal one's identity. The repair of moral injury requires the transformation of a moral identity in community.
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Affiliation(s)
- Jonathan M Cahill
- Center for Clinical Medical Ethics, Department of Medicine, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Ashley J Moyse
- Center for Clinical Medical Ethics, Department of Medicine, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Lydia S Dugdale
- Department of Medicine, Center for Clinical Medical Ethics, Columbia University, Vagelos College of Physicians & Surgeons, 622 W 168th St, PH 8E-105, 10032-3784, New York, NY, USA.
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29
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Best MC, Jones K, Bradford K, Kearney M. Chaplaincy Perspectives on the Role of Spirituality in Australian Health and Aged Care. J Relig Health 2023; 62:1473-1490. [PMID: 36738395 PMCID: PMC9898848 DOI: 10.1007/s10943-023-01752-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 06/13/2023]
Abstract
The aim of this study was to explore Australian chaplains' views of spirituality. Semi-structured online interviews were conducted with 16 participants. Participants relied heavily on metaphors and analogies to describe spirituality. Four inter-related themes were identified through reflexive thematic analysis: (1) The core of spirituality: spirituality as a source of meaning or belief which leads to connectedness with something greater than oneself; (2) A function of spirituality: spirituality empowers people to cope in a crisis, by providing motivation, hope and comfort; (3) The experience of spiritual crisis: admission to hospital or residential care can lead to existential struggle; and (4) The spiritual practice: of holding space between struggle and growth. Greater understanding of the theoretical basis of their work may allow chaplains to offer more in the therapeutic space.
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Affiliation(s)
- Megan C Best
- Institute for Ethics and Society, University of Notre Dame Australia, Broadway NSW 2007, P.O. Box 944, Sydney, Australia.
| | - Kate Jones
- Institute for Ethics and Society, University of Notre Dame Australia, Broadway NSW 2007, P.O. Box 944, Sydney, Australia
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30
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Okuhara T, Kagawa Y, Okada H, Tsunezumi A, Kiuchi T. Intervention studies to encourage HPV vaccination using narrative: A scoping review. Patient Educ Couns 2023; 111:107689. [PMID: 36868003 DOI: 10.1016/j.pec.2023.107689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 01/23/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This review aimed to provide an overview of intervention studies that aimed to encourage HPV vaccination using narratives. METHODS We searched MEDLINE, CINAHL, PsycINFO, and PsycARTICLES for English language articles that quantitatively examined the persuasive effect of narratives on encouraging HPV vaccination through interventions. RESULTS A total of 25 studies were identified. Most studies were conducted in the United States of America, adopted a convenient sampling of university students, measured vaccination intention as the primary outcome, and used text messages in the interventions. A minority of the studies measured vaccination behavior and examined the long-term effects of persuasion. Narratives were as effective as didactics and statistics in encouraging HPV vaccination in most included studies. The findings were mixed or scarce for the effect of combining narratives and statistics, and the person (the first vs. third), narrator, framing, and content of narratives. CONCLUSION More findings from a broader range of well-designed studies are needed to determine which narratives can encourage HPV vaccination across different populations. PRACTICE IMPLICATIONS Findings indicated using narratives can be a part of repertoire of messages encouraging HPV vaccination.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Yumi Kagawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Aiko Tsunezumi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
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31
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Ghosh CC, McVicar D, Davidson G, Shannon C, Armour C. Exploring the associations between auditory hallucinations and psychopathological experiences in 10,933 patient narratives: moving beyond diagnostic categories and surveys. BMC Psychiatry 2023; 23:307. [PMID: 37131149 PMCID: PMC10155450 DOI: 10.1186/s12888-023-04780-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/12/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Previous research suggests that auditory hallucinations are prevalent within both the clinical and general populations. Yet, we know little about how these phenomena are associated with other psychopathology symptoms and experiences. The current study aids investigations towards preventing, predicting and more effectively responding to such distressing occurrences. There have been substantial efforts in the literature to propose models of auditory hallucination and attempts to verify them. However, many of these studies used survey methods that restrict the person's responses to a set of pre-defined criteria or experiences and do not allow exploration of potential important other symptoms beyond them. This is the first study to explore the correlates of auditory hallucination using a qualitative dataset consisting of unrestricted responses of patients about their lived experiences with mental illness. METHOD The study used a dataset consisting of 10,933 narratives from patients diagnosed with mental illnesses. For analysis, the study used correlation on the text-based data. This approach is an alternative to the knowledge-based approach where experts manually read the narratives and infer the rules and relationships from the dataset. RESULT This study found at least 8 correlates of auditory hallucination (small correlation coefficients), with the unusual ones being "pain." The study also found that auditory hallucinations were independent of obsessive thoughts and compulsive behaviours, and dissociation, in contrast with the literature. CONCLUSION This study presents an innovative approach to explore the possible associations between symptoms without the restrictions of (or outside the confines of) traditional diagnostic categories. The study exemplified this by finding the correlates of auditory hallucination. However, any other symptom or experience of interest can be studied similarly. Potential future directions of these findings are discussed in the context of mental healthcare screening and treatment.
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Affiliation(s)
| | - Duncan McVicar
- Queen's Management School, Queen's University Belfast, Belfast, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
| | - Cherie Armour
- School of Psychology, Queen's University Belfast, Belfast, UK.
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Hammond H, Armstrong M, Thomas GA, Gilchrist ID. Audience immersion: validating attentional and physiological measures against self-report. Cogn Res Princ Implic 2023; 8:22. [PMID: 37074525 PMCID: PMC10113978 DOI: 10.1186/s41235-023-00475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
When an audience member becomes immersed, their attention shifts towards the media and story, and they allocate cognitive resources to represent events and characters. Here, we investigate whether it is possible to measure immersion using continuous behavioural and physiological measures. Using television and film clips, we validated dual-task reaction times, heart rate, and skin conductance against self-reported narrative engagement. We find that reaction times to a secondary task were strongly positively correlated with self-reported immersion: slower reaction times were indicative of greater immersion, particularly emotional engagement. Synchrony in heart rate across participants was associated with self-reported attentional and emotional engagement with the story, although we found no such relationship with skin conductance. These results establish both dual-task reaction times and heart rate as candidate measures for the real-time, continuous, assessment of audience immersion.
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Affiliation(s)
- Hugo Hammond
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK.
| | - Michael Armstrong
- British Broadcasting Corporation (BBC) Research and Development, Saltford, UK
| | - Graham A Thomas
- British Broadcasting Corporation (BBC) Research and Development, Saltford, UK
| | - Iain D Gilchrist
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK
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33
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Arabpour M, Nakhshab M, Humphry S, Kazemi Y. Systematic Analysis of Language Transcripts' (SALT) transcribing method and Narrative Assessment Protocol (NAP) online coding method: are they interchangeable? LOGOP PHONIATR VOCO 2023; 48:35-43. [PMID: 34698611 DOI: 10.1080/14015439.2021.1986572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: A narrative is a reliable tool for assessing the child's oral language. There are various narrative assessment tools. Most of them follow the Language Sample Analysis method such as Systematic Analysis of Language Transcripts (SALT) which is time-consuming and needs extensive training. The Narrative Assessment Protocol (NAP) offers a free and faster method of assessment to administer. The current study compared the NAP online and offline coding methods.Methods: Fifty-two kindergarteners (40-66 months old) were voice-recorded while generating a story. A transcriber coded the samples using both online and offline methods. Then, relative and absolute reliabilities were measured.Results: The results indicate a high correlation between the NAP offline and online scoring methods. Aside from a few items, both methods showed good correlations with each other.Conclusions: The NAP online coding method can be used as an alternative to an offline transcription to obtain a quick picture of a child's microstructure measures in narration.
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Affiliation(s)
- Maryam Arabpour
- Department of Speech Therapy, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahbubeh Nakhshab
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Stephen Humphry
- Graduate School of Education, University of Western Australia, Crawley, Australia
| | - Yalda Kazemi
- Department of Speech Therapy, Child Language Research Cluster, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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34
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Hällström E, Myr J, Hallin AE. Narrative retells in Swedish school-aged children - a clinical pilot study. LOGOP PHONIATR VOCO 2023; 48:12-22. [PMID: 34459699 DOI: 10.1080/14015439.2021.1966833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The aim of this pilot study was to evaluate two new retelling tasks intended for clinical use in terms of language sample size, effects of picture support, and order of presentation. METHODS Forty Swedish-speaking children in grades 4-6 participated in the study, 31 children with typical language development (TLD, mean age 11;1), and nine children with developmental language disorder (DLD, mean age 11;5). Two oral retells, one with and one without picture support, were analyzed with regards to productivity, syntactic complexity, basic Story Grammar (SG) units, and Internal Responses (IR). RESULTS Results showed no systematic order effects in the TLD group, although this needs to be investigated further, and good inter-rater reliability. Both tasks elicited sufficiently large language samples, except from one participant with DLD whose samples were excluded from subsequent comparisons. When appropriate, data were analyzed with ANOVA (productivity, mean length of C-unit/MLCU), otherwise t-tests (TLD-group) or non-parametric tests (DLD-group) were used. As expected, retells from participants with DLD were shorter, with shorter MLCU and fewer SG units compared to the TLD group. There were also task effects: in the task with picture support, all participants had longer MLCU, and participants with TLD also showed a higher proportion of subordinate clauses, indicating that pictures may function as a support for syntactic complexity. The task without picture support, on the other hand, elicited more C-units indicated by a significant main effect, and more SG units, which was a significant effect in the TLD group. CONCLUSIONS >We conclude that both tasks might be useful for Swedish speech-language pathologists.
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Affiliation(s)
- Elin Hällström
- Division of Speech Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Jenny Myr
- Division of Speech Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Anna Eva Hallin
- Division of Speech Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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35
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Silva JM, Durden TE, Hirsch A. Erasing inequality: Examining discrepancies between electronic health records and patient narratives to uncover perceived stigma and dismissal in clinical encounters. Soc Sci Med 2023; 323:115837. [PMID: 36931038 DOI: 10.1016/j.socscimed.2023.115837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023]
Abstract
Current policy efforts to reduce health disparities focus on integrating patients' social determinants of health (SDHs) into their electronic health records (EHRs), with the goal of addressing both clinical and social risks through the health system. Yet clinicians' documentation of and engagement with patients' social characteristics may, in certain circumstances, actually contribute to health disparities. This paper compares accounts of clinical encounters from in-depth interviews with forty-six non-college-educated women against their EHR's codes and free-text notes, which document the clinician's perspective of the encounter. We identify how documentation of clinical encounters may exacerbate the very health disparities that health systems seek to intervene upon by 1) translating social suffering stemming from structural inequality into stigmatized risk factors, and 2) suppressing conflicts over diagnosis and treatment, sometimes by framing observations of women's social identities as evidence of their unreliability as patients. We demonstrate how perceived negative interactions lead some women to resist the health system, either by self-treating in ways that could adversely affect their health or by attempting to challenge the authority of clinicians, which is not documented as resistance in their medical charts.
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Affiliation(s)
- Jennifer M Silva
- O'Neill School of Public and Environmental Affairs, Indiana University, 1315 E 10th Street, Bloomington, IN, 47405, USA.
| | - T Elizabeth Durden
- Department of Sociology and Anthropology, Bucknell University, 1 Dent Drive, Lewisburg, PA, 17837, USA.
| | - Annemarie Hirsch
- Department of Population Health Sciences, Geisinger, 100 North Academy Ave., Danville, PA, 17822, USA.
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Fried T, Plotkin-Amrami G. Not all diagnoses are created equal: Mothers' narratives of children, ADHD, and comorbid diagnoses. Soc Sci Med 2023; 323:115838. [PMID: 36933436 DOI: 10.1016/j.socscimed.2023.115838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/09/2023] [Accepted: 03/09/2023] [Indexed: 03/13/2023]
Abstract
Social research examining patients' and caretakers' narration of mental disorders, including ADHD, has been remarkably silent about comorbidity. Centering the theme of uncertainty and the question of what is "at stake" in mothers' mental health narratives of children (Kleinman, 1988), we characterize the patchwork process by which mothers deploy ADHD and comorbid diagnoses to account for key experiences and struggles in their and their child's lives. We found that ADHD had limited purchase in accounting for the emotional and social difficulties that were most urgent in mothers' narratives, despite the medical authority behind the ADHD label, which the mothers mostly accepted. However, mothers remained pervasively uncertain about the relationship between ADHD and comorbid mental health conditions, paralleling debates on the relationship between ADHD, emotion, and comorbidity in the psychiatric and psychological literature. Our findings contribute a conceptualization of comorbidity as a web of diverse moral vocabularies, institutional outcomes and perceptions of personhood, through which mothers of ADHD children maneuver over time. Through this perspective we illustrate how ADHD is co-constructed as a narrow neurological problem of 'attention,' and demonstrate the overlooked and crucial ways that comorbidity may shape parents' pragmatic and interpretive negotiation of ADHD. Kleinman, Arthur. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.
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Affiliation(s)
- Talia Fried
- The School of Education, Ben Gurion University of the Negev, Be'er Sheva, 8410501, Israel.
| | - Galia Plotkin-Amrami
- The School of Education, Ben Gurion University of the Negev, Be'er Sheva, 8410501, Israel
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Engebretsen E, Baker M. Health Preparedness and Narrative Rationality: A Call for Narrative Preparedness. Int J Health Policy Manag 2023; 12:7532. [PMID: 37579420 PMCID: PMC10461864 DOI: 10.34172/ijhpm.2023.7532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/06/2023] [Indexed: 08/16/2023] Open
Abstract
This conceptual paper argues the need for narrative preparedness, understood as the ability to engage and empathize with peoples' stories and the values they encode, assess them based on the universe in which people live, and acknowledge the narrative rationality of each story - even when it conflicts with the rationality of science. Expanding 'health preparedness' to encompass 'narrative preparedness' complements the ideals of patient centeredness, which are sometimes betrayed when implemented into concrete decisions because the rationality of science that underpins medical practice fails to make sense of patients' stories. We outline the central tenets of narrative preparedness and demonstrate its relevance by discussing various responses to mainstream discourses on COVID-19 as a case in point. We discuss and further develop Fisher's narrative paradigm, which provides a model that complements traditional, scientific rationality with attention to narrative rationality and a radical democratic ground for health political critique. Applying the narrative paradigm to authentic examples of vaccine hesitancy and anti-vaccination demonstrates how closer attention to the way narratives are assessed by different constituencies might help us mitigate some of the sources of resistance and misunderstanding that continue to plague public communication about important medical issues such as pandemics. Health authorities must acknowledge and engage with the stories people believe in and their reasons for doing so. The crucial question for the success of health policy interventions is not only 'what are the facts' but 'how do these facts make sense to people, and why.' To be prepared for the next pandemic, health professionals must learn to engage with people's stories and the processes by which they come to be understood and assessed differently by various constituencies.
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Affiliation(s)
- Eivind Engebretsen
- Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway
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Tagaki M. The Narratives of a Researcher with Disability as Interventions in Local Disability Policy-making. Integr Psychol Behav Sci 2023; 57:65-87. [PMID: 35907077 DOI: 10.1007/s12124-022-09720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 01/13/2023]
Abstract
This study examined the role of the narratives of a researcher in a residents' meeting on municipal disability policy. The research focuses on sessions from 2013 to 2019 of a local meeting spanning approximately 20 years in Yao City, Osaka, western Japan. As an advisory staff member and researcher, I recorded the meetings and analyzed them through the KJ method (a bottom-up qualitative procedure developed in Japan) and text mining. As a result, I suggested that the annual symposium should be an opportunity to promote people's awareness of disability issues. Appropriate topics for the symposium were considered to be the Disability Discrimination Act and the hardships experienced by people with disability following a disaster, because these covered various aspects of their lives. I asked them to respect the diversity of their disabilities. I also remarked that they could support people with and without disabilities during a disaster. I assert that my role was to promote awareness and narratives in members about aspects of themselves about which they were unaware, such as their potential roles as supporters. However, they gradually recognized the uncertainty and new difficulties, which generated productive narratives.
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Affiliation(s)
- Masakuni Tagaki
- Graduate School of Sustainable System Sciences, Osaka Metropolitan University, Sakai, Osaka, 599-8531, Japan.
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Rutherford HJV, Yatziv T, Vess M, Brooker RJ. Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period. Infant Ment Health J 2023; 44:218-227. [PMID: 36862383 PMCID: PMC10559800 DOI: 10.1002/imhj.22048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/14/2023] [Indexed: 03/03/2023]
Abstract
Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.
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Affiliation(s)
| | - Tal Yatziv
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Matthew Vess
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
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Molinaro ML, Polzer J, Rudman DL, Savundranayagam M. "I can't be the nurse I want to be": Counter-stories of moral distress in nurses' narratives of pediatric oncology caregiving. Soc Sci Med 2023; 320:115677. [PMID: 36669283 DOI: 10.1016/j.socscimed.2023.115677] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/28/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
As a term used in nursing and other health professions to describe when one is prevented by institutional constraints from pursuing the right course of action, moral distress has gained traction to examine the effects of restructuring on health and social care providers. Using a critical narrative methodology, this paper presents the counter-stories of nine pediatric oncology nurses in Ontario, Canada, whose stories illustrate the embeddedness of their caregiving and moral distress within institutional contexts that leave them stretched thin amongst multiple caregiving and administrative demands, and that limit their capacities to be the nurses they want to be. Informed by feminist philosophical theorizations of moral distress, we elucidate how the nurses' counter-stories: (i) re-locate the sources of their moral distress within institutional constraints that fracture their moral identities and moral relationships, and (ii) dis-locate dominant narratives of technological cure by ascribing value and meaning to the relational care through which they sustain moral responsibilities with patients and their families. By making visible the relational care that they find meaningful and that brings them in proximity to patients and families, these counter-stories assist nurses in restoring their damaged moral identities. This study demonstrates the power of identifying and mobilizing counter-stories in tracing and critically examining the conditions that structure nurses' experiences of moral distress. The findings add theoretical and empirical depth to contemporary understandings of moral distress and complement ongoing public discussion of burnout among nurses and other health care workers during the COVID-19 pandemic. These counter-narratives may act as resources for resistance among nurses, help to reduce the distance between management and health care workers, and catalyze changes in policy and practice so that nurses, and the full scope of their caregiving, are valued.
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Affiliation(s)
- Monica L Molinaro
- Health and Rehabilitation Sciences Graduate Program, The University of Western Ontario, 1151 Richmond Street, London, ON N6G 2V4, Canada; Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, Hamilton, ON L8P 1H6, Canada.
| | - Jessica Polzer
- Department of Gender, Sexuality & Women's Studies, The University of Western Ontario, 1151 Richmond Street London, ON N6A 5B8, Canada; School of Health Studies, The University of Western Ontario, 1151 Huron Drive, London, ON N6A 2K5, Canada
| | - Debbie Laliberte Rudman
- School of Occupational Therapy, The University of Western Ontario, 1201 Western Road, London, ON N6G 1H1, Canada
| | - Marie Savundranayagam
- School of Health Studies, The University of Western Ontario, 1151 Huron Drive, London, ON N6A 2K5, Canada
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Chen PY, Fu CP, Wang CC. Narratives in the medicolegal field from the perspective of physicians involved in medical dispute mediation meetings in Taiwan. Heliyon 2023; 9:e13716. [PMID: 36873161 PMCID: PMC9975097 DOI: 10.1016/j.heliyon.2023.e13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Medical treatment and narratives are interrelated. We examined this interrelation by evaluating the medical dispute mediation system in Taiwan. We conducted 16 semi-structured interviews with legal and administrative specialists in medical mediation and physicians involved in mediation meetings. The interview data were reproduced into almost verbatim text for coding and analysis. We examined how narratives were discussed in the field of medicine and identified two approaches to narratives. One was the narrative from a patient's storytelling, that is, narrative-based medicine. The other was the narrative of medical staff, which included shared decision-making and decision aids. Discussions of these approaches revolved around the avoidance of conflicts during medical treatment. However, knowing how to handle unsuccessful medical treatment is crucial. By applying polyphony in narratives, physicians can comprehend the role of narratives in unsuccessful medical treatment, helping themselves to practice how to develop narratives to communicate with patients and their surrogates when encountering any difficulty in different stages of medical treatment.
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Affiliation(s)
- Po-Yi Chen
- Center for Medical Humanities Education, School of Medicine, National Defense Medical Center, Taiwan
| | - Chung-Pei Fu
- Department of Occupational Therapy, College of Medicine, Fu-Jen Catholic University, Taiwan
| | - Chih-Chia Wang
- Center for Medical Humanities Education, School of Medicine, National Defense Medical Center, Taiwan.,Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan
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Wei G. Children's perezhivaniya and agency during the COVID-19 pandemic: Narrative research from China. Learn Cult Soc Interact 2023; 38:100683. [PMID: 36569216 PMCID: PMC9763210 DOI: 10.1016/j.lcsi.2022.100683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has changed the lives of children across the world. To understand these changes, this study explores how 14 Chinese children aged 6 to 12 years old experienced and reacted to the pandemic since its first outbreak in 2020. Applying Vygotsky's conceptualizations of perezhivanie and agency, the author interprets the children's narrative accounts of their thinking and actions during the pandemic. According to the three-dimensional narrative analyses conducted, perezhivaniya commonalities among the participating children include limited physical movement, scarcity of peer interaction, compulsory online learning, reconstruction of family relationships, and noticeable self-growth. Further, the participating children manifested their agency as resisting, exploring, self-control, committing, and envisioning. Different perezhivaniya lead children to manifest different types of agency-a process wherein mediational means play pivotal roles. This study contributes to theoretical discussions of the dialectical relation between perezhivanie and human agency. Moreover, it has practical implications for how adults can support the emergence of children's agency through means of mediation in perezhivaniya.
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Affiliation(s)
- Ge Wei
- College of Elementary Education, Capital Normal University, No. 105 North Road, West Third Ring, Haidian District, Beijing, China
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Lu AS, Pelarski V, Alon D, Baran A, McGarrity E, Swaminathan N, Sousa CV. The effect of narrative element incorporation on physical activity and game experience in active and sedentary virtual reality games. Virtual Real 2023; 27:1-16. [PMID: 36742343 PMCID: PMC9888740 DOI: 10.1007/s10055-023-00754-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
Narratives are pervasive in video games and have been found to increase physical activity in active video games. However, the effect of incorporating narrative elements has seldom been examined in fully immersive virtual reality games. We investigated the effect of narrative element incorporation (between-subject: narrative vs. no narrative) in active virtual reality and sedentary virtual reality games (within-subject) and examined between- and within-subject effects on physical activity behavior, game experience, and physical activity engagement. We randomized 36 sedentary college students to either the narrative or the non-narrative group. All participants played an active virtual reality and a sedentary virtual reality game in counter-balanced order. Before each game session, they either watched a 5-min narrative video (narrative) or directly played the original virtual reality games without narratives (non-narrative). We collected participants' physical activity data using wrist-worn accelerometers; we obtained their game experience and physical activity engagement via questionnaires. The narrative group spent a greater proportion of time in moderate-to-vigorous physical activity (%) and had less non-movement time during the active virtual reality gameplay than the non-narrative group (all p values < .05). The active virtual reality sessions induced a greater positive affect and greater physical activity engagement ratings than the sedentary virtual reality sessions. The incorporation of narrative elements in active virtual reality increased the relative time spent in moderate-to-vigorous physical activity and reduced non-movement time, compared to the non-narrative group. Active virtual reality encouraged more activity by participants and offered them a more enjoyable gaming experience in which they engaged more. Active virtual reality is a feasible physical activity promotion option among sedentary adults; the incorporation of narrative elements in active virtual reality helps increase relative moderate-to-vigorous physical activity and should be further explored for its efficacy. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-023-00754-7.
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Affiliation(s)
- Amy Shirong Lu
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Victoria Pelarski
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Dar Alon
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115 USA
| | - Aleksandra Baran
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Emma McGarrity
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Neha Swaminathan
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Caio Victor Sousa
- Health and Human Sciences, Frank R. Seaver College of Science and Engineering, Loyola Marymount University, Los Angeles, CA 90045 USA
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Capurso M, Pedale T, Santangelo V, Salmi LP, Mazzeschi C. Italian Children's Accounts of the Lockdown: Insights and Perspectives. J Child Fam Stud 2023; 32:145-159. [PMID: 36643882 PMCID: PMC9831020 DOI: 10.1007/s10826-022-02508-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 lockdown-imposed restrictions emerged as a risk to children's well-being. However, the extant literature often ignored children's experiences, emotions, struggles, hopes, and expectations. Based on a large sample of Italian students (N = 906; mean age = 9.4 years, 48.8% female), we drew data from a post-lockdown school re-entry program where students completed narrative activities in 2020. These narratives underwent quantitative content analysis according to gender and school level. Overall, children reported mixed feelings about the lockdown; they felt safe at home but also experienced fear and missed their friends, school, and freedom. Screen-time, technology and friendships helped, but children struggled to make sense of the events. Our findings show how children attempted to make sense of the lockdown experience and may provide key information for the development of community coping programs to help children facing crises in the future.
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Affiliation(s)
- Michele Capurso
- Department of Philosophy, Social & Human Sciences and Education, University of Perugia, Perugia, Italy
| | - Tiziana Pedale
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Perugia, Italy
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Valerio Santangelo
- Department of Philosophy, Social & Human Sciences and Education, University of Perugia, Perugia, Italy
| | | | - Claudia Mazzeschi
- Department of Philosophy, Social & Human Sciences and Education, University of Perugia, Perugia, Italy
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Cole M, Frye WS, Risko J, Hall CA. Parental experiences related to pediatric and adolescent chronic non-cancer pain: A qualitative exploration. J Pediatr Nurs 2023; 69:24-30. [PMID: 36599178 DOI: 10.1016/j.pedn.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/24/2022] [Accepted: 12/24/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE To explore parental experiences in personal functioning and parenting associated with having a child experiencing chronic non-cancer pain. METHODS Parents with children experiencing chronic pain were asked to fill out a survey prior to their initial Pediatric Pain Clinic or Pain Psychology appointment at a children's hospital in the southeastern United States. A retrospective analysis of qualitative data was conducted. Qualitative results from open-ended survey questions will be focused on within this manuscript. FINDINGS A total of 288 surveys were collected in this study, with 243 participants answering at least one qualitative question. Of participants who responded to open-ended survey questions, there were 88 responses to a question related to parental change, 73 to parental impact, and 239 to goals of the visit. Through thematic analysis, five qualitative themes were identified: Pain Central: The Hub, Juggling Life, Suffering Side by Side, Unrealized Dreams, and Gettin' it Under Control. DISCUSSION Parents do experience alterations in personal functioning and parenting as a result of having a child that experiences chronic non-cancer pain. Parents face struggles in many aspects of life including emotions, work, and interpersonal relationships. Theoretical considerations were discussed. APPLICATION TO PRACTICE Understanding the experiences parents have in raising a child with chronic pain is important in helping health care providers to recognize that this population may need interventions. This also assists in informing patient treatment, improving patient and parent care outcomes, and educating clinicians on how to better support parents.
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Zhang G, Hung J, Lin N. Coexistence of the social semantic effect and non-semantic effect in the default mode network. Brain Struct Funct 2023; 228:321-39. [PMID: 35394555 DOI: 10.1007/s00429-022-02476-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/23/2022] [Indexed: 01/07/2023]
Abstract
Neuroimaging studies have found both semantic and non-semantic effects in the default mode network (DMN), leading to an intense debate on the role of the DMN in semantic processes. Four different views have been proposed: (1) the general semantic view holds that the DMN contains several hub regions supporting general semantic processes; (2) the non-semantic view holds that the semantic effects observed in the DMN (especially the ventral angular gyrus) are confounded by difficulty and do not reflect semantic processing per se; (3) the multifunction view holds that the same areas in the DMN can support both semantic and non-semantic functions; and (4) the multisystem view holds that the DMN contains multiple subnetworks supporting different aspects of semantic processes separately. Using an fMRI experiment, we found that in one of the subnetworks of the DMN, called the social semantic network, all areas showed social semantic activation and difficulty-induced deactivation. The distributions of two non-semantic effects, that is, difficulty-induced and task-induced deactivations, showed dissociation in the DMN. In the bilateral angular gyri, the ventral subdivisions showed social semantic activation independent of difficulty, while the dorsal subdivisions showed no semantic effect but difficulty-induced activation. Our findings provide two insights into the semantic and non-semantic functions of the DMN, which are consistent with both the multisystem and multifunction views: first, the same areas of the DMN can support both social semantic and non-semantic functions; second, similar to the multiple semantic effects of the DMN, the non-semantic effects also vary across its subsystems.
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van Krieken K, de Graaf A, Das E. Can we distinguish mixed from ambiguous emotions and morality? Cogn Neurosci 2023; 14:68-69. [PMID: 36815736 DOI: 10.1080/17588928.2023.2181321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The neurocognitive model of Mixed and Ambiguous Emotions and Morality (MA-EM) makes a relevant case for putting non-unidimensional emotions and morality more prominently on the research agenda. However, existing research challenges its assumptions about the distinction between mixed and ambiguous emotions and morality, and how they relate to reflective versus simulative processing routes, in three respects. First, the emotional state of being moved is generally conceptualized as a non-ambiguous rather than an ambiguous emotion. Second, mixed emotions have been found to elicit reflection rather than simulation. Third, the morality of narrative characters is typically perceived as mixed rather than ambiguous.
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Affiliation(s)
- Kobie van Krieken
- Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
| | - Anneke de Graaf
- Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
| | - Enny Das
- Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
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Lee YJ, Rauben K, Liu C, Kim R, van der Velde N, Taylor C, Walsh A, Asasira M, Katongole I, Hatfield-King J, Blackwell S, Iheanacho T, Christ R, Ssekalo I. Evaluation of a pilot, community-led mental illness de-stigmatization theater intervention in rural uganda. BMC Psychiatry 2022; 22:794. [PMID: 36526984 PMCID: PMC9756628 DOI: 10.1186/s12888-022-04441-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In rural areas of low- and middle- income countries, mental health care is often unavailable and inaccessible, and stigma is a major barrier to treatment. Destigmatization can increase treatment-seeking attitudes, community support, and acceptance of individuals suffering from mental illness. This study's primary objective was to evaluate the impact of a community-led, theater-based destigmatization campaign for mental illness conducted in the Busoga region of Eastern Uganda. METHODS One hundred residents of the Busoga region were randomly selected via cluster sampling to complete a structured questionnaire assessing mental health stigma. Four focus groups were conducted for qualitative data on mental health stigma. Common misconceptions and specific points of stigma were identified from these responses, and local village health team personnel developed and performed a culturally-adapted theatrical performance addressing these points. Changes in perceptions of mental illness were measured among 57 attendees using two measures, the Broad Acceptance Scale (designed to reflect factors that contribute to structural stigma) and Personal Acceptance Scale (designed to reflect factors that contribute to interpersonal, or public stigma), before and after the performance. RESULTS There was a significant increase in acceptance according to the Broad Acceptance Scale (p < .001) and Personal Acceptance Scale (p < .001). Qualitative responses from play attendees also indicated a decrease in stigma and an increased sense of the importance of seeking treatment for mentally ill patients. CONCLUSION This study shows community-led, theater intervention may be an effective tool for the destigmatization of mental illness in rural areas of Uganda. Larger studies are needed to further test the efficacy of this approach and potential for longer-term scalabilityand sustainability.
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Affiliation(s)
| | | | - Curtis Liu
- grid.268275.c0000 0001 2284 9898Williams College, Williamstown, USA
| | - Rebecca Kim
- grid.268275.c0000 0001 2284 9898Williams College, Williamstown, USA
| | | | - Chelsea Taylor
- grid.268275.c0000 0001 2284 9898Williams College, Williamstown, USA
| | - Alyssa Walsh
- grid.261331.40000 0001 2285 7943The Ohio State University, Columbus, USA
| | - Mildred Asasira
- grid.442658.90000 0004 4687 3018Uganda Christian University, Mukono, Uganda
| | - Ivan Katongole
- grid.442658.90000 0004 4687 3018Uganda Christian University, Mukono, Uganda
| | | | | | | | - Ryan Christ
- grid.47100.320000000419368710Yale University, New Haven, USA
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Lam H, Nguyen F, Wang X, Stock A, Lenskaya V, Kooshesh M, Li P, Qazi M, Wang S, Dehghan M, Qian X, Si Q, Polydorides AD. An accessible, efficient, and accurate natural language processing method for extracting diagnostic data from pathology reports. J Pathol Inform 2022; 13:100154. [PMID: 36605108 PMCID: PMC9808011 DOI: 10.1016/j.jpi.2022.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/09/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Context Analysis of diagnostic information in pathology reports for the purposes of clinical or translational research and quality assessment/control often requires manual data extraction, which can be laborious, time-consuming, and subject to mistakes. Objective We sought to develop, employ, and evaluate a simple, dictionary- and rule-based natural language processing (NLP) algorithm for generating searchable information on various types of parameters from diverse surgical pathology reports. Design Data were exported from the pathology laboratory information system (LIS) into extensible markup language (XML) documents, which were parsed by NLP-based Python code into desired data points and delivered to Excel spreadsheets. Accuracy and efficiency were compared to a manual data extraction method with concordance measured by Cohen's κ coefficient and corresponding P values. Results The automated method was highly concordant (90%-100%, P<.001) with excellent inter-observer reliability (Cohen's κ: 0.86-1.0) compared to the manual method in 3 clinicopathological research scenarios, including squamous dysplasia presence and grade in anal biopsies, epithelial dysplasia grade and location in colonoscopic surveillance biopsies, and adenocarcinoma grade and amount in prostate core biopsies. Significantly, the automated method was 24-39 times faster and inherently contained links for each diagnosis to additional variables such as patient age, location, etc., which would require additional manual processing time. Conclusions A simple, flexible, and scaleable NLP-based platform can be used to correctly, safely, and quickly extract and deliver linked data from pathology reports into searchable spreadsheets for clinical and research purposes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Alexandros D. Polydorides
- Corresponding author at: Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1194, New York, NY 10029, USA.
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Feito Grande L, Domingo Moratalla T. [The carelessness and the inhospitable. Inhabiting times of pandemic.]. Rev Esp Salud Publica 2022; 96:e202210052. [PMID: 36196645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/08/2022] [Indexed: 06/16/2023] Open
Abstract
The pandemic has placed us in a situation of estrangement from ourselves. We have been acutely aware of our vulnerability and fragility. Through the stories of lived experiences, we have learned about and witnessed tragic circumstances in which inhospitality and neglect have become evident. We have been shocked by the awareness of the lack of recognition, accompaniment and welcome. Institutional decisions have prioritized public health, the good for all, but have forgotten the biographies of people, full of suffering. And this has produced a moral damage, a loss of trust, a feeling of injustice that we have not been able to fight against. This is why it is necessary to build hospitality, which can be achieved through care. Care with a political dimension that takes charge of reality and transforms society. The key is a responsibility in solidarity. Faced with the possibility of dehumanizing ourselves, we seek hospitality as an alternative way of narrating lives that have to be reconstructed, that have to relearn how to take care of each other amidst the multiple possibilities of estrangement that threaten us. Hospitality is at the heart of a narrative ethics at the height of our times.
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