A Comparative Study on Mental Disorder Conceptualization: A Cross-Disciplinary Analysis

The conceptualization of mental disorders varies among professionals, impacting diagnosis, treatment, and research. This cross-disciplinary study aimed to understand how various professionals, including psychiatrists, psychologists, medical students, philosophers, and social sciences experts, perceive mental disorders, their attitudes towards the disease status of certain mental states, and their emphasis on biological versus social explanatory attributions. A survey of 371 participants assessed their agreement on a variety of conceptual statements and the relative influence of biological or social explanatory attribution for different mental states. Our findings revealed a consensus on the need for multiple explanatory perspectives in understanding psychiatric conditions and the influence of social, cultural, moral, and political values on diagnosis and classification. Psychiatrists demonstrated balanced bio-social explanatory attributions for various mental conditions, indicating a potential shift from the biological attribution predominantly observed among medical students and residents in psychiatry. Further research into factors influencing these differing perspectives is necessary.

Don't throw the associative baby out with the Bayesian bathwater: Children are more associative when reasoning retrospectively under information processing demands

Causal reasoning is a fundamental cognitive ability that enables individuals to learn about the complex interactions in the world around them. However, the mechanisms that underpin causal reasoning are not well understood. For example, it remains unresolved whether children's causal inferences are best explained by Bayesian inference or associative learning. The two experiments and computational models reported here were designed to examine whether 5- and 6-year-olds will retrospectively reevaluate objects-that is, adjust their beliefs about the causal status of some objects presented at an earlier point in time based on the observed causal status of other objects presented at a later point in time-when asked to reason about 3 and 4 objects and under varying degrees of information processing demands. Additionally, the experiments and models were designed to determine whether children's retrospective reevaluations were best explained by associative learning, Bayesian inference, or some combination of both. The results indicated that participants retrospectively reevaluated causal inferences under minimal information-processing demands (Experiment 1) but failed to do so under greater information processing demands (Experiment 2) and that their performance was better captured by an associative learning mechanism, with less support for descriptions that rely on Bayesian inference. RESEARCH HIGHLIGHTS: Five- and 6-year-old children engage in retrospective reevaluation under minimal information-processing demands (Experiment 1). Five- and 6-year-old children do not engage in retrospective reevaluation under more extensive information-processing demands (Experiment 2). Across both experiments, children's retrospective reevaluations were better explained by a simple associative learning model, with only minimal support for a simple Bayesian model. These data contribute to our understanding of the cognitive mechanisms by which children make causal judgements.

Thought and language: Effects of group-mindedness on young children's interpretation of exclusive we

The current study investigated whether age-related changes in the conceptualization of social groups influences interpretation of the pronoun we. Sixty-four 2- and 4-year-olds (N = 29 female, 50 White-identifying) viewed scenarios in which it was ambiguous how many puppets performed an activity together. When asked who performed the activity, a speaker puppet responded, "We did!" In one condition, the speaker was near one and distant from another puppet, implying a dyadic interpretation of we. In another condition, the speaker was distant from both, thus pulling for a group interpretation. In the former condition, 2- and 4-year-olds favored the dyadic interpretation. In the latter condition, only 4-year-olds favored the group interpretation. Age-related conceptual development "expands" the set of conceivable plural person referents.

Resilience: conceptualisations and challenges for effective heatwave public health planning

OBJECTIVES

This article examines diverse perspectives on heatwave resilience in public health planning, interviewing stakeholders from various sectors. It identifies challenges, including operational, political, economic, and cultural aspects, hindering effective strategies. The study advocates for a holistic approach to heatwave resilience, emphasising interdisciplinary research and collaboration for targeted interventions. Enhancing resilience is crucial to mitigating adverse health impacts and safeguarding vulnerable populations during heatwaves. Conceptualisations of resilience related to heatwave public health planning and heatwave resilience vary significantly. There is a need to unveil the multifaceted nature of resilience in the context of heatwaves and identify key challenges that hinder effective public health planning efforts.

STUDY DESIGN

Qualitative study to explore key stakeholders' conceptualisations of resilience and highlight challenges and opportunities needed for greater heatwave resilience and public health planning.

METHODS

Interviews were conducted with a diverse group of key stakeholders involved in local, regional, and national heatwave planning, academics, civil sector and private sector representatives.

RESULTS

The findings of this study highlight diverse conceptualisations of resilience. Conceptualisations of resilience mainly differ on the following: 'whom'; 'what'; 'how'; 'when'; and 'why'. This analysis shows that the concept of resilience is well understood but has different functions. The analysis of challenges revealed several key problems, such as operational and technical; political and governance; organisational and institutional; economic; linguistic; cultural, social, and behavioural; and communication, information, and awareness. These significantly hinder effective heatwave public health planning strategies.

CONCLUSIONS

The study emphasises the need for a holistic and integrated approach to heatwave resilience. Addressing these challenges is crucial for enhancing heatwave public health planning. This study provides valuable insights into the complexities of heatwave resilience, offering guidance for different sectors of society to develop targeted interventions and strategies. The development of new resilience interdisciplinary and intersectoral research, practice, and governance will prove crucial to ongoing efforts to strengthen national heatwave resilience public health planning. By fostering resilience, societies can mitigate the adverse impacts of heatwaves and safeguard the health and well-being of vulnerable populations.

Infants rationally infer the goals of other people's reaches in the absence of first-person experience with reaching actions

Does knowledge of other people's minds grow from concrete experience to abstract concepts? Cognitive scientists have hypothesized that infants' first-person experience, acting on their own goals, leads them to understand others' actions and goals. Indeed, classic developmental research suggests that before infants reach for objects, they do not see others' reaches as goal-directed. In five experiments (N = 117), we test an alternative hypothesis: Young infants view reaching as undertaken for a purpose but are open-minded about the specific goals that reaching actions are aimed to achieve. We first show that 3-month-old infants, who cannot reach for objects, lack the expectation that observed acts of reaching will be directed to objects rather than to places. Infants at the same age learned rapidly, however, that a specific agent's reaching action was directed either to an object or to a place, after seeing the agent reach for the same object regardless of where it was, or to the same place regardless of what was there. In a further experiment, 3-month-old infants did not demonstrate such inferences when they observed an actor engaging in passive movements. Thus, before infants have learned to reach and manipulate objects themselves, they infer that reaching actions are goal-directed, and they are open to learning that the goal of an action is either an object or a place. RESEARCH HIGHLIGHTS: In the present experiments, 3-month-old prereaching infants learned to attribute either object goals or place goals to other people's reaching actions. Prereaching infants view agents' actions as goal-directed, but do not expect these acts to be directed to specific objects, rather than to specific places. Prereaching infants are open-minded about the specific goal states that reaching actions aim to achieve.

Conceptualisation and implementation of integrated disease surveillance globally: a scoping review

OBJECTIVES

The objective of this study was to examine the conceptualisation and operationalisation of Integrated Disease Surveillance (IDS) systems globally and the evidence for their effectiveness. Furthermore, to determine whether the recommendations made by Morgan et al. are supported by the evidence and what the evidence is to inform country development of IDS.

STUDY DESIGN

The study incorporated a scoping review.

METHODS

This review summarised evidence meeting the following inclusion criteria: Participants: any health sector; Concept: IDS; and Context: global. We searched Medline, Embase, and Epistemonikos for English publications between 1998 and 2022. Standard review methods were applied. A bespoke conceptual framework guided the narrative analysis. This scoping review is part of a research programme with three key elements, with the other studies being a survey of the International Association of National Public Health Institutes members on the current status of their disease surveillance systems and a deeper analysis and case studies of the surveillance systems in seven countries, to highlight the opportunities and challenges of integration.

RESULTS

Eight reviews and five primary studies, which were assessed as being of low quality, were included, mostly examining IDS in Africa, the human sector, and communicable diseases. None reported on the effects on disease control or on the evolution of IDS during the COVID-19 pandemic. Descriptions of IDS and of integration varied. Prerequisites of effective IDS systems mostly related to the adequacy of core functions and resourcing requirements. Laws or regulations supporting system integration and data sharing were not addressed. The provision of core functions and resourcing requirements were described as inadequate, financing as non-sustainable, and governance as poor. Enablers included active data sharing, close cooperation between agencies, clear reporting channels, integration of vertical programs, increased staff training, and adopting mobile reporting. Whilst the conceptual framework for IDS and Morgan et al.'s proposed principles were to some extent reflected in the highlighted priorities for IDS in the literature, the evidence base remains weak.

CONCLUSIONS

Available evidence is fragmented, incomplete, and of poor quality. The review found a lack of robust evaluation studies on the impact of IDS on disease control. Whilst a lack of evidence does not imply a lack of benefit or effect, it should signal the need to evaluate the process and impact of integration in the future development of surveillance systems. A common IDS definition and articulation of the parts that constitute an IDS system are needed. Further robust impact evaluations, as well as country reviews and evaluations of their IDS systems, are required to improve the evidence base.

"It's hard to say anything definitive about what severity really is": lay conceptualisations of severity in a healthcare context

BACKGROUND

Demand for healthcare outweighs available resources, making priority setting a critical issue. 'Severity' is a priority-setting criterion in many healthcare systems, including in Norway, Sweden, the Netherlands, and the United Kingdom. However, there is a lack of consensus on what severity means in a healthcare context, both in the academic literature and in policy. Further, while public preference elicitation studies demonstrate support for severity as a relevant concern in priority setting, there is a paucity of research on what severity is taken to mean for the public. The purpose of this study is to explore how severity is conceptualised by members of the general public.

METHODS

Semi-structured group interviews were conducted from February to July 2021 with members of the Norwegian adult public (n = 59). These were transcribed verbatim and subjected to thematic analysis, incorporating inductive and deductive elements.

RESULTS

Through the analysis we arrived at three interrelated main themes. Severity as subjective experience included perceptions of severity as inherently subjective and personal. Emphasis was on the individual's unique insight into their illness, and there was a concern that the assessment of severity should be fair for the individual. The second theme, Severity as objective fact, included perceptions of severity as something determined by objective criteria, so that a severe condition is equally severe for any person. Here, there was a concern for determining severity fairly within and across patient groups. The third theme, Severity as situation dependent, included perceptions of severity centered on second-order effects of illness. These included effects on the individual, such as their ability to work and enjoy their hobbies, effects on those surrounding the patient, such as next of kin, and effects at a societal level, such as production loss. We also identified a concern for determining severity fairly at a societal level.

CONCLUSIONS

Our findings suggest that severity is a polyvalent notion with different meanings attached to it. There seems to be a dissonance between lay conceptualisations of severity and policy operationalisations of the term, which may lead to miscommunications between members of the public and policymakers.

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact

BACKGROUND

The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts.

METHODS

This qualitative scoping review was conducted using Arksey and O'Malley's methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works.

RESULTS

A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI.

CONCLUSIONS

Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it's crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care.

Spatial relation categorization in infants and deep neural networks

Spatial relations, such as above, below, between, and containment, are important mediators in children's understanding of the world (Piaget, 1954). The development of these relational categories in infancy has been extensively studied (Quinn, 2003) yet little is known about their computational underpinnings. Using developmental tests, we examine the extent to which deep neural networks, pretrained on a standard vision benchmark or egocentric video captured from one baby's perspective, form categorical representations for visual stimuli depicting relations. Notably, the networks did not receive any explicit training on relations. We then analyze whether these networks recover similar patterns to ones identified in development, such as reproducing the relative difficulty of categorizing different spatial relations and different stimulus abstractions. We find that the networks we evaluate tend to recover many of the patterns observed with the simpler relations of "above versus below" or "between versus outside", but struggle to match developmental findings related to "containment". We identify factors in the choice of model architecture, pretraining data, and experimental design that contribute to the extent the networks match developmental patterns, and highlight experimental predictions made by our modeling results. Our results open the door to modeling infants' earliest categorization abilities with modern machine learning tools and demonstrate the utility and productivity of this approach.

Goal conceptualization has distinct effects on spatial and temporal bimanual coordination after left- and right- hemisphere stroke

Perception of task goal influences motor performance and coordination. In bimanual actions, it is unclear how one's perception of task goals influences bimanual coordination and performance in individuals with unilateral stroke. We characterized inter-limb coordination differences in individuals with chronic right- and left-hemisphere damaged (RCVA: n = 24, LCVA: n = 24) stroke and age-matched neurotypical controls (n = 24) as they completed bimanual reaching tasks under distinct goal conditions. In the dual-goal condition, participants reached to move two virtual bricks (cursors) assigned to each hand toward independent targets. In the common-goal condition, they moved a central common virtual brick representing both hands to a single, central target. Spatial and temporal coordination (cross-correlation coefficients of hand velocity and their time-lag), the redundant axis deviations (the hand deviations in the axis orthogonal to the axis along the cursor-target direction), and the contribution ratio of the paretic hand were measured. Compared to the dual-goal condition, reaching actions to the common-goal demonstrated better spatial bimanual coordination in all three participant groups. Temporal coordination was better during common-goal than dual-goal actions only for the LCVA group. Additionally, and novel to this field, sex, as a biological variable, differently influenced movement time and redundant axis deviation in participants with stroke under the common-goal condition. Specifically, female stroke survivors showed larger movements in the redundant axes and, consequently, longer movement times, which was more prominent in the LCVA group. Our results indicate that perception of task goals influences bimanual coordination, with common goal improving spatial coordination in neurotypical individuals and individuals with unilateral stroke and providing additional advantage for temporal coordination in those with LCVA. Sex influences bimanual performance in stroke survivors and needs to be considered in future investigations.

"It just depends": Parent, teacher, and expert conceptualization of social communication in young autistic children

LAY ABSTRACT

Improving social communication is often one goal during early autism services. However, researchers do not yet know whether their ideas about which social communication skills should be targeted during services for young autistic children are the same as the goals of autism community members, such as parents, teachers, and expert clinicians. This study used focus groups (meetings of small groups of community members) to ask people from these groups about what aspects of social communication are most important to support in young autistic children. A total of 43 people participated in these focus groups. These groups included parents (three groups; 21 people), teachers (two groups; 8 people), and experts in early social communication and autism (two groups; 14 people). Focus group participants talked about several aspects of social communication that were already familiar to the research team, such as problems with expressive communication, language understanding, and social interaction. However, participants also talked about several parts of social communication that were less familiar to the research team and had usually not been mentioned in previous research. These included (1) considering the value of unusual forms of communication, (2) taking context and setting into account when considering social communication, and (3) how communication and emotion regulation impact one another. The information from these focus groups will be helpful to making sure that researchers and clinicians focus their social communication supports on areas that are most important to parents and teachers.

Choosing human over AI doctors? How comparative trust associations and knowledge relate to risk and benefit perceptions of AI in healthcare

The development of artificial intelligence (AI) in healthcare is accelerating rapidly. Beyond the urge for technological optimization, public perceptions and preferences regarding the application of such technologies remain poorly understood. Risk and benefit perceptions of novel technologies are key drivers for successful implementation. Therefore, it is crucial to understand the factors that condition these perceptions. In this study, we draw on the risk perception and human-AI interaction literature to examine how explicit (i.e., deliberate) and implicit (i.e., automatic) comparative trust associations with AI versus physicians, and knowledge about AI, relate to likelihood perceptions of risks and benefits of AI in healthcare and preferences for the integration of AI in healthcare. We use survey data (N = 378) to specify a path model. Results reveal that the path for implicit comparative trust associations on relative preferences for AI over physicians is only significant through risk, but not through benefit perceptions. This finding is reversed for AI knowledge. Explicit comparative trust associations relate to AI preference through risk and benefit perceptions. These findings indicate that risk perceptions of AI in healthcare might be driven more strongly by affect-laden factors than benefit perceptions, which in turn might depend more on reflective cognition. Implications of our findings and directions for future research are discussed considering the conceptualization of trust as heuristic and dual-process theories of judgment and decision-making. Regarding the design and implementation of AI-based healthcare technologies, our findings suggest that a holistic integration of public viewpoints is warranted.

Homework as a driver of change in psychotherapy

BACKGROUND AND OBJECTIVES

The utilization of Between-Session Homework (BSH) holds a longstanding tradition in the field of psychotherapy. Significantly, it serves as a pivotal catalyst for change within behavioral and cognitive-behavioral therapies, and has also garnered endorsement within psychodynamic and humanistic-experiential therapies. While our current conceptualization of BSH is characterized by assimilation and integration, diversity prevails in how BSH is incorporated into the treatment plan, spanning various therapy stages, thus necessitating a customized therapist-client interpersonal dynamic. Far from being a panacea, the employment of BSH emerges as a highly sophisticated and intricate clinical methodology, demanding a high degree of therapist proficiency and competence to facilitate client engagement.

METHODS

In this introductory paper, we present an issue of the Journal of Clinical Psychology: In Session that exemplifies the diverse modalities through which BSH can be integrated into clinical practice across various client demographics and within distinct psychotherapeutic paradigms. We place specific emphasis on the pivotal role of BSH and its interplay with proposed mechanisms of change throughout the course of treatment.

RESULTS

Initially, we provide an overarching view of the subject and expound on empirical research substantiating the efficacy of BSH in psychotherapy. Subsequently, we delve into strategies for adeptly integrating and monitoring BSH within clinical practice.

CONCLUSIONS

Our primary objectives encompass affording readers a more lucid comprehension of (1) the content and nature of homework; (2) the influence of BSH on treatment outcomes; and (3) the ways through which therapists can foster client engagement with BSH. Finally, we introduce the six papers comprising this issue.

That means something to me: How linguistic and emotional experience affect the acquisition, representation, and processing of novel abstract concepts

We used a novel linguistic training paradigm to investigate the experience-dependent acquisition, representation, and processing of novel emotional and neutral abstract concepts. Participants engaged in mental imagery (n = 32) or lexico-semantic rephrasing (n = 34) of linguistic material during five training sessions and successfully learned the novel abstract concepts. Feature production after training showed that specifically emotion features enriched the emotional concepts' representations. Unexpectedly, for participants engaging in vivid mental imagery during training a higher semantic richness of the acquired emotional concepts slowed down lexical decisions. Rephrasing, in turn, promoted a better learning and processing performance than imagery, probably due to stronger established lexical associations. Our results confirm the importance of emotional and linguistic experience and additional deep lexico-semantic processing for the acquisition, representation, and processing of abstract concepts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Varieties of Happiness: Mapping Lay Conceptualizations of Happiness in a Spanish Sample

Research on lay conceptions of happiness is essential to determine what is investigated in happiness studies. Whereas psychological investigation has traditionally emphasized the importance of studying people's everyday conceptions and their relation to cultural and social factors to advance psychological theory, this line of research is still largely overlooked in the field. The Spanish context has also received very limited attention in the area. To fill these gaps, this paper examined 547 lay definitions of happiness in a sample of Spanish participants. The aims of the study were threefold. First, to map and classify the definitions elicited through an open-ended question using a bottom-up approach. Second, to analyze the relationship of happiness definitions with different sociodemographic factors. Third, to explore the relationship between happiness conceptualizations and two different happiness measures. The final classification yielded 39 codes, 15 categories, and 3 overarching types of definitions. Three main findings resulted from the study. First, happiness emerged as a highly heterogeneous concept characterized by diverse social, psychological, and theoretical descriptions. Social types of definitions stood out in the sample. Second, most definitions varied significantly with sociodemographic factors. Third, happiness scores tended to show no significant association with happiness definitions. Implications derived from these results were discussed. Altogether, the paper highlights the value of exploring lay conceptions of happiness to advance toward a more comprehensive and fine-grained understanding of what happiness means for -and, to a certain extent, of how it is experienced by- people of different cultural backgrounds and social settings.

The Dimensional Conceptualization of Personality Disorders: Personality Organization, Personality Functioning, and Personality Disorders

Over the past several decades, significant criticism of the categorical classification system for personality disorders has highlighted the need to transition to a dimensional classification system. This study reviewed key issues involved in the potential conversion of the diagnostic system of personality disorders from a categorical to a dimensional model. The result suggests that Kernberg's concept of personality organization can be used to indicate the overall severity of personality pathology.

The Role of Attention in Category Representation

Numerous studies have found that selective attention affects category learning. However, previous research did not distinguish between the contribution of focusing and filtering components of selective attention. This study addresses this issue by examining how components of selective attention affect category representation. Participants first learned a rule-plus-similarity category structure, and then were presented with category priming followed by categorization and recognition tests. Additionally, to evaluate the involvement of focusing and filtering, we fit models with different attentional mechanisms to the data. In Experiment 1, participants received rule-based category training, with specific emphasis on a single deterministic feature (D feature). Experiment 2 added a recognition test to examine participants' memory for features. Both experiments indicated that participants categorized items based solely on the D feature, showed greater memory for the D feature, were primed exclusively by the D feature without interference from probabilistic features (P features), and were better fit by models with focusing and at least one type of filtering mechanism. The results indicated that selective attention distorted category representation by highlighting the D feature and attenuating P features. To examine whether the distorted representation was specific to rule-based training, Experiment 3 introduced training, emphasizing all features. Under such training, participants were no longer primed by the D feature, they remembered all features well, and they were better fit by the model assuming only focusing but no filtering process. The results coupled with modeling provide novel evidence that while both focusing and filtering contribute to category representation, filtering can also result in representational distortion.

Patient competence in chronic illness: A concept derivation

AIMS AND OBJECTIVES

This paper aims to inform nursing and other healthcare disciplines by clearly defining patient competence and the skills required to improve self-care behaviours.

BACKGROUND

Competence has been defined in education and leadership. However, competence in persons with chronic disease has not been expanded upon since one publication in 1983. Patient competence needs to be developed and defined so that healthcare disciplines can understand the attributes necessary for a patient to be deemed competent to promote self-care behaviours.

DESIGN

A concept derivation.

METHODS

Walker and Avant's approach to concept derivation was used to identify a base concept (competence) that is well-defined in another field, define the concepts associated with the parent field, and transpose that definition to a new field to formulate a redefined concept. PsycINFO, Scopus, Web of Science and Medline were searched, and 21 articles were included.

RESULTS

Patient competence is defined as the ability of a person with a chronic illness to reach skill mastery, achieve knowledge, maintain a positive attitude and develop trust in themselves and in healthcare providers that will facilitate active engagement to improve self-care behaviours.

CONCLUSIONS

Defining patient competence is important in assisting nurses and other healthcare providers in understanding the attributes needed to deem a patient competent, especially those living with chronic illnesses requiring lifelong self-care behaviours. More research is needed to aid in the designing of a precise instrument for measuring this phenomenon.

RELEVANCE TO CLINICAL PRACTICE

Concept derivation of patient competence provides a framework for nurses and other members of the healthcare profession to understand the attributes needed to determine patient competence.

Equity-related 'knots' in theory of change development: Conceptualization and case illustrations

Theory of change (ToC) is an approach widely used to guide planning, implementing, and evaluating change initiatives. While there is substantial guidance, there has been little attention on equity within ToC research and practice. We propose and illustrate the metaphor of 'knots' to frame practical and ethical challenges that arise when centering equity within ToC processes. Drawing on our experiences using a ToC approach in two case examples, we identify and illustrate five equity-related knots: (a) clarify root causes, pathways, and success; (b) facilitate participation across power and perspective differences; (c) integrate research evidence and practitioner knowledge; (d) represent complex change visually; and (e) creatively navigate constraints. We show why framing these as knots can help practitioners make wise judgments within the circumstances and close with recommendations for including knots in ToC processes, reporting, and guidance.

An analysis of time conceptualisations and good care in an acute hospital setting

This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the-clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising-there is a place for a fast-paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients.

Patient readiness for shared decision making about treatment: Conceptualisation and development of the ReadySDM

INTRODUCTION

Shared decision making (SDM) requires an active role of both clinicians and patients. We aimed to conceptualise patient readiness for SDM about treatment, and to develop a patient questionnaire to assess readiness.

METHODS

We used the results of a scoping review and a qualitative study to inform the patient readiness construct. We conducted five additional rounds of data collection to finalise the construct definition and develop the Patient Readiness for SDM Questionnaire (ReadySDM ) in an oncological setting: (1) longitudinal interviews with patients with cancer during and after a treatment decision-making process; (2) a pilot study among experts, clinicians, and patients for feedback on the concept and items; (3) a field test among (former) patients with cancer to test item format and content validity, and to reduce the number of items; (4) cognitive interviews with people with low literacy to test the comprehensibility of the questionnaire; and (5) a field test among (former) patients who faced a cancer treatment decision in the last year, to test the content validity of the final version of the questionnaire.

RESULTS

A total of 251 people participated in the various rounds of data collection. We identified eight elements of patient readiness for SDM about treatment: (1) understanding of and attitude towards SDM; (2) information skills; (3) skills in communicating and claiming space; (4) self-awareness; (5) consideration skills; (6) self-efficacy; (7) emotional distress; and (8) experienced time. We developed the 20-item ReadySDM to retrospectively measure these elements in an oncological setting.

CONCLUSION

We conducted a thorough procedure to conceptualise patient readiness and to develop the ReadySDM . The questionnaire aims to provide novel insights into ways to enhance SDM in daily practice.

PATIENT OR PUBLIC CONTRIBUTION

Multiple people with lived experience were involved in various phases of the study. They were asked for input on the study design, the conceptualisation of readiness, and the development of the questionnaire.

Generalisation of unpredictable action-effect features: Large individual differences with little on-average effect

Ideomotor theory suggests that selecting a response is achieved by anticipating the consequences of that response. Evidence for this is the response-effect compatibility (REC) effect, that is, responding tends to be faster when the (anticipated) predictable consequences of a response (the action effects) are compatible rather than incompatible with the response. The present experiments investigated the extent to which the consequences must be exactly versus categorically predictable. According to the latter, an abstraction from particular instances to the categories of dimensional overlap might take place. For participants in one group of Experiment 1, left-hand and right-hand responses produced compatible or incompatible action effects in perfectly predictable positions to the left or right of fixation, and a standard REC effect was observed. For participants in another group of Experiment 1, as well as in Experiments 2 and 3, the responses also produced action effects to the left or right of fixation, but the eccentricity of the action effects (and thus their precise location) was unpredictable. On average, the data from the latter groups suggest that there is little, if any, tendency for participants to abstract the critical left/right features from spatially somewhat unpredictable action effects and use them for action selection, although there were large individual differences in these groups. Thus, at least on average across participants, it appears that the spatial locations of action effects must be perfectly predictable for these effects to have a strong influence on the response time.

A Concept Analysis of Paternal Bonding With Prematurely Born Infants

BACKGROUND

Maternal bonding in infancy has long been the focus of research and practice. Despite emerging evidence highlighting the importance of paternal bonding, little attention has been focused on fathers. Simultaneously, there is little clarity regarding possible differences between bonding and attachment.

PURPOSE

This article aims to clarify the concept of paternal bonding with infants born prematurely.

METHODS/SEARCH STRATEGY

Using Walker and Avant's approach to concept analysis, we selected databases and searched them for relevant studies published between 2012 and 2022. We identified 28 articles that (1) defined bonding specific to fathers of infants born prematurely, (2) were peer-reviewed, and (3) were in English. From the articles, we extracted and analyzed data specific to concept definitions, antecedents, and consequences.

RESULTS

Regarding paternal bonding with infants born prematurely, our analyses of the 28 studies yielded a conceptual definition of this topic that extends beyond the commonly used definition emphasizing emotional connection. The newly formulated definition covers the cognitive, behavioral, and dynamic, as well as emotional, attributes of bonding. We identify and discuss antecedents and consequences of bonding.

IMPLICATIONS FOR PRACTICE AND RESEARCH

Our findings led to a consistent conceptual definition of the bonding phenomenon in question. The definition should serve as a conceptual basis for future guidelines governing clinical practice and research. Through our findings, nurses can better understand and promote paternal bonding with infants born prematurely. Finally, our findings can improve researchers' exploration of this topic.

Recruitment of the premotor cortex during arithmetic operations by the monkey

Arithmetic operations are complex mental processes rooted in the abstract concept of numerosity. Despite the significance, the neural architecture responsible for these operations has remained largely uncharted. In this study, we explored the presence of specific neuronal activity in the dorsal premotor cortex of the monkey dedicated to numerical addition and subtraction. Our findings reveal that many of these neural activities undergo a transformation, shifting their coding from arithmetic to motor representations. These motor representations include information about which hand to use and the number of steps involved in the action. We consistently observed that cells related to the right-hand encoded addition, while those linked to the left-hand encoded subtraction, suggesting that arithmetic operations and motor commands are intertwining with each other. Furthermore, we used a multivariate decoding technique to predict the monkey's behaviour based on the activity of these arithmetic-related cells. The classifier trained to discern arithmetic operations, including addition and subtraction, not only predicted the arithmetic decisions but also the subsequent motor actions of the right and left-hand. These findings imply a cognitive extension of the motor cortex's function, where inherent neural systems are repurposed to facilitate arithmetic operations.

Health literacy in the context of child health promotion: a scoping review of conceptualizations and descriptions

BACKGROUND

Increasing health literacy (HL) in children could be an opportunity for a more health literate future generation. The aim of this scoping review is to provide an overview of how HL is conceptualized and described in the context of health promotion in 9-12-year-old children.

METHODS

A systematic and comprehensive search for 'health literacy' and 'children' and 'measure' was performed in accordance with PRISMA ScR in PubMed, Embase.com and via Ebsco in CINAHL, APA PsycInfo and ERIC. Two reviewers independently screened titles and abstracts and evaluated full-text publications regarding eligibility. Data was extracted systematically, and the extracted descriptions of HL were analyzed qualitatively using deductive analysis based on previously published HL definitions.

RESULTS

The search provided 5,401 original titles, of which 26 eligible publications were included. We found a wide variation of descriptions of learning outcomes as well as competencies for HL. Most HL descriptions could be linked to commonly used definitions of HL in the literature, and some combined several HL dimensions. The descriptions varied between HL dimensions and were not always relevant to health promotion. The educational setting plays a prominent role in HL regarding health promotion.

CONCLUSION

The description of HL is truly diverse and complex encompassing a wide range of topics. We recommend adopting a comprehensive and integrated approach to describe HL dimensions, particularly in the context of health promotion for children. By considering the diverse dimensions of HL and its integration within educational programs, children can learn HL skills and competencies from an early age.

Equity in family planning policies and programs in Uganda: conceptualization, dimensions and implementation constraints

BACKGROUND

Equity is at the core and a fundamental principle of achieving the family planning (FP) 2030 Agenda. However, the conceptualization, definition, and measurement of equity remain inconsistent and unclear in many FP programs and policies. This paper aims to document the conceptualization, dimensions and implementation constraints of equity in FP policies and programs in Uganda.

METHODS

A review of Ugandan literature and key informant interviews with 25 key stakeholders on equity in FP was undertaken between April and July 2020. We searched Google, Google Scholar and PubMed for published and grey literature from Uganda on equity in FP. A total of 112 documents were identified, 25 met the inclusion criteria and were reviewed. Data from the selected documents were extracted into a Google master matrix in MS Excel. Data analysis was done across the thematic areas by collating similar information. Data were analyzed using thematic content analysis approach.

RESULTS

A limited number of documents had an explicit definition of equity, which varied across documents and stakeholders. The definitions revolved around universal access to FP information and services. There was a limited focus on equity in FP programs in Uganda. The dimensions most commonly used to assess equity were either geographical location, or socio-demographics, or wealth quintile. Almost all the key informants noted that equity is a very important element, which needs to be part of FP programming. However, implementation constraints (e.g. lack of quality comprehensive FP services, duplicated FP programs and a generic design of FP programs with limited targeting of the underserved populations) continue to hinder effective implementation of equitable FP programs in Uganda. Clients' constraints (e.g. limited contraceptive information) and policy constraints (inadequate focus on equity in policy documents) also remain key challenges.

CONCLUSIONS

There is lack of a common understanding and definition of equity in FP programs in Uganda. There is need to build consensus on the definitions and measurements of equity with a multidimensional lens to inform clear policy and programming focus on equity in FP programs and outcomes. To improve equitable access to and use of FP services, attention must be paid to addressing implementation, client and policy constraints.

Engaging people with lived experiences on community advisory boards in community-based participatory research: a scoping review protocol

INTRODUCTION

Community-based participatory research (CBPR) is a collaborative research approach that equally engages researchers and community stakeholders throughout all steps of the research process to facilitate social change and increase research relevance. Community advisory boards (CABs) are a CBPR tool in which individuals with lived experience and community organisations are integrated into the research process and ensure the work aligns with community priorities. We seek to (1) explore the best practices for the recruitment and engagement of people with lived experiences on CABs and (2) identify the scope of literature on minimising power dynamics between organisations and community members with lived experience who work on CABs together.

METHODS AND ANALYSIS

This scoping review will follow the Arksey and O'Malley methodological framework, informed by Levac et al, and will be reported using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. Detailed and robust search strategies have been developed for Embase, Medline and PsychINFO. Grey literature references and reference lists of included articles published between 1 January 1990 and 30 March 2023 will be considered. Two reviewers will independently screen references in two successive stages of title/abstract and full-text screening. Conflicts will be decided by consensus or a third reviewer. Thematic analysis will be applied in three phases: open coding, axial coding and abstraction. Extracted data will be recorded and presented in a tabular format and/or graphical summaries, with a descriptive overview discussing how the research findings relate to the research questions. At this time, a preliminary search of peer-reviewed and grey literature has been conducted. Search results for peer-reviewed literature have been uploaded to Covidence for review and appraisal for relevance.

ETHICS AND DISSEMINATION

Formal ethics approval is not required for this review. Review findings will inform ongoing and future CBPR community advisory board dynamics.

REGISTRATION

The protocol has been registered prospectively on the Open Science Framework (https://doi.org/10.17605/OSF.IO/QF5D3).

Consent as a compositional act - a framework that provides clarity for the retention and use of data

BACKGROUND

Informed consent is one of the key principles of conducting research involving humans. When research participants give consent, they perform an act in which they utter, write or otherwise provide an authorisation to somebody to do something. This paper proposes a new understanding of the informed consent as a compositional act. This conceptualisation departs from a modular conceptualisation of informed consent procedures.

METHODS

This paper is a conceptual analysis that explores what consent is and what it does or does not do. It presents a framework that explores the basic elements of consent and breaks it down into its component parts. It analyses the consent act by first identifying its basic elements, namely: a) data subjects or legal representative that provides the authorisation of consent; b) a specific thing that is being consented to; and c) specific agent(s) to whom the consent is given.

RESULTS

This paper presents a framework that explores the basic elements of consent and breaks it down into its component parts. It goes beyond only providing choices to potential research participants; it explains the rationale of those choices or consenting acts that are taking place when speaking or writing an authorisation to do something to somebody.

CONCLUSIONS

We argue that by clearly differentiating the goals, the procedures of implementation, and what is being done or undone when one consent, one can better face the challenges of contemporary data-intensive biomedical research, particularly regarding the retention and use of data. Conceptualising consent as a compositional act enhances more efficient communication and accountability and, therefore, could enable more trustworthy acts of consent in biomedical science.

A scoping review to map the research on the mental health of students and graduates during their university-to-work transitions

OBJECTIVES

This scoping review maps the extant literature on students' and graduates' mental health experiences throughout their university-to-work transitions. The current review investigates the methodological features of the studies, the main findings, and the theories that the studies draw on to conceptualise mental health and transitions.

DESIGN

This project used a scoping review methodology created and developed by Peters and colleagues and the Joanna Briggs Institute. The review searched academic databases and screened existing studies that met predetermined inclusion criteria.

DATA SOURCES

Seven academic databases and Google Scholar were searched with sets of search terms.

ELIGIBILITY

The included studies examined participants who were final-year university students or those who had graduated from university within a 3-year period. Studies published in English since 2000 and from any country were included. The review included studies examining the negative dimensions of mental health. The review excluded studies focusing on medical students and graduates.

DATA EXTRACTION

Basic information about the studies and their findings on mental health and university-to-work transitions was retrieved. The findings are presented in tables and in a qualitative thematic summary.

RESULTS

The scoping review included 12 studies. Mental health was often not explicitly defined and it's theoretical foundations were not clearly articulated. The review identified factors, including a lack of social support and economic precarity, as sources of adverse mental health. Other protective factors in these studies-variables that guard against mental health problems-were identified, such as career preparedness and having a good job.

CONCLUSIONS

Despite the methodological focus on the negative aspects of mental health, people's mental health experiences during university-to-work transitions are not uniformly negative. Clear conceptualisations of mental health in future studies will aid in developing resources to improve well-being.

TRIAL REGISTRATION NUMBER

This scoping review adhered to a protocol previously published in this journal and that is registered on the Open Science Framework website (https://osf.io/gw86x).

"Roses have thorns for a reason": The promises and perils of critical youth participatory research with system-impacted girls of Color

Scholarship on girlhood-especially for girls of Color-is often relegated to studying risk and emphasizing individual deficits over humanizing girls and centering their voices. This approach to generating scholarship renders oppressive systems and processes invisible from inquiry and unaddressed by practice, with particularly insidious consequences for youth in the legal system. Critical youth participatory action research (YPAR) is acknowledged as an antidote to these conceptualizations because it resists deficit-oriented narratives circling systems-impacted youth by inviting them to the knowledge-generating table. In this paper, we present an empirical analysis of the promises and perils that emerged as we conducted a year-long critical YPAR project alongside five system-impacted girls of Color. Our thematic analysis of process notes (30 meetings, 120 h) documents the stories posited by girls, in a democratized space, about the injustices of interconnected institutions, and unearths a complicated tension for both youth and adult coresearchers around the promises and perils of engaging in YPAR within the academy. These findings underscore the importance of using intersectional, collaborative research to challenge perceptions around how we legitimize knowledge. We describe lessons learned in conducting YPAR in academic settings and highlight recommendations to grow youth-adult partnerships within oppressive systems to share power.

Conceptualization and Assessment of 24-H Timing of Eating and Energy Intake: A Methodological Systematic Review of the Chronic Disease Literature

Timing of eating (TOE) and energy intake (TOEI) has important implications for chronic disease risk beyond diet quality. The 2020 Dietary Guidelines Advisory Committee recommended developing consistent terminology to address the lack of TOE/TOEI standardization. The primary objective of this methodological systematic review was to characterize the conceptualization and assessment of TOE/TOEI within the chronic disease literature (International Prospective Register of Systematic Reviews registration number: CRD42021236621). Literature searches in Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, Embase, PubMed, and Scopus were limited to English language publications from 2000 to August 2022. Eligible studies reported the association between TOE/TOEI and obesity, cardiovascular disease, type 2 diabetes mellitus, cancer, or a related clinical risk factor among adults (≥19 y) in observational and intervention studies. A qualitative synthesis described and compared TOE/TOEI conceptualization, definitions, and assessment methods across studies. Of the 7579 unique publications identified, 259 studies (observational [51.4 %], intervention [47.5 %], or both [1.2 %]) were eligible for inclusion. Key findings indicated that most studies (49.6 %) were conducted in the context of obesity and body weight. TOE/TOEI variables or assigned conditions conceptualized interrelated aspects of time and eating or energy intake in varying ways. Common TOE/TOEI conceptualizations included the following: 1) timepoint (specific time to represent when intake occurs, such as time of breakfast [74.8 %]); 2) duration (length of time or interval when intake does/does not occur, such as "eating window" [56.5 %]); 3) distribution (proportion of daily intake at a given time interval, such as "percentage of energy before noon" [29.8 %]); and 4) cluster (grouping individuals based on temporal ingestive characteristics [5.0 %]). Assessment, definition, and operationalization of 24-h TOE/TOEI variables varied widely across studies. Observational studies most often used surveys or questionnaires (28.9 %), whereas interventions used virtual or in-person meetings (23.8 %) to assess TOE/TOEI adherence. Overall, the diversity of terminology and methods solidifies the need for standardization to guide future research in chrononutrition and to facilitate inter-study comparisons.

Conceptualisations of "good care" within informal caregiving networks for older people in rural South Africa

Good care in social policy statements is commonly implied as familial and person-centred, provided by family members and focused on upholding the autonomy, dignity and respect of the care recipient. Policy consideration of the relational nature of caregiving, the sociomaterial determinants of good care, the practical knowledge of caregivers and responsibilities of the state, is limited. Drawing on the ethics of care theory and a care ecology framework, which conceptualises the dynamic interactions between formal and informal care "systems," we analysed ethnographic data of the interactions of 21 caregivers and their older care recipients in South Africa to understand how they conceptualised good care. Conceptualisations of good care included: having the right, altruistic and reciprocal, motivations; providing care frequently and consistently; and demonstrating hope for a better future through practical action. Caregivers also considered restricting autonomy a feature of good care, when doing so was perceived to be in the care recipient's best interest. Conceptualisations of good care were influenced by but also countered policy and cultural ideals. When they subverted policy values and practices, by overriding autonomy, for instance, caregivers' conceptualisations reflected their practical experiences of caregiving amidst gross material inadequacies, underpinned by deficiencies in the formal care system. We highlight the need for policies, interventions and theories of care that focus broadly on the care ecology and particularly on the "carescape" (formal care system). We advocate relational approaches that consider and balance the needs, desires and rights of caregivers and care recipients, and recognise caregivers' experiential knowledge, rather than person-centred approaches that focus exclusively on the care recipient.

"Even when you write with a pencil there is an eraser to clean it": Examining men's conceptualisations of and involvement in emergency contraceptive use in Accra, Ghana

Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy. This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use. Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term 'emergency contraception' was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from 'emergency' are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.

Bewilderment, aquilombar, and the antimanicolonial: three ideas to radicalize Brazilian Psychiatric Reform

This article is part of a study aimed to map antiracist knowledge and practices in mental health by monitoring the practices of three collectives of professionals working in/with the psychosocial care network in the city of São Paulo, allowing us to characterize their intervention strategies. To contribute to the conceptualization of this article, through a review of the decolonial literature, three major ideas have been outlined that have allowed us to give substance to the decolonization of Psychiatric Reform: bewilderment, which, in dialogue with Achille Mbembe and Frantz Fanon, invites us to affirm madness and blackness without, however, establishing fixations; the antimanicolonial, which occurs in the promotion of the free and countercultural exercise of imagining diasporas, in light of that proposed by Édouard Glissant, Paul Gilroy, and Lélia Gonzales regarding an Atlantic (de)orientation in which elements of the black diaspora and Latin America can re-signify blackness and unreason; and aquilombar, as a liberatory praxis whose genesis lies in the quilombos as a living metaphor for the radicalisation of relationships in differences, based on Abdias do Nascimento's quilombismo, Clóvis Moura's quilombagem, Beatriz Nascimento's (k)quilombo, and Mariléa de Almeida's devir quilomba.

Participation of adolescents with and without physical disabilities and chronic diseases: A comprehensive conceptualization

BACKGROUND

In 2001, the International Classification of Functioning and Disability (ICF) introduced participation as a main goal of rehabilitation processes. However, to date, a comprehensive concept of participation in the rehabilitative context is missing, particularly in German-speaking countries. We thus aimed to refine and extend the existing concepts of participation in this brief communication.

METHODS

In preceding studies, we conducted semi-structured interviews with adolescents who either had chronic diseases and/or physical disabilities or had no impairments and focus groups with parents and experts. Based on these diverse perspectives and findings, we refine the term participation.

RESULTS

Participation is a construct that is embedded in a social context and consists of objective (i.e., attendance) and subjective (i.e., satisfaction and involvement) dimensions. These dimensions are reflected in different domains and areas that are relevant to adolescents' lives. In addition, the subjective relevance of respective areas in life needs to be regarded as a weighing component when evaluating participation.

CONCLUSION

Our results reflect international models on participation, refine the existing concept, and underline the multidimensional character of participation. These findings are urgently needed to develop appropriate instruments, for example, for assessing whether rehabilitative processes are effective regarding the goal of participation.

The appearance of multidimensionality: Exploring the case for unidimensionality of the PTSD Checklist for DSM-5 using a firefighter sample

Rasmussen et al. (2019) described the proliferation of factors for posttraumatic stress disorder (PTSD) measures and raised concerns about the construct validity of factors that include two or three items. In this brief report, we describe how the pattern of covariation among the responses to items of well-established measures, such as the PTSD Checklist for DSM-5 (PCL-5), can give the appearance of multidimensionality. We evaluated whether the structure of the 20-item PCL-5 is unidimensional, using the methods of multidimensional item response theory (MIRT) and the concept of a testlet. These analyses were done using a sample of trauma-exposed urban firefighters. A unidimensional and a bifactor model, which includes a general factor composed of all items and four specific factors mirroring the DSM-5 conceptualization, were evaluated for both Likert-type multiple-category and binary coding system of the PCL-5 item response data. Seven testlets were created from the 20 PCL-5 items following the seven-factor model (Armour et al., 2015) presented in Table 1 of Rasmussen et al. (2019). Findings using the unidimensional nominal item response theory model for the seven testlets indicated that the PCL-5 may be considered unidimensional with a single score representing individual differences on a continuum that ranges from low to high. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis

BACKGROUND

Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear.

AIM

To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science.

METHOD

Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms 'wellness', 'health', 'health care', and 'health care and wellness'; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria.

RESULTS

Based on the findings from this concept analysis, a definition of wellness was developed: 'a holistic and multidimensional concept represented on a continuum of being well that goes beyond health'. Implications for nursing practice were correspondingly presented.

CONCLUSION

Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.

Structure shapes the representation of a novel category

Concepts contain rich structures that support flexible semantic cognition. These structures can be characterized by patterns of feature covariation: Certain features tend to cluster in the same items (e.g., feathers, wings, can fly). Existing computational models demonstrate how this kind of structure can be leveraged to slowly learn the distinctions between categories, on developmental timescales. However, it is not clear whether and how we leverage feature structure to quickly learn a novel category. We thus investigated how the internal structure of a new category is first extracted from experience, with the prediction that feature-based structure would have a rapid and broad influence on the learned category representation. Across three experiments, novel categories were designed with patterns of feature associations determined by carefully constructed graph structures, with Modular graphs-exhibiting strong clusters of feature covariation-compared against Random and Lattice graphs. In Experiment 1, a feature inference task using verbal stimuli revealed that Modular structure broadly facilitated category learning. Experiment 2 replicated this effect in visual categories. In Experiment 3, a statistical learning paradigm revealed that this Modular benefit relates to high-level structure rather than pairwise feature associations and persists even when category structure is incidental to the task. A neural network model was readily able to account for these effects, suggesting that correlational feature structure may be encoded within rapidly learned, distributed category representations. These findings constrain theories of category representation and link theories of category learning with structure learning more broadly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Developing psychoanalytic case conceptualization skills through didactic teaching: A randomized controlled trial

OBJECTIVE

Time-limited didactic interventions have been shown to be effective in developing "generic" case conceptualization skills. The objective of this study is to test whether similar interventions can be used to develop case conceptualization skills that are "specific" to a treatment modality.

METHOD

University psychology students were randomized to a target (n = 62) or a control group (n = 62). The target group received a training on psychoanalytic case conceptualization skills based on the newly-developed operators model. The control group received a training on generic case conceptualization skills based on the well-established 5 Ps model.

RESULTS

The students' self-efficacy for case conceptualization significantly increased in both groups. However, students in the target group reported a significantly greater increase in psychoanalytic case conceptualization skills and in their ability to make clinical inferences. The teaching method, as well as the case conceptualization models, were acceptable to students. However, the 5 Ps model was significantly more acceptable to students than the operators model.

CONCLUSIONS

This is the first RCT to provide evidence that psychoanalytic case conceptualization skills can be developed through didactic teaching and that they constitute a specific set of skills that are not developed by learning generic case conceptualization skills.

Conceptualisation of violence and discipline among students, teachers, and parents in Nyarugusu Refugee Camp, Tanzania

BACKGROUND

Little academic research has been conducted on how people conceptualise 'violence' and 'discipline', especially in humanitarian settings. This may limit the transferability of violence prevention interventions. This paper examines the understanding of violence and discipline concepts among students, teachers, and parents in the Nyarugusu Refugee Camp in Tanzania.

METHODS

A qualitative study was undertaken as part of the larger trial testing the effectiveness of the EmpaTeach intervention to prevent physical violence from teachers to students implemented in 27 schools in Nyarugusu Refugee Camp. Data from baseline and midline surveys in control schools that did not receive the intervention informed this paper where a total of 14 in-depth interviews (eight with students and six teachers) and six focus group discussions (two with teachers and four with parents from the Parent Teacher Association) were analyzed. Both audio recordings from in-depth interviews and focus group discussions were transcribed verbatim, and translated from Kiswahili to English (Congolese) and Kirundi to English (Burundian). Translated data were verified and coded using thematic analysis based on the views of students, teachers, and parents.

RESULTS

Participants revealed that the same behavioural acts could be differentially classified as violence or discipline. Violence was understood in relation to the consequences of acts, which could include physical or psychological harm, or other harms which were seen as detrimental to children's futures and life chances, particularly adolescent pregnancy. Sexual acts without consent were also seen as violence. In contrast, discipline was understood according to intent, and perceived acts done towards students to correct bad behaviour.

CONCLUSION

Results imply that education about the harmful consequences of behavioural acts intended as discipline, may be important for violence prevention interventions and that framing interventions in terms of positive child development could help change discipline strategies in schools.

Nursing privilege: A concept analysis

AIM

The study aimed to provide a comprehensive concept analysis of nursing privileges by elucidating its meaning and implications within the healthcare context.

DESIGN

A concept analysis paper.

METHODS

A comprehensive literature review was conducted from nursing and healthcare databases, professional nursing organizations, and regulatory bodies. Documents reviewed include research studies, policy documents and professional guidelines. The study employed Walker and Avant's eight-step method of concept analysis. This involved identifying the uses of the concept, its underlying attributes and referents, and constructing model, borderline, related and contrary cases. The antecedents, consequences and empirical referents of nursing privileges were also determined.

RESULTS

The analysis uncovered vital attributes defining nursing privileges, encompassing professional authority, autonomy, access to resources, information, influence, decision-making power, respect and recognition. Additionally, antecedents and consequences of nursing privilege were identified, spanning development and resource access, as well as professional satisfaction and enhanced patient care.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Optimizing dense feed-forward neural networks

Deep learning models have been widely used during the last decade due to their outstanding learning and abstraction capacities. However, one of the main challenges any scientist has to face using deep learning models is to establish the network's architecture. Due to this difficulty, data scientists usually build over complex models and, as a result, most of them result computationally intensive and impose a large memory footprint, generating huge costs, contributing to climate change and hindering their use in computational-limited devices. In this paper, we propose a novel dense feed-forward neural network constructing method based on pruning and transfer learning. Its performance has been thoroughly assessed in classification and regression problems. Without any accuracy loss, our approach can compress the number of parameters by more than 70%. Even further, choosing the pruning parameter carefully, most of the refined models outperform original ones. Furthermore, we have verified that our method not only identifies a better network architecture but also facilitates knowledge transfer between the original and refined models. The results obtained show that our constructing method not only helps in the design of more efficient models but also more effective ones.

Compositional diversity in visual concept learning

Humans leverage compositionality to efficiently learn new concepts, understanding how familiar parts can combine together to form novel objects. In contrast, popular computer vision models struggle to make the same types of inferences, requiring more data and generalizing less flexibly than people do. Here, we study these distinctively human abilities across a range of different types of visual composition, examining how people classify and generate "alien figures" with rich relational structure. We also develop a Bayesian program induction model which searches for the best programs for generating the candidate visual figures, utilizing a large program space containing different compositional mechanisms and abstractions. In few shot classification tasks, we find that people and the program induction model can make a range of meaningful compositional generalizations, with the model providing a strong account of the experimental data as well as interpretable parameters that reveal human assumptions about the factors invariant to category membership (here, to rotation and changing part attachment). In few shot generation tasks, both people and the models are able to construct compelling novel examples, with people behaving in additional structured ways beyond the model capabilities, e.g. making choices that complete a set or reconfigure existing parts in new ways. To capture these additional behavioral patterns, we develop an alternative model based on neuro-symbolic program induction: this model also composes new concepts from existing parts yet, distinctively, it utilizes neural network modules to capture residual statistical structure. Together, our behavioral and computational findings show how people and models can produce a variety of compositional behavior when classifying and generating visual objects.

How and why to use 'vulnerability': an interdisciplinary analysis of disease risk, indeterminacy and normality

In recent years, 'vulnerability' has been getting more traction in theoretical, professional and popular spaces as an alternative or complement to the concept of risk. As a group of science and technology studies scholars with different disciplinary orientations yet a shared concern with biomedicine, self and society, we investigate how vulnerability has become a salient and even dominant idiom for discussing disease and disease risk. We argue that this is at least partly due to an inherent indeterminacy in what 'vulnerability' means and does, both within and across different discourses. Through a review of feminist and disability theory, and a discussion of how vulnerability and disease both get recruited into a binary conceptualisation of normal versus abnormal, we argue that vulnerability's indeterminacy is, in fact, its strength, and that it should be used differently than risk. Using COVID-19 management in the UK as an illustration of the current ambivalence and ambiguity in how vulnerability versus risk is applied, we suggest that instead of being codified or quantified, as it has started to be in some biomedical and public health applications, vulnerability and its remedies should be determined in conjunction with affected communities and in ways that are polyvalent, flexible and nuanced. The concept of vulnerability encapsulates an important precept: we must recognise inequality as undesirable while not attempting to 'solve' it in deterministic ways. Rather than becoming fixed into labels, unidirectional causalities or top-down universalising metrics, vulnerability could be used to insist on relational, context-specific understandings of disease and disease risk-in line with contemporary social justice movements that require non-hierarchical and non-universal approaches to problems and solutions.

Redefining hypnosis: A narrative review of theories to move towards an integrative model

Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.

Four best-practice recommendations for improving the conceptualization and operationalization of motivational intensity: Reply to Kaczmarek and Harmon-Jones

Replies to the comments made by Kaczmarek and Harmon-Jones (see record 2024-44184-002) on the current authors original article (see record 2021-21096-001). Kaczmarek and Harmon-Jones (2023) provide a commentary on our original empirical piece, does motivational intensity exist distinct from valence and arousal? (Campbell et al., 2021). In this response, we articulate the motivation behind our work, including the major issues with the conceptualization and operationalization of motivational intensity in prior literature. For example, while motivational intensity was proposed to replace valence as the determinant of cognitive scope more than a decade and a half ago, in both this original work and ongoing work since then, motivational intensity has been operationalized in a variety of questionable ways, including via participants' ratings of valence, rather than motivational intensity. That is, in multiple studies, differences in cognitive processes measured in two conditions have been attributed to motivational intensity which was not explicitly measured, while the conditions do demonstrably differ in the valence participants experienced. We explain exactly what we found in Campbell et al. (2021) and our subsequent follow-up work (Campbell et al., 2023), and what aspects of our interpretation converge versus diverge with the views offered in Kaczmarek and Harmon-Jones' commentary. We also identify four important recommendations for best-practice research going forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The successor representation subserves hierarchical abstraction for goal-directed behavior

Humans have the ability to craft abstract, temporally extended and hierarchically organized plans. For instance, when considering how to make spaghetti for dinner, we typically concern ourselves with useful "subgoals" in the task, such as cutting onions, boiling pasta, and cooking a sauce, rather than particulars such as how many cuts to make to the onion, or exactly which muscles to contract. A core question is how such decomposition of a more abstract task into logical subtasks happens in the first place. Previous research has shown that humans are sensitive to a form of higher-order statistical learning named "community structure". Community structure is a common feature of abstract tasks characterized by a logical ordering of subtasks. This structure can be captured by a model where humans learn predictions of upcoming events multiple steps into the future, discounting predictions of events further away in time. One such model is the "successor representation", which has been argued to be useful for hierarchical abstraction. As of yet, no study has convincingly shown that this hierarchical abstraction can be put to use for goal-directed behavior. Here, we investigate whether participants utilize learned community structure to craft hierarchically informed action plans for goal-directed behavior. Participants were asked to search for paintings in a virtual museum, where the paintings were grouped together in "wings" representing community structure in the museum. We find that participants' choices accord with the hierarchical structure of the museum and that their response times are best predicted by a successor representation. The degree to which the response times reflect the community structure of the museum correlates with several measures of performance, including the ability to craft temporally abstract action plans. These results suggest that successor representation learning subserves hierarchical abstractions relevant for goal-directed behavior.

Explicating narrow and broad conceptualizations of environmental influences on personality

BACKGROUND

A surge of studies aims to identify environmental factors that explain individual differences, personality stability, and personality development. This special issue builds on this large interest and solicited articles on broad and narrow environmental factors of personality.

OBJECTIVE

We provide an overview of the motivations behind the special issue, review each of the articles, and present data on researchers' perceptions of environmental factors contributing to personality expression and development.

METHOD

We review 16 special issue articles, thematically grouped into seven topics-culture and race, genes and environment, geography and habitat, major/minor life events, social relationships, socioeconomic status and economic inequality, and work. We also present data on researchers' (N = 223) responses and ratings of environmental influences on personality expression and development.

RESULTS

In the open-ended responses, the most important environmental influences were family, culture, peers, relationships, and trauma. Among the least important were weather, birth order, geography, climate, and shared environment. Nearly all the environmental influences featured in this special issue were considered at least somewhat important; however, there was considerable heterogeneity in how important researchers found each topic.

CONCLUSIONS

There is no perfect consensus among researchers as to which environmental factors contribute most to personality expression and development. We hope that there is a larger surge of studies on personality constructs beyond traits, that contextualize concepts within a cultural and historical framework and develop more stringent theories to hypothesize about the environmental influences on personality.

Trauma-Informed Care in Acute Adult Public Mental Health Settings: A Scoping Study Examining Implementation

Trauma-informed care (TIC) is not a new concept. Despite TIC being at the forefront of international acute public mental health services policy, and researched since 2006, implementation has been hampered. This paper reports findings from a scoping study examining clinical and lived experience workers experience of TIC in Acute Adult Public Mental Health Services. In this scoping study five databases and grey literature were scanned in 2021 and updated in 2023, to address the question: What is known about TIC concerning the clinical and mental health lived experience workforce in the acute adult public mental health service? Forty-six papers met the inclusion criteria. Analysis revealed commitment in conceptualisation of TIC in mental health policy, requirements for incorporating TIC in acute adult mental health care, and barriers to implementation, including dissonance towards role expectations. The literature calls for investment in implementing TIC, which includes an increased workforce consisting of mental health lived experience workers, clinical staff with TIC knowledge and skills, and specialist TIC experts. Further research is needed to understand more fully the opportunities and barriers to implementing TIC in acute public mental health settings.