Voice-Dictated versus Typed-in Clinician Notes: Linguistic Properties and the Potential Implications on Natural Language Processing

PubMed Central

Zheng, Kai; Mei, Qiaozhu; Yang, Lei; Manion, Frank J.; Balis, Ulysses J.; Hanauer, David A.

2011-01-01

In this study, we comparatively examined the linguistic properties of narrative clinician notes created through voice dictation versus those directly entered by clinicians via a computer keyboard. Intuitively, the nature of voice-dictated notes would resemble that of natural language, while typed-in notes may demonstrate distinctive language features for reasons such as intensive usage of acronyms. The study analyses were based on an empirical dataset retrieved from our institutional electronic health records system. The dataset contains 30,000 voice-dictated notes and 30,000 notes that were entered manually; both were encounter notes generated in ambulatory care settings. The results suggest that between the narrative clinician notes created via these two different methods, there exists a considerable amount of lexical and distributional differences. Such differences could have a significant impact on the performance of natural language processing tools, necessitating these two different types of documents being differentially treated. PMID:22195229

Extracting important information from Chinese Operation Notes with natural language processing methods.

PubMed

Wang, Hui; Zhang, Weide; Zeng, Qiang; Li, Zuofeng; Feng, Kaiyan; Liu, Lei

2014-04-01

Extracting information from unstructured clinical narratives is valuable for many clinical applications. Although natural Language Processing (NLP) methods have been profoundly studied in electronic medical records (EMR), few studies have explored NLP in extracting information from Chinese clinical narratives. In this study, we report the development and evaluation of extracting tumor-related information from operation notes of hepatic carcinomas which were written in Chinese. Using 86 operation notes manually annotated by physicians as the training set, we explored both rule-based and supervised machine-learning approaches. Evaluating on unseen 29 operation notes, our best approach yielded 69.6% in precision, 58.3% in recall and 63.5% F-score. Copyright © 2014 Elsevier Inc. All rights reserved.

The Use of Slave Narratives in a High School English Class.

ERIC Educational Resources Information Center

Jolley, Susan Arpajian

2002-01-01

Notes that the key to making nonfiction work in the classroom is to connect it to the basic curriculum set forth by the school. Describes how the author's use of nonfiction slave narratives grew out of her teaching of two works of fiction. Discusses how she teaches slave narratives as a separate unit. (SG)

Secondary Traumatization in Psychiatric Mental Health Nurses: Validation of Five Key Concepts.

PubMed

Hubbard, Grace B; Beeber, Linda; Eves, Erin

2017-04-01

The purpose of this study was to validate five concepts central to secondary traumatization (ST) using narratives of psychiatric mental health advanced practice nurses. The study was designed as a directed content analysis of narrative notes (N-30). Consistency was found between narrative notes and the concepts. This study revealed that exposure and vulnerability precede empathic engagement, reaction, and alteration/transformation. The bidirectional outcome of alteration/transformation suggested that conditions leading to ST could have a positive outcome. Failure to recognize symptoms of ST and provide reflective supervision may compromise the nurse's ability to maintain a work-life balance and provide quality patient care. © 2015 Wiley Periodicals, Inc.

Narrative Intervention: A School-Based Counseling Strategy for Students with Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Kamali, Khosrow; Yoosefi Looyeh, Majid

2013-01-01

This article describes a group narrative intervention for improving the behavior of 8- to 11-year-old children with attention-deficit/hyperactivity disorder at home and school. (Contains 2 tables and 1 note.)

Wit and Humor in the Slave Narratives

ERIC Educational Resources Information Center

Dance, Daryl

1977-01-01

Notes that although the slave narratives were usually intended to serve in the cause of abolition, not all of them were bitter, unrelieved tirades against the institution of slavery, but rather there were frequently moments of relieving laughter. (Author)

Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences

PubMed Central

Snellman, Ingrid; Gustafsson, Christine; Gustafsson, Lena-Karin

2012-01-01

In today's healthcare system, there is an imbalance between what patients expect of caregivers' care and their perception of the care they get. How is it possible to reduce this imbalance? The aim of this paper was to describe attributes associated with meaningful encounters in the Swedish healthcare system based on patients' and caregivers' written narratives and to note the differences and similarities between the attributes identified by the two groups. This paper is a qualitative descriptive study. The analysis was guided by qualitative content analyses. Based on patients' narratives, attributes associated with a meaningful encounter fell into four categories: the kind-hearted caregiver, the thoughtful caregiver, the mutually oriented caregiver, and the helpful caregiver. Based on caregivers' narratives, the attributes were categorized as being humane, caring through physical contact, caring by nurturing communication, joy and laughter in care, and a sense of mutuality. The results show that there are both similarities and differences in patients' and caregivers' opinions about the attributes of a meaningful encounter. Knowing more about the attributes associated with meaningful encounters makes it possible for caregivers to individualize care for patients and makes it easier to help and support patients in what they most need support with. PMID:22701802

A Multidimensional Theory of Suicide.

PubMed

Leenaars, Antoon A; Dieserud, Gudrun; Wenckstern, Susanne; Dyregrov, Kari; Lester, David; Lyke, Jennifer

2018-04-05

Theory is the foundation of science; this is true in suicidology. Over decades of studies of suicide notes, Leenaars developed a multidimensional model of suicide, with international (crosscultural) studies and independent verification. To corroborate Leenaars's theory with a psychological autopsy (PA) study, examining age and sex of the decedent, and survivor's relationship to deceased. A PA study in Norway, with 120 survivors/informants was undertaken. Leenaars' theoretical-conceptual (protocol) analysis was undertaken of the survivors' narratives and in-depth interviews combined. Substantial interjudge reliability was noted (κ = .632). Overall, there was considerable confirmatory evidence of Leenaars's intrapsychic and interpersonal factors in suicide survivors' narratives. Differences were found in the age of the decedent, but not in sex, nor in the survivor's closeness of the relationship. Older deceased people were perceived to exhibit more heightened unbearable intrapsychic pain, associated with the suicide. Leenaars's theory has corroborative verification, through the decedents' suicide notes and the survivors' narratives. However, the multidimensional model needs further testing to develop a better evidence-based way of understanding suicide.

A Constructivist Study of Middle School Students' Narratives and Ecological Illustrations

ERIC Educational Resources Information Center

Stokrocki, Mary L.; Flatt, Barbara; York, Emily

2010-01-01

Using participant observation, we describe/interpret the results of teaching a constructivist unit that empowered students in narrative writing and illustration. Participant observation methods included daily note taking, pre-post questioning, and photographing artworks. We analyzed students' stories and illustrations with borrowed and emerging…

Maternal Autonomy Support and Dyadic Verbal Synchrony during Narrative Coconstruction: Links with Child Attachment Representations and Independent Narrative Competence

ERIC Educational Resources Information Center

Kelly, Kimberly Reynolds

2018-01-01

This study investigated the empirical bases for 2 dimensions of narrative coconstruction (autonomy support and verbal synchrony) with 65 mother-child dyads. Links between the 2 narrative dimensions and child narrative competence were tested, and differences in autonomy support and verbal synchrony across attachment groups (child story-stem…

Performing Silence: Gender, Violence, and Resistance in Women's Narratives from Lahaul, India

ERIC Educational Resources Information Center

Bhattacharya, Himika

2009-01-01

This article presents two different ways of understanding silence, through a discussion of women's narratives of violence from Lahaul, India. Here I illustrate how feminist ethnography works its way into re-conceptualizing silence as a tool women use to resist existing patriarchal discourses of honor, tribe and nation. (Contains 1 note.)

Suicide and Suicide Prevention: Greek versus Biblical Perspectives.

ERIC Educational Resources Information Center

Kaplan, Kalman J.

1992-01-01

Compares suicide in Greek tragedy and Hebrew Bible, concentrating on life situations portrayed in two sets of narratives promoting or preventing suicide. Notes frequency of suicides in Greek tragedy and infrequency of suicides in Bible. Compares stories of Narcissus and Jonah in attempt to pinpoint what is suicide-promoting in Greek narratives and…

The American Slave Narrative. Dramatic Resource Material for the Classroom

ERIC Educational Resources Information Center

Polsky, Milton

1976-01-01

Notes that the story of the black runaway who escapes the slave status under great risk to live as a free man or woman comprises one of the most meaningful chapters in United States history. The slave narrative genre offers resource material which all children should find compelling and inspiring. (Author/AM)

Crafting and retelling everyday lives--disabled people's contribution to bioethical concerns.

PubMed

Matthews, Nicole; Ellem, Kathleen; Chenoweth, Lesley

2013-01-01

This commentary draws out themes from the narrative symposium on "living with the label "disability" from the perspective of auto/biography and critical disability studies in the humanities. It notes the disconnect between the experiences discussed in the stories and the preoccupations of bioethicists. Referencing Rosemarie Garland-Thompson's recent work, it suggests that life stories by people usually described as "disabled" offer narrative, epistemic and ethical resources for bioethics. The commentary suggests that the symposium offers valuable conceptual tools and critiques of taken-for-granted terms like "dependency". It notes that these narrators do not un-problematically embrace the term "disability", but emphasize the need to redefine, strategically deploy or reject this term. Some accounts are explicitly critical of medical practitioners while others redefine health and wellbeing, emphasizing the need for reciprocity and respect for the knowledge of people with disability, including knowledge from their experience of "the variant body" (Leach Scully, 2008).

Training addiction professionals in empirically supported treatments: perspectives from the treatment community.

PubMed

Hartzler, Bryan; Rabun, Carl

2014-01-01

Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, "Seeking Safety," and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge their receipt of training.

Heuristic evaluation of eNote: an electronic notes system.

PubMed

Bright, Tiffani J; Bakken, Suzanne; Johnson, Stephen B

2006-01-01

eNote is an electronic health record (EHR) system based on semi-structured narrative documents. A heuristic evaluation was conducted with a sample of five usability experts. eNote performed highly in: 1)consistency with standards and 2)recognition rather than recall. eNote needs improvement in: 1)help and documentation, 2)aesthetic and minimalist design, 3)error prevention, 4)helping users recognize, diagnosis, and recover from errors, and 5)flexibility and efficiency of use. The heuristic evaluation was an efficient method of evaluating our interface.

Narratives of "Doing, Knowing, Being and Becoming": Examining the Impact of an Attachment-Informed Approach within Initial Teacher Education

ERIC Educational Resources Information Center

Kearns, Sarah; Hart, Norma

2017-01-01

The Scottish Government's vision of improving outcomes for children prioritises attachment theory and research in promoting children's well-being across children's services. This theme is also noted as increasing international relevance. Our narrative research springs from the experience of designing and delivering the first course within initial…

Narrative Configuration: Some Notes on the Workings of Hindsight

ERIC Educational Resources Information Center

Kvernbekk, Tone

2013-01-01

In this paper I analyze the role of hindsight in narrative configuration. Configuration means the grasping together of disparate elements into a coherent whole. I argue that hindsight, importantly, brings the temporal constraints on what we can know to the fore, but is a double-edged sword. On the one hand, hindsight is an indispensable tool both…

Physician Information Needs and Electronic Health Records (EHRs): Time to Reengineer the Clinic Note.

PubMed

Koopman, Richelle J; Steege, Linsey M Barker; Moore, Joi L; Clarke, Martina A; Canfield, Shannon M; Kim, Min S; Belden, Jeffery L

2015-01-01

Primary care physicians face cognitive overload daily, perhaps exacerbated by the form of electronic health record documentation. We examined physician information needs to prepare for clinic visits, focusing on past clinic progress notes. This study used cognitive task analysis with 16 primary care physicians in the scenario of preparing for office visits. Physicians reviewed simulated acute and chronic care visit notes. We collected field notes and document highlighting and review, and we audio-recorded cognitive interview while on task, with subsequent thematic qualitative analysis. Member checks included the presentation of findings to the interviewed physicians and their faculty peers. The Assessment and Plan section was most important and usually reviewed first. The History of the Present Illness section could provide supporting information, especially if in narrative form. Physicians expressed frustration with the Review of Systems section, lamenting that the forces driving note construction did not match their information needs. Repetition of information contained in other parts of the chart (eg, medication lists) was identified as a source of note clutter. A workflow that included a patient summary dashboard made some elements of past notes redundant and therefore a source of clutter. Current ambulatory progress notes present more information to the physician than necessary and in an antiquated format. It is time to reengineer the clinic progress note to match the workflow and information needs of its primary consumer. © Copyright 2015 by the American Board of Family Medicine.

Fault Lines: Seismicity and the Fracturing of Energy Narratives in Oklahoma

NASA Astrophysics Data System (ADS)

Grubert, E.; Drummond, V. A.; Brandt, A. R.

2016-12-01

Fault Lines: Seismicity and the Fracturing of Energy Narratives in Oklahoma Virginia Drummond1, Emily Grubert21Stanford University, Stanford Earth Summer Undergraduate Research Program2Stanford University, Emmett Interdisciplinary Program in Environment and ResourcesOklahoma is an oil state where residents have historically been supportive of the oil and gas industry. However, a dramatic increase in seismic activity between 2009 and 2015 widely attributed to wastewater injection associated with oil production is a new and highly salient consequence of oil development, affecting local communities' relationship to the environment and to the oil industry. Understanding how seismicity plays into Oklahoma's evolving dialogue about energy is integral to understanding both the current realities and the future of energy communities in Oklahoma.This research engages Oklahoma residents through open-ended interviews and mixed quantitative-qualitative survey research to characterize how energy narratives shape identity in response to conflict between environmental outcomes and economic interest. We perform approximately 20 interviews with residents of Oklahoma, with particular attention to recruiting residents from a wide range of age groups and who work either within or outside the oil and gas industry. General population surveys supplementing detailed interviews with information about community characteristics, social and environmental priorities, and experience with hazards are delivered to residents selected at random from zip codes known to have experienced significant seismicity. We identify narratives used by residents in response to tension between economic and environmental concerns, noting Oklahoma as an interesting case study for how a relatively pro-industry community reacts to and reframes its relationship with energy development, given conflict. In particular, seismicity has fractured the dominant narrative of oil development as positive into new narratives framing the oil industry as responsible and responsive, framing oil development as posing real but acceptable risks, and framing oil development as dangerous, with links to a broader social narrative about the risks of hydraulic fracturing more generally.

What We Call Smart: A New Narrative for Intelligence and Learning. School-Age Children Series.

ERIC Educational Resources Information Center

Miller, Lynda

Noting that the collective stories of special education have grown out of a tradition that, by its nature tends to perpetuate problems, this book examines such narratives and how they influence thinking and belief about intelligence and learning. It begins by examining how the current story of intelligence developed and illustrates some of the…

Gossip, humor, and the art of becoming an intimate of Jesus.

PubMed

Capps, Donald

2012-03-01

In Living Stories (Capps 1997) I addressed the rather broad consensus among clergy and laity alike that gossip is destructive of congregational life, a consensus based on the view that gossip invariably involves negatively critical conversations about other individuals and groups. However, this view is not supported by social scientific research and literary studies on gossip, which present a more complex picture of this form of human communication. On the other hand, the claim that gossip is trivial is more difficult to challenge, so I made a case for the importance of the trivial through consideration of the formal similarities between gossip and the narratives that comprise the Gospels, including the fact that both employ an "esthetic of surfaces" that focuses on specific personal particulars and that the stories that are told derive their power from the freedom that the participants in the conversation gain from entering imaginatively into the life of other persons. The present article furthers the exploration of the affinities between gossip and Gospel narratives by noting the role of humor in fostering good gossip and the mutually supportive role of gossip and humor in the art of becoming an intimate of Jesus.

Use of Narrative Nursing Records for Nursing Research

PubMed Central

Park, Hyeoun-Ae; Cho, InSook; Ahn, Hee-Jung

2012-01-01

To explore the usefulness of narrative nursing records documented using a standardized terminology-based electronic nursing records system, we conducted three different studies on (1) the gaps between the required nursing care time and the actual nursing care time, (2) the practice variations in pressure ulcer care, and (3) the surveillance of adverse drug events. The narrative nursing notes, documented at the point of care using standardized nursing statements, were extracted from the clinical data repository at a teaching hospital in Korea and analyzed. Our findings were: the pediatric and geriatric units showed relatively high staffing needs; overall incidence rate of pressure ulcer among the intensive-care patients was 15.0% and the nursing interventions provided for pressure-ulcer care varied depending on nursing units; and at least one adverse drug event was noted in 53.0% of the cancer patients who were treated with cisplatin. A standardized nursing terminology-based electronic nursing record system allowed us to explore answers to different various research questions. PMID:24199111

Narrative constructions of historical realities in testimony with Bosnian survivors of "ethnic cleansing".

PubMed

Weine, S; Laub, D

1995-08-01

Mental health care for traumatized refugees includes practices common to mainstream mental health care but also modifications and innovations in technique and approach. One such innovation, the testimony method, was first described by a group of Chilean psychiatrists working with Chilean survivors of torture from political repression (Cienfuego and Monelli 1983). The testimony method has been used as a time-limited psychotherapeutic intervention, often within the context of an extended, supportive psychotherapy. This method consists of asking individuals to tell in detail the story of their experiences of victimization from state-sponsored violence and recording their narrative accounts verbatim. Agger and Jensen's account of this method depicts testimony as a universal practice, appearing in multiple cultures and at different points in history (Agger and Jensen 1990). They also note that testimony simultaneously functions in both the private and public domains; and as confession embodying the person's spiritual, ethical, aesthetic, and philosophical values, and as evidence documenting the occurrence of evil events to the world.

Korean Basic Course. Volume Two.

ERIC Educational Resources Information Center

Park, B. Nam

Volume Two of the Korean Basic Course contains Units 29 through 47. Most units consist of (1) a basic dialog, (2) notes on the basic dialog, (3) additional vocabulary and phrases, (4) grammar notes, (5) drills, (6) a supplementary dialog for comprehension, (7) a narrative for comprehension and reading, and (8) exercises. Two of the last units…

The two voices of Alzheimer's: attitudes toward brain health by diagnosed individuals and support persons.

PubMed

Beard, Renée L; Fetterman, David J; Wu, Bei; Bryant, Lucinda

2009-06-01

Most individuals with Alzheimer's are cared for in their homes by unpaid family members. Research on caregiving focuses disproportionally on costs of care, service utilization, and negative psychosocial outcomes. Few narrative accounts of Alzheimer's exist; those that do suffer similar pejorative framings and narrow foci. No studies that we are aware of examine the health beliefs of diagnosed individuals and support persons, or their attitudes about brain health. This research reports perceptions of "aging well" held by those most intimately acquainted with Alzheimer's. Diagnosed individuals and their support persons (N = 85) were enrolled into 14 focus groups. Grounded theory methods were used to collect, code, and analyze textual interview data into overarching themes. Respondents found physical and mental health, social activity, independence, and happiness integral to aging well. An acceptance of various limitations was also deemed crucial. Support persons placed more emphasis on lifestyle factors and memory loss as potential obstacles. Diagnosed respondents defined memory loss in less medicalized terms, whereas support persons labeled it Alzheimer's and negatively characterized those affected. Both groups warned against discussing "prevention" of dementia: Diagnosed individuals noted the implication of "aging poorly" and support persons cautioned against blaming diagnosed individuals. These findings can be used to encourage positive health beliefs and behaviors tailored to the needs of diagnosed seniors and their families, to help practitioners and researchers identify and become sensitive to differences between and among older adults, and to further advance the utility of narrative accounts for informing health interventions and education efforts.

Natural language processing of clinical notes for identification of critical limb ischemia.

PubMed

Afzal, Naveed; Mallipeddi, Vishnu Priya; Sohn, Sunghwan; Liu, Hongfang; Chaudhry, Rajeev; Scott, Christopher G; Kullo, Iftikhar J; Arruda-Olson, Adelaide M

2018-03-01

Critical limb ischemia (CLI) is a complication of advanced peripheral artery disease (PAD) with diagnosis based on the presence of clinical signs and symptoms. However, automated identification of cases from electronic health records (EHRs) is challenging due to absence of a single definitive International Classification of Diseases (ICD-9 or ICD-10) code for CLI. In this study, we extend a previously validated natural language processing (NLP) algorithm for PAD identification to develop and validate a subphenotyping NLP algorithm (CLI-NLP) for identification of CLI cases from clinical notes. We compared performance of the CLI-NLP algorithm with CLI-related ICD-9 billing codes. The gold standard for validation was human abstraction of clinical notes from EHRs. Compared to billing codes the CLI-NLP algorithm had higher positive predictive value (PPV) (CLI-NLP 96%, billing codes 67%, p < 0.001), specificity (CLI-NLP 98%, billing codes 74%, p < 0.001) and F1-score (CLI-NLP 90%, billing codes 76%, p < 0.001). The sensitivity of these two methods was similar (CLI-NLP 84%; billing codes 88%; p < 0.12). The CLI-NLP algorithm for identification of CLI from narrative clinical notes in an EHR had excellent PPV and has potential for translation to patient care as it will enable automated identification of CLI cases for quality projects, clinical decision support tools and support a learning healthcare system. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Elaboration and Autonomy Support in Low-Income Mothers' Reminiscing: Links to Children's Autobiographical Narratives

ERIC Educational Resources Information Center

Leyva, Diana; Reese, Elaine; Grolnick, Wendy; Price, Carrie

2008-01-01

Maternal elaboration and autonomy support during reminiscing facilitate middle-class children's autobiographical narrative skills. In this study, low-income Hispanic, White, and Black mothers' elaboration and autonomy support in reminiscing were examined in relation to children's joint and independent autobiographical narratives and engagement.…

An Alternative Way of Responding to Powerful Ideas: Notes to Accompany the Poem Entitled "Five Principles of Quality in Narratives of Action Research"

ERIC Educational Resources Information Center

Saunders, Lesley

2007-01-01

This paper is written in a personal capacity and mainly takes the form of a poem--in five sections--composed as a response to some of the ideas in the article by Hannu Heikkinen and colleagues in this same issue of "Educational Action Research": "Action research as narrative: five principles for validation". The poem takes its…

Developing the personal narratives of children with complex communication needs associated with intellectual disabilities: What is the potential of Storysharing® ?

PubMed

Bunning, Karen; Gooch, Lynsey; Johnson, Miranda

2017-07-01

Sharing personal experience in narrative is challenging for individuals with intellectual disabilities. The aim was to investigate the potential of Storysharing ® (Storysharing is an innovative communication method based on personal narrative, which has been developed to support conversations with people who have severe difficulties in communication) intervention. The study involved eleven pupil-educational supporter dyads at a special school. Storysharing ® was implemented over a 15-week period. Personal narratives were captured on video pre- and post-intervention. The data were analysed for discourse and narrative. Significant differences revealed a decline in 'query-answer' sequences and an increase in supporter use of 'prompts'. After intervention, there were fewer story episodes. Narrative structure showed gains in action sequences leading to climax, and in closing elements, indicating a more complete narrative. The Storysharing ® intervention appears to be associated with changes to the dyadic, personal narratives illustrating its potential. © 2016 John Wiley & Sons Ltd.

[Contributions of cortisol suppression tests to understanding of psychiatric disorders: a narrative review of literature].

PubMed

Tajima-Pozo, Kazuhiro; Montes-Montero, Ana; Güemes, Itziar; González-Vives, Sara; Díaz-Marsá, Marina; Carrasco, José Luis

2013-01-01

Activity of the hypothalamic-pituitary-adrenal axis had been studied for the past half century, when some researchers noted that some patients with Cushing's syndrome and severe mood disorders had high baseline cortisol levels, which resulted in an inhibited response in the 1mg dexamethasone suppression test. Altered dexamethasone suppression test results were subsequently found in many psychiatric diseases, including anorexia nervosa, obsessive-compulsive disorder, degenerative dementia, bipolar disorders, and schizophrenia. The relationship between high baseline cortisol levels and stress has also been studied. Some researches on the genesis of borderline personality disorder focused on traumatic childhood backgrounds. Other investigations aimed at elucidating the relationship between traumatic backgrounds and some psychiatric disorders noted that patients with post-traumatic stress disorder and borderline personality disorder showed an enhanced cortisol suppression with low cortisol doses (0.5 mg). Recent studies showed that use of an ultra-low dose of cortisol during the dexamethasone suppression test may be helpful for detecting disorders with hyperactivity of the hypothalamic-pituitary-adrenal axis. Recent advances in neuroimaging support the existence of hyperactivity of the hypothalamic-pituitary-adrenal axis in patients with borderline personality disorder, relating a decreased pituitary gland volume to major traumatic backgrounds and suicidal attempts. The purpose of this paper is to make a narrative review of research using dexamethasone suppression test in psychiatric disorders, in order to ascertain its value as a supplemental diagnostic test or as a prognostic marker. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

The union of narrative and executive function: different but complementary

PubMed Central

Friend, Margaret; Bates, Raven Phoenix

2014-01-01

Oral narrative production develops dramatically from 3 to 5 years of age, and is a key factor in a child's ability to communicate about the world. Concomitant with this are developments in executive function (EF). For example, executive attention and behavioral inhibition show marked development beginning around 4 years of age. Both EF and oral narrative abilities have important implications for academic success, but the relationship between them is not well understood. The present paper utilizes a cross-lagged design to assess convergent and predictive relations between EF and narrative ability. As a collateral measure, we collected a Language Sample during 10 min of free play. Language Sample did not share significant variance with Narrative Production, thus general language growth from Wave 1 to Wave 2 cannot account for the predictive relations between EF and Narrative. Our findings suggest that although EF and Narrative ability appear independent at each Wave, they nevertheless support each other over developmental time. Specifically, the ability to maintain focus at 4 years supports subsequent narrative ability and narrative ability at 4 years supports subsequent facility and speed in learning and implementing new rules. PMID:24872811

The role of patient narratives in healthcare innovation: supporting translation and meaning making.

PubMed

Pedersen, Anne Reff

2016-01-01

The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly aims to examine how patient narratives, in the form of diaries and radio montage, help to create new insights into patient experience for healthcare professionals, and support professionals' enrolment and mobilisation in innovation projects. Two case studies were undertaken. These drew upon qualitative interviews with staff and participant observation during innovation workshops. Patient diaries and a recorded montage of patient voices were also collected. The findings illuminate translation processes in healthcare innovation and the emergence of meaning making process for staff through the active use of patient narratives. The paper highlights the critical role of meaning making as an enabler of patient-centred change processes in healthcare via: local clinic mangers defining problems and ideas; collecting and sharing patient narratives in innovation workshops; and healthcare professionals' interpretation of patient narratives supporting new insights into patient experience. This study demonstrates how healthcare professionals' meaning making can be supported by articulating, constructing, listening and interpreting patient narratives. The two cases demonstrate how patient narratives serve as reflective devices for healthcare professionals. This study presents a novel demonstration of the importance of patient narratives for translating healthcare innovation in a clinical practice setting.

Linguistic pattern analysis of misspellings of typically developing writers in grades 1-9.

PubMed

Bahr, Ruth Huntley; Sillian, Elaine R; Berninger, Virginia W; Dow, Michael

2012-12-01

A mixed-methods approach, evaluating triple word-form theory, was used to describe linguistic patterns of misspellings. Spelling errors were taken from narrative and expository writing samples provided by 888 typically developing students in Grades 1-9. Errors were coded by category (phonological, orthographic, and morphological) and specific linguistic feature affected. Grade-level effects were analyzed with trend analysis. Qualitative analyses determined frequent error types and how use of specific linguistic features varied across grades. Phonological, orthographic, and morphological errors were noted across all grades, but orthographic errors predominated. Linear trends revealed developmental shifts in error proportions for the orthographic and morphological categories between Grades 4 and 5. Similar error types were noted across age groups, but the nature of linguistic feature error changed with age. Triple word-form theory was supported. By Grade 1, orthographic errors predominated, and phonological and morphological error patterns were evident. Morphological errors increased in relative frequency in older students, probably due to a combination of word-formation issues and vocabulary growth. These patterns suggest that normal spelling development reflects nonlinear growth and that it takes a long time to develop a robust orthographic lexicon that coordinates phonology, orthography, and morphology and supports word-specific, conventional spelling.

Multiple narratives: How underserved urban girls engage in co-authoring life stories and scientific stories

NASA Astrophysics Data System (ADS)

Thompson, Jessica Jane

Contemporary critics of science education have noted that girls often fail to engage in learning because they cannot "see themselves" in science. Yet theory on identity, engagement, and the appropriation of scientific discourse remains underdeveloped. Using identity as a lens, I constructed 2-two week lunchtime science sessions for 17 ethnic-minority high school girls who were failing their science classes. The units of instruction were informed by a pilot study and based on principles from literature on engagement in identity work and engagement in productive disciplinary discourse. Primary data sources included 19 hours of videotaped lunchtime sessions, 88 hours of audio-taped individual student interviews (over the course of 3--4 years), and 10 hours of audio-taped small group interviews. Secondary data sources included student journals, 48 hours of observations of science classes, teacher surveys about student participation, and academic school records. I used a case-study approach with narrative and discourse analysis. Not only were the girls individually involved in negotiating ideas about their narratives about themselves and their future selves, but collectively some of the girls productively negotiated multiple identities, appropriated scientific and epistemological discourse and learned science content. This was accomplished through the use of a hybrid discourse that blended identity talk with science talk. The use of this talk supported these girls in taking ownership for or becoming advocates for certain scientific ideas.

Narrative reflective practice in medical education for residents: composing shifting identities

PubMed Central

Clandinin, Jean; Cave, Marie Thérèse; Cave, Andrew

2011-01-01

As researchers note, medical educators need to create situations to work with physicians in training to help them attend to the development of their professional identities. While there is a call for such changes to be included in medical education, educational approaches that facilitate attention to the development of medical students’ professional identities, that is, who they are and who they are becoming as physicians, are still under development. One pedagogical strategy involves narrative reflective practice as a way to develop physician identity. Using this approach, medical residents first write narrative accounts of their experiences with patients in what are called “parallel charts”. They then engage in a collaborative narrative inquiry within a sustained inquiry group of other residents and two researcher/facilitators (one physician, one narrative researcher). Preliminary studies of this approach are underway. Drawing on the experiences of one medical resident in one such inquiry group, we show how this pedagogical strategy enables attending to physician identity making. PMID:23745070

Narrative reflective practice in medical education for residents: composing shifting identities.

PubMed

Clandinin, Jean; Cave, Marie Thérèse; Cave, Andrew

2011-01-01

As researchers note, medical educators need to create situations to work with physicians in training to help them attend to the development of their professional identities. While there is a call for such changes to be included in medical education, educational approaches that facilitate attention to the development of medical students' professional identities, that is, who they are and who they are becoming as physicians, are still under development. One pedagogical strategy involves narrative reflective practice as a way to develop physician identity. Using this approach, medical residents first write narrative accounts of their experiences with patients in what are called "parallel charts". They then engage in a collaborative narrative inquiry within a sustained inquiry group of other residents and two researcher/facilitators (one physician, one narrative researcher). Preliminary studies of this approach are underway. Drawing on the experiences of one medical resident in one such inquiry group, we show how this pedagogical strategy enables attending to physician identity making.

Assessing the difficulty and time cost of de-identification in clinical narratives.

PubMed

Dorr, D A; Phillips, W F; Phansalkar, S; Sims, S A; Hurdle, J F

2006-01-01

To characterize the difficulty confronting investigators in removing protected health information (PHI) from cross-discipline, free-text clinical notes, an important challenge to clinical informatics research as recalibrated by the introduction of the US Health Insurance Portability and Accountability Act (HIPAA) and similar regulations. Randomized selection of clinical narratives from complete admissions written by diverse providers, reviewed using a two-tiered rater system and simple automated regular expression tools. For manual review, two independent reviewers used simple search and replace algorithms and visual scanning to find PHI as defined by HIPAA, followed by an independent second review to detect any missed PHI. Simple automated review was also performed for the "easy" PHI that are number- or date-based. From 262 notes, 2074 PHI, or 7.9 +/- 6.1 per note, were found. The average recall (or sensitivity) was 95.9% while precision was 99.6% for single reviewers. Agreement between individual reviewers was strong (ICC = 0.99), although some asymmetry in errors was seen between reviewers (p = 0.001). The automated technique had better recall (98.5%) but worse precision (88.4%) for its subset of identifiers. Manually de-identifying a note took 87.3 +/- 61 seconds on average. Manual de-identification of free-text notes is tedious and time-consuming, but even simple PHI is difficult to automatically identify with the exactitude required under HIPAA.

Using In-Training Evaluation Report (ITER) Qualitative Comments to Assess Medical Students and Residents: A Systematic Review.

PubMed

Hatala, Rose; Sawatsky, Adam P; Dudek, Nancy; Ginsburg, Shiphra; Cook, David A

2017-06-01

In-training evaluation reports (ITERs) constitute an integral component of medical student and postgraduate physician trainee (resident) assessment. ITER narrative comments have received less attention than the numeric scores. The authors sought both to determine what validity evidence informs the use of narrative comments from ITERs for assessing medical students and residents and to identify evidence gaps. Reviewers searched for relevant English-language studies in MEDLINE, EMBASE, Scopus, and ERIC (last search June 5, 2015), and in reference lists and author files. They included all original studies that evaluated ITERs for qualitative assessment of medical students and residents. Working in duplicate, they selected articles for inclusion, evaluated quality, and abstracted information on validity evidence using Kane's framework (inferences of scoring, generalization, extrapolation, and implications). Of 777 potential articles, 22 met inclusion criteria. The scoring inference is supported by studies showing that rich narratives are possible, that changing the prompt can stimulate more robust narratives, and that comments vary by context. Generalization is supported by studies showing that narratives reach thematic saturation and that analysts make consistent judgments. Extrapolation is supported by favorable relationships between ITER narratives and numeric scores from ITERs and non-ITER performance measures, and by studies confirming that narratives reflect constructs deemed important in clinical work. Evidence supporting implications is scant. The use of ITER narratives for trainee assessment is generally supported, except that evidence is lacking for implications and decisions. Future research should seek to confirm implicit assumptions and evaluate the impact of decisions.

Teacher Narratives and Student Engagement: Testing Narrative Engagement Theory in Drug Prevention Education

PubMed Central

Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Pettigrew, Jonathan; Shin, YoungJu; Graham, John

2015-01-01

Testing narrative engagement theory, this study examines student engagement and teachers’ spontaneous narratives told in a narrative-based drug prevention curriculum. The study describes the extent to which teachers share their own narratives in a narrative-based curriculum, identifies dominant narrative elements, forms and functions, and assesses the relationships among teacher narratives, overall lesson narrative quality, and student engagement. One hundred videotaped lessons of the keepin’ it REAL drug prevention curriculum were coded and the results supported the claim that increased narrative quality of a prevention lesson would be associated with increased student engagement. The quality of narrativity, however, varied widely. Implications of these results for narrative-based prevention interventions and narrative pedagogy are discussed. PMID:26690668

Reba and Her Insurgent Prose: Sex Work, HIV/AIDS, and Subaltern Narratives.

PubMed

Basu, Ambar

2017-08-01

Narratives of cultural stakeholders in marginalized sex worker spaces often do not find the traction to influence mainstream health discourse. Furthermore, such narratives are framed against the grain of the dominant cultural narrative; they are resistive texts, and they depict enactments of resistance to the normal order. This article, based on 12 weeks of field study in a sex worker community in India, foregrounds how sex workers communicatively frame and enact resistance, and hence formulate insurgent texts, along a continuum-from overt violence to covert negotiation on issues such as condom and alcohol use. Making note of these insurgent texts is crucial to understanding how meanings of health are locally made in a sex worker community as it is often that members of such marginalized communities take recourse to covert and ritualistic forms of resistance to work, to survive, and to stay free of HIV infection.

"Why Am I the Way I Am?" Narrative Work in the Context of Stigmatized Identities.

PubMed

Rance, Jake; Gray, Rebecca; Hopwood, Max

2017-12-01

There are particular complexities faced by people attempting to tell their stories in the context of social stigma, such as the hostility which often surrounds injecting drug use. In this article, we identify some of the distinct advantages of taking a narrative approach to understanding these complexities by exploring a single case study, across two life-history interviews, with "Jimmy," a young man with a history of social disadvantage, incarceration, and heroin dependence. Drawing on Miranda Fricker's notion of "hermeneutical injustice," we consider the effects of stigmatization on the sociocultural practice of storytelling. We note the way Jimmy appears both constrained and released by his story-how he conforms to but also resists the master narrative of the "drug user." Narrative analysis, we conclude, honors the complex challenges of the accounting work evident in interviews such as Jimmy's, providing a valuable counterpoint to other forms of qualitative inquiry in the addictions field.

A Whole Other Story: Inclusive Victimhood Narratives Reduce Competitive Victimhood and Intergroup Hostility.

PubMed

Adelman, Levi; Leidner, Bernhard; Ünal, Helin; Nahhas, Eman; Shnabel, Nurit

2016-10-01

Conflict narratives, having at their core the belief that the ingroup suffered more than the outgroup (competitive victimhood), are key in maintaining conflicts. Three experiments conducted with Jewish Israelis (Study 1), Turkish Kurds (Study 2), and Americans (Study 3) tested whether conflict narratives can reduce conflict. Studies 1 and 3 showed that people respond to inclusive victimhood narratives that emphasize both ingroup and outgroup suffering with a reduction in competitive victimhood and, in turn, reduced support for aggressive policies-but only when people were relatively less concerned that acknowledgment of outgroup suffering might risk loss of third-party support. Study 2 further found that inclusive narratives reduce conflict for low-power groups, yet without being moderated by concern. Together, these studies show that inclusive victimhood narratives can reduce conflict when people are not concerned about losing third-party support. The important role of third parties in conflict resolution is discussed. © 2016 by the Society for Personality and Social Psychology, Inc.

Predicting better performance on a college preparedness test from narrative comprehension at the age of 6 years: An fMRI study.

PubMed

Horowitz-Kraus, Tzipi; Eaton, Kenneth; Farah, Rola; Hajinazarian, Ardag; Vannest, Jennifer; Holland, Scott K

2015-12-10

To investigate whether high performance on college preparedness tests at 18 years of age can be predicted from brain activation patterns during narrative comprehension at 5-7 years of age. In this longitudinal study, functional MRI data during an auditory narrative-comprehension task were acquired from 15 children (5-7 years of age) who also provided their American College Testing (ACT) scores at the age of 18 years. Active voxels during the narrative-comprehension task were correlated with both composite ACT scores and the reading-comprehension component of the exam. Higher composite ACT scores and behavioral scores for reading comprehension were positively correlated with greater activation in frontal and anterior brain regions during the narrative-comprehension task. Our results suggest that neural circuits supporting higher ACT performance are predictable from a narrative-comprehension task at the age of 5-7 years. This supports a critical role for the anterior cingulate cortex, which is a part of the cingulo-opercular cognitive-control network early in development, as a facilitator for better ACT scores. This study highlights that shared neural circuits that support overall ACT performance and neural circuits that support reading comprehension both rely on neural circuits related to narrative comprehension in childhood, suggesting that interventions involving narrative comprehension should be considered for individuals with reading and other academic difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.

Workarounds to Intended Use of Health Information Technology: A Narrative Review of the Human Factors Engineering Literature.

PubMed

Patterson, Emily S

2018-05-01

Objective To integrate and synthesize insights from recent studies of workarounds to the intended use of health information technology (HIT) by health care professionals. Background Systems are safest when the documentation of how work is done in policies and procedures closely matches what people actually do when they are working. Proactively identifying and managing workarounds to the intended use of technology, including deviations from expected workflows, can improve system safety. Method A narrative review of studies of workarounds with HIT was conducted to identify themes in the literature. Results Three themes were identified: (1) Users circumvented new additional steps in the workflow when using HIT, (2) interdisciplinary team members communicated via HIT in text fields that were intended for other purposes, and (3) locally developed paper-based and manual whiteboard systems were used instead of HIT to support situation awareness of individuals and groups; an example of a locally developed system was handwritten notes about a patient on a piece of paper folded up and carried in a nurse's pocket. Conclusion Workarounds were employed to avoid changes to workflow, enable interdisciplinary communication, coordinate activities, and have real-time portable access to summarized and synthesized information. Application Implications for practice include providing summary overview displays, explicitly supporting role-based communication and coordination through HIT, and reducing the risk to reputation due to electronic monitoring of individual performance.

Use of IDEF modeling to develop an information management system for drug and alcohol outpatient treatment clinics

NASA Astrophysics Data System (ADS)

Hoffman, Kenneth J.

1995-10-01

Few information systems create a standardized clinical patient record in which there are discrete and concise observations of patient problems and their resolution. Clinical notes usually are narratives which don't support an aggregate and systematic outcome analysis. Many programs collect information on diagnosis and coded procedures but are not focused on patient problems. Integrated definition (IDEF) methodology has been accepted by the Department of Defense as part of the Corporate Information Management Initiative and serves as the foundation that establishes a need for automation. We used IDEF modeling to describe present and idealized patient care activities. A logical IDEF data model was created to support those activities. The modeling process allows for accurate cost estimates based upon performed activities, efficient collection of relevant information, and outputs which allow real- time assessments of process and outcomes. This model forms the foundation for a prototype automated clinical information system (ACIS).

Integrating Journalism Into Health Promotion: Creating and Disseminating Community Narratives.

PubMed

Brown, Louis D; Berryhill, Joseph C; Jones, Eric C

2018-06-01

Media coverage of mental health and other social issues often relies on episodic narratives that suggest individualistic causes and solutions, while reinforcing negative stereotypes. Community narratives can provide empowering alternatives, serving as media advocacy tools used to shape the policy debate on a social issue. This article provides health promotion researchers and practitioners with guidance on how to develop and disseminate community narratives to broaden awareness of social issues and build support for particular programs and policy solutions. To exemplify the community narrative development process and highlight important considerations, this article examines a narrative from a mental health consumer-run organization. In the narrative, people with mental health problems help one another while operating a nonprofit organization, thereby countering stigmatizing media portrayals of people with mental illness as dangerous and incompetent. The community narrative frame supports the use of consumer-run organizations, which are not well-known and receive little funding despite evidence of effectiveness. The article concludes by reviewing challenges to disseminating community narratives, such as creating a product of interest to media outlets, and potential solutions, such as engaging media representatives through community health partnerships and using social media to draw attention to the narratives.

Conceptualizing Mathematics Using Narratives and Art

ERIC Educational Resources Information Center

Kurz , Terri L.; Bartholomew, Barbara

2013-01-01

Narratives are a wonderful way to allow students to personalize mathematics. In the context of this article, the authors define narratives as short stories, written by students, that contain a mathematical work problem centered on students' lives and interests. These narratives can be supported with art, such as drawings or photographs. When…

Medial Temporal Lobe Damage Causes Deficits in Episodic Memory and Episodic Future Thinking Not Attributable to Deficits in Narrative Construction

PubMed Central

Race, Elizabeth; Keane, Margaret M.; Verfaellie, Mieke

2015-01-01

The medial temporal lobe (MTL) makes critical contributions to episodic memory, but its contributions to episodic future thinking remain a matter of debate. By one view, imagining future events relies on MTL mechanisms that also support memory for past events. Alternatively, it has recently been suggested that future thinking is independent of MTL-mediated processes and can be supported by regions outside the MTL. The current study investigated the nature and necessity of MTL involvement in imagining the future and tested the novel hypothesis that the MTL contributes to future thinking by supporting online binding processes related to narrative construction. Human amnesic patients with well-characterized MTL damage and healthy controls constructed narratives about (a) future events, (b) past events, and (c) visually-presented pictures. While all three tasks place similar demands on narrative construction, only the past and future conditions require memory/future thinking to mentally generate relevant narrative information. Patients produced impoverished descriptions of both past and future events but were unimpaired at producing detailed picture narratives. In addition, future-thinking performance positively correlated with episodic memory performance but did not correlate with picture narrative performance. Finally, future-thinking impairments were present when MTL lesions were restricted to the hippocampus and did not depend on the presence of neural damage outside the MTL. These results indicate that the ability to generate and maintain a detailed narrative is preserved in amnesia and suggest that a common MTL mechanism supports both episodic memory and episodic future thinking. PMID:21753003

Medial temporal lobe damage causes deficits in episodic memory and episodic future thinking not attributable to deficits in narrative construction.

PubMed

Race, Elizabeth; Keane, Margaret M; Verfaellie, Mieke

2011-07-13

The medial temporal lobe (MTL) makes critical contributions to episodic memory, but its contributions to episodic future thinking remain a matter of debate. By one view, imagining future events relies on MTL mechanisms that also support memory for past events. Alternatively, it has recently been suggested that future thinking is independent of MTL-mediated processes and can be supported by regions outside the MTL. The current study investigated the nature and necessity of MTL involvement in imagining the future and tested the novel hypothesis that the MTL contributes to future thinking by supporting online binding processes related to narrative construction. Human amnesic patients with well characterized MTL damage and healthy controls constructed narratives about (1) future events, (2) past events, and (3) visually presented pictures. While all three tasks place similar demands on narrative construction, only the past and future conditions require memory/future thinking to mentally generate relevant narrative information. Patients produced impoverished descriptions of both past and future events but were unimpaired at producing detailed picture narratives. In addition, future-thinking performance positively correlated with episodic memory performance but did not correlate with picture narrative performance. Finally, future-thinking impairments were present when MTL lesions were restricted to the hippocampus and did not depend on the presence of neural damage outside the MTL. These results indicate that the ability to generate and maintain a detailed narrative is preserved in amnesia and suggest that a common MTL mechanism supports both episodic memory and episodic future thinking.

Linguistic Pattern Analysis of Misspellings of Typically Developing Writers in Grades 1 to 9

PubMed Central

Bahr, Ruth Huntley; Silliman, Elaine R.; Berninger, Virginia W.; Dow, Michael

2012-01-01

Purpose A mixed methods approach, evaluating triple word form theory, was used to describe linguistic patterns of misspellings. Method Spelling errors were taken from narrative and expository writing samples provided by 888 typically developing students in grades 1–9. Errors were coded by category (phonological, orthographic, and morphological) and specific linguistic feature affected. Grade level effects were analyzed with trend analysis. Qualitative analyses determined frequent error types and how use of specific linguistic features varied across grades. Results Phonological, orthographic, and morphological errors were noted across all grades, but orthographic errors predominated. Linear trends revealed developmental shifts in error proportions for the orthographic and morphological categories between grades 4–5. Similar error types were noted across age groups but the nature of linguistic feature error changed with age. Conclusions Triple word-form theory was supported. By grade 1, orthographic errors predominated and phonological and morphological error patterns were evident. Morphological errors increased in relative frequency in older students, probably due to a combination of word-formation issues and vocabulary growth. These patterns suggest that normal spelling development reflects non-linear growth and that it takes a long time to develop a robust orthographic lexicon that coordinates phonology, orthography, and morphology and supports word-specific, conventional spelling. PMID:22473834

Using narrative inquiry to listen to the voices of adolescent mothers in relation to their use of social networking sites (SNS).

PubMed

Nolan, Samantha; Hendricks, Joyce; Williamson, Moira; Ferguson, Sally

2018-03-01

This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers. Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support. Discussion paper. This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, "social networking sites", online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995-June 2017. Narrative research inherently values the individual "story" of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents. Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process. © 2017 John Wiley & Sons Ltd.

Care & Advocacy: Narratives from a School for Immigrant Youth. Educational Leadership for Social Justice

ERIC Educational Resources Information Center

Bennett, Jo

2012-01-01

This is a book of oral narratives, collected from participants at a school created for first-generation, immigrant youth. The narrations from the students, teachers, administration, professional staff, and support personnel document the power of caring relationships in an educational setting. The narratives underscore the importance of teachers,…

A story of change: The influence of narrative on African-Americans with diabetes

PubMed Central

Goddu, Anna P.; Raffel, Katie E.; Peek, Monica E.

2015-01-01

Objective To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. Methods In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. Results African-American adults (n = 36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative – discussing stories, rehearsing their messages with role-play, and building social support through storytelling – was reported as especially influential. Conclusion Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. Practice implications Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants. PMID:25986500

A story of change: The influence of narrative on African-Americans with diabetes.

PubMed

Goddu, Anna P; Raffel, Katie E; Peek, Monica E

2015-08-01

To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. African-American adults (n=36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative - discussing stories, rehearsing their messages with role-play, and building social support through storytelling - was reported as especially influential. Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A pilot test of the acceptability and efficacy of narrative and non-narrative health education materials in a low health literacy population

PubMed Central

Moran, Meghan Bridgid; Frank, Lauren B.; Chatterjee, Joyee S.; Murphy, Sheila T.; Baezconde-Garbanati, Lourdes

2016-01-01

Although entertainment-education narratives are increasingly being used to communicate health information to a diversity of populations, there is limited evidence examining the use of narrative health education videos in low compared with adequate health literacy populations. There are also very few studies directly comparing narrative materials to more traditional, non-narrative materials. Because individuals with low health literacy are less likely than those with adequate health literacy to benefit from health communication interventions, it is especially important to develop an evidence base supporting the use of narrative health education materials in low literacy populations. This study extends knowledge on the use of narrative health education materials in populations with low health literacy by conducting a randomized trial comparing the acceptability and efficacy (knowledge gain) of two fact-equivalent films, one in a narrative and one in a non-narrative format, on individuals with adequate and low health literacy. This study finds that while both films were well-accepted and produced knowledge gains, the narrative film was more effective in this regard. This effect occurred regardless of health literacy level, indicating that narrative health communication materials are appropriate for individuals with low health literacy and do not exacerbate existing health disparities. These findings add to a small but growing body of evidence testing narrative health education materials in individuals with low health literacy, and provide new evidence supporting narrative, entertainment-education style video as a health communication tool to help reduce health literacy-related health disparities. PMID:27872657

GCSE Assessment Notes: Six GCSE Assessment Assignments.

ERIC Educational Resources Information Center

Graham, Stephen

1988-01-01

Provided are copy masters, instructions for use, and grading criteria for six problems used as part of the practical assessment for a modular science course. Each problem gives a narrative and a list of materials necessary to complete the problem. (CW)

A narrative analysis of spiritual distress in geriatric physical rehabilitation.

PubMed

Mundle, Robert

2015-03-01

Drawing upon narrative data generated in a semi-structured interview with an 82-year-old female patient in geriatric physical rehabilitation, this clinical case study provides a detailed example of recognizing, assessing, and addressing spiritual distress as a symptom of physical pain. Data analysis focused on narrative content as well as on the interactive and performative aspects of narrating spiritual health issues in a close reading of two "attachment narratives." Results support the "narrative turn" in healthcare, including the therapeutic benefits of empathic listening as "narrative care" in geriatric rehabilitation and in healthcare in general. © The Author(s) 2015.

Variability in Mothers' Support for Preschoolers' Contributions to Co-Constructed Narratives as a Function of Child Age

ERIC Educational Resources Information Center

Zevenbergen, Andrea A.; Holmes, Ashley; Haman, Ewa; Whiteford, Nichole; Thielges, Shelly

2016-01-01

Children's narrative abilities in the preschool years have been found to predict their later literacy skills. Mothers' verbalizations during shared personal narratives with their preschoolers have been shown to facilitate children's development of narrative skills. The present study sought to extend the literature by investigating mothers' use of…

The anthropology of dementia: a narrative perspective.

PubMed

Randall, William L

2009-03-01

This article draws on recent thinking in the field of narrative gerontology to lend support to Mahnaz Hashmi's "anthropological perspective" on dementia. From a narrative perspective, the relational component of human life--and thus of dementia--is underscored. Moreover, when the narrative dimensions of memory are considered, the line between "normal" and "pathological" is revealed as finer than commonly assumed.

EEG Spectral Dynamics of Video Commercials: Impact of the Narrative on the Branding Product Preference

PubMed Central

Wang, Regina W. Y.; Chang, Yu-Ching; Chuang, Shang-Wen

2016-01-01

Neuromarketing has become popular and received a lot of attention. The quality of video commercials and the product information they convey to consumers is a hotly debated topic among advertising agencies and product advertisers. This study explored the impact of advertising narrative and the frequency of branding product exposures on the preference for the commercial and the branding product. We performed electroencephalography (EEG) experiments on 30 subjects while they watched video commercials. The behavioral data indicated that commercials with a structured narrative and containing multiple exposures of the branding products had a positive impact on the preference for the commercial and the branding product. The EEG spectral dynamics showed that the narratives of video commercials resulted in higher theta power of the left frontal, bilateral occipital region, and higher gamma power of the limbic system. The narratives also induced significant cognitive integration-related beta and gamma power of the bilateral temporal regions and the parietal region. It is worth noting that the video commercials with a single exposure of the branding products would be indicators of attention. These new findings suggest that the presence of a narrative structure in video commercials has a critical impact on the preference for branding products. PMID:27819348

EEG Spectral Dynamics of Video Commercials: Impact of the Narrative on the Branding Product Preference.

PubMed

Wang, Regina W Y; Chang, Yu-Ching; Chuang, Shang-Wen

2016-11-07

Neuromarketing has become popular and received a lot of attention. The quality of video commercials and the product information they convey to consumers is a hotly debated topic among advertising agencies and product advertisers. This study explored the impact of advertising narrative and the frequency of branding product exposures on the preference for the commercial and the branding product. We performed electroencephalography (EEG) experiments on 30 subjects while they watched video commercials. The behavioral data indicated that commercials with a structured narrative and containing multiple exposures of the branding products had a positive impact on the preference for the commercial and the branding product. The EEG spectral dynamics showed that the narratives of video commercials resulted in higher theta power of the left frontal, bilateral occipital region, and higher gamma power of the limbic system. The narratives also induced significant cognitive integration-related beta and gamma power of the bilateral temporal regions and the parietal region. It is worth noting that the video commercials with a single exposure of the branding products would be indicators of attention. These new findings suggest that the presence of a narrative structure in video commercials has a critical impact on the preference for branding products.

Artistic drawing as a mnemonic device

NASA Astrophysics Data System (ADS)

Baker Christensen, Leslie

Despite art-based learning being widely used, existing data are primarily qualitative, and most research has not isolated particular variables such as memory for empirical study. The few experiments that have been conducted demonstrated that drawing improves free recall of unpaired words, and retention improves after lessons integrated with drawing, drama, and narrative exercises. To help fill the gap in the current literature, the present study compared the effectiveness of encoding and the rate of memory decay between a drawing mnemonic and note taking on a paired associates task. Using a within-subjects experimental design, participants were presented with word pairs and asked to complete either a drawing mnemonic (DM) or note taking (NT) to assist memorization. Participants were tested immediately after the word pair presentation and after a 20-minute delay. Results supported the hypothesis that the DM condition would produce superior encoding, as evidenced by greater retention on the immediate test. However, no memory decay was observed in the experiment, and therefore results on the delayed test were inconclusive. In fact, scores for the NT condition improved over time whereas the scores for the DM condition did not, which might imply that note taking results in a different consolidation process than drawing. Findings from this study suggested that arts integration can be an effective method to support memory for learned information. Future studies that examine the effect of rehearsal and the long-term effectiveness of a drawing mnemonic are warranted. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd.

Ethnicity and cultural models of recovery from breast cancer.

PubMed

Coreil, Jeannine; Corvin, Jaime A; Nupp, Rebecca; Dyer, Karen; Noble, Charlotte

2012-01-01

Recovery narratives describe the culturally shared understandings about the ideal or desirable way to recover from an illness experience. This paper examines ethnic differences in recovery narratives among women participating in breast cancer support groups in Central Florida, USA. It compares groups serving African-American, Latina, and European American women, with the objective of better understanding the appeal of ethnic-specific illness support groups for culturally diverse populations. A mixed-method study design combined qualitative and quantitative measures, including in-depth interviews, participant observation at support group meetings, collection of printed documents, and a structured survey. Core elements of the recovery narrative drew from the dominant societal cancer discourse of optimism and personal transformation through adversity; however, important ethnic differences were evident in the meaning assigned to these themes. Groups gave distinctive salience to themes of faith and spirituality, empowerment through the migration experience, and becoming a better person through the journey of recovery. The findings suggest that ethnic cancer support groups draw upon dominant societal discourses about cancer, but they espouse distinctive recovery narratives that are consonant with the groups' cultural models of illness. Similarity between ethnic members' individual recovery narratives and that of the group may contribute to the appeal of ethnic illness support groups for culturally diverse populations.

Supporting narrative retells for people with aphasia using augmentative and alternative communication: photographs or line drawings? Text or no text?

PubMed

Griffith, Julie; Dietz, Aimee; Weissling, Kristy

2014-05-01

The purpose of this study was to examine how the interface design of an augmentative and alternative communication (AAC) device influences the communication behaviors of people with aphasia during a narrative retell task. A case-series design was used. Four narratives were created on an AAC device with combinations of personally relevant (PR) photographs, line drawings (LDs), and text for each participant. The narrative retells were analyzed to describe the expressive modality units (EMUs) used, trouble sources experienced, and whether trouble sources were repaired. The researchers also explored the participants' perceived helpfulness of the interface features. The participants primarily used spoken EMUs to retell their narratives. They relied on PR photographs more frequently than LDs; however, they reported both picture types to be equally helpful. Text was frequently used and reported as helpful by all 4 people with aphasia. Participants experienced similar rates of trouble sources across conditions; however, they displayed unique trends for successful repairs of trouble sources. For narrative retells, LDs may serve as an effective visual support when PR photographs are unavailable. Individual assessment is necessary to determine the optimum combination of supports in AAC systems for people with aphasia.

Mood and narrative entwinement: some implications for educational practice.

PubMed

Conroy, Sherrill A; Dobson, Stephen

2005-09-01

Moods are one way of existentially reading the authenticity of people and are entwined within any narrative. Attunement between narrative and its mood is crucial for understanding the implicit message of the narrator. Sometimes, a master narrative is interrupted by counternarratives, so that narrative recognition becomes problematic. People can disguise their existential state when narrating, but the mood discloses it nonetheless. The authors explore the relationship between mood and narrative, and how the two are connected with how a person acts authentically or inauthentically. They provide selected empirical examples of narratives from medical students to support their argument. The educational relevance of their discussion comprises the final section. Educators in any educational program must first reflect on, then make explicit the manner in which narrative and mood are used to communicate knowledge.

Towards interactive narrative medicine.

PubMed

Cavazza, Marc; Charles, Fred

2013-01-01

Interactive Storytelling technologies have attracted significant interest in the field of simulation and serious gaming for their potential to provide a principled approach to improve user engagement in training scenarios. In this paper, we explore the use of Interactive Storytelling to support Narrative Medicine as a reflective practice. We describe a workflow for the generation of virtual narratives from high-level descriptions of patients' experiences as perceived by physicians, which can help to objectivize such perceptions and support various forms of analysis.

Blogs Written by Families During Their Child's Hospitalization: A Thematic Narrative Analysis.

PubMed

Jones, Carolyn W; Lynn, Mary R

2018-04-04

To identify stressors experienced by parents whose child is hospitalized in an intensive care unit, and identify coping mechanisms utilized to ameliorate those stressors. Using Lazarus and Folkman's Transactional Model of Stress and Coping as a framework, 20 publicly available blogs written by parents while their child was a patient in intensive care were analyzed using thematic analysis techniques. Stressors and coping techniques were identified, and grouped by theme for further analysis. The most frequently noted types of stressors were related to information; both knowing and not knowing information related to their child's condition was reported as stressful, as well as waiting for information and when the information was not what was expected. Reframing was the emotion-focused technique most often identified by the parents, and seeking support was the most frequently noted problem-focused coping mechanism. Illness blogs represent a rich source of information regarding the experiences of families with a child in the hospital. Parents transitioned from more emotion-focused coping strategies to problem-focused strategies during their child's hospital stay. When nurses give information to parents, they should be aware that knowing information can be stressful as well as not knowing, and care should be taken to provide support for parents after information is given. Nurses can also help parents identify sources of support. Writing about their experiences, either online or in a journal, may help parents cope in stressful situations. Copyright © 2017 Elsevier Inc. All rights reserved.

Game Design Narrative for Learning: Appropriating Adventure Game Design Narrative Devices and Techniques for the Design of Interactive Learning Environments

ERIC Educational Resources Information Center

Dickey, Michele D.

2006-01-01

The purpose of this conceptual analysis is to investigate how contemporary video and computer games might inform instructional design by looking at how narrative devices and techniques support problem solving within complex, multimodal environments. Specifically, this analysis presents a brief overview of game genres and the role of narrative in…

Acknowledging individual responsibility while emphasizing social determinants in narratives to promote obesity-reducing public policy: a randomized experiment.

PubMed

Niederdeppe, Jeff; Roh, Sungjong; Shapiro, Michael A

2015-01-01

This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity's social determinants were less likely to engage in counterargument and felt more empathy for the story's main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity.

Acknowledging Individual Responsibility while Emphasizing Social Determinants in Narratives to Promote Obesity-Reducing Public Policy: A Randomized Experiment

PubMed Central

Niederdeppe, Jeff; Roh, Sungjong; Shapiro, Michael A.

2015-01-01

This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity’s social determinants were less likely to engage in counterargument and felt more empathy for the story’s main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity. PMID:25706743

Vampires and a Moco Jumbie

ERIC Educational Resources Information Center

Blaisdell, Bob

2013-01-01

Vampires and a Moco Jumbie is a narrative-essay about teaching Basic Composition in New York City in the early 1990s. To the surprise and delight of the teacher, the students describe in class discussions and in their writings their beliefs in the supernatural. Contains one note.

Literacy, Community, and Youth Acts of Place-Making

ERIC Educational Resources Information Center

Kinloch, Valerie

2009-01-01

Valerie Kinloch describes how the literacy narratives around place-making by Phillip, an African American teenager who resides in this historic community, demonstrate complexities of confronting power, struggle, and identity within an out-of-school community that is rapidly becoming gentrified. (Contains 3 notes.)

Changing the Poisonous Narrative

ERIC Educational Resources Information Center

Dodge, Arnold

2012-01-01

In this interview conducted by educator Arnold Dodge, education historian Diane Ravitch discusses what's wrong with the agenda of the "corporate reform movement." She notes that a current obsession with testing and a persistent blaming of teachers is subverting learning for students. The emphasis on competition, entrepreneurship, and…

Taiwanese medical students' narratives of intercultural professionalism dilemmas: exploring tensions between Western medicine and Taiwanese culture.

PubMed

Ho, Ming-Jung; Gosselin, Katherine; Chandratilake, Madawa; Monrouxe, Lynn V; Rees, Charlotte E

2017-05-01

In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between Western medicine and Taiwanese culture. A narrative interview method was employed with 64 Taiwanese medical students to collect narratives of professionalism dilemmas. Noting the prominence of culture in students' narratives, we explored this theme further using secondary analysis, identifying tensions between Western medicine and Taiwanese culture and categorizing students' intercultural professionalism dilemmas according to Friedman and Berthoin Antal's 'intercultural competence' framework: involving combinations of advocacy (i.e., championing one's own culture) and inquiry (i.e., exploring one's own and others' cultures). One or more intercultural dilemmas were identified in nearly half of students' professionalism dilemma narratives. Qualitative themes included: family relations, local policy, end-of-life care, traditional medicine, gender relations and Taiwanese language. Of the 62 narratives with sufficient detail for further analysis, the majority demonstrated the 'suboptimal' low advocacy/low inquiry approach (i.e., withdrawal or inaction), while very few demonstrated the 'ideal' high advocacy/high inquiry approach (i.e., generating mutual understanding, so 'intercultural competence'). Though nearly half of students' professionalism narratives concerned intercultural dilemmas, most narratives represented disengagement from intercultural dilemmas, highlighting a possible need for more attention on intercultural competence training in Taiwan. The advocacy/inquiry framework may help educators to address similar disconnects between Western medicine and non-Western cultures in other contexts.

Multimodal Narrative Inquiry: Six Teacher Candidates Respond

ERIC Educational Resources Information Center

Morawski, Cynthia M.; Rottmann, Jennifer

2016-01-01

In this paper we present findings of a study on the implementation of a multimodal teacher narrative inquiry component, theoretically grounded by Rosenblatt's theory of transaction analysis, methodologically supported by action research and practically enacted by narrative inquiry and multimodal learning. In particular, the component offered…

Do Medical Students' Narrative Representations of "The Good Doctor" Change Over Time? Comparing Humanism Essays From a National Contest in 1999 and 2013.

PubMed

Rutberg, Pooja C; King, Brandy; Gaufberg, Elizabeth; Brett-MacLean, Pamela; Dinardo, Perry; Frankel, Richard M

2017-04-01

To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession. The authors noted a highly similar distribution of primary and secondary relational themes for essays from 1999 and 2013. The majority of the essays emphasized the centrality of the doctor-patient relationship. Student essays focused little on teamwork, systems innovation, or technology use-all important developments in contemporary medicine. Medical students' narrative reflections are increasingly used as rich sources of information about the lived experience of medical education. The findings reported here suggest that medical students understand the "good doctor" as a relational being, with an enduring emphasis on the doctor-patient relationship. Medical education would benefit from including an emphasis on the relational aspects of medicine. Future research should focus on relational learning as a pedagogical approach that may support the formation of caring, effective physicians embedded in a complex array of relationships within clinical, community, and larger societal contexts.

Cultural Pedagogy and Bridges to Literacy: Home and Kindergarten.

ERIC Educational Resources Information Center

Korat, Ofra

2001-01-01

Presents five key aspects of cultural pedagogy theory: social interactions, self-identity, externalization of inner thought, educational institutions, and narratives. Views these aspects as critical vehicles to fostering the child's literacy development. Notes that within this framework, great importance has been assigned to the cooperative link…

Defining and Demonstrating Capabilities for Experience-Based Narrative Memory

DTIC Science & Technology

2011-07-01

extracting patterns from observed examples. For example, given a collection of five summaries of Shakespeare plays, the Analogical Story Merging System...notes the detailed similarities of Macbeth and Hamlet , how Julius Caesar shares some structure with Macbeth and Hamlet but nowhere near as much, and

How Children Respond to Art.

ERIC Educational Resources Information Center

Nodelman, Perry

1984-01-01

This essay discusses 13 pictorial devices with which one must be familiar to understand the illustrations in Virginia Lee Burton's "Mike Mulligan and His Steam Shovel." Color constancy, implied background, sharply drawn lines, abstractions of caricature, use of perspective, face on objects, and picture book narration are noted. (EJS)

Theory as a Second Story: Extending a Tale

ERIC Educational Resources Information Center

Benedict, Cathy

2011-01-01

In this article, the author states that she supports Wayne Bowman's (2006) concern with the impact narratives can have, including their potential to legitimize "existing patterns of privilege and possibility." She argues that "there is nothing inherently emancipatory about narrative." In fact, narrative "may, and often…

Classifying clinical notes with pain assessment using machine learning.

PubMed

Fodeh, Samah Jamal; Finch, Dezon; Bouayad, Lina; Luther, Stephen L; Ling, Han; Kerns, Robert D; Brandt, Cynthia

2017-12-26

Pain is a significant public health problem, affecting millions of people in the USA. Evidence has highlighted that patients with chronic pain often suffer from deficits in pain care quality (PCQ) including pain assessment, treatment, and reassessment. Currently, there is no intelligent and reliable approach to identify PCQ indicators inelectronic health records (EHR). Hereby, we used unstructured text narratives in the EHR to derive pain assessment in clinical notes for patients with chronic pain. Our dataset includes patients with documented pain intensity rating ratings > = 4 and initial musculoskeletal diagnoses (MSD) captured by (ICD-9-CM codes) in fiscal year 2011 and a minimal 1 year of follow-up (follow-up period is 3-yr maximum); with complete data on key demographic variables. A total of 92 patients with 1058 notes was used. First, we manually annotated qualifiers and descriptors of pain assessment using the annotation schema that we previously developed. Second, we developed a reliable classifier for indicators of pain assessment in clinical note. Based on our annotation schema, we found variations in documenting the subclasses of pain assessment. In positive notes, providers mostly documented assessment of pain site (67%) and intensity of pain (57%), followed by persistence (32%). In only 27% of positive notes, did providers document a presumed etiology for the pain complaint or diagnosis. Documentation of patients' reports of factors that aggravate pain was only present in 11% of positive notes. Random forest classifier achieved the best performance labeling clinical notes with pain assessment information, compared to other classifiers; 94, 95, 94, and 94% was observed in terms of accuracy, PPV, F1-score, and AUC, respectively. Despite the wide spectrum of research that utilizes machine learning in many clinical applications, none explored using these methods for pain assessment research. In addition, previous studies using large datasets to detect and analyze characteristics of patients with various types of pain have relied exclusively on billing and coded data as the main source of information. This study, in contrast, harnessed unstructured narrative text data from the EHR to detect pain assessment clinical notes. We developed a Random forest classifier to identify clinical notes with pain assessment information. Compared to other classifiers, ours achieved the best results in most of the reported metrics. Graphical abstract Framework for detecting pain assessment in clinical notes.

Medical student professionalism narratives: a thematic analysis and interdisciplinary comparative investigation.

PubMed

Bernard, Aaron W; Malone, Matthew; Kman, Nicholas E; Caterino, Jeffrey M; Khandelwal, Sorabh

2011-08-12

Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships. A thematic analysis was conducted on 377 professionalism narratives from medical students completing a required EM clerkship from July 2008 through May 2010. The narratives were analyzed using established thematic categories from prior research as well as basic descriptive characteristics. Chi-square analysis was used to compare the frequency of thematic categories to prior research in IM. Finally, emerging themes not fully appreciated in the established thematic categories were created using grounded theory. Observations involving interactions between attending physician and patient were most abundant. The narratives were coded as positive 198 times, negative 128 times, and hybrid 37 times. The two most abundant narrative themes involved manifesting respect (36.9%) and spending time (23.7%). Both of these themes were statistically more likely to be noted by students on EM clerkships compared to IM clerkships. Finally, one new theme regarding cynicism emerged during analysis. This analysis describes an informal curriculum that is diverse in themes. Student narratives suggest their clinical experiences to be influential on professionalism development. Medical students focus on different aspects of professionalism depending on clerkship specialty.

Medical Student Professionalism Narratives: A Thematic Analysis and Interdisciplinary Comparative Investigation

PubMed Central

2011-01-01

Background Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships. Methods A thematic analysis was conducted on 377 professionalism narratives from medical students completing a required EM clerkship from July 2008 through May 2010. The narratives were analyzed using established thematic categories from prior research as well as basic descriptive characteristics. Chi-square analysis was used to compare the frequency of thematic categories to prior research in IM. Finally, emerging themes not fully appreciated in the established thematic categories were created using grounded theory. Results Observations involving interactions between attending physician and patient were most abundant. The narratives were coded as positive 198 times, negative 128 times, and hybrid 37 times. The two most abundant narrative themes involved manifesting respect (36.9%) and spending time (23.7%). Both of these themes were statistically more likely to be noted by students on EM clerkships compared to IM clerkships. Finally, one new theme regarding cynicism emerged during analysis. Conclusions This analysis describes an informal curriculum that is diverse in themes. Student narratives suggest their clinical experiences to be influential on professionalism development. Medical students focus on different aspects of professionalism depending on clerkship specialty. PMID:21838887

The Heterogeneity of Picture-Supported Narratives in Alzheimer's Disease

ERIC Educational Resources Information Center

Duong, A.; Giroux, F.; Tardif, A.; Ska, B.

2005-01-01

This study describes discourse patterns produced by 46 Alzheimer disease (AD) patients and 53 normal elderly subjects in two picture-supported narratives. Nine measures derived from a cognitive model of discourse processing were obtained and submitted to cluster analysis. Results indicate that discourse patterns elicited from both stimuli were…

Using ICT-Supported Narratives in Teaching Science and Their Effects on Middle School Students

ERIC Educational Resources Information Center

Ekici, Fatma Taskin; Pekmezci, Sultan

2015-01-01

Effective and sustainable science education is enriched by the use of visuals, auditory, and tactile experiences. In order to provide effective learning, instruction needs to include multimodal approaches. Integrating ICT supported narrations into learning environments may provide effective and sustainable learning methods. Investigated in this…

Challenging Inquiry and Building Community: Analyzing ESL and Bilingual Teachers' Narratives

ERIC Educational Resources Information Center

Musanti, Sandra I.

2017-01-01

The study explores English as a second language (ESL) and bilingual teachers' narratives within a learning community as they collectively engage in reflecting on practices to more effectively support English learners. This longitudinal qualitative study integrates narrative inquiry approach and critical incident methodology. Participants were…

Narrative Learning, EAL and Metacognitive Development

ERIC Educational Resources Information Center

Cortazzi, Martin; Jin, Lixian

2007-01-01

This paper elaborates some aspects of narrative learning--defined here as learning to tell stories and learning from, about and through narratives--in the context of primary-age pupils who use English as an Additional Language (EAL). The paper introduces some principles to support their language development in classroom interaction. We argue that…

Design of an extensive information representation scheme for clinical narratives.

PubMed

Deléger, Louise; Campillos, Leonardo; Ligozat, Anne-Laure; Névéol, Aurélie

2017-09-11

Knowledge representation frameworks are essential to the understanding of complex biomedical processes, and to the analysis of biomedical texts that describe them. Combined with natural language processing (NLP), they have the potential to contribute to retrospective studies by unlocking important phenotyping information contained in the narrative content of electronic health records (EHRs). This work aims to develop an extensive information representation scheme for clinical information contained in EHR narratives, and to support secondary use of EHR narrative data to answer clinical questions. We review recent work that proposed information representation schemes and applied them to the analysis of clinical narratives. We then propose a unifying scheme that supports the extraction of information to address a large variety of clinical questions. We devised a new information representation scheme for clinical narratives that comprises 13 entities, 11 attributes and 37 relations. The associated annotation guidelines can be used to consistently apply the scheme to clinical narratives and are https://cabernet.limsi.fr/annotation_guide_for_the_merlot_french_clinical_corpus-Sept2016.pdf . The information scheme includes many elements of the major schemes described in the clinical natural language processing literature, as well as a uniquely detailed set of relations.

Transforming Professional Healthcare Narratives into Structured Game-Informed-Learning Activities

ERIC Educational Resources Information Center

Begg, Michael; Ellaway, Rachel; Dewhurst, David; Macleod, Hamish

2007-01-01

Noting the dependency of healthcare education on practice-based learning, Michael Begg, Rachel Ellaway, David Dewhurst, and Hamish Macleod suggest that creating a virtual clinical setting for students to interact with virtual patients can begin to address educational demands for clinical experience. They argue that virtual patient simulations that…

Readerly and Writerly "Letters from the Park."

ERIC Educational Resources Information Center

Conde, Susana

1993-01-01

Discusses in depth the film "Cartas del parque" ("Letters from the Park"), the first of six films in the "Amores Dificiles" series. Notes that the film is pervaded by the traditional overdetermination of gender roles. Suggests that an intrusive and authoritative narrator makes of this both a "readerly" and a…

Black Preschoolers' Social Cognition: Storytelling and False Belief.

ERIC Educational Resources Information Center

Curenton, Stephanie M.; Wilson, Melvin N.; Lillard, Angeline S.

Noting that the lower performance of low-income children on false belief tasks in comparison to that of middle-income children has not been adequately explained, this study examined the possibility that black children's experiences and talents with storytelling may facilitate their performance on false belief tasks when narrative questions are…

"Cirque du Freak."

ERIC Educational Resources Information Center

Rivett, Miriam

2002-01-01

Considers the marketing strategies that underpin the success of the "Cirque du Freak" series. Describes how "Cirque du Freak" is an account of events in the life of schoolboy Darren Shan. Notes that it is another reworking of the vampire narrative, a sub-genre of horror writing that has proved highly popular with both adult and…

The Goat Portage: Students' Stories and Learning from Canoe Trips.

ERIC Educational Resources Information Center

Horwood, Bert

This study explores how high school students learn from their experiences in an extracurricular adventure program and illustrates how students' narrative inquiries relate to experiential learning. Twelve canoe trips were studied by participant observation methods. Data were collected from recorded interviews with students and staff, field notes,…

Teaching thoughtful practice: narrative pedagogy in addictions education.

PubMed

Vandermause, Roxanne K; Townsend, Ryan P

2010-07-01

Preparing practitioners for this rapidly changing and demanding health care environment is challenging. A surge in knowledge development and scientific advancement has placed a priority on technical skill and a focus on content driven educational processes that prepare students for evidence-based practice. However, the most difficult health care scenarios require thinking-in-action and thoughtfulness as well as didactic knowledge. It is our contention that interpretive educational methods, like narrative pedagogy, will promote judgment-based practice that includes use of evidence and delivery of thoughtful care. In this article, we describe and interpret a narrative approach to addictions content and teaching thoughtful practice. We present our pedagogical process, including observations and field notes, to show how interpretive pedagogies can be introduced into nursing curricula. By presenting this process, the reader is invited to consider interpretive methods as a way to inspire and habituate thoughtful practice and judgment-based care. Copyright 2009 Elsevier Ltd. All rights reserved.

Temporally contiguous pencast instruction promotes meaningful learning for dental and dental hygiene students in physiology.

PubMed

Roesch, Darren M

2014-01-01

Smartpens allow for the creation of computerized "pencasts" that combine voice narration with handwritten notes and illustrations. The purpose of this study was to test the effects of voluntary participation in extracurricular instruction with a pencast on student learning. Dental and dental hygiene students were given instruction in a complex physiological topic using lecture and static slides. An Internet link to a pencast that covered the complex topic in a more temporally contiguous fashion was also provided for voluntary review. The students were given a multiple-choice exam that consisted of retention and transfer test questions. Sixty-nine percent of the students who did not watch the pencast and 89 percent of the students who watched the pencast answered the retention test question correctly (p=0.08). Fifty-four percent of the students who did not watch the pencast and 90 percent of the students who watched the pencast answered the transfer test question correctly (p=0.005). This finding indicates that students who watched the pencast performed better on a transfer test, a measurement of meaningful learning, than students who received only the narrated instruction with static images. This supports the hypothesis that temporally contiguous instruction promotes more meaningful learning than lecture accompanied only by static slide images.

The hippocampus facilitates integration within a symbolic field.

PubMed

Cornelius, John Thor

2017-10-01

This paper attempts to elaborate a fundamental brain mechanism involved in the creation and maintenance of symbolic fields of thought. It will integrate theories of psychic spaces as explored by Donald Winnicott and Wilfred Bion with the neuroscientific examinations of those with bilateral hippocampal injury to show how evidence from both disciplines sheds important light on this aspect of mind. Possibly originating as a way of maintaining an oriented, first person psychic map, this capacity allows individuals a dynamic narrative access to a realm of layered elements and their connections. If the proposed hypothesis is correct, the hippocampus facilitates the integration of this symbolic field of mind, where narrative forms of thinking, creativity, memory, and dreaming are intertwined. Without the hippocampus, there is an inability to engage many typical forms of thought itself. Also, noting the ways these individuals are not impaired supports theories about other faculties of mind, providing insight into their possible roles within human thought. The evidence of different systems working in conjunction with the symbolic field provides tantalizing clues about these fundamental mechanisms of brain and mind that are normally seamlessly integrated, and hints at future areas of clinical and laboratory research, both within neuroscience and psychoanalysis. © 2017 The Authors. The International Journal of Psychoanalysis published by John Wiley & Sons Ltd on behalf of Institute of Psychoanalysis.

Employee reactions and adjustment to euthanasia-related work: identifying turning-point events through retrospective narratives.

PubMed

Reeve, Charlie L; Spitzmuller, Christiane; Rogelberg, Steven G; Walker, Alan; Schultz, Lisa; Clark, Olga

2004-01-01

This study used a retrospective narrative procedure to examine the critical events that influence reactions and adjustment to euthanasia-related work of 35 employees who have stayed in the animal care and welfare field for at least 2 years. The study analyzed adjustment trajectory graphs and interview notes to identify turning-point events that spurred either a positive or negative change in shelter workers' psychological well-being. Analysis of the identified turning-point events revealed 10 common event themes that have implications for a range of work, personnel, and organizational practices. The article discusses implications for shelter, employee, and animal welfare.

Caveat actor, Caveat emptor: some notes on some hazards of Tinseltown teaching.

PubMed

Greenberg, Harvey Roy

2009-06-01

The use of films in teaching psychiatry and psychotherapy remains problematic for a number of reasons. The bulk of films are made for commercial reasons, not for educational purposes. Scientific truth is often overshadowed by narrative requirement in films. In most 'mainstream' cinema and 'indie' productions, diagnostic accuracy is still seriously compromised by narrative considerations. Clinical reality continues to be undermined and overridden by the need--as makers see it--to tell a powerful story in aid of huge box office receipts. Therapists in films are also often caricatures and caution must be employed in using cinema in real-time individual therapy.

Tissue-Resident T Cells as the Central Paradigm of Chlamydia Immunity

PubMed Central

Johnson, Raymond M.

2016-01-01

For almost 2 decades, results from Chlamydia pathogenesis investigations have been conceptualized using a cytokine polarization narrative. Recent viral immunity studies identifying protective tissue-resident memory T cells (Trm) suggest an alternative paradigm based on localized immune networks. As Chlamydia vaccines enter the preclinical pipeline and, in the case of an attenuated trachoma vaccine, are given to human subjects, it may be useful to ask whether cytokine polarization is the appropriate framework for understanding and evaluating vaccine efficacy. In this review, we revisit C. trachomatis pathogenesis data from mice and humans using a Trm narrative and note a comfortable concordance with the Chlamydia pathogenesis literature. PMID:26787715

Narrative constructions of health care issues and policies: the case of President Clinton's apology-by-proxy for the Tuskegee syphilis experiment.

PubMed

Carmack, Heather J; Bates, Benjamin R; Harter, Lynn M

2008-06-01

The Tuskegee Syphilis Experiment (TSE) has shaped African Americans' views of the American health care system, contributing to a reluctance to participate in biomedical research and a suspicion of the medical system. This essay examines public discourses surrounding President Clinton's attempt to restore African Americans' trust by apologizing for the TSE. Through a narrative reading, we illustrate the failure of this text as an attempt to reconcile the United States Public Health Service and the African American public. We conclude by noting the limitations of rhetoric when equal prominence is not given to policy proposals in national apologies.

A Mosaic of Words: Using Photo-Narration to Support All Learners

ERIC Educational Resources Information Center

Marinak, Barbara A.; Strickland, Martha J.; Keat, Jane Blakely

2010-01-01

This article describes collaboration between three university professors and six preschool teachers who used photo-narration and the Language Experience Approach to support the language development of young children. For more than a century, educators have used children's personal experiences as a basis for language and literacy instruction. The…

The Influence of Kinetic Structure in Films on Biology Students' Achievement and Attitude.

ERIC Educational Resources Information Center

Simmons, Ellen Stephanie

1980-01-01

Tested and supported was the hypothesis that students receiving high-structured film narrations will acquire more knowledge and will respond more favorably than those receiving low-structured film narrations. Results contribute additional data to evidence supporting the need for critical application of the kinetic structure theory in evaluating…

Social Narrative Strategies to Support Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Coogle, Christan Grygas; Ahmed, Siddiq; Aljaffal, Mohammed Abdulaziz; Alsheef, Manal Yousef; Hamdi, Hamad Ali

2018-01-01

The purpose of this manuscript is to identify social narrative strategies that can be used to enhance the social skills of young children identified with autism spectrum disorder. We provide a description as well as scenarios describing how educators might consider using social narrative strategies. We conclude with resources to attain additional…

Supporting Oral Narrative Development of Kindergarten English Language Learners Using Multimedia Stories

ERIC Educational Resources Information Center

Yang, Sha

2016-01-01

Narrative ability comes before literacy for bilingual students and helps narrow down the gap in text-level literacy between English language learners (ELLs) and native English speakers. Kindergarten ELLs are the best age group to receive intervention to improve their oral narrative skills. Multimedia stories have potential to assist kindergarten…

Comparison of information content of structured and narrative text data sources on the example of medication intensification.

PubMed

Turchin, Alexander; Shubina, Maria; Breydo, Eugene; Pendergrass, Merri L; Einbinder, Jonathan S

2009-01-01

OBJECTIVE To compare information obtained from narrative and structured electronic sources using anti-hypertensive medication intensification as an example clinical issue of interest. DESIGN A retrospective cohort study of 5,634 hypertensive patients with diabetes from 2000 to 2005. MEASUREMENTS The authors determined the fraction of medication intensification events documented in both narrative and structured data in the electronic medical record. The authors analyzed the relationship between provider characteristics and concordance between intensifications in narrative and structured data. As there is no gold standard data source for medication information, the authors clinically validated medication intensification information by assessing the relationship between documented medication intensification and the patients' blood pressure in univariate and multivariate models. RESULTS Overall, 5,627 (30.9%) of 18,185 medication intensification events were documented in both sources. For a medication intensification event documented in narrative notes the probability of a concordant entry in structured records increased by 11% for each study year (p < 0.0001) and decreased by 19% for each decade of provider age (p = 0.035). In a multivariate model that adjusted for patient demographics and intraphysician correlations, an increase of one medication intensification per month documented in either narrative or structured data were associated with a 5-8 mm Hg monthly decrease in systolic and 1.5-4 mm Hg decrease in diastolic blood pressure (p < 0.0001 for all). CONCLUSION Narrative and structured electronic data sources provide complementary information on anti-hypertensive medication intensification. Clinical validity of information in both sources was demonstrated by correlation with changes in blood pressure.

Comprehensive modeling of critical health care activities, costs, and data needs within the context of addiction rehabilitiation

NASA Astrophysics Data System (ADS)

Hoffman, Kenneth J.; Keithley, Hudson

1994-12-01

There are few systems which aggregate standardized pertinent clinical observations of discrete patient problems and resolutions. The systematic information supplied by clinicians is generally provided to justify reimbursement from insurers. Insurers, by their nature, and expert in modeling health care costs by diagnosis, procedures, and population risk groups. Medically, they rely on clinician generated diagnostic and coded procedure information. Clinicians will document a patient's status at a discrete point in time through narrative. Clinical notes do not support aggregate and systematic analysis of outcome. A methodology exists and has been used by the US Army Drug and Alcohol Program to model the clinical activities, associated costs, and data requirements of an outpatient clinic. This has broad applicability for a comprehensive health care system to which patient costs and data requirements can be established.

The impact of Asian American value systems on palliative care: illustrative cases from the family-focused grief therapy trial.

PubMed

Mondia, Stephen; Hichenberg, Shira; Kerr, Erica; Eisenberg, Megan; Kissane, David W

2012-09-01

Clinicians meet people from different ethnic backgrounds, yet need to respond in culturally sensitive ways. This article focuses on Asian American families. Within a randomized controlled trial of family therapy commenced during palliative care and continued into bereavement, 3 families of Asian American background were examined qualitatively from a cultural perspective by listening to recordings of 26 therapy sessions and reviewing detailed supervision notes compiled by each therapist. A synopsis of each family's therapy narrative is presented. Prominent themes include family closeness, respect for hierarchy within the family, gender-determined roles, intergenerational tensions, preoccupation with shame and limited emotional expressiveness. Family therapists working with culturally diverse families need to pay thoughtful attention to ethnic issues as they strive to support them during palliative care and bereavement.

In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey

PubMed Central

2014-01-01

Background Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers’ actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. Objective The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals’ treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients’ health travel. Methods This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists’ written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to identify characteristics and themes using qualitative analysis software. Results The narrative posts of 36 individuals undergoing 47 procedures who traveled to Turkey for medical care between 2007 and 2012 were analyzed. The narratives came from 13 countries, not including the narratives for which patient origin could not be determined. Travelers were predominantly from Europe (16/36, 44%) and North America (10/36, 28%). Factors driving travelers away from their home country (push factors) were cost and lack of treatment options or insufficient insurance coverage in their home country. Leading factors attracting patients to destination (pull factors) were lower costs, physician’s expertise and responsiveness, and familiarity or interest in Turkey. Health travelers to Turkey were generally satisfied with the outcomes of their procedures and care provided by their physicians, many noting intent to return. Communication challenges, food, transportation, and gaps in customer service emerged as key areas for improvement. Conclusions This analysis provides an understanding of the insights of medical tourists through the words of actual health travelers. This nonintrusive methodology provides candid insights of common themes of health travelers and may be applied to study other patient experiences. The findings of this research expands the body of knowledge in medical tourism and serves as a platform for further qualitative and quantitative research on health travelers’ experiences. PMID:24513565

In the words of the medical tourist: an analysis of Internet narratives by health travelers to Turkey.

PubMed

Ozan-Rafferty, Margaret E; Johnson, James A; Shah, Gulzar H; Kursun, Attila

2014-02-06

Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers' actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals' treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients' health travel. This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists' written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to identify characteristics and themes using qualitative analysis software. The narrative posts of 36 individuals undergoing 47 procedures who traveled to Turkey for medical care between 2007 and 2012 were analyzed. The narratives came from 13 countries, not including the narratives for which patient origin could not be determined. Travelers were predominantly from Europe (16/36, 44%) and North America (10/36, 28%). Factors driving travelers away from their home country (push factors) were cost and lack of treatment options or insufficient insurance coverage in their home country. Leading factors attracting patients to destination (pull factors) were lower costs, physician's expertise and responsiveness, and familiarity or interest in Turkey. Health travelers to Turkey were generally satisfied with the outcomes of their procedures and care provided by their physicians, many noting intent to return. Communication challenges, food, transportation, and gaps in customer service emerged as key areas for improvement. This analysis provides an understanding of the insights of medical tourists through the words of actual health travelers. This nonintrusive methodology provides candid insights of common themes of health travelers and may be applied to study other patient experiences. The findings of this research expands the body of knowledge in medical tourism and serves as a platform for further qualitative and quantitative research on health travelers' experiences.

The dialectic in becoming a mother: experiencing a postpartum phenomenon.

PubMed

Sethi, S

1995-01-01

In this study of the phenomenon of the postpartum period grounded theory methodology was used to investigate the experiences of first-time mothers during the first three months following their deliveries. The sample consisted of 12 primipara women and 3 multipara women. The data were generated by using unstructured interviews and field notes. Each woman was interviewed twice, the first time between 2 and 3 weeks postpartum, and the second time between 10 and 12 weeks postpartum. The final data for analysis consisted of: data generated through interviews, field notes, and the narratives of four mothers found in the non-fiction literature. Constant comparative analysis resulted in the generation of four categories and corresponding subcategories. These were: (1) Giving of Self; (2) Redefining Self; (3) Redefining Relationships; and (4) Redefining Professional Goals. The categories were not mutually exclusive. All the categories converged to provide support for the core variable 'Dialectic in Becoming a Mother'. The dialectic perspective demonstrated that, in becoming mothers, the women experienced transition, contradictions, tensions and transformations. A theoretical model was developed to show relationships among these major concepts. The findings of this study will be useful in effecting change in the provision of care to postpartum women and their families.

Emplotment, Embodiment, Engagement: Narrative Technology in Support of Physical Education, Sport and Physical Activity

ERIC Educational Resources Information Center

Hall, Tony

2012-01-01

This paper is based on a keynote lecture delivered at the International Association of Physical Education in Higher Education 2011 Conference, University of Limerick, on the sub theme: "Technologies in Support of Physical Education, Sport, and Physical Activity." The paper outlines and illustrates a framework: narrative technology, which can be…

African American Online Doctor of Management Students' Perceptions of Dissertation Writing and Support: Narrative Inquiry

ERIC Educational Resources Information Center

Diggs, Betty Jean

2017-01-01

The purpose of this qualitative narrative inquiry was to explore how African American Online doctor of management students perceived engaging support to maintain motivation throughout the dissertation writing process. The study involved collecting and analyzing data from 10 African American online doctoral students who matriculated into an online…

Teaching Writing: Support Material for Text Level Objectives. The National Literacy Strategy.

ERIC Educational Resources Information Center

Department for Education and Skills, London (England).

These 10 fliers focus on strategies to improve students' writing. The fliers are: (1) Improving Writing (covers general points related to all types of writing); (2) Writing Narrative (covers the main points to writing narrative, helping children to build up a repertoire of different types of narrative); (3) Writing Poetry (covers the main points…

The Stories We Tell: Exploring Narrative in Education for Justice and Equality in Multicultural Contexts

ERIC Educational Resources Information Center

Osler, Audrey

2015-01-01

This paper focuses on the role of narrative in enabling educational processes to support justice and equality in multicultural societies. It draws on Bhabha's (2003) concept "the right to narrate", arguing that conceptions of multicultural education which focus exclusively on the nation are insufficient in a globalized and interdependent…

Representing Latino/a Culture in Introductory Spanish Textbooks.

ERIC Educational Resources Information Center

Elissondo, Guillermina

This paper examines the kinds of visuals that Spanish language textbooks use to legitimize Latino/a culture, noting how different groups are presented and represented by the narratives; how ethnicity, class, gender, age, and sexual inclinations interplay with power relations, and what ideologies weave the textual fabric of foreign language books.…

Postrace: Every Good-bye Ain't Gone

ERIC Educational Resources Information Center

Ford, Iris Carter

2010-01-01

In this commentary, anthropologist Iris Carter Ford reflects on the preceding pieces by Carmen Kynard and Signithia Fordham. She identifies parallels among the two essays and her own life, drawing out themes that emerge from the narratives. Integrating ideas about "talking black" and "talking back," Ford notes that both phenomena have roots in…

Octavia Butler and Virginia Hamilton: Black Women Writers and Science Fiction.

ERIC Educational Resources Information Center

Hampton, Gregory Jerome; Brooks, Wanda M.

2003-01-01

Notes that African American literature has always had science fiction elements in its focus on narratives of the alienated and marginalized "other." Contends that Octavia Butler and Virginia Hamilton are two African American writers of science fiction who examine the connections between the stories of a culture and the genre of science…

Theorizing Teacher Identity: Self-Narratives and Finding Place in an Audit Society

ERIC Educational Resources Information Center

Bullough, Robert V., Jr.

2015-01-01

Noting the need for richer theories of identity and identity formation in education, the author describes aspects of D. P. McAdams' psychosocial constructivist framework enriched by select concepts drawn from Life Course research for conceptualizing and analyzing identity development within audit-driven societies and educational systems. Drawing…

Stories in Our Classrooms: Diverse Human Lives, as Narrated by Standardizing Policies

ERIC Educational Resources Information Center

Bomer, Randy

2006-01-01

Bomer challenges the logic and effectiveness of current educational policy, noting that just as educational practice was becoming interdisciplinary and promoting holistic growth, philanthropic organizations pulled away from the effort with the expectation that government and other funding entities would pick up the responsibility. They didn't.…

Finding Other Truths

ERIC Educational Resources Information Center

Xiong, Pang Hlub

2015-01-01

In this article, the author notes that much too often, students' deficits become the primary narrative for them and educators forget to see the many promises that these students hold. They begin to confine their potential and seek to make them fit the mold of their presumptions. Teachers take an unspoken vow to be their champions, their coach, and…

"A New Kind of Rule": The Subversive Narrator in "Alice's Adventures in Wonderland" and "The Pied Piper of Hamelin."

ERIC Educational Resources Information Center

Blackburn, William

1986-01-01

Compares "Alice's Adventures in Wonderland" to "The Pied Piper of Hamelin," noting that both: (1) were begun for the amusement of specific children; (2) use a subterranean journey as a device; (3) are critical of social authority; and (4) have problematic endings. (SRT)

Narrative Problems of Graphic Design History.

ERIC Educational Resources Information Center

Margolin, Victor

1994-01-01

Discusses three major accounts (by Philip Meggs, Enric Satue and Richard Hollis) of graphic design history. Notes that these texts address the history of graphic design, but each raises questions about what material to include, as well as how graphic design is both related to and distinct from other visual practices such as typography, art…

Teaching Culture in a North American Context: Halloween Revisited.

ERIC Educational Resources Information Center

Mollica, Anthony; And Others

1996-01-01

Notes that information presented in dialog form in a foreign language lends itself more easily to conversation than does intricate narrative prose. Using background information on Halloween, the article adapts the text to present information about the target culture as well as to humorously present facts about the North American festivity.…

Charles Dickens, Social Worker in His Time

ERIC Educational Resources Information Center

Andrews, Arlene Bowers

2012-01-01

As the world marks the 200th anniversary of Charles Dickens's birth, social workers may take note of the contributions Dickens made to 19th century social reform. Ever the advocate for people who were poor and oppressed, Dickens, in his timeless fictional narratives, continues to have relevance for contemporary social justice advocacy. This…

Stories about ourselves: How national narratives influence the diffusion of large-scale energy technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Malone, Elizabeth L.; Hultman, Nathan E.; Anderson, Kate

Examining past examples of rapid, transformational changes in energy technologies could help governments understand the factors associated with such transitions. We used an existing dataset to assess government strategies to connect new energy technologies with national narratives. Analyzing the diffusion stories told by experts, we demonstrate how governments connected the new technologies with their national narratives. The United States government supported the development of nuclear power after World War II with the national narrative that the United States was destined to improve creation, increasing the potential of raw materials exponentially for the nation’s good (“atoms for peace,” electricity “too cheapmore » to meter”). In Brazil, the development of sugar cane ethanol was supported by the government’s invoking the national narrative of suffering leading to knowledge and redemption, coupled with the quest for improved societal well-being (technological development to produce ethanol and employment for farmers). In Sweden, biomass energy was tied to the national narrative of local control, as well as love of nature and tradition (the use of natural products). We found strong evidence that the pairing of technological transformations with national narratives facilitated the successful development and implementation of these major energy technologies in the three cases analyzed here.« less

Stories about ourselves: How national narratives influence the diffusion of large-scale energy technologies

DOE PAGES

Malone, Elizabeth L.; Hultman, Nathan E.; Anderson, Kate; ...

2017-07-03

Examining past examples of rapid, transformational changes in energy technologies could help governments understand the factors associated with such transitions. We used an existing dataset to assess government strategies to connect new energy technologies with national narratives. Analyzing the diffusion stories told by experts, we demonstrate how governments connected the new technologies with their national narratives. The United States government supported the development of nuclear power after World War II with the national narrative that the United States was destined to improve creation, increasing the potential of raw materials exponentially for the nation’s good (“atoms for peace,” electricity “too cheapmore » to meter”). In Brazil, the development of sugar cane ethanol was supported by the government’s invoking the national narrative of suffering leading to knowledge and redemption, coupled with the quest for improved societal well-being (technological development to produce ethanol and employment for farmers). In Sweden, biomass energy was tied to the national narrative of local control, as well as love of nature and tradition (the use of natural products). We found strong evidence that the pairing of technological transformations with national narratives facilitated the successful development and implementation of these major energy technologies in the three cases analyzed here.« less

Narrative persuasion, causality, complex integration, and support for obesity policy.

PubMed

Niederdeppe, Jeff; Shapiro, Michael A; Kim, Hye Kyung; Bartolo, Danielle; Porticella, Norman

2014-01-01

Narrative messages have the potential to convey causal attribution information about complex social issues. This study examined attributions about obesity, an issue characterized by interrelated biological, behavioral, and environmental causes. Participants were randomly assigned to read one of three narratives emphasizing societal causes and solutions for obesity or an unrelated story that served as the control condition. The three narratives varied in the extent to which the character in the story acknowledged personal responsibility (high, moderate, and none) for controlling her weight. Stories that featured no acknowledgment and moderate acknowledgment of personal responsibility, while emphasizing environmental causes and solutions, were successful at increasing societal cause attributions about obesity and, among conservatives, increasing support for obesity-related policies relative to the control group. The extent to which respondents were able to make connections between individual and environmental causes of obesity (complex integration) mediated the relationship between the moderate acknowledgment condition and societal cause attributions. We conclude with a discussion of the implications of this work for narrative persuasion theory and health communication campaigns.

Forensic historiography: narratives and science.

PubMed

Drukteinis, Albert M

2014-01-01

Psychiatrists function, in part, as historians who rely on patient narratives to help them understand presenting mental disorders and explain their causes. Forensic psychiatrists have been skeptical of using narratives, raising concerns about their lack of objectivity and potential for bias. They also have criticized narratives as being more performative than scientific. Recent authors, however, have pointed out that narratives may be helpful in forming forensic opinions and supporting oral testimony, while stressing that their use must be consistent with the ethics espoused by forensic psychiatry. This article reviews the role of narratives in understanding human events and the ubiquitous presence of narratives in the judicial process. It delves into the inescapability of using explicit or implicit narratives in the course of forensic practice, as well as how they may be meaningfully incorporated into evaluations and find expression alongside scientific principles. © 2014 American Academy of Psychiatry and the Law.

Quantifying care coordination using natural language processing and domain-specific ontology

PubMed Central

Popejoy, Lori L; Khalilia, Mohammed A; Popescu, Mihail; Galambos, Colleen; Lyons, Vanessa; Rantz, Marilyn; Hicks, Lanis; Stetzer, Frank

2015-01-01

Objective This research identifies specific care coordination activities used by Aging in Place (AIP) nurse care coordinators and home healthcare (HHC) nurses when coordinating care for older community-dwelling adults and suggests a method to quantify care coordination. Methods A care coordination ontology was built based on activities extracted from 11 038 notes labeled with the Omaha Case management category. From the parsed narrative notes of every patient, we mapped the extracted activities to the ontology, from which we computed problem profiles and quantified care coordination for all patients. Results We compared two groups of patients: AIP who received enhanced care coordination (n=217) and HHC who received traditional care (n=691) using 128 135 narratives notes. Patients were tracked from the time they were admitted to AIP or HHC until they were discharged. We found that patients in AIP received a higher dose of care coordination than HHC in most Omaha problems, with larger doses being given in AIP than in HHC in all four Omaha categories. Conclusions ‘Communicate’ and ‘manage’ activities are widely used in care coordination. This confirmed the expert hypothesis that nurse care coordinators spent most of their time communicating about their patients and managing problems. Overall, nurses performed care coordination in both AIP and HHC, but the aggregated dose across Omaha problems and categories is larger in AIP. PMID:25324557

"I just want my life back!" - Men's narratives about living with fibromyalgia.

PubMed

Sallinen, Merja; Mengshoel, Anne Marit

2017-10-26

Fibromyalgia is characterized by chronic widespread pain and an array of other symptoms. It is less common among men than among women and the results concerning the severity of men's symptoms are contradictory. The purpose of this study was to elucidate the impacts of fibromyalgia on men's daily life and work ability. The data were collected through life story interviews of five men with fibromyalgia. The results of a narrative analysis are presented in a form of two model narratives: "Adjusting the life to match the illness" and "Being imprisoned by the pain". The first narrative is a description of finding a balance between the illness and wellness, whereas the second is an account of debilitating symptoms, unsuccessful treatment, and rehabilitation interventions. The results suggest that adjusting one's activities may help to manage the symptoms and to support work ability in many cases but for some patients the experience of feeling healthy or pain free might be nothing but a fading memory. Narrative approach is well applicable to rehabilitation of patients with fibromyalgia: an illness narrative may help the patient and professionals to understand the situation better and to set realistic and relevant goals for rehabilitation. Implications for rehabilitation In addition to chronic pain, men with fibromyalgia suffer from daytime tiredness and cognitive challenges that substantially interfere with their work ability and daily functioning. Vocational rehabilitation interventions, including e.g., adjustments of work tasks and hours, should be started early on to support work ability. The results indicate that psychosocial support is needed to improve health related quality of life of patients with severe and complex symptoms, especially if return-to-work is not an option. Men with fibromyalgia seem to lack peer support both in face-to face groups and in on-line groups. "All-male" support groups could be explored in rehabilitation settings in the future. Using a narrative approach in rehabilitation might result in a shared understanding of the patient's situation. This could help the professionals to set more individual, realistic, and relevant goals for rehabilitation, which in turn might improve rehabilitation outcomes.

Effects of Competing Narratives on Public Perceptions of Opioid Pain Reliever Addiction during Pregnancy.

PubMed

Kennedy-Hendricks, Alene; McGinty, Emma E; Barry, Colleen L

2016-10-01

Opioid pain reliever addiction has increased among women of reproductive age over the last fifteen years. News media and public attention have focused on the implications of this trend for infants exposed to opioids prenatally, with state policy responses varying in the extent to which they are punitive or public health oriented. We fielded a six-group randomized experiment among a nationally representative sample of US adults to test the effects of narratives portraying a woman with opioid pain reliever addiction during pregnancy on beliefs about people addicted to opioid pain relievers, perceptions of treatment effectiveness, policy attitudes, and emotional responses. Portraying a high socioeconomic status (SES) woman in the narrative lowered perceptions of individual blame for addiction and reduced public support for punitive policies. Depicting the barriers to treatment faced by a low SES woman lowered support for punitive policies and increased support for expanded insurance coverage for treatment. The extent to which narratives portraying successfully treated addiction affected public attitudes depended on the SES of the woman portrayed. These findings can inform the development of communication strategies to reduce stigma toward this population, reduce support for punitive policies, and increase support for more public health-oriented approaches to addressing this problem. Copyright © 2016 by Duke University Press.

Tissue-Resident T Cells as the Central Paradigm of Chlamydia Immunity.

PubMed

Johnson, Raymond M; Brunham, Robert C

2016-04-01

For almost 2 decades, results from Chlamydia pathogenesis investigations have been conceptualized using a cytokine polarization narrative. Recent viral immunity studies identifying protective tissue-resident memory T cells (Trm) suggest an alternative paradigm based on localized immune networks. As Chlamydia vaccines enter the preclinical pipeline and, in the case of an attenuated trachoma vaccine, are given to human subjects, it may be useful to ask whether cytokine polarization is the appropriate framework for understanding and evaluating vaccine efficacy. In this review, we revisit C. trachomatis pathogenesis data from mice and humans using a Trm narrative and note a comfortable concordance with the Chlamydia pathogenesis literature. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

"And They Let You Know You're Not Alone and That's What They're Here For": Persistence Narratives of Women Immigrants in Public Library Literacy Programs.

ERIC Educational Resources Information Center

Cuban, Sondra

This study examines persistence narratives of female immigrants in three public library literacy programs. The narrative analysis method was used. Transcripts of student interviews and biographical portraits were read, and incidents, images, events, and statements concerning persistence supports and barriers, literacy, and language learning were…

Developing the Personal Narratives of Children with Complex Communication Needs Associated with Intellectual Disabilities: What Is the Potential of Storysharing®?

ERIC Educational Resources Information Center

Bunning, Karen; Gooch, Lynsey; Johnson, Miranda

2017-01-01

Background: Sharing personal experience in narrative is challenging for individuals with intellectual disabilities. The aim was to investigate the potential of Storysharing® (Storysharing is an innovative communication method based on personal narrative, which has been developed to support conversations with people who have severe difficulties in…

A Comparison of Narrative Exposure Therapy, Supportive Counseling, and Psychoeducation for Treating Posttraumatic Stress Disorder in an African Refugee Settlement

ERIC Educational Resources Information Center

Neuner, Frank; Schauer, Margarete; Klaschik, Christine; Karunakara, Unni; Elbert, Thomas

2004-01-01

Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions. Narrative exposure therapy (NET) is a short-term approach based on cognitive-behavioral therapy and testimony therapy. The efficacy of narrative exposure therapy was evaluated in a randomized controlled trial.…

"This Guy's Dead": Seeking the Origins of the Dystopian Narrative of the American High School in the Popular Culture

ERIC Educational Resources Information Center

Witte, Shelbie; Goodson, Todd

2011-01-01

Educators' work is impacted by the political narratives constructed by politicians and legislators. The manipulation of cultural archetypes, including the representations of schools and teachers, in order to create compelling narratives in support of policy is also part of the context within which educators work. The past 25 years have been laden…

Will it never end? The narratives of incest victims on the termination of sexual abuse.

PubMed

Lorentzen, Erlend; Nilsen, Håvard; Traeen, Bente

2008-01-01

The aim of this study is to investigate how child sexual abuse is terminated. This study attempts to gain insight into how people exposed to incest narrate the termination of the incest relationship. Seven women and one man were recruited from the Incest Support Centre and from snowballing for a 1-2-hour-long in-depth interview using a narrative approach. The subjects' narratives varied according to how they perceived their own role in the termination process, their relationship with the offender, and how well they remembered the stage of termination. A common feature of the narratives was that the feeling of being a victim lasted after the abuse stopped. In this respect, the lack of support from family, friends, and healthcare personnel and the psychological power exercised by the offender were important issues in the narratives. It is suggested that the termination process is affected by the victims' ability to regulate influence and mentalization. Furthermore, a transfer of cultural meanings from the social environment to the individual must have taken place. Future research should focus on the significance of the termination process in terms of psychological functioning and the construction of self and identity.

Children's moral emotions, narratives, and aggression: relations with maternal discipline and support.

PubMed

Arsenio, William; Ramos-Marcuse, Fatima

2014-01-01

Children who attribute more positive emotions to hypothetical moral victimizers are typically more aggressive and have more behavior problems. Little is known, however, about when individual differences in these moral emotion attributions first emerge or about maternal correlates of these differences. In this study, 63 4-6-year-olds judged how they would feel after victimizing peers for gain and enacted event conclusions using narrative methods adapted from the MacArthur Story Stem Battery. In addition, children's mothers completed assessments of their disciplinary styles and social support, and children's aggressive tendencies were assessed based on ratings from mothers and a second familiar adult. Results revealed that most preschoolers expected to feel happy after their victimizing acts, but variations in happy victimization were unrelated to children's aggression. Several of children's narrative themes, including making amends (e.g., apologizing, reparations), aggressive acts, and mentions of death/killing, however, were related to children's aggression. Moreover, two maternal disciplinary dimensions, higher warmth and reasoning, as well as greater social support were also related to lower child aggression. Children's emotion attributions and moral narratives, however, were unrelated to maternal disciplinary practices or social support.

The influence of child sexual abuse on the self from adult narrative perspectives.

PubMed

Krayer, Anne; Seddon, Diane; Robinson, Catherine A; Gwilym, Hefin

2015-01-01

The impact of child sexual abuse on the adult self is not yet clearly understood. We explored adult perspectives through the use of narrative interviews (N = 30). Three key themes or views of self were identified in all narratives to varying degrees: the worthless self, the self as unknown, and the potential/developing self. Ambivalence and tension were present in all narratives. Individuals were challenged to integrate the sexual abuse experience in a constructive way and develop a more coherent perception of the self. The narrative method highlighted the dynamic nature of peoples' experiences at the same time recognizing that the narratives themselves are in progress. Reactions to disclosure, social support, and interpersonal connections are crucial at every turn.

Organizational routines, innovation, and flexibility: the application of narrative networks to dynamic workflow.

PubMed

Hayes, Gillian R; Lee, Charlotte P; Dourish, Paul

2011-08-01

The purpose of this paper is to demonstrate how current visual representations of organizational and technological processes do not fully account for the variability present in everyday practices. We further demonstrate how narrative networks can augment these representations to indicate potential areas for successful or problematic adoption of new technologies and potential needs for additional training. We conducted a qualitative study of the processes and routines at a major academic medical center slated to be supported by the development and installation of a new comprehensive HIT system. We used qualitative data collection techniques including observations of the activities to be supported by the new system and interviews with department heads, researchers, and both clinical and non-clinical staff. We conducted a narrative network analysis of these data by choosing exemplar processes to be modeled, selecting and analyzing narrative fragments, and developing visual representations of the interconnection of these narratives. Narrative networks enable us to view the variety of ways work has been and can be performed in practice, influencing our ability to design for innovation in use. Narrative networks are a means for analyzing and visualizing organizational routines in concert with more traditional requirements engineering, workflow modeling, and quality improvement outcome measurement. This type of analysis can support a deeper and more nuanced understanding of how and why certain routines continue to exist, change, or stop entirely. At the same time, it can illuminate areas in which adoption may be slow, more training or communication may be needed, and routines preferred by the leadership are subverted by routines preferred by the staff. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Documentary Evidence and the Construction of Narratives in Legal and Historical Contexts.

PubMed

Jones, Gwynneth C D

2015-02-01

Based on her experiences as an expert witness in Canadian litigation related to Aboriginal peoples, the author shares some personal reflections on the use of the written record as "evidence" in a legal context. As end users in a litigation context will be constructing their own narratives, a historian can add value in the courtroom by sharing skills in analyzing and providing context for written materials as well as providing a narrative based on their content. This process of simultaneously constructing and deconstructing a narrative can support the legitimacy of multiple narratives and provide space for evidence of other types, particularly oral evidence.

A Narrative Evaluation of Mandarin-Speaking Children With Language Impairment.

PubMed

Hao, Ying; Sheng, Li; Zhang, Yiwen; Jiang, Fan; de Villiers, Jill; Lee, Wendy; Liu, Xueman Lucy

2018-02-15

We aimed to study narrative skills in Mandarin-speaking children with language impairment (LI) to compare with children with LI speaking Indo-European languages. Eighteen Mandarin-speaking children with LI (mean age 6;2 [years;months]) and 18 typically developing (TD) age controls told 3 stories elicited using the Mandarin Expressive Narrative Test (de Villiers & Liu, 2014). We compared macrostructure-evaluating descriptions of characters, settings, initiating events, internal responses,plans, actions, and consequences. We also studied general microstructure, including productivity, lexical diversity, syntactic complexity, and grammaticality. In addition, we compared the use of 6 fine-grained microstructure elements that evaluate particular Mandarin linguistic features. Children with LI exhibited weaknesses in 5 macrostructure elements, lexical diversity, syntactic complexity, and 3 Mandarin-specific, fine-grained microstructure elements. Children with LI and TD controls demonstrated comparable performance on 2 macrostructure elements, productivity, grammaticality, and the remaining 3 fine-grained microstructure features. Similarities and differences are noted in narrative profiles of children with LI who speak Mandarin versus those who speak Indo-European languages. The results are consistent with the view that profiles of linguistic deficits are shaped by the ambient language. Clinical implications are discussed.

Science education researchers as orthographers: documenting Keiyo (Kenya) knowledge, learning and narratives about snakes

NASA Astrophysics Data System (ADS)

Thomson, Norman

2003-01-01

Using Keiyo (Kenya) knowledge, learning and oral narratives about snakes, the paper advances the argument that science educators have a pivotal role as orthographers in 'preserving and promoting science for all'. Linguists, and a growing number of scientists, realize that in processes of globalisation, many indigenous languages and cultures are facing extinction, especially languages that remain unwritten, such as the Keiyo language. Within these languages are several thousand years of indigenous science education that include knowledge, teaching and learning about local environments. Science educators are a missing link in the ongoing conversations between biologists, linguists and indigenous cultures. Today, it is also known that reptiles are at greater risk for extinction than amphibians. In an area noted for its reptiles (Kenya's Rift Valley), Keiyo elders and students (n = 748) were interviewed or given a questionnaire to determine indigenous names for snakes and how Keiyo oral narratives of snakes are used in teaching and learning. They provided names for 19 of 34 (55%) snake species and 278 narratives that include snakes. The data are being used to document Keiyo language and construct relevant written science curriculum materials for Keiyo children

Supporting Latino communities' natural helpers: a case study of promotoras in a research capacity building course.

PubMed

Otiniano, Angie Denisse; Carroll-Scott, Amy; Toy, Peggy; Wallace, Steven P

2012-08-01

Promotores have unique access to underserved and hard-to-reach Latino communities facing health disparities. Although promotores are involved in community change, they rarely receive training that gives them the skills to be partners in research. We present a case study of promotoras who participated in a research capacity building course focused on assessing community health needs. Data comes from course application surveys, follow-up notes, and narratives from qualitative phone interviews of eight promotoras. Content analysis drawing from grounded theory was conducted to identify and describe emerging themes. Four themes emerged as promotoras discussed their experience learning basic research skills and teaching others: (1) challenges, (2) support, (3) building capacity, and (4) using research. Promotores play an important role in the health of Latino communities and are increasingly asked to participate in research processes; however they have few opportunities for training and professional development in this area. Capacity building opportunities for promotores need to be tailored to their needs and provide them with support. Fostering collaboration between promotores and partnering with local community-based organizations can help facilitate needed research skill-building among promotores.

"I Have the Power to Change This": College Women's Agency and Sexual Assault

ERIC Educational Resources Information Center

Germain, Lauren J.

2012-01-01

Noting the prevalence of sexual violence at American Institutions of Higher Education (IHEs), this study aims to inform discourse on college women's post-assault experiences and perceptions of the institution. Using a feminist, post-structuralist framework, this study examines the narratives of 26 traditionally-aged college women who…

The "Human Problem" in Educational Research: Notes from the Psychoanalytic Archive

ERIC Educational Resources Information Center

Farley, Lisa

2015-01-01

In this paper, I theorize fantasies of idealization at work in narratives of educational research. I take as an example one of the very first psychoanalytically oriented studies in the field: Marion Milner's, "The Human Problem in Schools," published in 1938. Evidence is drawn from Milner's published book as well as from the historical…

How Urban Fathers Represent the Transition to Fathering: A Discourse Analysis of Fathering Narratives.

ERIC Educational Resources Information Center

Gadsden, Vivian; Wortham, Stanton; Wojcik, Teresa

Noting that researchers rarely ask urban fathers about their perspectives and choices regarding fatherhood, this pilot study examined the experiences of urban fathers, focusing on their views of the challenges of fatherhood and how they accounted for both their irresponsible and their promising fathering behaviors; the study's larger goal will be…

Development and Efficacy of a Rite of Passage for Evangelical Women

ERIC Educational Resources Information Center

Abdallah, Amy F. Davis

2012-01-01

Ritual theorist Ronald Grimes notes a lack of rites of passage in Western society, yet a parallel longing for them. Although Grimes hesitates to invent new rites, such invention is the interest of this article. Building on research that juxtaposes ritual theory and Evangelical values, this work narrates the invention and implementation of a rite…

The human factor: Biomedicine in the manned space program to 1980

NASA Technical Reports Server (NTRS)

Pitts, J. A.

1985-01-01

The purpose of this publication is to provide NASA personnel, NASA managers, and the biomedical and historical research communities a well-documented, historical summary of the content and organization of NASA's biomedical programs from Project Mercury up to the Shuttle program. The publication includes not only a major narrative portion, but appendixes and reference notes.

Researchers Hooked on Teaching. Noted Scholars Discuss the Synergies of Teaching and Research. Foundations for Organizational Science Series.

ERIC Educational Resources Information Center

Andre, Rae, Ed.; Frost, Peter J., Ed.

This collection of 19 essays is organized into a narrative of the teaching-research dilemma. The essays include: (1) "Struggling With Balance" (Cynthia V. Fukami); (2) "My Career as a Teacher: Promise, Failure, Redemption" (Howard E. Aldrich); (3) "Teaching and Research: A Puzzling Dichotomy" (Barbara A. Gutek); (4)…

Paradise Lost and Found: Obedience, Disobedience, and Storytelling in C.S. Lewis and Philip Pullman.

ERIC Educational Resources Information Center

Wood, Naomi

2001-01-01

Considers how in the fantasy series "The Chronicles of Narnia" and "His Dark Materials," by C.S. Lewis and Philip Pullman respectively, the authors use symbols and themes from "Paradise Lost." Notes that each author's narrative choice uses his view of cosmic order to persuade readers that obedience should be…

The ''Coconut Tree'' Model of Careers: The Case of French Academia

ERIC Educational Resources Information Center

Altman, Yochanan; Bournois, Frank

2004-01-01

This research note sets out to explain the main features of the French university academic career--the ''coconut tree,'' as it is colloquially known, setting it firmly within a social and cultural context; outlining the logic and functions of career stages, explaining its rituals and conventions, its rewards and pitfalls. These are narrated by two…

Zitkala-Sa and the Problem of Regionalism: Nations, Narratives, and Critical Traditions

ERIC Educational Resources Information Center

Totten, Gary

2005-01-01

Although Yankton Sioux writer Zitkala-Sa (Gertrude Bonnin, 1876-1938) was, as P. Jane Hafen notes, "virtually unknown for many decades," much critical work has appeared since Dexter Fisher's 1979 article,"Zitkala-Sa: Evolution of a Writer." Some critics desiring to bring Zitkala-Sa into the conversation about turn-of-the-century American women…

32 CFR 766.5 - Conditions governing use of aviation facilities by civil aircraft.

Code of Federal Regulations, 2011 CFR

2011-07-01

... weather minimums as follows: (1) Visual Flight Operations shall be conducted in accordance with Federal Aviation Regulations (FAR), § 91.105 of this title. If more stringent visual flight rules minimums have... must be noted in § 766.5 of the license application. If a narrative report from the pilot is available...

32 CFR 766.5 - Conditions governing use of aviation facilities by civil aircraft.

Code of Federal Regulations, 2010 CFR

2010-07-01

... weather minimums as follows: (1) Visual Flight Operations shall be conducted in accordance with Federal Aviation Regulations (FAR), § 91.105 of this title. If more stringent visual flight rules minimums have... must be noted in § 766.5 of the license application. If a narrative report from the pilot is available...

Disciplinarity, Divorce, and the Displacement of Labor Issues: Rereading Histories of Composition and Literature

ERIC Educational Resources Information Center

Ianetta, Melissa

2010-01-01

This essay argues that a trend in histories of literary and writing studies is to bifurcate the origins of the fields and so engage in those modernist narrative fallacies described by Jean-Francois Lyotard. Such works limit our understanding of past practices and the longstanding connections between disciplinarity and labor. (Contains 2 notes.)

A Lay Ethics Quest for Technological Futures: About Tradition, Narrative and Decision-Making.

PubMed

van der Burg, Simone

2016-01-01

Making better choices about future technologies that are being researched or developed is an important motivator behind lay ethics interventions. However, in practice, they do not always succeed to serve that goal. Especially authors who have noted that lay ethicists sometimes take recourse to well-known themes which stem from old, even 'archetypical' stories, have been criticized for making too little room for agency and decision-making in their approach. This paper aims to contribute to a reflection on how lay ethics can acquire more practical relevance. It will use resources in narrative ethics to suggest that in order to be relevant for action, facilitators of lay ethics interventions need to invite participants to engage in a narrative quest. As part of a quest, lay ethicists should be asked to (1) reflect on a specific question or choice, (2) use diverse (imaginative) input which is informative about the heterogeneity of viewpoints that are defended in society and (3) argue for their standpoints.

Aging and the segmentation of narrative film.

PubMed

Kurby, Christopher A; Asiala, Lillian K E; Mills, Steven R

2014-01-01

The perception of event structure in continuous activity is important for everyday comprehension. Although the segmentation of experience into events is a normal concomitant of perceptual processing, previous research has shown age differences in the ability to perceive structure in naturalistic activity, such as a movie of someone washing a car. However, past research has also shown that older adults have a preserved ability to comprehend events in narrative text, which suggests that narrative may improve the event processing of older adults. This study tested whether there are age differences in event segmentation at the intersection of continuous activity and narrative: narrative film. Younger and older adults watched and segmented a narrative film, The Red Balloon, into coarse and fine events. Changes in situational features, such as changes in characters, goals, and objects predicted segmentation. Analyses revealed little age-difference in segmentation behavior. This suggests the possibility that narrative structure supports event understanding for older adults.

Making sense of Islamic creationism in Europe.

PubMed

Hameed, Salman

2015-05-01

Islamic creationism has been noted as a serious concern in Europe. There have been reports of boycotts of university evolution lectures and, in one extreme case, even a threat of violence. While religious objections are indeed at play in some cases, our understanding of the rise of Islamic creationism should also take into account socioeconomic disparities and its impact on education for Muslim minorities in Europe. Furthermore, the broader narrative of rejection of evolution in Europe, for some Muslims, may be bound up in reactions to the secular culture and in the formation of their own minority religious identity. On the other hand, the stories of Muslim rejection of evolution in media end up reinforcing the stereotype of Muslims as "outsiders" and a threat to the European education system. A nuanced understanding of this dynamic may benefit those who support both the propagation of good science and favor cultural pluralism. © The Author(s) 2014.

Re-claiming citizenship through the arts.

PubMed

Dupuis, Sherry L; Kontos, Pia; Mitchell, Gail; Jonas-Simpson, Christine; Gray, Julia

2016-05-01

Healthcare literature, public discourse, and policy documents continue to represent persons with dementia as "doomed" and "socially dead." This tragedy meta-narrative produces and reproduces misunderstandings about dementia and causes stigma, oppression, and discrimination for persons living with dementia. With few opportunities to challenge the dominant discourse, persons with dementia continue to be denied their citizenship rights. Drawing on the concept of narrative citizenship, we describe a community-based, critical arts-based project where persons with dementia, family members, visual and performance artists, and researchers came together to interrogate the tragedy discourse and construct an alternative narrative of dementia using the arts. Our research demonstrates the power of the arts to create transformative spaces in which to challenge dominant assumptions, foster critical reflection, and envision new possibilities for mutual support, caring, and relating. This alternative narrative supports the reclamation of citizenship for persons living with dementia and fosters the relational citizenship of all. © The Author(s) 2016.

Chinese mental illness narratives: controlling the spirit.

PubMed

Ramsay, Guy

2009-01-01

Through analysis of local level narrative themes and linguistic features and their attendant narrative 'domains' and emotive content, this study explicates the discursive forms of Chinese personal narratives about mental illness published in a psychoeducational volume in mainland China. The cultural phenomena underpinning the explicated discursive forms are considered. The study finds that the Chinese mental illness narratives emphasize the problematic nature of the illness experience for the individual concerned, as well as the importance of gaining control over the personal and social disembodiment that mental illness brings about. The language of medicine presents as a dominant linguistic feature of the texts. Narrative authors appear to respond to their illness experience by negotiating and utilizing social relationships and support structures and through active medical intercession. As such, their narratives appear deeply culturally marked despite their psychoeducational intent and institutional context of publication. The study findings bear out the call for more attention to be given to the cultural dimension when analysing illness narratives.

Narrative communication in cancer prevention and control: a framework to guide research and application.

PubMed

Kreuter, Matthew W; Green, Melanie C; Cappella, Joseph N; Slater, Michael D; Wise, Meg E; Storey, Doug; Clark, Eddie M; O'Keefe, Daniel J; Erwin, Deborah O; Holmes, Kathleen; Hinyard, Leslie J; Houston, Thomas; Woolley, Sabra

2007-06-01

Narrative forms of communication-including entertainment education, journalism, literature, testimonials, and storytelling-are emerging as important tools for cancer prevention and control. To stimulate critical thinking about the role of narrative in cancer communication and promote a more focused and systematic program of research to understand its effects, we propose a typology of narrative application in cancer control. We assert that narrative has four distinctive capabilities: overcoming resistance, facilitating information processing, providing surrogate social connections, and addressing emotional and existential issues. We further assert that different capabilities are applicable to different outcomes across the cancer control continuum (e.g., prevention, detection, diagnosis, treatment, survivorship). This article describes the empirical evidence and theoretical rationale supporting propositions in the typology, identifies variables likely to moderate narrative effects, raises ethical issues to be addressed when using narrative communication in cancer prevention and control efforts, and discusses potential limitations of using narrative in this way. Future research needs based on these propositions are outlined and encouraged.

Mothering differently: narratives of mothers with intellectual disability whose children have been compulsorily removed.

PubMed

Mayes, Rachel; Llewellyn, Gwynnyth

2012-06-01

Despite the frequency with which mothers with intellectual disability have their children removed, little theoretical or empirical work has understood the mothers' perspectives on this. A few studies have reported mothers' feelings of grief and loss and their sense of powerlessness in the child protection system. This qualitative study explores the daily life narratives of 7 mothers with intellectual disability following the involuntarily removal of their children. For most mothers, having a child removed was not a one-off experience. The serial nature of the experience yielded 3 different narratives, lived out in different ways. In some cases, women told a different narrative for each of their removed children. All women remained focused on their children in care. The multiple and varied narratives of mothers with intellectual disability who have children in care suggest that their support needs may differ from each other and over time. How their support needs might best be met remains an unanswered question. Further research is also needed to identify any adverse health and social consequences for mothers with children in care as well as the effects on their children.

Drawing the line between constituent structure and coherence relations in visual narratives

PubMed Central

Cohn, Neil; Bender, Patrick

2016-01-01

Theories of visual narrative understanding have often focused on the changes in meaning across a sequence, like shifts in characters, spatial location, and causation, as cues for breaks in the structure of a discourse. In contrast, the theory of Visual Narrative Grammar posits that hierarchic “grammatical” structures operate at the discourse level using categorical roles for images, which may or may not co-occur with shifts in coherence. We therefore examined the relationship between narrative structure and coherence shifts in the segmentation of visual narrative sequences using a “segmentation task” where participants drew lines between images in order to divide them into sub-episodes. We used regressions to analyze the influence of the expected constituent structure boundary, narrative categories, and semantic coherence relationships on the segmentation of visual narrative sequences. Narrative categories were a stronger predictor of segmentation than linear coherence relationships between panels, though both influenced participants’ divisions. Altogether, these results support the theory that meaningful sequential images use a narrative grammar that extends above and beyond linear semantic shifts between discourse units. PMID:27709982

Drawing the line between constituent structure and coherence relations in visual narratives.

PubMed

Cohn, Neil; Bender, Patrick

2017-02-01

Theories of visual narrative understanding have often focused on the changes in meaning across a sequence, like shifts in characters, spatial location, and causation, as cues for breaks in the structure of a discourse. In contrast, the theory of visual narrative grammar posits that hierarchic "grammatical" structures operate at the discourse level using categorical roles for images, which may or may not co-occur with shifts in coherence. We therefore examined the relationship between narrative structure and coherence shifts in the segmentation of visual narrative sequences using a "segmentation task" where participants drew lines between images in order to divide them into subepisodes. We used regressions to analyze the influence of the expected constituent structure boundary, narrative categories, and semantic coherence relationships on the segmentation of visual narrative sequences. Narrative categories were a stronger predictor of segmentation than linear coherence relationships between panels, though both influenced participants' divisions. Altogether, these results support the theory that meaningful sequential images use a narrative grammar that extends above and beyond linear semantic shifts between discourse units. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Writing and reading in the electronic health record: an entirely new world.

PubMed

Han, Heeyoung; Lopp, Lauri

2013-02-05

Electronic health records (EHRs) are structured, distributed documentation systems that differ from paper charts. These systems require skills not traditionally used to navigate a paper chart and to produce a written clinic note. Despite these differences, little attention has been given to physicians' electronic health record (EHR)-writing and -reading competence. This study aims to investigate physicians' self-assessed competence to document and to read EHR notes; writing and reading preferences in an EHR; and demographic characteristics associated with their perceived EHR ability and preference. Fourteen 5-point Likert scale items, based on EHR system characteristics and a literature review, were developed to measure EHR-writing and -reading competence and preference. Physicians in the midwest region of the United States were invited via e-mail to complete the survey online from February to April 2011. Factor analysis and reliability testing were conducted to provide validity and reliability of the instrument. Correlation and regression analysis were conducted to pursue answers to the research questions. Ninety-one physicians (12.5%), from general and specialty fields, working in inpatient and outpatient settings, participated in the survey. Despite over 3 years of EHR experience, respondents perceived themselves to be incompetent in EHR writing and reading (Mean = 2.74, SD = 0.76). They preferred to read succinct, narrative notes in EHR systems. However, physicians with higher perceived EHR-writing and -reading competence had less preference toward reading succinct (r= - 0.33, p<0.001) and narrative (r= - 0.36, p<0.001) EHR notes than physicians with lower perceived EHR competence. Physicians' perceived EHR-writing and -reading competence was strongly related to their EHR navigation skills (r=0.55, p<0.0001). Writing and reading EHR documentation is different for physicians. Maximizing navigation skills can optimize non-linear EHR writing and reading. Pedagogical questions remain related to how physicians and medical students are able to retrieve correct information effectively and to understand thought patterns in collectively lengthier and sometimes fragmented EHR chart notes.

The influence of narrative risk communication on feelings of cancer risk.

PubMed

Janssen, Eva; van Osch, Liesbeth; de Vries, Hein; Lechner, Lilian

2013-05-01

Evidence is accumulating for the importance of feelings of risk in explaining cancer preventive behaviours, but best practices for influencing these feelings are limited. The aim of this experimental study was to compare the effects of narrative and non-narrative risk communication about sunbed use on ease of imagination and feelings of cancer risk. A total of 233 female sunbed users in the general Dutch population were randomly assigned to one of three conditions: a narrative message (i.e., personal testimonial), a non-narrative cognitive message (i.e., factual risk information using cognitive-laden words), or a non-narrative affective message (i.e., factual risk information using affective-laden words). Ease of imagination and feelings of risk were assessed directly after the risk information was given (T1). Three weeks after the baseline session, feelings of risk were measured again (T2). The results revealed that sunbed users who were exposed to narrative risk information could better imagine themselves developing skin cancer and reported higher feelings of skin cancer risk at T1. Moreover, ease of imagination mediated the effects of message type on feelings of risk at T1 and T2. The findings provide support for the effects of narrative risk communication in influencing feelings of cancer risk through ease of imagination. Cancer prevention programmes may therefore benefit from including narrative risk information. Future research is important to investigate other mechanisms of narrative information and their most effective content and format. What is already known on this subject? Evidence is growing for the importance of feelings of risk in explaining cancer preventive behaviours. Narratives have increasingly been considered as an effective format for persuasive risk messages and studies have shown narrative risk communication to be effective in influencing cognitive risk beliefs. What does this study add? Increasing understanding of how feelings of cancer risk can be influenced since best practices for influencing these feelings are limited. Extending knowledge about the underlying mechanisms of narrative effects on feelings of cancer risk (i.e., the mediating role of ease of imagination) using a non-student sample. The findings provide support for the effects of narrative risk communication in influencing feelings of cancer risk through ease of imagination. © 2012 The British Psychological Society.

Learning to research in first grade: Bridging the transition from narrative to expository texts and tasks

NASA Astrophysics Data System (ADS)

Weise, Richard

Decades of research indicate that students at all academic grade and performance levels perform poorly with informational texts and tasks and particularly with locating assignment-relevant information in expository texts. Students have little understanding of the individual tasks required, the arc of the activity, the hierarchical structure of the information they seek, or how to reconstitute and interpret the information they extract. Poor performance begins with the introduction of textbooks and research assignments in fourth grade and continues into adulthood. However, to date, neither educators nor researchers have substantially addressed this problem. In this quasi-experimental study, we ask if first-grade children can perform essential tasks in identifying, extracting, and integrating assignment-relevant information and if instruction improves their performance. To answer this question, we conducted a 15-week, teacher-led, intervention in two first-grade classrooms in an inner-city Nashville elementary school. We created a computer learning environment (NoteTaker) to facilitate children's creation of a mental model of the research process and a narrative/expository bridge curriculum to support the children's transition from all narrative to all expository texts and tasks. We also created a new scaffolding taxonomy and a reading-to-research model to focus our research. Teachers participated in weekly professional development workshops. The results of this quasi-experimental study indicate that at-risk, first-grade children are able to (a) identify relevant information in an expository text, (b) categorize the information they identify, and (c) justify their choice of category. Children's performance in the first and last tasks significantly improved with instruction, and low-performing readers showed the greatest benefits from instruction. We find that the children's performance in categorizing information depended upon content-specific knowledge that was not taught, as well as on the process knowledge that was taught. We also find that children's narrative reading performance predicted their initial-performance for each assessment measure. We argue that first-grade children are developmentally ready to read expository texts and to learn reading-to-research tasks and that primary-school literacy instruction should not be limited to reading and writing stories.

Quantifying care coordination using natural language processing and domain-specific ontology.

PubMed

Popejoy, Lori L; Khalilia, Mohammed A; Popescu, Mihail; Galambos, Colleen; Lyons, Vanessa; Rantz, Marilyn; Hicks, Lanis; Stetzer, Frank

2015-04-01

This research identifies specific care coordination activities used by Aging in Place (AIP) nurse care coordinators and home healthcare (HHC) nurses when coordinating care for older community-dwelling adults and suggests a method to quantify care coordination. A care coordination ontology was built based on activities extracted from 11,038 notes labeled with the Omaha Case management category. From the parsed narrative notes of every patient, we mapped the extracted activities to the ontology, from which we computed problem profiles and quantified care coordination for all patients. We compared two groups of patients: AIP who received enhanced care coordination (n=217) and HHC who received traditional care (n=691) using 128,135 narratives notes. Patients were tracked from the time they were admitted to AIP or HHC until they were discharged. We found that patients in AIP received a higher dose of care coordination than HHC in most Omaha problems, with larger doses being given in AIP than in HHC in all four Omaha categories. 'Communicate' and 'manage' activities are widely used in care coordination. This confirmed the expert hypothesis that nurse care coordinators spent most of their time communicating about their patients and managing problems. Overall, nurses performed care coordination in both AIP and HHC, but the aggregated dose across Omaha problems and categories is larger in AIP. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Theorizing Foreshadowed Death Narratives: Examining the Impact of Character Death on Narrative Processing and Skin Self-Exam Intentions.

PubMed

Jensen, Jakob D; Yale, Robert N; Krakow, Melinda; John, Kevin K; King, Andy J

2017-01-01

Narratives are common in health campaigns and interventions, with many depicting individuals battling a particular illness or disease. Past research has focused primarily on the form and effects of survivor stories, but considerably less attention has been devoted to stories in which 1 or more of the central characters passes away. The goal of the current study was to compare the relative persuasive impact of survivor and death narratives in influencing skin prevention behaviors and to test narrative mediators that might explicate underlying mechanisms of effect. To that end, adults (N = 635, M age = 32.43 [SD = 11.23]) were randomly assigned to 1 of 6 narrative intervention conditions in an online message experiment. Participants read 1 of 2 stories about a person with melanoma (Rusty or Diane) that was manipulated as a narrative depicting the survival, death, or foreshadowed death of the main character. Foreshadowed death narratives increased intentions to perform a skin self-exam (SSE), a relationship that was mediated by narrative transportation and perceived SSE benefits. The results support the central postulate of narrative transportation theory and the utility of using foreshadowed death narratives in communication-based interventions designed to increase SSE frequency.

Theorizing Foreshadowed Death Narratives: Examining the Impact of Character Death on Narrative Processing and Skin Self-Exam Intentions

PubMed Central

JENSEN, JAKOB D.; YALE, ROBERT N.; KRAKOW, MELINDA; JOHN, KEVIN K.; KING, ANDY J.

2017-01-01

Narratives are common in health campaigns and interventions, with many depicting individuals battling a particular illness or disease. Past research has focused primarily on the form and effects of survivor stories, but considerably less attention has been devoted to stories in which 1 or more of the central characters passes away. The goal of the current study was to compare the relative persuasive impact of survivor and death narratives in influencing skin prevention behaviors and to test narrative mediators that might explicate underlying mechanisms of effect. To that end, adults (N = 635, M age = 32.43 [SD = 11.23]) were randomly assigned to 1 of 6 narrative intervention conditions in an online message experiment. Participants read 1 of 2 stories about a person with melanoma (Rusty or Diane) that was manipulated as a narrative depicting the survival, death, or foreshadowed death of the main character. Foreshadowed death narratives increased intentions to perform a skin self-exam (SSE), a relationship that was mediated by narrative transportation and perceived SSE benefits. The results support the central postulate of narrative transportation theory and the utility of using foreshadowed death narratives in communication-based interventions designed to increase SSE frequency. PMID:28060585

First-Hand Experience with Engineering Design and Career Interest in Engineering: An Informal STEM Education Case Study

ERIC Educational Resources Information Center

Ayar, Mehmet C.

2015-01-01

The purpose of this study is to present students' experiences, interest in engineering, and personal narratives while participating in a robotics summer camp in a metropolitan city in Turkey. In this study, I used qualitative data collection methods such as interviews, field notes, and observations. I used the four principles of Engle and Conant…

"What Have the Humanities to Offer 21st-Century Europe?": Reflections of a Note Taker

ERIC Educational Resources Information Center

Parker, Jan

2008-01-01

The Humanities have much to offer 21st-century Europe, in terms of both method and issues which may complement and correct those of Science and Social Science. These include, for instance, humanities' generation of plural narratives and plural explanations, of attention to singularity and complexity, and to others' sensibilities and ways of…

"As if Reviewing His Life": Bull Lodge's Narrative and the Mediation of Self-Representation

ERIC Educational Resources Information Center

Gone, Joseph P.

2006-01-01

In 1980, on behalf of the Gros Ventre people, George P. Horse Capture published "The Seven Visions of Bull Lodge, as Told by His Daughter, Garter Snake." "The Seven Visions" describes a lifetime of personal encounters with Powerful other-than-human Persons by the noted Gros Ventre warrior and ritual leader, Bull Lodge (ca.…

Navigating Orientalism: Asian Women Faculty in the Canadian Academy

ERIC Educational Resources Information Center

Mayuzumi, Kimine

2015-01-01

While individuals of note have been documented, there has been a paucity of research into the collective voices of Asian women faculty in higher education. To fill this gap, the study brings forward the narratives of nine Asian women faculty members in the Canadian academy who have roots in East Asia. Employing the concept of Orientalism within a…

Sin Fronteras Boy: Students Create Collaborative Websites to Explore the Border

ERIC Educational Resources Information Center

Cornell, Grace

2012-01-01

Around one table, four 4th-grade girls chat quietly as they write on their laptops: Ruby interviews Alejandra about her experience crossing the U.S.-Mexico border as a 6-year-old. Meanwhile, Cindy turns notes from an interview with her uncle into a narrative about his immigration experience. Next to them, four boys work on the "Sin Fronteras…

Synthesizing Current Views of Audience: Notes toward a Fuller Understanding of Audience.

ERIC Educational Resources Information Center

Roen, Duane H.

The concept of audience has emerged as a central theme in many scholarly discussions. Walter Ong focuses on fiction and believes that what has been said about fictional narrative applies to all writing. Lev Vygotsky offers the view that students work in the zone of proximal development and observes that thought itself develops as a result of our…

Oak Ridge Reservation environmental report for 1992. Volume 1: Narrative

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koncinski, W.S.

The two volumes of this report present data and supporting narratives regarding the impact of the US Department of Energy`s (DOE`s) Oak Ridge Reservation (ORR) on its environs and the public during 1992. This Volume (Volume 1) includes all narrative descriptions, summaries, and conclusions and is intended to be a ``stand-alone`` report for the reader who does not want to review in detail all of the 1992 data for the ORR. Volume 2 includes the detailed data in formats that ensure all the environmental data are represented. Narratives are not included in Vol. 2.

The meaning of support as narrated by family carers who care for a senior relative at home.

PubMed

Stoltz, Peter; Willman, Ania; Udén, Giggi

2006-05-01

The authors' aim in this study is to illuminate the meaning of support as narrated by family members who care for a senior relative at home. This study originates from a context of advanced in-home palliative care in Sweden. Twenty individuals who cared for a senior relative at home participated. Narrative interviews resulted in a text, which the authors analyzed in three recurring phases, naive understanding, structural analyses, and comprehensive understanding, using a phenomenological hermeneutical method. They formulated two themes from the analysis: Experiencing a togetherness with others in caring and Sensing togetherness with oneself in caring. The meaning of support was understood here as Sensing togetherness. In the comprehensive understanding, the authors further illuminate this meaning using literature on the concepts of friendship, inner strength, and manageability through the sense of coherence theory. They provide suggestions for relevance to practice and further research.

Divergent neural responses to narrative speech in disorders of consciousness.

PubMed

Iotzov, Ivan; Fidali, Brian C; Petroni, Agustin; Conte, Mary M; Schiff, Nicholas D; Parra, Lucas C

2017-11-01

Clinical assessment of auditory attention in patients with disorders of consciousness is often limited by motor impairment. Here, we employ intersubject correlations among electroencephalography responses to naturalistic speech in order to assay auditory attention among patients and healthy controls. Electroencephalographic data were recorded from 20 subjects with disorders of consciousness and 14 healthy controls during of two narrative audio stimuli, presented both forwards and time-reversed. Intersubject correlation of evoked electroencephalography signals were calculated, comparing responses of both groups to those of the healthy control subjects. This analysis was performed blinded and subsequently compared to the diagnostic status of each patient based on the Coma Recovery Scale-Revised. Subjects with disorders of consciousness exhibit significantly lower intersubject correlation than healthy controls during narrative speech. Additionally, while healthy subjects had higher intersubject correlation values in forwards versus backwards presentation, neural responses did not vary significantly with the direction of playback in subjects with disorders of consciousness. Increased intersubject correlation values in the backward speech condition were noted with improving disorder of consciousness diagnosis, both in cross-sectional analysis and in a subset of patients with longitudinal data. Intersubject correlation of neural responses to narrative speech audition differentiates healthy controls from patients and appears to index clinical diagnoses in disorders of consciousness.

The Oral Narrative Comprehension and Production Abilities of Verbal Preschoolers on the Autism Spectrum.

PubMed

Westerveld, Marleen F; Roberts, Jacqueline M A

2017-10-05

This study described the oral narrative comprehension and production skills of verbal preschool-age children on the autism spectrum and investigated correlations between oral narrative ability and norm-referenced language test performance. Twenty-nine preschool-age children (aged 4;0-5;9 years;months) with autism, who obtained an age-equivalent score of at least 36 months on the expressive communication subscale of the Vineland Adaptive Behavior Scales-Second Edition (Sparrow, Cicchetti, & Balla, 2005), participated. Children listened to an unfamiliar fictional narrative and answered comprehension questions afterward. After listening to the narrative a second time, children were asked to retell the narrative without picture support. Narratives were transcribed and analyzed for length, semantic diversity, grammatical complexity and accuracy, intelligibility, inclusion of critical events, and narrative stage. All children participated in the comprehension task, and 19 children produced an analyzable narrative retell. Compared with published data on typically developing children, significant difficulties were observed in narrative comprehension, intelligibility, and grammatical accuracy. Most of the children told descriptive or action sequences, with only 1 child producing an abbreviated episode. Significant positive correlations were found (a) between performance on the Peabody Picture Vocabulary Test-Fourth Edition (Dunn & Dunn, 2007) and semantic diversity and narrative comprehension and (b) between parent-reported receptive communication competence (Vineland Adaptive Behavior Scales-Second Edition) and narrative comprehension. This study provides preliminary evidence of specific difficulties in oral narrative comprehension and production skills in verbal preschoolers on the autism spectrum.

Explicit Oral Narrative Intervention for Students with Williams Syndrome

PubMed Central

Diez-Itza, Eliseo; Martínez, Verónica; Pérez, Vanesa; Fernández-Urquiza, Maite

2018-01-01

Narrative skills play a crucial role in organizing experience, facilitating social interaction and building academic discourse and literacy. They are at the interface of cognitive, social, and linguistic abilities related to school engagement. Despite their relative strengths in social and grammatical skills, students with Williams syndrome (WS) do not show parallel cognitive and pragmatic performance in narrative generation tasks. The aim of the present study was to assess retelling of a TV cartoon tale and the effect of an individualized explicit instruction of the narrative structure. Participants included eight students with WS who attended different special education levels. Narratives were elicited in two sessions (pre and post intervention), and were transcribed, coded and analyzed using the tools of the CHILDES Project. Narratives were coded for productivity and complexity at the microstructure and macrostructure levels. Microstructure productivity (i.e., length of narratives) included number of utterances, clauses, and tokens. Microstructure complexity included mean length of utterances, lexical diversity and use of discourse markers as cohesive devices. Narrative macrostructure was assessed for textual coherence through the Pragmatic Evaluation Protocol for Speech Corpora (PREP-CORP). Macrostructure productivity and complexity included, respectively, the recall and sequential order of scenarios, episodes, events and characters. A total of four intervention sessions, lasting approximately 20 min, were delivered individually once a week. This brief intervention addressed explicit instruction about the narrative structure and the use of specific discourse markers to improve cohesion of story retellings. Intervention strategies included verbal scaffolding and modeling, conversational context for retelling the story and visual support with pictures printed from the cartoon. Results showed significant changes in WS students’ retelling of the story, both at macro- and microstructure levels, when assessed following a 2-week interval. Outcomes were better in microstructure than in macrostructure, where sequential order (i.e., complexity) did not show significant improvement. These findings are consistent with previous research supporting the use of explicit oral narrative intervention with participants who are at risk of school failure due to communication impairments. Discussion focuses on how assessment and explicit instruction of narrative skills might contribute to effective intervention programs enhancing school engagement in WS students. PMID:29379455

Family experiences of living with an eating disorder: a narrative analysis.

PubMed

Papathomas, Anthony; Smith, Brett; Lavallee, David

2015-03-01

Families are considered important in the management and treatment of eating disorders. Yet, rarely has research focused on family experiences of living with an eating disorder. Addressing this gap, this study explores the experiences of an elite 21-year-old triathlete with an eating disorder in conjunction with the experiences of her parents. Family members attended interviews individually on three separate occasions over the course of a year. In line with the narrative approach adopted, whereby stories are considered the primary means to construct experience, interviews encouraged storytelling through an open-ended, participant-led structure. Narrative analysis involved repeated readings of the transcripts, sensitising towards issues of narrative content (key themes) and structure (overarching plot). Family difficulties arose when personal experiences strayed from culturally dominant narrative forms and when family members held contrasting narrative preferences. Suggestions are forwarded as to how an appreciation of eating disorder illness narratives might inform treatment and support. © The Author(s) 2015.

Narratives and traits in personality development among New Zealand Māori, Chinese, and European adolescents.

PubMed

Reese, Elaine; Chen, Yan; McAnally, Helena M; Myftari, Ella; Neha, Tia; Wang, Qi; Jack, Fiona

2014-07-01

Narrative and trait levels of personality were assessed in a sample of 268 adolescents from age 12 to 21 from New Zealand Māori, Chinese, and European cultures. Adolescents narrated three critical events and completed a Big Five personality inventory. Each narrative was coded for causal and thematic coherence. NZ Chinese adolescents reported lower levels of extraversion, agreeableness, conscientiousness, and openness, and higher levels of neuroticism, than NZ Māori or European adolescents. Cultural differences were also evident in narrative coherence. Adolescents in all three groups demonstrated age-related increases in thematic coherence, but only NZ European adolescents demonstrated the expected age-related increases in causal coherence. Narrative identity and traits were distinct aspects of personality for younger adolescents, but were linked for middle and older adolescents. These findings support the importance of both narrative identity and traits in understanding personality development in adolescents across cultures. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

A narrative review of mental health support for people during transition from incarceration to community: the grass can be greener on the other side of the fence.

PubMed

Smith-Merry, Jennifer; Mellifont, Damian; McKenzie, Kirsty; Clenaghan, Paul

2018-04-28

Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.

Coming out narratives of older gay men living in New Zealand.

PubMed

Neville, Stephen; Kushner, Bernie; Adams, Jeffery

2015-10-01

Explore the coming out narratives in a group of older gay men. A narrative gerontological approach was employed to explore the coming out narratives of older gay men. Semi-structured digitally recorded individual interviews were undertaken with 12 gay men aged between 65 and 81 years who lived in the community. Data were analysed using a narrative data analytic process. Three collective narratives related to the coming out of older gay men were identified: 'early gay experiences', 'trying not to be gay' and 'acceptance'. Older gay men come from diverse socio-cultural backgrounds. However, they all grew up in an era where same-sex attraction was a criminal offence. The path to accepting being a gay man was individualised and stressful for these participants. Consequently health and social service providers need to support the ongoing development of resilience and provide a person-centred approach to care that promotes wellbeing. © 2015 AJA Inc.

Institutional narratives in the discourse between oncology social workers and cancer patients' self-help organization.

PubMed

Kacen, Lea; Bakshy, Iris

2005-09-01

In this study, the authors examine a discourse between members of a cancer patients' self-help organization (CP-SHO) and oncological social workers (OSWs) on support groups for cancer patients. Eight OSWs and 8 CP-SHO volunteers served as the key research population. Using the interpretive-narrative approach to research, the authors apply a variety of data collection methods and a combination of data analysis methods: narrative analysis and discourse analysis. The findings point to the simultaneous existence of two institutional narratives for each organization, one internal and the other external. Discourse between the organizations takes place mainly at the external institutional narrative level, with each body maintaining the mistaken impression that the other's perception of reality is similar to its own (false consensus). In the meantime, the internal narratives that attest to the latent meaning of the discourse govern the interaction and prevent effective dialogue between the respective organizations.

Narrative Art and Incarcerated Abused Women

ERIC Educational Resources Information Center

Williams, Rachel; Taylor, Janette Y.

2004-01-01

This article describes an arts and narrative intervention program using visual art, storytelling, music, journaling, and support groups with incarcerated abused women to address the following questions: How can visual art and music empower incarcerated female survivors of domestic violence? Can art, music, storytelling, journaling, and support…

MedEx: a medication information extraction system for clinical narratives

PubMed Central

Stenner, Shane P; Doan, Son; Johnson, Kevin B; Waitman, Lemuel R; Denny, Joshua C

2010-01-01

Medication information is one of the most important types of clinical data in electronic medical records. It is critical for healthcare safety and quality, as well as for clinical research that uses electronic medical record data. However, medication data are often recorded in clinical notes as free-text. As such, they are not accessible to other computerized applications that rely on coded data. We describe a new natural language processing system (MedEx), which extracts medication information from clinical notes. MedEx was initially developed using discharge summaries. An evaluation using a data set of 50 discharge summaries showed it performed well on identifying not only drug names (F-measure 93.2%), but also signature information, such as strength, route, and frequency, with F-measures of 94.5%, 93.9%, and 96.0% respectively. We then applied MedEx unchanged to outpatient clinic visit notes. It performed similarly with F-measures over 90% on a set of 25 clinic visit notes. PMID:20064797

Clinical Relation Extraction Toward Drug Safety Surveillance Using Electronic Health Record Narratives: Classical Learning Versus Deep Learning.

PubMed

Munkhdalai, Tsendsuren; Liu, Feifan; Yu, Hong

2018-04-25

Medication and adverse drug event (ADE) information extracted from electronic health record (EHR) notes can be a rich resource for drug safety surveillance. Existing observational studies have mainly relied on structured EHR data to obtain ADE information; however, ADEs are often buried in the EHR narratives and not recorded in structured data. To unlock ADE-related information from EHR narratives, there is a need to extract relevant entities and identify relations among them. In this study, we focus on relation identification. This study aimed to evaluate natural language processing and machine learning approaches using the expert-annotated medical entities and relations in the context of drug safety surveillance, and investigate how different learning approaches perform under different configurations. We have manually annotated 791 EHR notes with 9 named entities (eg, medication, indication, severity, and ADEs) and 7 different types of relations (eg, medication-dosage, medication-ADE, and severity-ADE). Then, we explored 3 supervised machine learning systems for relation identification: (1) a support vector machines (SVM) system, (2) an end-to-end deep neural network system, and (3) a supervised descriptive rule induction baseline system. For the neural network system, we exploited the state-of-the-art recurrent neural network (RNN) and attention models. We report the performance by macro-averaged precision, recall, and F1-score across the relation types. Our results show that the SVM model achieved the best average F1-score of 89.1% on test data, outperforming the long short-term memory (LSTM) model with attention (F1-score of 65.72%) as well as the rule induction baseline system (F1-score of 7.47%) by a large margin. The bidirectional LSTM model with attention achieved the best performance among different RNN models. With the inclusion of additional features in the LSTM model, its performance can be boosted to an average F1-score of 77.35%. It shows that classical learning models (SVM) remains advantageous over deep learning models (RNN variants) for clinical relation identification, especially for long-distance intersentential relations. However, RNNs demonstrate a great potential of significant improvement if more training data become available. Our work is an important step toward mining EHRs to improve the efficacy of drug safety surveillance. Most importantly, the annotated data used in this study will be made publicly available, which will further promote drug safety research in the community. ©Tsendsuren Munkhdalai, Feifan Liu, Hong Yu. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 25.04.2018.

Clinical Relation Extraction Toward Drug Safety Surveillance Using Electronic Health Record Narratives: Classical Learning Versus Deep Learning

PubMed Central

Munkhdalai, Tsendsuren; Liu, Feifan

2018-01-01

Background Medication and adverse drug event (ADE) information extracted from electronic health record (EHR) notes can be a rich resource for drug safety surveillance. Existing observational studies have mainly relied on structured EHR data to obtain ADE information; however, ADEs are often buried in the EHR narratives and not recorded in structured data. Objective To unlock ADE-related information from EHR narratives, there is a need to extract relevant entities and identify relations among them. In this study, we focus on relation identification. This study aimed to evaluate natural language processing and machine learning approaches using the expert-annotated medical entities and relations in the context of drug safety surveillance, and investigate how different learning approaches perform under different configurations. Methods We have manually annotated 791 EHR notes with 9 named entities (eg, medication, indication, severity, and ADEs) and 7 different types of relations (eg, medication-dosage, medication-ADE, and severity-ADE). Then, we explored 3 supervised machine learning systems for relation identification: (1) a support vector machines (SVM) system, (2) an end-to-end deep neural network system, and (3) a supervised descriptive rule induction baseline system. For the neural network system, we exploited the state-of-the-art recurrent neural network (RNN) and attention models. We report the performance by macro-averaged precision, recall, and F1-score across the relation types. Results Our results show that the SVM model achieved the best average F1-score of 89.1% on test data, outperforming the long short-term memory (LSTM) model with attention (F1-score of 65.72%) as well as the rule induction baseline system (F1-score of 7.47%) by a large margin. The bidirectional LSTM model with attention achieved the best performance among different RNN models. With the inclusion of additional features in the LSTM model, its performance can be boosted to an average F1-score of 77.35%. Conclusions It shows that classical learning models (SVM) remains advantageous over deep learning models (RNN variants) for clinical relation identification, especially for long-distance intersentential relations. However, RNNs demonstrate a great potential of significant improvement if more training data become available. Our work is an important step toward mining EHRs to improve the efficacy of drug safety surveillance. Most importantly, the annotated data used in this study will be made publicly available, which will further promote drug safety research in the community. PMID:29695376

Breaking the Boundaries: Using the Writing Experience To Examine the Conflicts between Personal and "American" Democratic Ideals in the Schoolroom.

ERIC Educational Resources Information Center

Hamberger, Nan Marie; Moore, Robert L.

Noting that one way to break boundaries that separate one person from another is to use the writing experience to identify and analyze values, this paper presents guidelines for defining values, discussing values, and teaching about values. Teaching and discussion aids are provided to enhance the examination of narratives and biographies, which…

Industrial R&D Expenditures Rise to $22 Billion in 1974. Science Resources Studies Highlights, January 14, 1976.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. Div. of Science Resources Studies.

Reported in this newsletter in narrative, graphical, and tabular form are data related to industrial research and development expenditures in 1974, showing a seven percent increase over 1973. It is noted that more than 80 percent of a total of $22.3 billion was spent by five industries; these included electrical equipment and communication,…

High Stakes Principalship--Sleepless Nights, Heart Attacks and Sudden Death Accountabilities: Reading Media Representations of the United States Principal Shortage.

ERIC Educational Resources Information Center

Thomson, Pat; Blackmore, Jill; Sachs, Judyth; Tregenza, Karen

2003-01-01

Subjects a corpus of predominantly United States news articles to deconstructive narrative analysis and finds that the dominant media representation of principals' work is one of long hours, low salary, high stress, and sudden death from high stakes accountabilities. Notes that the media picture may perpetuate the problem, and that it is at odds…

Management Approaches to Stomal and Peristomal Complications: A Narrative Descriptive Study.

PubMed

Beitz, Janice M; Colwell, Janice C

2016-01-01

The purpose of this study was to identify optimal interventions for selected complications based on WOC nurse experts' judgment/expertise. A cross-sectional quantitative descriptive design with qualitative, narrative-type components was used for this study. Following validation rating of appropriateness of interventions and quantitative rankings of first-, second-, and third-line approaches, participants provided substantive handwritten narrative comments about listed interventions. Comments were organized and prioritized using frequency count. Narrative comments reflected the quantitative rankings of efficacy of approaches. Clinicians offered further specific suggestions regarding product use and progression of care for selected complications. Narrative analysis using descriptive quantitative frequency count supported the rankings of most preferred treatments of selected stomal and peristomal complications. Findings add to the previous research on prioritized approaches and evidence-based practice in ostomy care.

The Use of the Clinical Ethnographic Narrative Interview to Understand and Support Help Seeking After Gender-Based Violence

PubMed Central

Saint Arnault, Denise M.

2017-01-01

Gender-based violence (GBV), characterized by the abduction or rape of women and girls to humiliate, intimidate, and traumatize them and their communities, is a profoundly disturbing tactic in international conflict. Long after armed conflict has ended, survivors continue to experience physical injuries, psychological trauma, and social and cultural stigma. Guilt, shame, and continued interpersonal violence can become a normalized part of daily life, significantly challenging the road to healing and recovery. Research about self-disclosure and narrative after GBV has shown that help seeking rates are shockingly low, with estimates ranging from 4-27%. From a feminist and a humanistic perspective, studying trauma history and related help seeking is delicate work that must use interview processes that ensure the survivor can tell her story without revictimization, while also aiming to restore personal mastery, empowerment, and self-understanding. Based on theories about benefits and challenges of the narrative after GBV and trauma, we propose that the Clinical Ethnographic Narrative Interview (CENI) allows researchers and practitioners a safe container to examine the complex interplay between suffering, culture, and help seeking. Using this interview, the interviewer and the participant work as partners to define, compare, and contrast the socio-cultural barriers and facilitators of help seeking. This paper explains the narrative theory and the challenges and benefits of the narrative approach after trauma. Then we provide support for the use of the CENI for an understanding of the help seeking process and facilitating a health-promoting narrative interview for survivors. We then address implications for research, practice, and policy. PMID:29098071

The Use of the Clinical Ethnographic Narrative Interview to Understand and Support Help Seeking After Gender-Based Violence.

PubMed

Saint Arnault, Denise M

2017-09-01

Gender-based violence (GBV), characterized by the abduction or rape of women and girls to humiliate, intimidate, and traumatize them and their communities, is a profoundly disturbing tactic in international conflict. Long after armed conflict has ended, survivors continue to experience physical injuries, psychological trauma, and social and cultural stigma. Guilt, shame, and continued interpersonal violence can become a normalized part of daily life, significantly challenging the road to healing and recovery. Research about self-disclosure and narrative after GBV has shown that help seeking rates are shockingly low, with estimates ranging from 4-27%. From a feminist and a humanistic perspective, studying trauma history and related help seeking is delicate work that must use interview processes that ensure the survivor can tell her story without revictimization, while also aiming to restore personal mastery, empowerment, and self-understanding. Based on theories about benefits and challenges of the narrative after GBV and trauma, we propose that the Clinical Ethnographic Narrative Interview (CENI) allows researchers and practitioners a safe container to examine the complex interplay between suffering, culture, and help seeking. Using this interview, the interviewer and the participant work as partners to define, compare, and contrast the socio-cultural barriers and facilitators of help seeking. This paper explains the narrative theory and the challenges and benefits of the narrative approach after trauma. Then we provide support for the use of the CENI for an understanding of the help seeking process and facilitating a health-promoting narrative interview for survivors. We then address implications for research, practice, and policy.

In their own words: Success stories from The Great Lakes Native American Research Center for Health.

PubMed

Dellinger, Matthew; Jackson, Brian; Poupart, Amy

2016-01-01

In 2009, the Great Lakes Native American Research Center for Health (GLNARCH) set out to generate a promotional video that highlights the successes of the program. Ten GLNARCH interns were interviewed and filmed for participation in the promotional video using a documentary production style. During the editing and transcription process, interviewer responses were noted for relevance to theoretical frameworks--specifically, tribal critical race theory, mentoring, and cultural compatibility--which guided GLNARCH program design. Quotations were transcribed to illustrate these themes. Though the interviews were not intended as a formal qualitative analysis, powerful narratives that are relevant to participatory research emerged. The emergence of narratives that align with relevant theoretical frameworks suggests a novel methodology for a culturally responsive, participatory reporting system.

Remediating Viking Origins: Genetic Code as Archival Memory of the Remote Past

PubMed Central

King, Turi; Brown, Steven D

2013-01-01

This article introduces some early data from the Leverhulme Trust-funded research programme, ‘The Impact of the Diasporas on the Making of Britain: evidence, memories, inventions’. One of the interdisciplinary foci of the programme, which incorporates insights from genetics, history, archaeology, linguistics and social psychology, is to investigate how genetic evidence of ancestry is incorporated into identity narratives. In particular, we investigate how ‘applied genetic history’ shapes individual and familial narratives, which are then situated within macro-narratives of the nation and collective memories of immigration and indigenism. It is argued that the construction of genetic evidence as a ‘gold standard’ about ‘where you really come from’ involves a remediation of cultural and archival memory, in the construction of a ‘usable past’. This article is based on initial questionnaire data from a preliminary study of those attending DNA collection sessions in northern England. It presents some early indicators of the perceived importance of being of Viking descent among participants, notes some emerging patterns and considers the implications for contemporary debates on migration, belonging and local and national identity. PMID:24179286

Remediating Viking Origins: Genetic Code as Archival Memory of the Remote Past.

PubMed

Scully, Marc; King, Turi; Brown, Steven D

2013-10-01

This article introduces some early data from the Leverhulme Trust-funded research programme, 'The Impact of the Diasporas on the Making of Britain: evidence, memories, inventions'. One of the interdisciplinary foci of the programme, which incorporates insights from genetics, history, archaeology, linguistics and social psychology, is to investigate how genetic evidence of ancestry is incorporated into identity narratives. In particular, we investigate how 'applied genetic history' shapes individual and familial narratives, which are then situated within macro-narratives of the nation and collective memories of immigration and indigenism. It is argued that the construction of genetic evidence as a 'gold standard' about 'where you really come from' involves a remediation of cultural and archival memory, in the construction of a 'usable past'. This article is based on initial questionnaire data from a preliminary study of those attending DNA collection sessions in northern England. It presents some early indicators of the perceived importance of being of Viking descent among participants, notes some emerging patterns and considers the implications for contemporary debates on migration, belonging and local and national identity.

Narrated Animated Solution Videos in a Mastery Setting

ERIC Educational Resources Information Center

Schroeder, Noah; Gladding, Gary; Gutmann, Brianne; Stelzer, Timothy

2015-01-01

Narrated animated solution videos were implemented in a clinical study that compared a mastery setting that employed repeated cycles of testing with instructional support to a group that had a single opportunity to experience the materials. The mastery setting students attempted sequential questions sets on a topic, with animated solutions between…

Exploring Teacher Induction: Collaborative Self-Studies across Institutions

ERIC Educational Resources Information Center

Smith, Déirdre; Engemann, Joe

2015-01-01

Educators from eight institutions engaged in collaborative self-studies of their own practices to gain deeper insight into the significance of narrative-based writing supporting the process of teacher induction. A series of teacher induction institutes based on narrative writing processes provided the context for critical exploration of the lived…

Transforming Online Learning through Narrative and Student Agency

ERIC Educational Resources Information Center

Lindgren, Robb; McDaniel, Rudy

2012-01-01

Efforts to improve online learning have focused primarily on the technology platform for delivering educational content and supporting student discourse. In this paper we describe an alternative approach that invokes two powerful forces behind human learning: narrative and agency. Each of these constructs and their potential impacts on learning is…

Photovoice: Facilitating Fathers' Narratives of Care

ERIC Educational Resources Information Center

Hegarty, Ann

2016-01-01

This paper critically explores the power of photographic images and photovoice research methodology to support the emergence of narratives of care amongst twenty Irish fathers. In the context of economic recession, the breadwinner role for these men was exchanged with one of at-home father. Men's daily care of children included language and…

Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

ERIC Educational Resources Information Center

Day, Kristen W.

2009-01-01

In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

Characterizing the Pain Narratives of Parents of Youth With Chronic Pain.

PubMed

Noel, Melanie; Beals-Erickson, Sarah E; Law, Emily F; Alberts, Nicole M; Palermo, Tonya M

2016-10-01

Questionnaire-based research has shown that parents exert a powerful influence on and are profoundly influenced by living with a child with chronic pain. Examination of parents' pain narratives through an observational lens offers an alternative approach to understanding the complexity of pediatric chronic pain; however, the narratives of parents of youth with chronic pain have been largely overlooked. The present study aimed to characterize the vulnerability-based and resilience-based aspects of the pain narratives of parents of youth with chronic pain. Pain narratives of 46 parents were recorded during the baseline session as part of 2 clinical trials evaluating a behavioral intervention for parents of youth with chronic pain. The narratives were coded for aspects of pain-related vulnerability and resilience. Using exploratory cluster analysis, 2 styles of parents' pain narratives were identified. Distress narratives were characterized by more negative affect and an exclusively unresolved orientation toward the child's diagnosis of chronic pain, whereas resilience narratives were characterized by positive affect and a predominantly resolved orientation toward the child's diagnosis. Preliminary support for the validity of these clusters was provided through our finding of differences between clusters in parental pain catastrophizing about child pain (helplessness). Findings highlight the multidimensional nature of parents' experience of their child's pain problem. Clinical implications in terms of assessment and treatment are discussed.

Narrative pedagogy and simulation: future directions for nursing education.

PubMed

Walsh, Mike

2011-05-01

Narrative pedagogy has been developed over the last decade in nursing as a means of complementing a conventional content and competency driven pedagogy. It focuses attention on the human experience of health care by deriving shared meanings from interpretation of stories. This allows students to explore the different perspectives of those involved. The emotional experiences of participants can be understood, conventional wisdom challenged and new knowledge emerge as students work together to construct their learning. Individual stories are embedded within the narrative and teachers have successfully used literature and film as narratives to help them explore the meaning of health care with students. Modern technology has opened up a new range of electronic narratives such as virtual simulation. These are considered and rejected as devices for a health care narrative due to their dehumanized and unrealistic nature. However it is argued that a multimedia online simulation of a typical neighbourhood can achieve the goal of providing a suitable narrative. Human actors replace avatars and real world settings replace gaming environments as the stories of people in this community are related and used to support narrative pedagogy. An example of such a narrative developed jointly in the UK and Canada is discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

NASA Astrophysics Data System (ADS)

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2007-02-01

In this paper we describe our research using a multi-user virtual environment, Quest Atlantis, to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment gaming engine to establish a virtual world through which students learned about science inquiry, water quality concepts, and the challenges in balancing scientific and socio-economic factors. Overall, students were clearly engaged, participated in rich scientific discourse, submitted quality work, and learned science content. Further, through participation in this narrative, students developed a rich perceptual, conceptual, and ethical understanding of science. This study suggests that multi-user virtual worlds can be effectively leveraged to support academic content learning.

Erratum to: Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

NASA Astrophysics Data System (ADS)

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2010-08-01

In this paper we describe our research using a multi-user virtual environment, Quest Atlantis, to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment gaming engine to establish a virtual world through which students learned about science inquiry, water quality concepts, and the challenges in balancing scientific and socio-economic factors. Overall, students were clearly engaged, participated in rich scientific discourse, submitted quality work, and learned science content. Further, through participation in this narrative, students developed a rich perceptual, conceptual, and ethical understanding of science. This study suggests that multi-user virtual worlds can be effectively leveraged to support academic content learning.

How The Fault in Our Stars illuminates four themes of the Adolescent End of Life Narrative.

PubMed

Kirkman, Anna Obergfell; Hartsock, Jane A; Torke, Alexia M

2018-05-26

Adolescents who face life-limiting illness have unique developmental features and strong personal preferences around end of life (EOL) care. Understanding and documenting those preferences can be enhanced by practising narrative medicine. This paper aims to identify a new form of narrative, the Adolescent End of Life Narrative, and recognise four central themes. The Adolescent EOL Narrative can be observed in young adult fiction, The Fault in Our Stars , which elucidates the notion that terminally ill adolescents have authentic preferences about their life and death. Attaining narrative competence and appreciating the distinct perspective of the dying adolescent allows medical providers and parents to support the adolescent in achieving a good death. By thinking with the Adolescent EOL Narrative, adults can use Voicing my CHOiCES, an EOL planning guide designed for adolescents, to effectively capture the adolescent's preferences, and the adolescent can make use of this type of narrative to make sense of their lived experience. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Being the Mother of an Adolescent Suffering From a Spinal Cord Injury: Possibilities of a Personal Narrative in Phenomenology.

PubMed

Angel, Sanne

2015-01-01

The single case can be a very fruitful source of knowledge. A mother's narratives of her experiences when her adolescent son suffered a spinal cord injury seemed very rich and informative. The challenge arises in the dissemination of this knowledge. With a phenomenological approach the narratives of a mother's experiences were analyzed. This revealed an experience characterized by (1) being emotionally overwhelmed due to the shock of the accident, (2) resisting imagination and acceptance of a disrupted life path for the adolescent, (3) balancing your assistance to provide the needed support maintaining the adolescent's dignity when helpless, (4) comforting and supporting the adolescent when in need for comfort and support yourself, and (5) reconciling parental assistance with the need for professional assistance. The discussion explores what the findings from the single case can tell us about being in a situation like this, and to what extent this knowledge can be disseminated to assist health professionals.

Notes of a Racial Caste Baby. Color Blindness and the End of Affirmative Action. Critical America Series.

ERIC Educational Resources Information Center

Fair, Bryan K.

This book is a defense of remedial affirmative action and an assertion that it is a policy that is a fair and workable solution to the chronic problem of racial caste in the United States. The personal narrative of the author, eighth of 10 children born to a single mother on public assistance, is combined with the discussion of American history…

The Dissertation and Graduation: Not Just a Black and White Process--Mountain Climbing, Middle Passage, and Learning as a Postdoctoral Fellow

ERIC Educational Resources Information Center

Moore, Felicia M.

2005-01-01

The purpose of this narrative essay was to share my experiences as a postdoctoral fellow in the Center for Curriculum Materials in Science. Data used to write this article came from two interviews, an on-line survey, and notes from a reflective journal collected during postdoctoral tenure. My experiences as a postdoctoral fellow have been…

Learning by Reading for Robust Reasoning in Intelligent Agents

DTIC Science & Technology

2018-04-24

SUPPLEMENTARY NOTES 14. ABSTRACT Our hypotheses are that analogical processing plays multiple roles in enabling machines to learn by reading, and that...systems). Our overall hypotheses are that analogical processing plays multiple roles in learning by reading, and that qualitative representations provide...from reading this text? Narrative function can be seen as a kind of communication act, but the idea goes a bit beyond that. Communication acts are

'I am not a tragedy. I am full of hope': communication impairment narratives in newspapers.

PubMed

O Malley-Keighran, Mary-Pat; Coleman, Mary

2014-01-01

Individual attitudes and more general attitudes in society can negatively influence the functioning of people with communication disorders according to the World Health Organisation's (WHO) International Classification of Functioning, Disability, and Health (ICF) (2002). Personal narratives have been recommended as the best means to convey and understand a person's life experience and have been investigated extensively. Investigations of personal narratives of communication impairment in mass media continue to be relatively rare in the literature. Published narratives can enrich understandings of clients' experiences by elucidating available representations of lived experiences of communication impairment. To answer the following research questions: What types of personal narratives of communication impairments are currently being disseminated in Irish newspapers? How are experiences of communication impairments represented in these narratives? The study was qualitative, deploying inductive analysis and drawing on Frank's (1995) typology of illness narratives to analyse narratives that were published in two Irish national newspapers over a 12-month period. The results illustrate the under-representation of communication impairments in Irish newspapers as ten out of 51 narratives in the corpus pertained to conditions that may have associated communication impairments. None of the narratives related the lived experience of a person with communication impairment in depth. A combination of quest and chaos narrative types was identified in six out of the ten narratives. Three out of the ten narratives featured a combination of chaos and restitution narrative types. One narrative was identified as being entirely a quest narrative. Three narratives contained elements of restitution. Inductive analysis revealed six main themes in the data (two for each narrative type) with one sub-theme identified for each main theme. The six main themes are: positive stances, re-evaluation of life, despair, fear, hope and support of others. The under-representation of the lived experience of people with communication impairments in Irish national newspapers may be seen as contributing to a general lack of understanding and awareness of communication impairments. This under-representation, coupled with a lack of awareness, may potentially affect the ability of people with communication impairments to re-engage with and reintegrate into their communities. © 2013 Royal College of Speech and Language Therapists.

The Narrative Waltz: The Role of Flexibility in Writing Proficiency

ERIC Educational Resources Information Center

Allen, Laura K.; Snow, Erica L.; McNamara, Danielle S.

2016-01-01

A commonly held belief among educators, researchers, and students is that high-quality texts are easier to read than low-quality texts, as they contain more engaging narrative and story-like elements. Interestingly, these assumptions have typically failed to be supported by the literature on writing. Previous research suggests that higher quality…

Youth Practitioner Professional Narratives: Changing Identities in Changing Times

ERIC Educational Resources Information Center

Price, Mark

2018-01-01

This paper examines youth practitioner professionality responses to neo-liberal policy changes in youth work and the youth support sector in the UK, from New Labour to Conservative-led administrations. Using a narrative inquiry approach, six early career practitioners explore and recount their experiences of moving into the field during changing…

Stories of Learning and Their Significance to Future Pathways and Aspirations

ERIC Educational Resources Information Center

Barnes, Sally-Anne; Brown, Alan

2016-01-01

This explores the narratives from three individuals in low-skilled employment in the UK. The interviewees reflected upon their experiences of learning from compulsory education and beyond and their pathways through education to employment. The narratives illustrate how with the support of significant others, resilience and proactivity, they can…

Teens Telling Tales: How Maternal and Peer Audiences Support Narrative Identity Development

ERIC Educational Resources Information Center

McLean, Kate C.; Jennings, Lauren E.

2012-01-01

Prior research has shown that parents help children to develop the requisite skills to construct an autobiographical self in past event conversations, yet research in adolescence is lacking. Further, friendships increase in importance during adolescence, and these new relationships may play a role in narrative identity development. The current…

Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

ERIC Educational Resources Information Center

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2007-01-01

In this paper we describe our research using a multi-user virtual environment, "Quest Atlantis," to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment…

Understanding Principal Leadership: An International Perspective and a Narrative Approach

ERIC Educational Resources Information Center

Slater, Charles L.

2011-01-01

This article reviews recent literature in educational administration that supports the argument that leadership matters. School principals exert influence on teachers, who in turn affect student achievement. There is a need for an international approach both to replicate large studies and to use a narrative approach to study leaders in their…

Narratives of Community Educators Fostering Adult Education and Community Development

ERIC Educational Resources Information Center

Delgado, Perla Guadalupe

2017-01-01

This qualitative research reports on the narratives of six community educators and utilizes anatomy of story as a framework. The research question directing this study was: What can we learn from the journeys and trajectories of community educators? Supporting sub-questions included: (1) what are their efforts fostering adult education? and (2)…

Scaffolding Narrative Skills: A Meta-Analysis of Instruction in Early Childhood Settings

ERIC Educational Resources Information Center

Pesco, Diane; Gagné, Andréanne

2017-01-01

Research Findings: Children's ability to tell stories and to understand the stories of others typically emerges in early childhood, supported by primary caregivers and educators. This article reviews instruction designed to foster children's narrative skills in preschool and kindergarten settings and examines the effects using meta-analysis. The…

Connecting the Links: Narratives, Simulations and Serious Games in Prehospital Training.

PubMed

Heldal, Ilona; Backlund, Per; Johannesson, Mikael; Lebram, Mikael; Lundberg, Lars

2017-01-01

Due to rapid and substantial changes in the health sector, collaboration and supporting technologies get more into focus. Changes in education and training are also required. Simulations and serious games (SSG) are often advocated as promising technologies supporting training of many and in the same manner, or increasing the skills necessary to deal with new, dangerous, complex or unexpected situations. The aim of this paper is to illustrate and discuss resources needed for planning and performing collaborative contextual training scenarios. Based on a practical study involving prehospital nurses and different simulator technologies the often-recurring activity chains in prehospital training were trained. This paper exemplifies the benefit of using narratives and SSGs for contextual training contributing to higher user experiences. The benefits of using simulation technologies aligned by processes can be easier defined by narratives from practitioners. While processes help to define more efficient and effective training, narratives and SSGs are beneficial to design scenarios with clues for higher user experiences. By discussing illustrative examples, the paper contributes to better understanding of how to plan simulation-technology rich training scenarios.

Narrative discourse deficits in amyotrophic lateral sclerosis.

PubMed

Ash, Sharon; Menaged, Anna; Olm, Christopher; McMillan, Corey T; Boller, Ashley; Irwin, David J; McCluskey, Leo; Elman, Lauren; Grossman, Murray

2014-08-05

We examined narrative discourse in amyotrophic lateral sclerosis (ALS) to assess the role of executive functioning in support of language and the neuroanatomical basis for such support. We analyzed a semistructured speech sample in 26 patients with ALS and 19 healthy seniors for narrative discourse features of coherence. Regression analyses related a measure of discourse coherence ("local connectedness") to gray matter atrophy and reduced white matter fractional anisotropy. Patients with ALS were impaired relative to controls on measures of discourse adequacy, including local connectedness and maintenance of the theme. These discourse measures were related to measures of executive functioning but not to motor functioning. Regressions related local connectedness to gray matter atrophy in ventral and dorsal prefrontal regions and to reduced fractional anisotropy in white matter tracts mediating projections between prefrontal regions. Patients with ALS exhibit deficits in their ability to organize narrative discourse. These deficits appear to be related in part to executive limitations. Consistent with the hypothesis that ALS is a multisystem disorder, this deficit is related to disease in prefrontal regions. © 2014 American Academy of Neurology.

Beyond risk factors to lived experiences: young women's experiences of health in Papua New Guinea.

PubMed

Hinton, Rachael L; Earnest, Jaya

2009-01-01

The health of young women in rural Papua New Guinea (PNG) is often examined using individual-based risk factors which are decontextualized from the social and cultural relationships within which women's lives are embedded. Understanding the health meanings and perceptions of rural PNG women is important for bridging the gap between current health program delivery and the real needs of women. The objective of this study was to explore the health perceptions of rural PNG young women and to identify points in the lifespan where support may be required. Thirty-three young women aged between 15 and 29 years were involved in the research. Multiple data collection methods were used within interpretive qualitative methodology and these included in-depth interviews, focus group discussions, photo narrative and ranking exercises. The study was conducted in a rural community in the Wosera district of the East Sepik Province of PNG from mid-2005 to early 2006. Following a community meeting and targeted awareness about the project to female youth, purposive and snowball sampling was used to recruit young women aged 15-24 years. The mean age of participants was 21 years. Single and married participants, unmarried mothers, school leavers and current school attendees were represented. Informed consent was obtained prior to the sharing of women's narratives. Data were categorized and analysed for emerging themes and cross checked with participants for verification. Young women viewed their health in the context of their social and cultural world and in terms of their wider life experiences. The main theme uncovered young women's strong desires for independence. Young women depended on their parents for emotional support and material possessions, and positive parental support provided young women with the opportunity to move towards independence. Freedom from economic constraints was identified as important for autonomy, and having money was discussed as a requisite for good health. Young women discussed that building healthy relationships was integral to health. For single young women this was connected with having the freedom to spend time with friends and boyfriends. Married young women noted that their health was related to the quality of their marital and familial relationships and the level of support available to meet the demands of new roles and responsibilities. The young women's narratives document the importance of the connection between the diverse health needs of young women and the social and cultural environment in which they live. The role of connectedness with family, friends and community in young women's lives is an important issue and can provide opportunities for the delivery of culturally appropriate support to young women in response to key transitional points in their health experiences. Health practitioners and policy-makers in PNG need to reconsider their assumptions underlying women's health programs and interventions in rural areas, and broaden their perspective of health to recognise the ways in which women's personal experiences influence health.

The role of 'social support' in the experience of fibromyalgia - narratives from South Africa.

PubMed

Cooper, Silvie; Gilbert, Leah

2017-05-01

This paper focuses on the role of 'social support' in the experience of fibromyalgia (a musculoskeletal pain disorder) in South Africa. In-depth semi-structured interviews were used to collect narratives from 15 participants. Sources of social support constitute important mechanisms for coping with the illness experience of fibromyalgia. In providing a space for consultation and validation of the diagnosis of fibromyalgia, and the person living with the condition, people giving support fulfil a critical role in shaping the experience. The findings show how support from family, partners, and peers plays an integral role in the process of accepting fibromyalgia diagnosis, adapting to the demands of the condition, and seeking help from healthcare providers. The findings also show the ways in which people with fibromyalgia provide support for others with the condition, and the importance of this peer network in shaping the paths and outcomes of this illness experience. The findings of this study corroborate existing evidence that show fibromyalgia to be a complex condition to manage, due to the multiplicity, uncertainty and contestation that feature in the experience of the illness. Additionally, this study presents the challenges related to the limitations of access to healthcare in the South African context, and the utility of narrative approaches in garnering insight into the ways in which social support is harnessed in this environment. © 2016 John Wiley & Sons Ltd.

The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing.

PubMed

Hassmiller, Susan; Bilazarian, Ani

2018-04-01

The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement.

HIV diagnosis rituals and identity narratives.

PubMed

Roth, N L; Nelson, M S

1997-04-01

Using the constitutive view of health communication as a framework, this essay explores the construction of HIV diagnoses in narratives about physician/patient interactions. Narrative analysis reveals the life-changing impact of HIV diagnosis and the incongruence of the routine ways in which most diagnoses are handled. It also highlights the importance of HIV-positive communities in the construction of HIV-positive identities. These analyses suggest a review of how all diagnoses are delivered, and a need for further exploration of the role of supportive communities in construction of identity.

[Raising children with mental disabilities: mothers' narratives].

PubMed

Bastos, Olga Maria; Deslandes, Suely Ferreira

2008-09-01

Technical advances in neonatology have increased the life expectancy of children with serious health problems. Many of these children experience developmental delay (mental disability) and require special care. The family must adapt to better provide for the child's needs. This study aimed to identify mothers' reactions and the obstacles they face to obtain what they consider the best treatment for their children. The study methodology was based on analysis of the mothers' narratives, drawing on medical anthropology and linguistics. The most typical plots in the narratives showed the impact of the diagnosis and the search for means to adapt to the child's care, as well as the difficulties encountered in the public health system to obtain what the mothers considered adequate care. The value ascribed to characters in the support network showed the importance of such support in these situations.

Characterizing the Pain Narratives of Parents of Youth with Chronic Pain

PubMed Central

Noel, Melanie; Beals-Erickson, Sarah E.; Law, Emily F.; Alberts, Nicole; Palermo, Tonya M.

2015-01-01

Objectives Questionnaire-based research has shown that parents exert a powerful influence on and are profoundly influenced by living with a child with chronic pain. Examination of parents' pain narratives through an observational lens offers an alternative approach to understanding the complexity of pediatric chronic pain; however, the narratives of parents of youth with chronic pain have been largely overlooked. The present study aimed to characterize the vulnerability- and resilience-based aspects of the pain narratives of parents of youth with chronic pain. Methods Pain narratives of 46 parents were recorded during the baseline session as part of two clinical trials evaluating a behavioral intervention for parents of youth with chronic pain. The narratives were coded for aspects of pain-related vulnerability and resilience. Results Using exploratory cluster analysis, two styles of parents’ pain narratives were identified. Distress narratives were characterized by more negative affect and an exclusively unresolved orientation towards the child’s diagnosis of chronic pain whereas resilience narratives were characterized by positive affect and a predominantly resolved orientation towards the child’s diagnosis. Preliminary support for the validity of these clusters was provided through our finding of differences between clusters in parental pain catastrophizing about child pain (helplessness). Discussion Findings highlight the multidimensional nature of parents’ experience of their child’s pain problem. Clinical implications in terms of assessment and treatment are discussed. PMID:26736026

Report for Batch Leach Analyses on Sediments at 100-HR-3 Operable Unit, Boreholes C7620, C7621, C7622, C7623, C7626, C7627, C7628, C7629, C7630, and C7866. Revision 1.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lindberg, Michael J.

2012-04-25

This is a revision to a previously released report. This revision contains additional analytical results for the sample with HEIS number B2H4X7. Between November 4, 2010 and October 26, 2011 sediment samples were received from 100-HR-3 Operable Unit for geochemical studies. The analyses for this project were performed at the 331 building located in the 300 Area of the Hanford Site. The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures and/or nationally recognized test procedures. The data sets include the sample identification numbers, analytical results, estimated quantification limits (EQL), and quality control data. The preparatory andmore » analytical quality control requirements, calibration requirements, acceptance criteria, and failure actions are defined in the on-line QA plan 'Conducting Analytical Work in Support of Regulatory Programs' (CAW). This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL. Samples were received with a chain of custody (COC) and were analyzed according to the sample identification numbers supplied by the client. All Samples were refrigerated upon receipt until prepared for analysis. All samples were received with custody seals intact unless noted in the Case Narrative. Holding time is defined as the time from sample preparation to the time of analyses. The prescribed holding times were met for all analytes unless noted in the Case Narrative. All reported analytical results meet the requirements of the CAW or client specified SOW unless noted in the case narrative. Due to the requirements of the statement of work and sampling events in the field, the 28 day and the 48 hr requirements cannot be met. The statement of work requires samples to be selected at the completion of the borehole. It is not always possible to complete a borehole and have the samples shipped to the laboratory within the hold time requirements. Duplicate RPD for Uranium 238 (38.9%) was above the acceptance limit (35) in 1E05003-DUP1 for ICPMS-Tc-U-WE The sample result is less than 10 times the detection limits. Duplicate recoveries are not applicable to this analyte. Duplicate RPD for Silver 107 (68.2%) was above the acceptance limit (35) in 2C06004-DUP1 for ICPMS-RCRA-AE The sample result is less than 10 times the detection limits. Duplicate recoveries are not applicable to this analyte. Matrix Spike Recovery for Chromium, Hexavalent (48.8%) was outside acceptance limits (75-125) in 1E23001-MS1 for Hexavalent Chromium/Soil. Potential Matrix interference. Sample results associated with this batch are below the EQL. There should be no impact to the data as reported. Matrix Spike Recovery for Chromium, Hexavalent (50.2%) was outside acceptance limits (75-125) in 2B22010-MS1 for Hexavalent Chromium/Soil. Potential Matrix interference. Sample results associated with this batch are below the EQL. There should be no impact to the data as reported.« less

Electricity and Vital Force: Discussing the Nature of Science Through a Historical Narrative

NASA Astrophysics Data System (ADS)

Schiffer, Hermann; Guerra, Andreia

2015-05-01

Seeking a historical-philosophical approach to science teaching, narrative texts have been used as pedagogical tools to improve the learning experience of students. A review of the literature of different types of narrative texts and their different rates of effectiveness in science education is presented. This study was developed using the so-called Historical Narrative as a tool to introduce science content from a historical-philosophical approach, aiming to discuss science as a human construction. This project was carried out in a 9th grade Physics class in K-12 school, in Rio de Janeiro, Brazil. The steps involved in constructing a Historical Narrative based on the controversy over animal electrical fluid between Luigi Galvani and Alessandro Volta is reported herein. Finally, qualitative research results of the activities inspired by this Historical Narrative are presented with the purpose of answering the research question: to what extent do Historical Narratives support and enhance discussions about the Nature of Science (NOS), through teaching the scientific content in a historical-philosophical approach with 9th grade students? The results indicate that Historical Narrative, based on historical episodes, is a good "door opener" to teach scientific content in a historical-philosophical approach, introducing discussions about the Nature of Science without neglecting the scientific content or simplifying the discussions about the NOS.

Relations Between Narrative Coherence, Identity, and Psychological Well-being in Emerging Adulthood

PubMed Central

Waters, Theodore E. A.; Fivush, Robyn

2014-01-01

Objective The hypothesis that the ability to construct a coherent account of personal experience is reflective, or predictive, of psychological adjustment cuts across numerous domains of psychological science. It has been argued that coherent accounts of identity are especially adaptive. We tested these hypotheses by examining relations between narrative coherence of personally significant autobiographical memories and three psychological well-being components (Purpose and Meaning; Positive Self View; Positive Relationships). We also examined the potential moderation of the relations between coherence and well-being by assessing the identity content of each narrative. Method We collected two autobiographical narratives of personally significant events from 103 undergraduate students and coded them for coherence and identity content. Two additional narratives about generic/recurring events were also collected and coded for coherence. Results We confirmed the prediction that constructing coherent autobiographical narratives is related to psychological well-being. Further, we found that this relation was moderated by the narratives’ relevance to identity and that this moderation held after controlling for narrative ability more generally (i.e. coherence of generic/recurring events). Conclusion These data lend strong support to the coherent narrative identity hypothesis and the prediction that unique events are a critical feature of identity construction in emerging adulthood. PMID:25110125

Historical imagination, narrative learning and nursing practice: graduate nursing students' reader-responses to a nurse's storytelling from the past.

PubMed

Wood, Pamela J

2014-09-01

Storytelling and narrative are widely used in nurse education and the value of narrative-based curricula, such as those governed by narrative pedagogy, is well recognised. Storytelling stimulates students' imagination, a central feature of narrative learning. One form of story and imagination yet to be fully considered by educators is the historical story and historical imagination. The use of historical storytelling creates a temporal dissonance between the story and reader that stimulates readers' imagination and response, and enables them to gain rich insights which can be applied to the present. Reader-response theory can support educators when using narrative and storytelling. This article presents an analysis of graduate nursing students' reader-responses to a nurse's story from the past. This narrative learning group used their historical imagination in responding to the story and prompted and challenged each other in their interpretation and in translating their responses to their current nursing practice. The article discusses this analysis within the context of reader-response theory and its potential application to narrative-based learning in nurse education. Historical stories stimulate historical imagination and offer a different frame of reference for students' development of textual competence and for applying insights to the present. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bootstrapping a de-identification system for narrative patient records: cost-performance tradeoffs.

PubMed

Hanauer, David; Aberdeen, John; Bayer, Samuel; Wellner, Benjamin; Clark, Cheryl; Zheng, Kai; Hirschman, Lynette

2013-09-01

We describe an experiment to build a de-identification system for clinical records using the open source MITRE Identification Scrubber Toolkit (MIST). We quantify the human annotation effort needed to produce a system that de-identifies at high accuracy. Using two types of clinical records (history and physical notes, and social work notes), we iteratively built statistical de-identification models by annotating 10 notes, training a model, applying the model to another 10 notes, correcting the model's output, and training from the resulting larger set of annotated notes. This was repeated for 20 rounds of 10 notes each, and then an additional 6 rounds of 20 notes each, and a final round of 40 notes. At each stage, we measured precision, recall, and F-score, and compared these to the amount of annotation time needed to complete the round. After the initial 10-note round (33min of annotation time) we achieved an F-score of 0.89. After just over 8h of annotation time (round 21) we achieved an F-score of 0.95. Number of annotation actions needed, as well as time needed, decreased in later rounds as model performance improved. Accuracy on history and physical notes exceeded that of social work notes, suggesting that the wider variety and contexts for protected health information (PHI) in social work notes is more difficult to model. It is possible, with modest effort, to build a functioning de-identification system de novo using the MIST framework. The resulting system achieved performance comparable to other high-performing de-identification systems. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

RAMESES publication standards: meta-narrative reviews

PubMed Central

2013-01-01

Background Meta-narrative review is one of an emerging menu of new approaches to qualitative and mixed-method systematic review. A meta-narrative review seeks to illuminate a heterogeneous topic area by highlighting the contrasting and complementary ways in which researchers have studied the same or a similar topic. No previous publication standards exist for the reporting of meta-narrative reviews. This publication standard was developed as part of the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project. The project's aim is to produce preliminary publication standards for meta-narrative reviews. Methods We (a) collated and summarized existing literature on the principles of good practice in meta-narrative reviews; (b) considered the extent to which these principles had been followed by published reviews, thereby identifying how rigor may be lost and how existing methods could be improved; (c) used a three-round online Delphi method with an interdisciplinary panel of national and international experts in evidence synthesis, meta-narrative reviews, policy and/or publishing to produce and iteratively refine a draft set of methodological steps and publication standards; (d) provided real-time support to ongoing meta-narrative reviews and the open-access RAMESES online discussion list so as to capture problems and questions as they arose; and (e) synthesized expert input, evidence review and real-time problem analysis into a definitive set of standards. Results We identified nine published meta-narrative reviews, provided real-time support to four ongoing reviews and captured questions raised in the RAMESES discussion list. Through analysis and discussion within the project team, we summarized the published literature, and common questions and challenges into briefing materials for the Delphi panel, comprising 33 members. Within three rounds this panel had reached consensus on 20 key publication standards, with an overall response rate of 90%. Conclusion This project used multiple sources to draw together evidence and expertise in meta-narrative reviews. For each item we have included an explanation for why it is important and guidance on how it might be reported. Meta-narrative review is a relatively new method for evidence synthesis and as experience and methodological developments occur, we anticipate that these standards will evolve to reflect further theoretical and methodological developments. We hope that these standards will act as a resource that will contribute to improving the reporting of meta-narrative reviews. To encourage dissemination of the RAMESES publication standards, this article is co-published in the Journal of Advanced Nursing and is freely accessible on Wiley Online Library (http://www.wileyonlinelibrary.com/journal/jan). Please see related articles http://www.biomedcentral.com/1741-7015/11/21 and http://www.biomedcentral.com/1741-7015/11/22 PMID:23360661

Messaging to Increase Public Support for Naloxone Distribution Policies in the United States: Results from a Randomized Survey Experiment.

PubMed

Bachhuber, Marcus A; McGinty, Emma E; Kennedy-Hendricks, Alene; Niederdeppe, Jeff; Barry, Colleen L

2015-01-01

Barriers to public support for naloxone distribution include lack of knowledge, concerns about potential unintended consequences, and lack of sympathy for people at risk of overdose. A randomized survey experiment was conducted with a nationally-representative web-based survey research panel (GfK KnowledgePanel). Participants were randomly assigned to read different messages alone or in combination: 1) factual information about naloxone; 2) pre-emptive refutation of potential concerns about naloxone distribution; and 3) a sympathetic narrative about a mother whose daughter died of an opioid overdose. Participants were then asked if they support or oppose policies related to naloxone distribution. For each policy item, logistic regression models were used to test the effect of each message exposure compared with the no-exposure control group. The final sample consisted of 1,598 participants (completion rate: 72.6%). Factual information and the sympathetic narrative alone each led to higher support for training first responders to use naloxone, providing naloxone to friends and family members of people using opioids, and passing laws to protect people who administer naloxone. Participants receiving the combination of the sympathetic narrative and factual information, compared to factual information alone, were more likely to support all policies: providing naloxone to friends and family members (OR: 2.0 [95% CI: 1.4 to 2.9]), training first responders to use naloxone (OR: 2.0 [95% CI: 1.2 to 3.4]), passing laws to protect people if they administer naloxone (OR: 1.5 [95% CI: 1.04 to 2.2]), and passing laws to protect people if they call for medical help for an overdose (OR: 1.7 [95% CI: 1.2 to 2.5]). All messages increased public support, but combining factual information and the sympathetic narrative was most effective. Public support for naloxone distribution can be improved through education and sympathetic portrayals of the population who stands to benefit from these policies.

Mediated Military Leadership: A Narrative Analysis of Military Leadership Training Material

DTIC Science & Technology

1988-12-01

that Washington became a living symbol of the Revolution.(11) Schwartz notes that sociologist Emil Durkheim once observed that "We see society...constantly creating sacred things out of ordinary ones." Durkheim added that if society finds a person who represents its "principle aspirations... this man...These archetypes were created to symbolize important cultural values. As such, the ideograph of leadership was created to describe what Durkheim

Development of professional knowledge in action: experiences from an action science design focusing on acknowledging communication in mental health.

PubMed

Vatne, Solfrid; Bjornerem, Heidi; Hoem, Elisabeth

2009-03-01

This article reports a multi-professional development project that was based on an action science design. The purpose was to develop 'acknowledging communication' in a psychiatric department for young people, and the objective to study the staffs' experiences of participating in the project. The professional part of the project has its foundation in Schibbye's treatment theory of inter-subjective understanding of relationships, and involves three main approaches from her theory: self-reflection, self-delimitation and emotional presence. The article presents the specific action design used, where reflection processes were developed in three different arenas: multidisciplinary Reflection groups, a Leader support group for the group leaders of the Reflection groups and collective Project seminars for all employees. A formal study programme designed to increase professional expertise, 15 European Credit Transfer System (ECTS), was also offered. The research methods included the researcher's process notes taken during the process, field notes from participating in the Leader support group, and qualitative interviews of eight informants participating in the various reflection arenas. The article presents and discusses the experiences evolved from the methods that were developed during the professional action science project: reflection on specific situations of interaction with patients in the form of oral/written narratives and the development of video presentations in combination with 'reflective teams'. The study showed that to facilitate change in the role of staff members, it is important to combine several reflection arenas where theoretical principles can be converted into practical action. By drawing data from only one study site, the study has a limited transferability, but should be of interest for professionals working with clinical change processes.

Successful African American women in science: A narrative inquiry

NASA Astrophysics Data System (ADS)

Petty, Cailisha L.

This study used narrative inquiry as a methodology to explore the lived experiences of five African American women in science across the academic spectrum, from doctoral candidate to full professor. The research questions guiding the inquiry included one overarching question and three sub-questions: What are the lifestories of successful African American women in science?; a) How do successful African American women in science define themselves?; b) What have been the facilitators and barriers encountered by successful African American women in science?; and c) What have been the systems of support for African American women in science? The study was theoretically positioned within the frameworks of Critical Race Theory and Black Feminist Thought. The two theories were used to guide all aspects of the study including methodology, data collection, and analysis. Data included eleven 40-60 minute semi-structured interview transcripts as well as the participants' Curriculum Vitae. The study design and data analysis were built upon Clandinin and Connelly's (2000) and Clandinin's (2006) model of narrative inquiry which explores narratives as a means to understand experience. Analysis and interpretation created three dominant narratives: Scientific Beginnings, An Unexpected Journey, and Lift as You Climb. Each narrative set explores multiple stories that describe storylines which aligned with the participants' goals of who they were and who they were becoming as scientists; and, storylines of tension which ran counter to the women's goals and aspirations. Barriers and support systems are revealed, as well as the meanings the participants made of their experiences and how it affected their lives.

Enhancing Writing Achievement through a Digital Learning Environment: Case Studies of Three Struggling Adolescent Male Writers

ERIC Educational Resources Information Center

Pruden, Manning; Kerkhoff, Shea N.; Spires, Hiller A.; Lester, James

2017-01-01

The aim of this study was to explore how "Narrative Theatre," a narrative-centered digital learning environment, supported the writing processes of 3 struggling adolescent male writers. We utilized a multicase study approach to capture 3 sixth-grade participants' experiences with the digital learning environment before, during, and after…

Northern Helping Practitioners and the Phenomenon of Secondary Trauma

ERIC Educational Resources Information Center

O'Neill, Linda K.

2010-01-01

This article highlights a narrative inquiry study that considered the experience of and the effects on 8 northern helping practitioners (5 women, 3 men, ages 30-60) who have 7 to 40 years of experience in providing trauma support in isolated communities in northern BC and the Yukon. Using a three-phase narrative analysis, 10 categories provided a…

The Evaluation of a Personal Narrative Language Intervention for School-Age Children with Down Syndrome

ERIC Educational Resources Information Center

Finestack, Lizbeth; O'Brien, Katy H.; Hyppa-Martin, Jolene; Lyrek, Kristen A.

2017-01-01

The purpose of this study was to evaluate the feasibility of an intervention focused on improving personal narrative skills of school-age children with Down syndrome (DS) using an approach involving visual supports. Four females with DS, ages 10 through 15 years, participated in this multiple baseline across participants single-subject…

Reflections on Structural Inequality, Struggle and the Meanings of Citizenship: A "zainichi" Korean Teacher Narrative

ERIC Educational Resources Information Center

Osler, Audrey

2018-01-01

Teachers across the globe engage in day-to-day struggles for justice, often with support from unions and community-led groups. Teacher narratives reveal opportunities for building an inclusive theory and practice of education for social justice. I profile one teacher, a third generation "zainichi" Korean permanent resident in Japan,…

Beating the Odds: Untold Stories of Fifteen African American Parents of Successful Students

ERIC Educational Resources Information Center

Leffall, Sonia E.

2017-01-01

The purpose of this narrative analysis study is to explore how fifteen African American parents of successful middle and high school students constructed their parental roles and what parental involvement strategies they employed to support their children's academic success. Based on their narratives, the findings are as follows: (a) The process…

An Examination of Police Officers' Perceptions of Effective School Responses to Active Shooter Scenarios: A Phenomenological Narrative Study

ERIC Educational Resources Information Center

Adkins, Florence E.

2015-01-01

This qualitative phenomenological research study used narrative inquiry to examine police officer perceptions of effective school responses to active shooting scenarios. Creswell's (2013) six step process for analyzing and interpreting qualitative data was used to examine the interview information. The study results support the idea that changes…

Age and Task-Related Effects on Young Children's Understanding of a Complex Picture Story

ERIC Educational Resources Information Center

Hayward, Denyse; Schneider, Phyllis; Gillam, Ronald B.

2009-01-01

In this study we examined age- and task-related effects in story schema knowledge across an independent narrative task (story formulations) and a supported narrative task (answering questions). We also examined age-related changes to questions about the story as a whole. Participants were typically developing English-speaking children aged 4, 5,…

Narratives of Adolescent Girls Journeying via Feminist Participatory Action Research through the Aftermath of Divorce

ERIC Educational Resources Information Center

Botha, Carolina S.; Hay, Johnnie

2016-01-01

This article documents the (often counter-normative) narrative journey of four South African adolescent girls whose biological parents had divorced--and one (or both) parent(s) remarried. Through purposive sampling within a qualitative research paradigm of feminist participatory action research, they were supported in group context by the primary…

Children's Reading Comprehension and Narrative Recall in Sung and Spoken Story Contexts

ERIC Educational Resources Information Center

Kouri, Theresa; Telander, Karen

2008-01-01

A growing number of reading professionals have advocated teaching literacy through music and song; however, little research exists supporting such practices. The purpose of this study was to determine if sung story book readings would enhance story comprehension and narrative re-tellings in children with histories of speech and language delay.…

You’re a good structure, Charlie Brown: The distribution of narrative categories in comic strips

PubMed Central

Cohn, Neil

2014-01-01

Cohn’s (2013) theory of “Visual Narrative Grammar” argues that sequential images take on categorical roles in a narrative structure, which organizes them into hierarchic constituents analogous to the organization of syntactic categories in sentences. This theory proposes that narrative categories, like syntactic categories, can be identified through diagnostic tests that reveal tendencies for their distribution throughout a sequence. This paper describes four experiments testing these diagnostics to provide support for the validity of these narrative categories. In Experiment 1, participants reconstructed unordered panels of a comic strip into an order that makes sense. Experiment 2 measured viewing times to panels in sequences where the order of panels was reversed. In Experiment 3 participants again reconstructed strips, but also deleted a panel from the sequence. Finally, in Experiment 4 participants identified where a panel had been deleted from a comic strip, and rated that strip’s coherence. Overall, categories had consistent distributional tendencies within experiments and complementary tendencies across experiments. These results point toward an interaction between categorical roles and a global narrative structure. PMID:24646175

You're a good structure, Charlie Brown: the distribution of narrative categories in comic strips.

PubMed

Cohn, Neil

2014-01-01

Cohn's (2013) theory of "Visual Narrative Grammar" argues that sequential images take on categorical roles in a narrative structure, which organizes them into hierarchic constituents analogous to the organization of syntactic categories in sentences. This theory proposes that narrative categories, like syntactic categories, can be identified through diagnostic tests that reveal tendencies for their distribution throughout a sequence. This paper describes four experiments testing these diagnostics to provide support for the validity of these narrative categories. In Experiment 1, participants reconstructed unordered panels of a comic strip into an order that makes sense. Experiment 2 measured viewing times to panels in sequences where the order of panels was reversed. In Experiment 3, participants again reconstructed strips but also deleted a panel from the sequence. Finally, in Experiment 4 participants identified where a panel had been deleted from a comic strip and rated that strip's coherence. Overall, categories had consistent distributional tendencies within experiments and complementary tendencies across experiments. These results point toward an interaction between categorical roles and a global narrative structure. © 2014 Cognitive Science Society, Inc.

Emplotting Hikikomori: Japanese Parents' Narratives of Social Withdrawal.

PubMed

Rubinstein, Ellen

2016-12-01

Hikikomori, often glossed as "social withdrawal," emerged as a sociomedical condition among Japanese youth at the end of the twentieth century, and it continues to fascinate and concern the public. Explanatory frameworks for hikikomori abound, with different stakeholders attributing it to individual psychopathology, poor parenting, and/or a lack of social support structures. This article takes an interpretive approach to hikikomori by exploring parents' narrative constructions of hikikomori children in support group meetings and in-depth interviews. I argue that some parents were able to find hope in hikikomori by 'emplotting' their children's experiences into a larger narrative about onset, withdrawal, and recovery, which helped them remain invested in the present by maintaining a sense of possibility about the future. Contrary to literature that examines hikikomori as an epidemic of isolated individuals, I demonstrate how parents play a key role in hikikomori through meaning-making activities that have the potential to shape their children's experiences of withdrawal.

“These Are Just Stories, Mulder”: Exposure to Conspiracist Fiction Does Not Produce Narrative Persuasion

PubMed Central

Nera, Kenzo; Pantazi, Myrto; Klein, Olivier

2018-01-01

Narrative persuasion, i.e., the impact of narratives on beliefs, behaviors and attitudes, and the mechanisms underpinning endorsement of conspiracy theories have both drawn substantial attention from social scientists. Yet, to date, these two fields have evolved separately, and to our knowledge no study has empirically examined the impact of conspiracy narratives on real-world conspiracy beliefs. In a first study, we exposed a group of participants (n = 37) to an X-Files episode before asking them to fill in a questionnaire related to their narrative experience and conspiracy beliefs. A control group (n = 41) had to answer the conspiracy beliefs items before watching the episode. Based on past findings of both the aforementioned fields of research, we hypothesized that the experimental group would show greater endorsement of conspiracy beliefs, an effect expected to be mediated by identification to the episodes' characters. We furthermore hypothesized that identification would be associated with cognitive elaboration of the topics developed in the narrative. The first two hypotheses were disproved since no narrative persuasion effect was observed. In a second study, we sought to replicate these results in a larger sample (n = 166). No persuasive effect was found in the new data and a Bayesian meta-analysis of the two studies strongly supports the absence of a positive effect of exposure to narrative material on endorsement of conspiracy theories. In both studies, a significant relation between conspiracy mentality and enjoyment was observed. In the second study, this relation was fully mediated by two dimensions of perceived realism, i.e., plausibility and narrative consistency. We discuss our results, based on theoretical models of narrative persuasion and compare our studies with previous narrative persuasion studies. Implications of these results for future research are also discussed. PMID:29875710

"These Are Just Stories, Mulder": Exposure to Conspiracist Fiction Does Not Produce Narrative Persuasion.

PubMed

Nera, Kenzo; Pantazi, Myrto; Klein, Olivier

2018-01-01

Narrative persuasion, i.e., the impact of narratives on beliefs, behaviors and attitudes, and the mechanisms underpinning endorsement of conspiracy theories have both drawn substantial attention from social scientists. Yet, to date, these two fields have evolved separately, and to our knowledge no study has empirically examined the impact of conspiracy narratives on real-world conspiracy beliefs. In a first study, we exposed a group of participants ( n = 37) to an X-Files episode before asking them to fill in a questionnaire related to their narrative experience and conspiracy beliefs. A control group ( n = 41) had to answer the conspiracy beliefs items before watching the episode. Based on past findings of both the aforementioned fields of research, we hypothesized that the experimental group would show greater endorsement of conspiracy beliefs, an effect expected to be mediated by identification to the episodes' characters. We furthermore hypothesized that identification would be associated with cognitive elaboration of the topics developed in the narrative. The first two hypotheses were disproved since no narrative persuasion effect was observed. In a second study, we sought to replicate these results in a larger sample ( n = 166). No persuasive effect was found in the new data and a Bayesian meta-analysis of the two studies strongly supports the absence of a positive effect of exposure to narrative material on endorsement of conspiracy theories. In both studies, a significant relation between conspiracy mentality and enjoyment was observed. In the second study, this relation was fully mediated by two dimensions of perceived realism, i.e., plausibility and narrative consistency. We discuss our results, based on theoretical models of narrative persuasion and compare our studies with previous narrative persuasion studies. Implications of these results for future research are also discussed.

Altered neural circuits accompany lower performance during narrative comprehension in children with reading difficulties: an fMRI study.

PubMed

Horowitz-Kraus, Tzipi; Buck, Catherine; Dorrmann, Dana

2016-10-01

Narrative comprehension is a linguistic ability that is foundational for future reading ability. The aim of the current study was to examine the neural circuitry of children with reading difficulties (RD) compared to typical readers during a narrative-comprehension task. We hypothesized that due to deficient executive functions, which support narrative comprehension abilities, children with RD would display altered activation and functional connectivity, as well as lower performance on a narrative-comprehension task. Children with RD and typical readers were scanned during a narrative-comprehension task and administered reading behavioral tests. Children with RD scored significantly lower on the narrative-comprehension task than did typical readers. Composite activation maps showed more diffused activation during narrative comprehension in the RD group. Maps comparing the two reading groups showed more activation in the frontal lobes (regions responsible for executive functions), and functional connectivity showed higher global efficiency in children with RD than in typical readers. Global efficiency was negatively correlated with phonological awareness and reading and executive function scores in the entire study group. Children with RD may suffer from narrative-comprehension difficulties due to diffused activation of language areas, as was observed during a narrative-comprehension task. Greater effort in this task may be reflected by the engagement of brain regions related to executive functions and higher functional connectivity or attributed to difficulties in phonological processing and reading and executive functions. Therefore, the accommodation given to children with RD of reading aloud may need to be revised due to the observed difficulty in this domain.

Shifting landscapes: immigrant women and postpartum depression.

PubMed

Morrow, Marina; Smith, Jules E; Lai, Yuan; Jaswal, Suman

2008-07-01

Utilizing an ethnographic narrative approach, we explored in the Canadian context the experiences of three groups of first-generation Punjabi-speaking, Cantonese-speaking, and Mandarin-speaking immigrant women with depression after childbirth. The information emerging from women's narratives of their experiences reveals the critical importance of the sociocultural context of childbirth in understanding postpartum depression. We suggest that an examination of women's narratives about their experiences of postpartum depression can broaden the understanding of the kinds of perinatal supports women need beyond health care provision and yet can also usefully inform the practice of health care professionals.

Do Children and Adolescents Have Different Types of Trauma Narratives and Does It Matter? Reliability and Face Validation for a Narrative Taxonomy.

PubMed

Scheeringa, Michael S; Lilly, Megan E; Staiger, Allison B; Heller, Maren L; Jones, Edward G; Weems, Carl F

2017-06-01

The construction of trauma narratives is a major component of several psychotherapy approaches for trauma-related problems, but questions remain as to whether fully expressive narratives are necessary and whether it is detrimental to ask avoidant youths to tell their narratives repeatedly. Characteristics of trauma narratives during psychotherapy have not been examined in youths and this represents a salient gap in knowledge. This study aimed to begin filling this gap by identifying categories of trauma narratives and empirically validating them. Youths (N = 47) aged 7 to 18 years, who were involved in a randomized controlled trial, received cognitive behavioral therapy. Transcripts of all narrative exposure therapy sessions for each youth were rated. Four categories were identified and were named expressive, avoidant, fabricated, and undemonstrative. Interrater reliability for identifying these categories was good, and face validation of the categories was supported by statistically significant differences between categories on the number of data elements of the trauma events, negative emotion words, and positive emotion words. These promising findings indicate that different types of narrative styles can be reliably identified. There was strong evidence for reduction of posttraumatic stress symptoms in each of the categories (Cohen's d = 0.9 to 2.5). Favorable treatment outcomes for all categories suggest that more remembering is not always better and clients appeared to effectively deal with memories in different ways. Copyright © 2017 International Society for Traumatic Stress Studies.

Climate Narratives: Combing multiple sources of information to develop risk management strategies for a municipal water utility

NASA Astrophysics Data System (ADS)

Yates, D. N.; Basdekas, L.; Rajagopalan, B.; Stewart, N.

2013-12-01

Municipal water utilities often develop Integrated Water Resource Plans (IWRP), with the goal of providing a reliable, sustainable water supply to customers in a cost-effective manner. Colorado Springs Utilities, a 5-service provider (potable and waste water, solid waste, natural gas and electricity) in Colorado USA, recently undertook an IWRP. where they incorporated water supply, water demand, water quality, infrastructure reliability, environmental protection, and other measures within the context of complex water rights, such as their critically important 'exchange potential'. The IWRP noted that an uncertain climate was one of the greatest sources of uncertainty to achieving a sustainable water supply to a growing community of users. We describe how historic drought, paleo-climate, and climate change projections were blended together into climate narratives that informed a suite of water resource systems models used by the utility to explore the vulnerabilities of their water systems.

An Evaluation of the UMLS in Representing Corpus Derived Clinical Concepts

PubMed Central

Friedlin, Jeff; Overhage, Marc

2011-01-01

We performed an evaluation of the Unified Medical Language System (UMLS) in representing concepts derived from medical narrative documents from three domains: chest x-ray reports, discharge summaries and admission notes. We detected concepts in these documents by identifying noun phrases (NPs) and N-grams, including unigrams (single words), bigrams (word pairs) and trigrams (word triples). After removing NPs and N-grams that did not represent discrete clinical concepts, we processed the remaining with the UMLS MetaMap program. We manually reviewed the results of MetaMap processing to determine whether MetaMap found full, partial or no representation of the concept. For full representations, we determined whether post-coordination was required. Our results showed that a large portion of concepts found in clinical narrative documents are either unrepresented or poorly represented in the current version of the UMLS Metathesaurus and that post-coordination was often required in order to fully represent a concept. PMID:22195097

Seeing the unseen: an Indigenous heritage's mapping project

NASA Astrophysics Data System (ADS)

Gagnon, Justine

2018-05-01

Based on an ongoing qualitative and collaborative research project led in partnership with the Innu community of Pessamit, this paper brings into focus some specific issues regarding memories recollection and representation in a context of deterritorialization. The Innu First Nation has a specific historical and political context related to resources exploitation. Since their traditional lands have been the site of several large-scale hydroelectric projects, they have been intimately - and to a large extent, forcibly - involved in the economic transformation of Quebec since the 1950s. It should be noted, however, that their ancestral occupation has never been formerly recognized by the federal and provincial governments, a political and legal context partly responsible for the material and cultural losses they had to deal with. Through interviews we have conducted with the elders that travelled the rivers before the floods, we tried to rebuild, in some way, the cultural heritage embedded in those submerged lands. We used different cartographic tools and materials in a way to support and trigger the personal narratives the elders were remembering and sharing. This cultural mapping process revealed three main issues I would like to focus on. First, as the cartographic representations were getting closer to the landscapes the elders perceived and experimented as kids and young adults, the localization of significant places and the creation of personal narratives became easier and fluid. Secondly, we found, through that inquiry, how important an enhanced visibility of innu's flooded heritage can be on a political level. Finally, we came to the conclusion that mapping should be considered more as a conversation than a visual representation only.

The Participants' Perspective: How Biographic-Narrative Intervention Influences Identity Negotiation and Quality of Life in Aphasia

ERIC Educational Resources Information Center

Corsten, Sabine; Schimpf, Erika J.; Konradi, Jürgen; Keilmann, Annerose; Hardering, Friedericke

2015-01-01

Background: People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such…

Becoming a member of the work force: perceptions of adults with Asperger Syndrome.

PubMed

Krieger, Beate; Kinébanian, Astrid; Prodinger, Birgit; Heigl, Franziska

2012-01-01

Research has shown that comparatively few adults with Asperger Syndrome (AS) participate in the competitive work force. The purpose of this study was to gain in-depth knowledge about contextual factors, which contribute to successful labor market participation in some adults with AS. This study was conducted by indepth-interviewing six adults with AS working in the competitive job market in Switzerland. A developmental and hermeneutic narrative approach was used for data collection and analysis. Two in-depth narrative interviews were conducted with each participant. A narrative analysis according to the theories of Paul Ricoeur was performed. Results showed that participants received pre-vocational requisites during their childhood through parents and friends that provided a feeling of security in social contexts. For participants, a supportive school setting resulted in academic achievements. The narratives reveal participants' capacities for understanding and adapting to social norms. Participants' understanding of their own needs was essential to the successful labor market participation. However, disclosure is rare and social stigma is still present. This study showed that successful labor participation of adults with AS can be enhanced through adequate social support already in the early stages of an individual's lifetime.

"It Was the Best of Times, It Was the Worst of Times": A Qualitative Investigation of Perfectionism and Drinking Narratives in Undergraduate Students.

PubMed

Nealis, Logan J; Mackinnon, Sean P

2017-01-01

Perfectionism is a transdiagnostic risk factor for mental health and interpersonal difficulties, but research on perfectionism and alcohol use in emerging adults remains equivocal. Qualitative research methods are underutilized in this area, and inductive analysis of drinking narratives in undergraduate perfectionists may help clarify conflicting results and support novel approaches to quantitative inquiry in this area. We interviewed 20 undergraduates high in perfectionism (6 adaptive perfectionists and 14 maladaptive perfectionists) using a narrative interview, with analyses focusing on a situation involving alcohol use. We coded interviews for emergent themes using thematic analysis. Five themes emerged as follows: (1) drinking as a social experience, (2) suffering consequences, (3) learning from alcohol, (4) alcohol use as escapism, and (5) reluctance and moderation. Our results add to existing literature by highlighting the interpersonal conflict in perfectionistic people's experience in relation to alcohol use during emerging adulthood. Results also suggest perfectionistic people may use alcohol and intoxication as a way to facilitate a "release" from unpleasant situations or emotions. Perfectionists reported both positive and negative experiences, which lends support for using a narrative perspective to help overcome preexisting assumptions about adaptive and maladaptive qualities of perfectionism.

Sounding Narrative Medicine: Studying Students’ Professional Identity Development at Columbia University College of Physicians and Surgeons

PubMed Central

Miller, Eliza; Balmer, Dorene; Hermann, Nellie; Graham, Gillian; Charon, Rita

2014-01-01

Purpose To learn what medical students derive from training in humanities, social sciences, and the arts in a narrative medicine curriculum and to explore narrative medicine’s framework as it relates to students’ professional development. Method On completion of required intensive, half-semester narrative medicine seminars in 2010, 130 second-year medical students at Columbia University College of Physicians and Surgeons participated in focus group discussions of their experiences. Focus group transcriptions were submitted to close iterative reading by a team who performed a grounded-theory-guided content analysis, generating a list of codes into which statements were sorted to develop overarching themes. Provisional interpretations emerged from the close and repeated readings, suggesting a fresh conceptual understanding of how and through what avenues such education achieves its goals in clinical training. Results Students’ comments articulated the known features of narrative medicine—attention, representation, and affiliation—and endorsed all three as being valuable to professional identity development. They spoke of the salience of their work in narrative medicine to medicine and medical education and its dividends of critical thinking, reflection, and pleasure. Critiques constituted a small percentage of the statements in each category. Conclusions Students report that narrative medicine seminars support complex interior, interpersonal, perceptual, and expressive capacities. Students’ lived experiences confirm some expectations of narrative medicine curricular planners while exposing fresh effects of such work to view. PMID:24362390

Assessing explicit error reporting in the narrative electronic medical record using keyword searching.

PubMed

Cao, Hui; Stetson, Peter; Hripcsak, George

2003-01-01

Many types of medical errors occur in and outside of hospitals, some of which have very serious consequences and increase cost. Identifying errors is a critical step for managing and preventing them. In this study, we assessed the explicit reporting of medical errors in the electronic record. We used five search terms "mistake," "error," "incorrect," "inadvertent," and "iatrogenic" to survey several sets of narrative reports including discharge summaries, sign-out notes, and outpatient notes from 1991 to 2000. We manually reviewed all the positive cases and identified them based on the reporting of physicians. We identified 222 explicitly reported medical errors. The positive predictive value varied with different keywords. In general, the positive predictive value for each keyword was low, ranging from 3.4 to 24.4%. Therapeutic-related errors were the most common reported errors and these reported therapeutic-related errors were mainly medication errors. Keyword searches combined with manual review indicated some medical errors that were reported in medical records. It had a low sensitivity and a moderate positive predictive value, which varied by search term. Physicians were most likely to record errors in the Hospital Course and History of Present Illness sections of discharge summaries. The reported errors in medical records covered a broad range and were related to several types of care providers as well as non-health care professionals.

Case Report Form Reporter: A Key Component for the Integration of Electronic Medical Records and the Electronic Data Capture System.

PubMed

Matsumura, Yasushi; Hattori, Atsushi; Manabe, Shiro; Takahashi, Daiyo; Yamamoto, Yuichiro; Murata, Taizo; Nakagawa, Akito; Mihara, Naoki; Takeda, Toshihiro

2017-01-01

To improve the efficiency of clinical research, we developed a system to integrate electronic medical records (EMRs) and the electronic data capture system (EDC). EDC is divided into case report form (CRF) reporter and CDMS with CRF receiver with data communication using the operational data model (ODM). The CRF reporter is incorporated into the EMR to share data witth the EMR. In the data transcription type, doctors enter data using a progress note template, which are transmitted to the reporter template. It then generates the ODM. In the direct record type, reporter templates open from the progress note and generate narrative text to make record in the progress note. The configuration files for a study are delivered from the contents server to minimize the setup. This system has been used for 15 clinical studies including 3 clinical trials. This system can save labor and financial costs in clinical research.

Transforming narratives into educational tools: the collaborative development of a transformative learning tool based on Nicaraguan adolescents' creative writing about intimate partner violence.

PubMed

Singleton, Robyn; Picado Araúz, María de la Paz; Trocin, Kathleen; Winskell, Kate

2017-01-01

The use of narrative has become increasingly popular in the public health, community development, and education fields. Via emotionally engaging plotlines with authentic, captivating characters, stories provide an opportunity for participants to be carried away imaginatively into the characters' world while connecting the story with their own lived experiences. Stories have been highlighted as valuable tools in transformative learning. However, little published literature exists demonstrating applications of stories in group-based transformative learning curricula. This paper describes the creation of a narrative-based transformative learning tool based on an analysis of Nicaraguan adolescents' meaning-making around intimate partner violence (IPV) in their creative narratives. In collaboration with a Nicaraguan organization, US researchers analyzed a sample of narratives ( n = 55; 16 male-authored, 39 female-authored) on IPV submitted to a 2014 scriptwriting competition by adolescents aged 15-19. The data were particularly timely in that they responded to a new law protecting victims of gender-based violence, Law 779, and contradicted social-conservative claims that the Law 779 destroys family unity. We incorporated results from this analysis into the creation of the transformative learning tool, separated into thematic sections. The tool's sections (which comprise one story and three corresponding activities) aim to facilitate critical reflection, interpersonal dialogue, and self- and collective efficacy for social action around the following themes derived from the analysis: IPV and social support; IPV and romantic love; masculinity; warning signs of IPV; and sexual abuse. As a collaboration between a public health research team based at a US university and a Nicaraguan community-based organization, it demonstrates the potential in the age of increasingly smooth electronic communication for novel community-university partnerships to facilitate the development of narrative-based tools to support transformative learning.

"There's no-fresh air there": narratives of smoke exposure among residents of extended-stay hotels.

PubMed

Lewinson, Terri; Bryant, Lawrence Oliver

2015-05-01

Hotel environments have been identified as places where hospitality workers and patrons are at an increased risk for smoke exposure and associated health hazards. However, little research has been conducted to understand experiences of long-term hotel residents. This article presents narrative accounts of tobacco smoke exposure from 37 residents at extended-stay hotels in a large metropolitan Atlanta county. Residents' narratives included an awareness of smoking as an unhealthy habit but a shared activity that facilitates social engagement at the hotel. Secondhand smoke narratives included descriptions of exposure from roommates and hotel neighbors. Thirdhand smoke narratives included reports of persistent pollution and smoke residue in the hotel environment. These results suggest a need for further research to understand the extent and impact of tobacco smoke exposure among this understudied population. The implications of this research support the efforts of social workers to engage in clean air advocacy and policy making for a vulnerable population.

Use of Social Media Among Individuals Who Suffer From Post-Traumatic Stress: A Qualitative Analysis of Narratives.

PubMed

Salzmann-Erikson, Martin; Hiçdurmaz, Duygu

2017-01-01

Suffering from post-traumatic stress impacts and restricts the life situation of the individual on several levels, not least regarding social difficulties. Social media on the Internet facilitate new possibilities for interaction and communication. Earlier research has demonstrated that people use social media to seek support and to discuss health-related issues. The current study aimed to describe how individuals suffering from post-traumatic stress use social media to convey authentic narratives of their daily lives, including illness, and further, to analyze the content of this media use. The data comprised YouTube videos, blogs, and forum discussions. Five categories cover the findings: (a) structure of the narrative, (b) narrating the trauma, (c) restrictions in life, (d) strategies in everyday living, and (e) online interaction. We stress that sharing narratives online facilitates a "verbalizing" of the life conditions of the sufferers and can be used as a self-care activity. © The Author(s) 2016.

Classifying injury narratives of large administrative databases for surveillance-A practical approach combining machine learning ensembles and human review.

PubMed

Marucci-Wellman, Helen R; Corns, Helen L; Lehto, Mark R

2017-01-01

Injury narratives are now available real time and include useful information for injury surveillance and prevention. However, manual classification of the cause or events leading to injury found in large batches of narratives, such as workers compensation claims databases, can be prohibitive. In this study we compare the utility of four machine learning algorithms (Naïve Bayes, Single word and Bi-gram models, Support Vector Machine and Logistic Regression) for classifying narratives into Bureau of Labor Statistics Occupational Injury and Illness event leading to injury classifications for a large workers compensation database. These algorithms are known to do well classifying narrative text and are fairly easy to implement with off-the-shelf software packages such as Python. We propose human-machine learning ensemble approaches which maximize the power and accuracy of the algorithms for machine-assigned codes and allow for strategic filtering of rare, emerging or ambiguous narratives for manual review. We compare human-machine approaches based on filtering on the prediction strength of the classifier vs. agreement between algorithms. Regularized Logistic Regression (LR) was the best performing algorithm alone. Using this algorithm and filtering out the bottom 30% of predictions for manual review resulted in high accuracy (overall sensitivity/positive predictive value of 0.89) of the final machine-human coded dataset. The best pairings of algorithms included Naïve Bayes with Support Vector Machine whereby the triple ensemble NB SW =NB BI-GRAM =SVM had very high performance (0.93 overall sensitivity/positive predictive value and high accuracy (i.e. high sensitivity and positive predictive values)) across both large and small categories leaving 41% of the narratives for manual review. Integrating LR into this ensemble mix improved performance only slightly. For large administrative datasets we propose incorporation of methods based on human-machine pairings such as we have done here, utilizing readily-available off-the-shelf machine learning techniques and resulting in only a fraction of narratives that require manual review. Human-machine ensemble methods are likely to improve performance over total manual coding. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

“It’s Not JUST Skin Cancer”: Understanding Their Cancer Experience From Melanoma Survivor Narratives Shared Online

PubMed Central

Banerjee, Smita C.; D’Agostino, Thomas A.; Gordon, Mallorie L.; Hay, Jennifer L.

2016-01-01

Cancer survivors narrate their experiences in unique ways, articulating different aspects of the cancer journey. The purpose of this study was to analyze the content of cancer narratives that melanoma survivors share online in order to present the ways that survivors narrate their cancer experience, to identify survivors’ motivations for sharing, and to better understand the ways in which survivors are impacted by and cope with the diagnosis and treatment of cancer. The sample consisted of 95 unique melanoma survivor narratives, accessed from the Melanoma Research Foundation in November 2015, that were inductively and deductively coded for key themes and subthemes. Emergent themes described different aspects of the melanoma experience during prediagnosis (identification of selfphenotype, searching for causes, suspicious findings, delay in diagnosis), diagnosis (communication of diagnosis, emotional responses), transition from diagnosis to beginning treatment (second opinion), treatment (positive reframing of attitude, proactive cancer management, side effects), and posttreatment phases (social support, vigilance behaviors posttreatment). Two themes that cut across all phases of the cancer journey included recognizing and dealing with uncertainty and survivors’ motive for sharing narrative. These findings have implications for understanding how melanoma survivors may benefit personally from sharing their cancer experience online and for the potential for survivor narratives to motivate behavior change and facilitate coping among readers. PMID:27982699

Negotiating competing discourses in narratives of midwifery leadership in the English NHS.

PubMed

Divall, Bernie

2015-11-01

to explore midwifery leaders' narratives of identity, within the context of one region of England. a qualitative study using narrative identity theory. Data were collected using in-depth, loosely structured narrative interviews. the study was undertaken in the Midlands region of England, in the context of a midwifery-specific leadership development programme. Participants were located in local NHS organisations and higher education institutions. the interviewees were midwives currently in one of a variety of formal leadership roles, who had recently completed a midwifery leadership development programme. Nine leaders were interviewed for the study. two central themes emerged: 'I am still a midwife' showed interviewees' continued self-identification according to their professional identity, despite the majority no longer holding a clinical role; 'Between a rock and a hard place' showed the challenges of maintaining a professionally-based identity narrative in the face of group and organisational discourses. among the midwifery leaders interviewed, narratives centred on a continued midwife self-identification. However, participants faced a number of challenges in maintaining this narrative, within the context of wider professional group and organisational discourses. midwifery leaders require the support of their professional group and organisational structures if they are to maintain a positive self- and social-identity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Personal narrative approaches in rehabilitation following traumatic brain injury: A synthesis of qualitative research.

PubMed

D'Cruz, Kate; Douglas, Jacinta; Serry, Tanya

2017-08-09

Although narrative storytelling has been found to assist identity construction, there is little direct research regarding its application in rehabilitation following traumatic brain injury (TBI). The aim of this review was to identify published evidence on the use of personal narrative approaches in rehabilitation following TBI and to synthesise the findings across this literature. A systematic search of four databases was conducted in December 2016. No limit was set on the start date of the search. Personal narrative approaches were defined as direct client participation in sharing personal stories using written, spoken or visual methods. The search retrieved 12 qualitative research articles on the use of personal narrative approaches in TBI rehabilitation. Thematic synthesis of the narrative data and authors' reported findings of the 12 articles yielded an overall theme of building a strengths-based identity and four sub-themes: 1) expressing and communicating to others; 2) feeling validated by the act of someone listening; 3) reflecting and learning about oneself; and 4) being productive. The findings of this review support the use of personal narrative approaches in addressing loss of identity following TBI. Healthcare professionals and the community are encouraged to seek opportunities for survivors of TBI to share their stories.

Narrative accounts of tracking the rural domestic violence survivors' journey: a feminist approach.

PubMed

Davis, K; Taylor, B; Furniss, D

2001-06-01

This research represents the first stage of a project to determine the level of use and effectiveness of informal support networks utilised by Australian rural women. We used a feminist narrative approach with semistructured interviews and a convenience sample of 26 rural women. Only 9 out of 12 women's stories are presented. We found that poverty and geographical, social, and emotional isolation resulted in the privatisation of abuse. Women were triggered to leave the family home when their children, friends, or family became victims of the abuse. They planned their escape by telephone with support of friends and family. Although they used these informal supports, the participants paradoxically expected a high level of expertise in domestic violence knowledge and skills. We recommend an integrated multilevel model of support for rural women in violent intimate relationships and their informal supporters.

Neural correlates and network connectivity underlying narrative production and comprehension: a combined fMRI and PET study.

PubMed

AbdulSabur, Nuria Y; Xu, Yisheng; Liu, Siyuan; Chow, Ho Ming; Baxter, Miranda; Carson, Jessica; Braun, Allen R

2014-08-01

The neural correlates of narrative production and comprehension remain poorly understood. Here, using positron emission tomography (PET), functional magnetic resonance imaging (fMRI), contrast and functional network connectivity analyses we comprehensively characterize the neural mechanisms underlying these complex behaviors. Eighteen healthy subjects told and listened to fictional stories during scanning. In addition to traditional language areas (e.g., left inferior frontal and posterior middle temporal gyri), both narrative production and comprehension engaged regions associated with mentalizing and situation model construction (e.g., dorsomedial prefrontal cortex, precuneus and inferior parietal lobules) as well as neocortical premotor areas, such as the pre-supplementary motor area and left dorsal premotor cortex. Narrative comprehension alone showed marked bilaterality, activating right hemisphere homologs of perisylvian language areas. Narrative production remained predominantly left lateralized, uniquely activating executive and motor-related regions essential to language formulation and articulation. Connectivity analyses revealed strong associations between language areas and the superior and middle temporal gyri during both tasks. However, only during storytelling were these same language-related regions connected to cortical and subcortical motor regions. In contrast, during story comprehension alone, they were strongly linked to regions supporting mentalizing. Thus, when employed in a more complex, ecologically-valid context, language production and comprehension show both overlapping and idiosyncratic patterns of activation and functional connectivity. Importantly, in each case the language system is integrated with regions that support other cognitive and sensorimotor domains. Copyright © 2014. Published by Elsevier Ltd.

Testing the Effects of Interactive Courseware Template for the Learning of History among Form One Students

ERIC Educational Resources Information Center

bin Mohamad, Rossafri; Muninday, Balakrishnan; Govindasamy, Malliga

2010-01-01

This article presents a study on the use of multimedia technology for the teaching of Form (Grade) One history, which is a form of narrative subject in nature. Specifically, it is to study the viability of multimedia materials in supporting active learning for subjects which are in narrative form. Due to the scarcity of interactive multimedia…

HIV status disclosure to families for social support in South Africa (NIMH Project Accept/HPTN 043).

PubMed

Maman, Suzanne; van Rooyen, Heidi; Groves, Allison K

2014-02-01

Literature on HIV status disclosure among persons living with HIV/AIDS (PLWHA) is dominated by research on the rates, barriers and consequences of disclosure to sexual partners, because of the assumed preventive health benefits of partner disclosure. Disclosure of HIV status can lead to an increase in social support and other positive psychosocial outcomes for PLWHA, but disclosure can also be associated with negative social outcomes including stigma, discrimination, and violence. The purpose of this article is to describe the HIV status disclosure narratives of PLWHA living in South Africa. Thirty in-depth interviews were conducted with 13 PLWHA (11 women, 2 men) over a three-year period. We explored disclosure narratives of the PLWHA through questions about who they chose to disclose to, how they disclosed to these individuals, and how these individuals reacted. Narratives focused on disclosure to family members and contained relatively little discussion of disclosure to sexual partners. Participants often disclosed first to one trusted family member, and news of the diagnosis remained with this person for a long period of time, prior to sharing with others. This family member helped the PLWHA cope with the news of their diagnosis and prepared them to disclose to others. Disclosure to one's partner was motivated primarily by a desire to encourage partners to test for HIV. Two participants described overtly negative reactions from a partner upon disclosure, and none of the PLWHA in this sample described very supportive relationships with their partners after disclosure. The critical role that family members played in the narratives of these PLWHA emphasizes the need for a greater focus on disclosure to families for social support in HIV counseling protocols.

Neurodevelopmental Versus Neurodegenerative Model of Schizophrenia and Bipolar Disorder: Comparison with Physiological Brain Development and Aging.

PubMed

Buoli, Massimiliano; Serati, Marta; Caldiroli, Alice; Cremaschi, Laura; Altamura, Alfredo Carlo

2017-03-01

Available data support a contribution of both neurodevelopmental and neurodegenerative factors in the etiology of schizophrenia (SCH) and bipolar disorder (BD). Of note, one of the most important issue of the current psychiatric research is to identify the specific factors that contribute to impaired brain development and neurodegeneration in SCH and BD, and especially how these factors alter normal brain development and physiological aging process. Our hypothesis is that only specific damages, taking place in precise brain development stages, are associated with future SCH /BD onset and that neurodegeneration consists of an acceleration of brain aging after SCH /BD onset. In support of our hypothesis, the results of the present narrative mini-review shows as neurodevelopmental damages generally contribute to neuropsychiatric syndromes (e.g. hypothyroidism or treponema pallidum), but only some of them are specifically associated with adult SCH and BD (e.g. toxoplasma or substance abuse), particularly if they happen in specific stages of brain development. On the other hand, cognitive impairment and brain changes, associated with long duration of SCH /BD, look like what happens during aging: memory, executive domains and prefrontal cortex are implicated both in aging and in SCH /BD progression. Future research will explore possible validity of this etiological model for SCH and BD.

Emotion regulation strategies in preschool children.

PubMed

Sala, Maria Nives; Pons, Francisco; Molina, Paola

2014-11-01

This study investigated the development of emotion regulation strategies as reflected in the narratives of children between the ages of 3 and 6 years. An experimental procedure based on story completion tasks was devised to elicit the emotion-related narratives of 69 preschool children. Coding of the narratives led to the observation of different emotion regulation strategies: Behavioural strategies, social support, and cognitive reappraisal. Several significant gender and age differences were identified in the use of these strategies. In addition, verbal skills, non-verbal intelligence, and emotion comprehension were found to be associated with use of the observed emotion regulation strategies, although only at specific ages. © 2014 The British Psychological Society.

The stories of nursing student repeaters: A narrative inquiry study.

PubMed

Lewis, Lisa Scandale

2018-01-01

This narrative inquiry study examined community college nursing student repeaters, who failed a required nursing course and then went on to repeat the course. The purpose of this study was to learn about the experience of this group of students who are at high risk for attrition. While each participant had a unique story, common narratives emerged and were presented as storylines. Two storylines that are new to the literature were: Repeating is an Emotional Journey, and Ultimately Repeating was the Best Thing for Me. These findings suggest that there is a need for additional support for this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

One size does not fit all: older adults benefit from redundant text in multimedia instruction

PubMed Central

Fenesi, Barbara; Vandermorris, Susan; Kim, Joseph A.; Shore, David I.; Heisz, Jennifer J.

2015-01-01

The multimedia design of presentations typically ignores that younger and older adults have varying cognitive strengths and weaknesses. We examined whether differential instructional design may enhance learning in these populations. Younger and older participants viewed one of three computer-based presentations: Audio only (narration), Redundant (audio narration with redundant text), or Complementary (audio narration with non-redundant text and images). Younger participants learned better when audio narration was paired with relevant images compared to when audio narration was paired with redundant text. However, older participants learned best when audio narration was paired with redundant text. Younger adults, who presumably have a higher working memory capacity (WMC), appear to benefit more from complementary information that may drive deeper conceptual processing. In contrast, older adults learn better from presentations that support redundant coding across modalities, which may help mitigate the effects of age-related decline in WMC. Additionally, several misconceptions of design quality appeared across age groups: both younger and older participants positively rated less effective designs. Findings suggest that one-size does not fit all, with older adults requiring unique multimedia design tailored to their cognitive abilities for effective learning. PMID:26284000

One size does not fit all: older adults benefit from redundant text in multimedia instruction.

PubMed

Fenesi, Barbara; Vandermorris, Susan; Kim, Joseph A; Shore, David I; Heisz, Jennifer J

2015-01-01

The multimedia design of presentations typically ignores that younger and older adults have varying cognitive strengths and weaknesses. We examined whether differential instructional design may enhance learning in these populations. Younger and older participants viewed one of three computer-based presentations: Audio only (narration), Redundant (audio narration with redundant text), or Complementary (audio narration with non-redundant text and images). Younger participants learned better when audio narration was paired with relevant images compared to when audio narration was paired with redundant text. However, older participants learned best when audio narration was paired with redundant text. Younger adults, who presumably have a higher working memory capacity (WMC), appear to benefit more from complementary information that may drive deeper conceptual processing. In contrast, older adults learn better from presentations that support redundant coding across modalities, which may help mitigate the effects of age-related decline in WMC. Additionally, several misconceptions of design quality appeared across age groups: both younger and older participants positively rated less effective designs. Findings suggest that one-size does not fit all, with older adults requiring unique multimedia design tailored to their cognitive abilities for effective learning.

Autism Narratives in Media Coverage of the MMR Vaccine-Autism Controversy under a Crip Futurism Framework.

PubMed

Mann, Benjamin W

2018-03-09

While previous studies in health communication have examined online news media regarding autism, there is a lack of research that critically examines how such media representations may stigmatize autism and seeks to eliminate the condition, particularly in the context of the resurging measles, mumps, and rubella (MMR) vaccine-autism controversy. To address this gap in the literature, this study analyzes 153 articles that engage the MMR vaccine-autism controversy from the top 10 online news sources in the U.S. from September 2015 through July 2017. It draws from Kafer's (2013) work in Feminist, Crip, Queer, using a lens of crip futurism to interpret three major narrative themes: a death and survival narrative that purports autism as a worst-case scenario, a societal problem narrative, and a preventative narrative that seeks to eliminate the condition. These themes suggest that online news media narratives about autism surrounding the autism-MMR controversy play into stereotypes about autism, including stigmatization and prioritization of preventive behaviors and cures over supporting the lived experiences of autistic individuals. Continued research on the impact of online media portrayals of autism specifically, and disability in health contexts generally, is called for.

Beware of Imitators: Al-Qa’ida through the Lens of its Confidential Secretary

DTIC Science & Technology

2012-06-04

reader; rather in all likelihood are the result of several factors, including Harun’s lapses in memory ; his having to make notes while evading the...they also earned it an indelible place in the collective memory of Washington’s political and intelligence community. In the mind of the then National...a reflective autobiographical style, e.g., the first part narrates his early life in the context of his native homeland, the Comoros Islands, and

The World of Endangered Wildlife. [Filmstrip, Cassette Tape Narration, Teacher's Guide, Two Copies of National Wildlife Magazine's Special Issue on Endangered Species, State-by-State List of Endangered Animals, and Wildlife Notes.

ERIC Educational Resources Information Center

National Wildlife Federation, Washington, DC.

The gradual disappearance of many species of wildlife, too often a prelude to extinction, is a problem of large proportions and increasing urgency. This filmstrip kit is designed to help students and teachers to understand the more serious threats to endangered species, what is being done about them, and how the individual can help. The kit…

The Impact of Marriage Equality on Sexual Minority Women's Relationships With Their Families of Origin.

PubMed

Riggle, Ellen D B; Drabble, Laurie; Veldhuis, Cindy B; Wootton, Angie; Hughes, Tonda L

2018-01-01

Support from family of origin is important to the health and wellbeing of sexual minority women (SMW) and structural stigma may impact that support. The recent extension of marriage rights to same-sex couples in all U.S. states provided an opportunity to examine whether this change in law would impact the relationship of SMW with their families of origin regarding their same-sex relationships, including marriage. Interviews with 20 SMW were conducted to learn about their perceptions of how support from families of origin had been impacted by or changed since the U.S. Supreme Court decision (Obergefell v. Hodges, 135 S. Ct. 2584, 2015). Thematic analysis of the narrative responses revealed stories of continued family support; increases in acceptance or support; mixed support/rejection or unclear messages; "don't ask, don't tell" or silence; and continued or increased family rejection. Most participant narratives included more than one theme. Implications for SMW's health and relationships are discussed.

Research on Social Networking Sites and Social Support from 2004 to 2015: A Narrative Review and Directions for Future Research.

PubMed

Meng, Jingbo; Martinez, Lourdes; Holmstrom, Amanda; Chung, Minwoong; Cox, Jeff

2017-01-01

The article presents a narrative review of scholarship on social support through social networking sites (SNSs) published from 2004 to 2015. By searching keywords related to social support and SNSs in major databases for social sciences, we identified and content analyzed directly relevant articles (N = 88). The article summarizes the prevalence of theory usage; the function of theory usage (e.g., testing a theory, developing a theory); major theories referenced; and methodologies, including research designs, measurement, and the roles of social support and SNS examined in this literature. It also reports four themes identified across the studies, indicating the trends in the current research. Based on the review, the article presents a discussion about study sites, conceptualization of social support, theoretical coherence, the role of social networks, and the dynamic relationships between SNS use and social support, which points out potential avenues for shaping a future research agenda.

Competing with big business: a randomised experiment testing the effects of messages to promote alcohol and sugary drink control policy.

PubMed

Scully, Maree; Brennan, Emily; Durkin, Sarah; Dixon, Helen; Wakefield, Melanie; Barry, Colleen L; Niederdeppe, Jeff

2017-12-28

Evidence-based policies encouraging healthy behaviours are often strongly opposed by well-funded industry groups. As public support is crucial for policy change, public health advocates need to be equipped with strategies to offset the impact of anti-policy messages. In this study, we aimed to investigate the effectiveness of theory-based public health advocacy messages in generating public support for sugary drink/alcohol policies (increased taxes; sport sponsorship bans) and improving resistance to subsequent anti-policy messages typical of the sugary drink/alcohol industry. We conducted a two-wave randomised online experiment assigning Australian adults to one of four health policies (sugary drink tax; sugary drink industry sports sponsorship ban; alcohol tax; alcohol industry sports sponsorship ban). Within each health policy, we randomised participants to one of five message conditions: (i) non-advocacy based message about the size and seriousness of the relevant health issue (control); (ii) standard pro-policy arguments alone; (iii) standard pro-policy arguments combined with an inoculation message (forewarning and directly refuting anti-policy arguments from the opposition); (iv) standard pro-policy arguments combined with a narrative message (a short, personal story about an individual's experience of the health issue); or (v) standard pro-policy arguments combined with a composite inoculation and narrative message. At time 1, we exposed participants (n = 6000) to their randomly assigned message. Around two weeks later, we re-contacted participants (n = 3285) and exposed them to an anti-policy message described as being from a representative of the sugary drink/alcohol industry. Generalised linear models tested for differences between conditions in policy support and anti-industry beliefs at both time points. Only the standard argument plus narrative message increased policy support relative to control at time 1. The standard argument plus narrative and standard argument plus inoculation messages were effective at increasing resistance to the persuasive impact of anti-policy messages relative to control at time 2. Dissemination of advocacy messages using inoculation or narrative components can help strengthen public resistance to subsequent anti-policy messages from industry groups.

site of identity work in the online Alzheimer’s support group.

PubMed

Kruk, Bartłomiej

2015-01-01

Narrative of personal experience, as a subjective interpretation of a set of events, constitutes a particularly fertile site for the construction of identity. It enables the teller to voice and (re-)organize disruptive phenomenological experiences, socialize emotions or forge interpersonal relations. Consequently, the narrator is able to access various facets of their identity and ‘bring multiple, partial selves to life’ (Ochs and Capps 1996: 19). Informed by the methods and insights of computer- mediated discourse analysis, conversation analysis and membership categorization analysis, and positioning narrative as a situated practice within social interaction, this paper scrutinizes publicly accessible data (15 forum threads) nested within a UK-based online Alzheimer’s support group to demonstrate how Alzheimer’s patients’ family caregivers co-construct their sense of self when disclosing morally delicate aspects of their identities. The analysis demonstrates that the discursive space of the online support group encourages caregivers to disclose disruptions of predicates and activities associated with the ‘family’ membership categorization device. It also shows that the medium-afforded mode of engagement enables caregivers to gradually incorporate their unveiled aversive experiences into their autobiographical flow, with the help of other participants’ responses which normalize these category disruptions.

Deeper than Blueberries: A Reciprocal Teaching Method Approach to Narrative Text in an Electronically Supported Learning Environment.

ERIC Educational Resources Information Center

Pisha, Bart; Brady, Mary

This paper describes a five-phase, 20-week, computer supported reading comprehension instruction process, which begins with access to powerful supports and direct teacher-mediated instruction. The process involves five phases: (1) fully supported reading and strategy instruction; (2) strategy practice in a fully supported reading environment with…

The importance of being authentic: persuasion, narration, and dialogue in health communication and education.

PubMed

Petraglia, Joseph

2009-03-01

A topic gaining attention in the field of education has been that of "authenticity"-the creation of learning environments that provide learners with richer and more realistic contexts in which to apply knowledge and practice skills. The subject of authenticity has yet to attract much attention in the field of public health and specifically in health communication and education, although these fields have long experience with the problem of getting audiences to translate knowledge into action. This article reviews the rationale for an interest in authenticity as it relates to health communication and education and notes that "authenticity" does not inhere in information but is an appraisal made by a member of the public who is persuaded to view the information as especially relevant to his or her health behavior and consonant with his or her prior experiences. This article argues that a public health communicator or educator can encourage such appraisals by using narrative formats that provide rich contextualization. But contextualizing behavior change information in the form of stories is not enough; there is a dialogic dimension to persuasion that aids in the process of authentication. Creating opportunities for dialogue between behavior change narratives and their audiences has its own challenges, but nonetheless deserves to be a priority in public health.

How Fuzzy-Trace Theory Predicts True and False Memories for Words, Sentences, and Narratives

PubMed Central

Reyna, Valerie F.; Corbin, Jonathan C.; Weldon, Rebecca B.; Brainerd, Charles J.

2016-01-01

Fuzzy-trace theory posits independent verbatim and gist memory processes, a distinction that has implications for such applied topics as eyewitness testimony. This distinction between precise, literal verbatim memory and meaning-based, intuitive gist accounts for memory paradoxes including dissociations between true and false memory, false memories outlasting true memories, and developmental increases in false memory. We provide an overview of fuzzy-trace theory, and, using mathematical modeling, also present results demonstrating verbatim and gist memory in true and false recognition of narrative sentences and inferences. Results supported fuzzy-trace theory's dual-process view of memory: verbatim memory was relied on to reject meaning-consistent, but unpresented, sentences (via recollection rejection). However, verbatim memory was often not retrieved, and gist memory supported acceptance of these sentences (via similarity judgment and phantom recollection). Thus, mathematical models of words can be extended to explain memory for complex stimuli, such as narratives, the kind of memory interrogated in law. PMID:27042402

Young Children in Intractable Conflicts: The Israeli Case.

PubMed

Nasie, Meytal; Diamond, Aurel Harrison; Bar-Tal, Daniel

2015-10-08

The article examines the political socialization of young Jewish-Israeli children who live under the Israeli-Palestinian intractable conflict. It proposes arguments and presents empirical evidence to suggest that the way in which political socialization of young children happens in this context contributes to the development of conflict-supporting narratives of ethos of conflict and collective memory by the youngest generation. As a result, the conflict solidifies adherence to these narratives in adulthood, thereby serving as a major obstacle to the processes of peace-making and peace-building. Specifically, as evidence for showing how the political socialization works in Israel, a series of studies conducted in Israeli kindergartens and elementary schools are presented. These studies recount the contents acquired by young children, as well as contents delivered by teachers, related to the Israeli-Palestinian conflict. This indicates the serious consequences of acquiring conflict-supporting narratives at an early age in societies involved in intractable conflict. © 2015 by the Society for Personality and Social Psychology, Inc.

Harmonizing community-based health worker programs for HIV: a narrative review and analytic framework.

PubMed

De Neve, Jan-Walter; Boudreaux, Chantelle; Gill, Roopan; Geldsetzer, Pascal; Vaikath, Maria; Bärnighausen, Till; Bossert, Thomas J

2017-07-03

Many countries have created community-based health worker (CHW) programs for HIV. In most of these countries, several national and non-governmental initiatives have been implemented raising questions of how well these different approaches address the health problems and use health resources in a compatible way. While these questions have led to a general policy initiative to promote harmonization across programs, there is a need for countries to develop a more coherent and organized approach to CHW programs and to generate evidence about the most efficient and effective strategies to ensure their optimal, sustained performance. We conducted a narrative review of the existing published and gray literature on the harmonization of CHW programs. We searched for and noted evidence on definitions, models, and/or frameworks of harmonization; theoretical arguments or hypotheses about the effects of CHW program fragmentation; and empirical evidence. Based on this evidence, we defined harmonization, introduced three priority areas for harmonization, and identified a conceptual framework for analyzing harmonization of CHW programs that can be used to support their expanding role in HIV service delivery. We identified and described the major issues and relationships surrounding the harmonization of CHW programs, including key characteristics, facilitators, and barriers for each of the priority areas of harmonization, and used our analytic framework to map overarching findings. We apply this approach of CHW programs supporting HIV services across four countries in Southern Africa in a separate article. There is a large number and immense diversity of CHW programs for HIV. This includes integration of HIV components into countries' existing national programs along with the development of multiple, stand-alone CHW programs. We defined (i) coordination among stakeholders, (ii) integration into the broader health system, and (iii) assurance of a CHW program's sustainability to be priority areas of harmonization. While harmonization is likely a complex political process, with in many cases incremental steps toward improvement, a wide range of facilitators are available to decision-makers. These can be categorized using an analytic framework assessing the (i) health issue, (ii) intervention itself, (iii) stakeholders, (iv) health system, and (v) broad context. There is a need to address fragmentation of CHW programs to advance and sustain CHW roles and responsibilities for HIV. This study provides a narrative review and analytic framework to understand the process by which harmonization of CHW programs might be achieved and to test the assumption that harmonization is needed to improve CHW performance.

Communicating about Mental Illness and Violence: Balancing Increased Support for Services and Stigma

PubMed Central

Goldman, Howard H.; Pescosolido, Bernice A.; Barry, Colleen L.

2017-01-01

In the ongoing national policy debate about how to best address serious mental illness (SMI), a major controversy among mental health advocates is whether drawing public attention to an apparent link between SMI and violence, shown to elevate stigma, is the optimal strategy for increasing public support for investing in mental health services or whether non-stigmatizing messages can be equally effective. We conducted a randomized experiment to examine this question. Participants in a nationally representative online panel (N=1,326) were randomized to read one of three brief narratives about SMI emphasizing violence, systemic barriers to treatment, or successful treatment and recovery or to a control arm. Narratives, or stories about individuals, are a common communication strategy used by policymakers, advocates, and the news media. Study results showed that narratives emphasizing violence and barriers to treatment were equally effective in increasing the public’s willingness to pay additional taxes to improve the mental health system (55% and 52% versus 42% in the control arm). Only the narrative emphasizing the link between SMI and violence increased stigma. For the mental health advocates dedicated to improving the public mental health system, findings offer an alternative to stigmatizing messages linking mental illness and violence. PMID:29630706

Communicating about Mental Illness and Violence: Balancing Stigma and Increased Support for Services.

PubMed

McGinty, Emma E; Goldman, Howard H; Pescosolido, Bernice A; Barry, Colleen L

2018-04-01

In the ongoing national policy debate about how to best address serious mental illness (SMI), a major controversy among mental health advocates is whether drawing public attention to an apparent link between SMI and violence, shown to elevate stigma, is the optimal strategy for increasing public support for investing in mental health services or whether nonstigmatizing messages can be equally effective. We conducted a randomized experiment to examine this question. Participants in a nationally representative online panel (N = 1,326) were randomized to a control arm or to read one of three brief narratives about SMI emphasizing violence, systemic barriers to treatment, or successful treatment and recovery. Narratives, or stories about individuals, are a common communication strategy used by policy makers, advocates, and the news media. Study results showed that narratives emphasizing violence or barriers to treatment were equally effective in increasing the public's willingness to pay additional taxes to improve the mental health system (55 percent and 52 percent, vs. 42 percent in the control arm). Only the narrative emphasizing the link between SMI and violence increased stigma. For mental health advocates dedicated to improving the public mental health system, these findings offer an alternative to stigmatizing messages linking mental illness and violence. Copyright © 2018 by Duke University Press.

"Think positively": Parkinson's disease, biomedicine, and hope in contemporary Germany.

PubMed

Metzler, Ingrid; Just, Paul

2017-06-01

Narratives of hope shape contemporary engagements with Parkinson's disease. On the one hand, a "biomedical narrative of hope" promises that biomedical research will help to transform this treatable but incurable disease into a curable one in the future. On the other hand, a more individual "illness narrative of hope" encourages patients to influence the course of Parkinson's disease by practicing self-care and positive thinking. This article asks how these two narratives of hope interact. It bases its argument on an analysis of data from 13 focus groups conducted in Germany in 2012 and 2014 with patients with Parkinson's disease and their relatives. Participants were asked to have their say on clinical trials for advanced therapies for Parkinson's disease and, while doing so, envisioned their biosocial selves in the present and the future. Three "modes of being" for patients were drawn from this body of data: a "users on stand-by" mode, an "unengaged" mode, and an "experimental pioneers" mode. Both narratives of hope were important to all three modes, yet they were mobilized at different frequencies and also had different statuses. While the biomedical narrative of hope was deemed an important "dream of the future" that participants passively supported without having to make it their own, the illness narrative of hope was a truth discourse that took an imperative form: having Parkinson's disease implied the need to maintain a positive attitude.

Narrative and emotion process in psychotherapy: an empirical test of the Narrative-Emotion Process Coding System (NEPCS).

PubMed

Boritz, Tali Z; Bryntwick, Emily; Angus, Lynne; Greenberg, Leslie S; Constantino, Michael J

2014-01-01

While the individual contributions of narrative and emotion processes to psychotherapy outcome have been the focus of recent interest in psychotherapy research literature, the empirical analysis of narrative and emotion integration has rarely been addressed. The Narrative-Emotion Processes Coding System (NEPCS) was developed to provide researchers with a systematic method for identifying specific narrative and emotion process markers, for application to therapy session videos. The present study examined the relationship between NEPCS-derived problem markers (same old storytelling, empty storytelling, unstoried emotion, abstract storytelling) and change markers (competing plotlines storytelling, inchoate storytelling, unexpected outcome storytelling, and discovery storytelling), and treatment outcome (recovered versus unchanged at therapy termination) and stage of therapy (early, middle, late) in brief emotion-focused (EFT), client-centred (CCT), and cognitive (CT) therapies for depression. Hierarchical linear modelling analyses demonstrated a significant Outcome effect for inchoate storytelling (p = .037) and discovery storytelling (p = .002), a Stage × Outcome effect for abstract storytelling (p = .05), and a Stage × Outcome × Treatment effect for competing plotlines storytelling (p = .001). There was also a significant Stage × Outcome effect for NEPCS problem markers (p = .007) and change markers (p = .03). The results provide preliminary support for the importance of assessing the contribution of narrative-emotion processes to efficacious treatment outcomes in EFT, CCT, and CT treatments of depression.

A qualitative study of shopper experiences at an urban farmers' market using the Stanford Healthy Neighborhood Discovery Tool.

PubMed

Buman, Matthew P; Bertmann, Farryl; Hekler, Eric B; Winter, Sandra J; Sheats, Jylana L; King, Abby C; Wharton, Christopher M

2015-04-01

To understand factors which enhance or detract from farmers' market shopper experiences to inform targeted interventions to increase farmers' market utilization, community-building and social marketing strategies. A consumer-intercept study using the Stanford Healthy Neighborhood Discovery Tool to capture real-time perceptions via photographs and audio narratives. An urban farmers' market in a large metropolitan US city. Thirty-eight farmers' market shoppers, who recorded 748 unique coded elements through community-based participatory research methods. Shoppers were primarily women (65 %), 18-35 years of age (54 %), non-Hispanic (81 %) and white (73 %). Shoppers captured 291 photographs (7·9 (sd 6·3) per shopper), 171 audio narratives (5·3 (sd 4·7) per shopper), and ninety-one linked photograph + audio narrative pairs (3·8 (sd 2·8) per shopper). A systematic content analysis of the photographs and audio narratives was conducted by eight independent coders. In total, nine common elements emerged from the data that enhanced the farmers' market experience (61·8 %), detracted from the experience (5·7 %) or were neutral (32·4 %). The most frequently noted elements were freshness/abundance of produce (23·3 %), product presentation (12·8 %), social interactions (12·4 %) and farmers' market attractions (e.g. live entertainment, dining offerings; 10·3 %). While produce quality (i.e. freshness/abundance) was of primary importance, other contextual factors also appeared important to the shoppers' experiences. These results may inform social marketing strategies to increase farmers' market utilization and community-building efforts that target market venues.

What can Natural Language Processing do for Clinical Decision Support?

PubMed Central

Demner-Fushman, Dina; Chapman, Wendy W.; McDonald, Clement J.

2009-01-01

Computerized Clinical Decision Support (CDS) aims to aid decision making of health care providers and the public by providing easily accessible health-related information at the point and time it is needed. Natural Language Processing (NLP) is instrumental in using free-text information to drive CDS, representing clinical knowledge and CDS interventions in standardized formats, and leveraging clinical narrative. The early innovative NLP research of clinical narrative was followed by a period of stable research conducted at the major clinical centers and a shift of mainstream interest to biomedical NLP. This review primarily focuses on the recently renewed interest in development of fundamental NLP methods and advances in the NLP systems for CDS. The current solutions to challenges posed by distinct sublanguages, intended user groups, and support goals are discussed. PMID:19683066

Depression as a moderator of STAIR Narrative Therapy for women with post-traumatic stress disorder related to childhood abuse.

PubMed

Cloitre, Marylene; Garvert, Donn W; Weiss, Brandon J

2017-01-01

Background : Depression among those who have experienced childhood abuse is associated with earlier onset, more persistent and severe symptoms, more frequent relapse, and poorer treatment outcomes across a variety of psychiatric disorders. In addition, individuals with a history of childhood abuse are more likely to develop post-traumatic stress disorder (PTSD) co-occurring with depression. Objective : This study evaluated whether severity of depression moderated the outcome in a PTSD treatment for childhood abuse survivors. Specifically, we assessed whether individuals with significant depression obtained better outcomes when provided with a two-module treatment which included a skills training component with behavioral activation interventions, Skills Training in Affective and Interpersonal Regulation (STAIR) followed by a trauma-focused component, Narrative Therapy, as compared to two control conditions where one component (STAIR or Narrative Therapy) was replaced with Supportive Counseling. Method : Participants were 104 women with PTSD related to childhood abuse. Participants were randomized into three conditions: (1) STAIR plus Narrative Therapy (SNT), (2) STAIR plus Supportive Counseling (SSC), and (3) Supportive Counseling plus Narrative Therapy (SCNT). Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) PTSD symptom severity was assessed at pre-treatment, post-treatment, and 3 and 6 month follow-up. Results : Participants with severe depression showed superior PTSD symptom reduction following SNT, while those in the other two conditions experienced a loss of improvement after treatment ended. A similar finding was obtained among those with moderate depression, while among those with low levels of depression, outcomes did not differ across the three treatment conditions. Conclusions : Childhood abuse survivors with severe depression obtained superior outcomes in a treatment that combined skills training with trauma-focused work. Skills packages which contain behavioral activation interventions in combination with trauma-focused work may be particularly beneficial for patients with childhood abuse and severe depression.

Framing black boys: parent, teacher, and student narratives of the academic lives of black boys.

PubMed

Rowley, Stephanie J; Ross, Latisha; Lozada, Fantasy T; Williams, Amber; Gale, Adrian; Kurtz-Costes, Beth

2014-01-01

The discourse on Black boys tends to suggest that Black boys are in complete peril. We begin with evidence that Black boys are excelling in certain contexts (i.e., in certain states, in certain schools, and in certain courses). We then discuss the ways in which the narratives used by parents, teachers, and Black boys themselves may serve to further reinforce views that Black boys are beyond hope. Research on Black parents suggests that they tend to view their sons as vulnerable and have lower expectations for sons than for daughters. Studies of teachers show that they tend to view Black boys as unteachable, as social problems, and as scary. Research on Black boys shows that they are sometimes complicit in supporting these narratives by engaging in negative or ste reotypical behavior. We also include recent research that includes counter-narratives of Black boys. We end with suggestions for future research.

Directionality effects in simultaneous language interpreting: the case of sign language interpreters in The Netherlands.

PubMed

Van Dijk, Rick; Boers, Eveline; Christoffels, Ingrid; Hermans, Daan

2011-01-01

The quality of interpretations produced by sign language interpreters was investigated. Twenty-five experienced interpreters were instructed to interpret narratives from (a) spoken Dutch to Sign Language of The Netherlands (SLN), (b) spoken Dutch to Sign Supported Dutch (SSD), and (c) SLN to spoken Dutch. The quality of the interpreted narratives was assessed by 5 certified sign language interpreters who did not participate in the study. Two measures were used to assess interpreting quality: the propositional accuracy of the interpreters' interpretations and a subjective quality measure. The results showed that the interpreted narratives in the SLN-to-Dutch interpreting direction were of lower quality (on both measures) than the interpreted narratives in the Dutch-to-SLN and Dutch-to-SSD directions. Furthermore, interpreters who had begun acquiring SLN when they entered the interpreter training program performed as well in all 3 interpreting directions as interpreters who had acquired SLN from birth.

Service users' self-narratives on their journey from shame to pride: tales of transition.

PubMed

Natland, Sidsel; Celik, Hilde Dalen

2015-01-01

As part of a course on changing attitudes developed by KREM, a Norwegian service user organization, narratives are used to explore and understand identity formation. The process is based on the role of shame in the lives of those whose life experiences lead to a reliance on government social benefits to sustain themselves. Shame is identified as an obstacle that affects everyday life and undermines one's capacity to take actions that can lead to and support self-sufficiency. Exploring oneself through the construction of the fairy tale can provide service users with a renewed sense of empowerment. Using identity formation and the concept of shame as the conceptual framework, this analysis focuses on the use of narratives to construct and interpret stories. It concludes with both practice and research implications of using narratives to acquire an understanding and sensitivity to service user perspectives.

Women of Color Reflect on HIV-Related Stigma through PhotoVoice.

PubMed

Davtyan, Mariam; Farmer, Shu; Brown, Brandon; Sami, Mojgan; Frederick, Toni

2016-01-01

HIV-related stigma affects people living with HIV (PLWH), especially in communities of color. In our study, African American and Latina/Hispanic women living with HIV (WLWH) described experiences of stigma through PhotoVoice, a community-based participatory method of documentary photography. Ten WLWH from Los Angeles documented stigma experiences through photographs for up to 5 weeks and discussed their images during a focus group or semi-structured individual interview. Qualitative interpretive phenomenological analysis of participant narratives and photographs revealed lack of education and cultural myths as the main triggers of the stigma our participants faced. Stigma was experienced in health care settings, and participants identified depression, fear of intimate relationships, and nondisclosure of HIV status as its consequences. Social support and faith were noted as key coping mechanisms. WLWH recommended involving PLWH and public health officials in stigma reduction campaigns and youth education. PhotoVoice was perceived as a useful tool for education and self-improvement. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Projected fantasies and the political process: toward understanding why Hillary lost.

PubMed

Kibel, Howard D

2012-01-01

The author explores the events involved in the Democratic Party primary campaign of 2007-2008. Well before the campaign began, Senator Hillary Rodham Clinton was seen as the odds-on favorite to capture the nomination. But, that did not happen. Not only did she trail a relatively politically unknown, but she lost favor with many of those who would normally have supported her, such as advocates of gender progressivism, including many women. The author attempts to explain what happened by examining voter behavior, large group identity and its corollary of political identity, and the relation of large groups to leaders. Noting the effect of the sexual scandals during the Presidency of her husband, the author postulates that particular scenarios that have been repetitive throughout history, in art and literature, and reflected in mythology were graphed onto the perception of the Clintons. These narratives, much like Jung's archetypes, have evocative potential. Freud's early formulation of oedipal betrayal is used to explain the dynamics of infidelity and how that weakened Senator Clinton in the eyes of the public.

The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing

PubMed Central

Hassmiller, Susan; Bilazarian, Ani

2018-01-01

OBJECTIVE The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. METHODS A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. RESULTS Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. CONCLUSION Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement. PMID:29470381

Evaluation of Branched-Narrative Virtual Patients for Interprofessional Education of Psychiatry Residents.

PubMed

Wilkening, G Lucy; Gannon, Jessica M; Ross, Clint; Brennan, Jessica L; Fabian, Tanya J; Marcsisin, Michael J; Benedict, Neal J

2017-02-01

This pilot study evaluated the utility of branched-narrative virtual patients in an interprofessional education series for psychiatry residents. Third-year psychiatry residents attended four interprofessional education advanced psychopharmacology sessions that involved completion of a branched-narrative virtual patient and a debriefing session with a psychiatric pharmacist. Pre- and post-assessments analyzed resident learning and were administered around each virtual patient. Simulation 4 served as a comprehensive review. The primary outcome was differences in pre- and post-assessment scores. Secondary outcomes included resident satisfaction with the virtual patient format and psychiatric pharmacist involvement. Post-test scores for simulations 1, 2, and 3 demonstrated significant improvement (p < 0.05) from pre-test scores. Scores for simulation 4 did not retain significance. Resident satisfaction with the branched-narrative virtual patient format and psychiatric pharmacist involvement was high throughout the series (100 %; n = 18). Although there are important methodological limitations to this study including a small sample size and absence of a comparator group, this pilot study supports the use of branched-narrative virtual patients in an interprofessional education series for advanced learners.

The Complexities of Teaching Historical Conflictual Narratives in Integrated Palestinian-Jewish Schools in Israel

NASA Astrophysics Data System (ADS)

Bekerman, Zvi

2009-05-01

This paper addresses the complexities encountered by teachers and students when dealing with conflictual historical narratives in the context of integrated bilingual schools in Israel. The narratives presented are based on rich ethnographic data gathered from a long-standing research effort in the schools. They offer insights into how those involved in the educational initiative draw selectively from formal and informal sources in order to support their identification and sense of belonging within their particular political, national and religious communities. The vignettes rendered present a complex picture that is not necessarily encouraging in terms of the potential of education to help overcome situations of intractable conflict.

Support for Learning from Multimedia Explanations. A Comparison of Prompting, Signaling, and Questioning

ERIC Educational Resources Information Center

García-Rodicio, Héctor

2014-01-01

In one experiment 97 undergraduate students learned about plate tectonics from a multimedia presentation involving narrated animations and support in one of four forms. Support in the prompting condition included hints inducing participants to self-explain critical information. The signaling condition included overviews recapping critical…

Narratives in Mind and Media: A Cognitive Semiotic Account of Novices Interpreting Visual Science Media

NASA Astrophysics Data System (ADS)

Matuk, Camillia Faye

Visual representations are central to expert scientific thinking. Meanwhile, novices tend toward narrative conceptions of scientific phenomena. Until recently, however, relationships between visual design, narrative thinking, and their impacts on learning science have only been theoretically pursued. This dissertation first synthesizes different disciplinary perspectives, then offers a mixed-methods investigation into interpretations of scientific representations. Finally, it considers design issues associated with narrative and visual imagery, and explores the possibilities of a pedagogical notation to scaffold the understanding of a standard scientific notation. Throughout, I distinguish two categories of visual media by their relation to narrative: Narrative visual media, which convey content via narrative structure, and Conceptual visual media, which convey states of relationships among objects. Given the role of narrative in framing conceptions of scientific phenomena and perceptions of its representations, I suggest that novices are especially prone to construe both kinds of media in narrative terms. To illustrate, I first describe how novices make meaning of the science conveyed in narrative visual media. Vignettes of an undergraduate student's interpretation of a cartoon about natural selection; and of four 13-year olds' readings of a comic book about human papillomavirus infection, together demonstrate conditions under which designed visual narrative elements facilitate or hinder understanding. I next consider the interpretation of conceptual visual media with an example of an expert notation from evolutionary biology, the cladogram. By combining clinical interview methods with experimental design, I show how undergraduate students' narrative theories of evolution frame perceptions of the diagram (Study 1); I demonstrate the flexibility of symbolic meaning, both with the content assumed (Study 2A), and with alternate manners of presenting the diagram (Study 2B); finally, I show the effects of content assumptions on the diagrams students invent of phylogenetic data (Study 3A), and how first inventing a diagram influences later interpretations of the standard notation (Study 3B). Lastly, I describe the prototype design and pilot test of an interactive diagram to scaffold biology students' understanding of this expert scientific notation. Insights from this dissertation inform the design of more pedagogically useful representations that might support students' developing fluency with expert scientific representations.

The Construction of Self in Relationships: Narratives and References to Mental States during Picture-Book Reading Interactions between Mothers and Children.

PubMed

Rollo, Dolores; Longobardi, Emiddia; Spataro, Pietro; Sulla, Francesco

2017-01-01

Previous studies showed that mothers vary in the way in which they discuss past experiences with their children, since they can exhibit narrative ( elaborative ) or paradigmatic ( repetitive ) styles to different extents. Given this background, the aim of the present study was to analyze differences in the mothers' use of narrative styles and mental state language (MSL), as a function of children's age and gender. Thirty dyads consisting of mothers and their 4- to 6-year-old children were observed during a picture-book reading interaction. Maternal utterances were coded according to the categories described by Tessler and Nelson (1994), classifying each mother as Narrative or Paradigmatic . Eight categories of MSL were analyzed: perceptual, emotional (positive and negative), volitional, cognitive, communicative, and moral. The results confirmed the existence of the two maternal styles observed in the earlier studies. Importantly, we found that the mothers of younger children were more narrative than paradigmatic, whereas the opposite pattern occurred for the mothers of older children (they were more paradigmatic than narrative). As concerns MSL, the results indicated that the use of communicative terms was significantly more frequent for narrative than for paradigmatic mothers, and decreased linearly with children's age. Lastly, the mothers of younger children referred their MSL more frequently to the book characters than to themselves or to the child. Taken together, these results support the idea that mothers adapt their narrative styles and MSL input to the growing abilities of their children, therefore contributing to the development of social understanding.

Overlapping neural circuitry for narrative comprehension and proficient reading in children and adolescents.

PubMed

Horowitz-Kraus, Tzipi; Vannest, Jennifer J; Holland, Scott K

2013-11-01

Narrative comprehension is a perinatal linguistic ability which is more intuitive than reading activity. Whether there are specific shared brain regions for narrative comprehension and reading that are tuned to reading proficiency, even before reading is acquired, is the question of the current study. We acquired fMRI data during a narrative comprehension task at two age points, when children are age 5-7 (K-2nd grade) and later when the same children were age 11 (5th-7th grade). We then examined correlations between this fMRI data and reading and reading comprehension scores from the same children at age 11. We found that greater frontal and supramarginal gyrus (BA 40) activation in narrative comprehension at the age of 5-7 years old was associated with better word reading and reading comprehension scores at the age of 11. A shift towards temporal and occipital activation was found when correlating their narrative comprehension functional data at age 11, with reading scores at the same age point. We suggest that increased reliance on executive functions and auditory-visual networks when listening to stories before reading is acquired, facilitates reading proficiency in older age and may be a biomarker for future reading ability. Children, who rely on use of imagination/visualization as well as auditory processing for narrative comprehension when they reach age 11, also show greater reading abilities. Understanding concordant neural pathways supporting auditory narrative and reading comprehension might be guide for development of effective tools for reading intervention programs. Published by Elsevier Ltd.

The Construction of Self in Relationships: Narratives and References to Mental States during Picture-Book Reading Interactions between Mothers and Children

PubMed Central

Rollo, Dolores; Longobardi, Emiddia; Spataro, Pietro; Sulla, Francesco

2017-01-01

Previous studies showed that mothers vary in the way in which they discuss past experiences with their children, since they can exhibit narrative (elaborative) or paradigmatic (repetitive) styles to different extents. Given this background, the aim of the present study was to analyze differences in the mothers’ use of narrative styles and mental state language (MSL), as a function of children’s age and gender. Thirty dyads consisting of mothers and their 4- to 6-year-old children were observed during a picture-book reading interaction. Maternal utterances were coded according to the categories described by Tessler and Nelson (1994), classifying each mother as Narrative or Paradigmatic. Eight categories of MSL were analyzed: perceptual, emotional (positive and negative), volitional, cognitive, communicative, and moral. The results confirmed the existence of the two maternal styles observed in the earlier studies. Importantly, we found that the mothers of younger children were more narrative than paradigmatic, whereas the opposite pattern occurred for the mothers of older children (they were more paradigmatic than narrative). As concerns MSL, the results indicated that the use of communicative terms was significantly more frequent for narrative than for paradigmatic mothers, and decreased linearly with children’s age. Lastly, the mothers of younger children referred their MSL more frequently to the book characters than to themselves or to the child. Taken together, these results support the idea that mothers adapt their narrative styles and MSL input to the growing abilities of their children, therefore contributing to the development of social understanding. PMID:29234293

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

PubMed

Street, Annette F; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

PubMed Central

Street, Annette F.; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated. PMID:22530115

Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions.

PubMed

Brunton, Ginny; Thomas, James; O'Mara-Eves, Alison; Jamal, Farah; Oliver, Sandy; Kavanagh, Josephine

2017-12-11

Government policy increasingly supports engaging communities to promote health. It is critical to consider whether such strategies are effective, for whom, and under what circumstances. However, 'community engagement' is defined in diverse ways and employed for different reasons. Considering the theory and context we developed a conceptual framework which informs understanding about what makes an effective (or ineffective) community engagement intervention. We conducted a systematic review of community engagement in public health interventions using: stakeholder involvement; searching, screening, appraisal and coding of research literature; and iterative thematic syntheses and meta-analysis. A conceptual framework of community engagement was refined, following interactions between the framework and each review stage. From 335 included reports, three products emerged: (1) two strong theoretical 'meta-narratives': one, concerning the theory and practice of empowerment/engagement as an independent objective; and a more utilitarian perspective optimally configuring health services to achieve defined outcomes. These informed (2) models that were operationalized in subsequent meta-analysis. Both refined (3) the final conceptual framework. This identified multiple dimensions by which community engagement interventions may differ. Diverse combinations of intervention purpose, theory and implementation were noted, including: ways of defining communities and health needs; initial motivations for community engagement; types of participation; conditions and actions necessary for engagement; and potential issues influencing impact. Some dimensions consistently co-occurred, leading to three overarching models of effective engagement which either: utilised peer-led delivery; employed varying degrees of collaboration between communities and health services; or built on empowerment philosophies. Our conceptual framework and models are useful tools for considering appropriate and effective approaches to community engagement. These should be tested and adapted to facilitate intervention design and evaluation. Using this framework may disentangle the relative effectiveness of different models of community engagement, promoting effective, sustainable and appropriate initiatives.

How to improve the teaching of clinical reasoning: a narrative review and a proposal.

PubMed

Schmidt, Henk G; Mamede, Sílvia

2015-10-01

The development of clinical reasoning (CR) in students has traditionally been left to clinical rotations, which, however, often offer limited practice and suboptimal supervision. Medical schools begin to address these limitations by organising pre-clinical CR courses. The purpose of this paper is to review the variety of approaches employed in the teaching of CR and to present a proposal to improve these practices. We conducted a narrative review of the literature on teaching CR. To that end, we searched PubMed and Web of Science for papers published until June 2014. Additional publications were identified in the references cited in the initial papers. We used theoretical considerations to characterise approaches and noted empirical findings, when available. Of the 48 reviewed papers, only 24 reported empirical findings. The approaches to teaching CR were shown to vary on two dimensions. The first pertains to the way the case information is presented. The case is either unfolded to students gradually - the 'serial-cue' approach - or is presented in a 'whole-case' format. The second dimension concerns the purpose of the exercise: is its aim to help students acquire or apply knowledge, or is its purpose to teach students a way of thinking? The most prevalent approach is the serial-cue approach, perhaps because it tries to directly simulate the diagnostic activities of doctors. Evidence supporting its effectiveness is, however, lacking. There is some empirical evidence that whole-case, knowledge-oriented approaches contribute to the improvement of students' CR. However, thinking process-oriented approaches were shown to be largely ineffective. Based on research on how expertise develops in medicine, we argue that students in different phases of their training may benefit from different approaches to the teaching of CR. © 2015 John Wiley & Sons Ltd.

The influence of gender and gender typicality on autobiographical memory across event types and age groups.

PubMed

Grysman, Azriel; Fivush, Robyn; Merrill, Natalie A; Graci, Matthew

2016-08-01

Gender differences in autobiographical memory emerge in some data collection paradigms and not others. The present study included an extensive analysis of gender differences in autobiographical narratives. Data were collected from 196 participants, evenly split by gender and by age group (emerging adults, ages 18-29, and young adults, ages 30-40). Each participant reported four narratives, including an event that had occurred in the last 2 years, a high point, a low point, and a self-defining memory. Additionally, all participants completed self-report measures of masculine and feminine gender typicality. The narratives were coded along six dimensions-namely coherence, connectedness, agency, affect, factual elaboration, and interpretive elaboration. The results indicated that females expressed more affect, connection, and factual elaboration than males across all narratives, and that feminine typicality predicted increased connectedness in narratives. Masculine typicality predicted higher agency, lower connectedness, and lower affect, but only for some narratives and not others. These findings support an approach that views autobiographical reminiscing as a feminine-typed activity and that identifies gender differences as being linked to categorical gender, but also to one's feminine gender typicality, whereas the influences of masculine gender typicality were more context-dependent. We suggest that implicit gendered socialization and more explicit gender typicality each contribute to gendered autobiographies.

Call it a monster for lack of anything else: narrative insight in psychosis.

PubMed

Roe, David; Hasson-Ohayon, Ilanit; Kravetz, Shlomo; Yanos, Phil T; Lysaker, Paul H

2008-12-01

Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include "narrative insight" may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiate between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness.

The Design and Use of Educative Curricular Supports for Text-Based Discussions in Science

ERIC Educational Resources Information Center

Arias, Anna Maria; Palincsar, Annemarie S.; Davis, Elizabeth A.

2015-01-01

This article identifies the principles that informed the design of educative curriculum supports for teaching science texts and reports how elementary teachers chose to use the supports, which included identified learning goals, discussion moves to support sensemaking with the text, and narratives of teachers' uses of text in science teaching. The…

Geographers of Mars: cartographic inscription and exploration narrative in late Victorian representations of the red planet.

PubMed

Lane, K Maria D

2005-12-01

Over two decades spanning the turn of the twentieth century, astronomers' claims about the landscape and climate of Mars spurred widespread scientific and popular interest in the possibility that the red planet might be inhabited. This essay offers a new explanation for the power with which the notion of an inhabited Mars gripped noted scholars and everyday citizens on both sides of the Atlantic. Rather than pointing to a rekindling of age-old philosophical interest in the plurality of worlds, it argues that turn-of-the-century scientific narratives about Mars derived much of their power and popularity from ties with the newly established discipline of geography. From mapmaking to travelogue-style writing, astronomers borrowed powerful representational strategies from the discipline of geography to legitimize their claims about the red planet. In making the link between geographical and astronomical science more explicit, the essay further suggests that turn-of-the-century representations of Mars could be productively recontextualized alongside geographical works produced in the same period.

Narrative and evidence. How can case studies from the history of science support claims in the philosophy of science?

PubMed

Kinzel, Katherina

2015-02-01

A common method for warranting the historical adequacy of philosophical claims is that of relying on historical case studies. This paper addresses the question as to what evidential support historical case studies can provide to philosophical claims and doctrines. It argues that in order to assess the evidential functions of historical case studies, we first need to understand the methodology involved in producing them. To this end, an account of historical reconstruction that emphasizes the narrative character of historical accounts and the theory-laden character of historical facts is introduced. The main conclusion of this paper is that historical case studies are able to provide philosophical claims with some evidential support, but that, due to theory-ladenness, their evidential import is restricted. Copyright © 2014 Elsevier Ltd. All rights reserved.

Power and promise of narrative for advancing physical therapist education and practice.

PubMed

Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

2015-06-01

This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.

Managing "Spoiled Identities": Parents' Experiences of Compulsory Parenting Support Programmes

ERIC Educational Resources Information Center

Holt, Amanda

2010-01-01

While recent years have seen a rapid growth of research exploring the usefulness of parenting support programmes, no empirical research to date has specifically explored experiences of compulsory parenting support. The present study examines the narrative accounts of 17 parents who, through a Parenting Order, were made to participate in such…

Theory and practice of clinical ethics support services: narrative and hermeneutical perspectives.

PubMed

Porz, Rouven; Landeweer, Elleke; Widdershoven, Guy

2011-09-01

In this paper we introduce narrative and hermeneutical perspectives to clinical ethics support services (CESS). We propose a threefold consideration of 'theory' and show how it is interwoven with 'practice' as we go along. First, we look at theory in its foundational role: in our case 'narrative ethics' and 'philosophical hermeneutics' provide a theoretical base for clinical ethics by focusing on human identities entangled in stories and on moral understanding as a dialogical process. Second, we consider the role of theoretical notions in helping practitioners to understand their situation in clinical ethics practice, by using notions like 'story', 'responsibility', or 'vulnerability' to make explicit and explain their practical experience. Such theoretical notions help us to interpret clinical situations from an ethical perspective and to foster moral awareness of practitioners. And, thirdly, we examine how new theoretical concepts are developed by interpreting practice, using practice to form and improve our ethical theory. In this paper, we discuss this threefold use of theory in clinical ethics support services by reflecting on our own theoretical assumptions, methodological steps and practical experiences as ethicists, and by providing examples from our daily work. In doing so, we illustrate that theory and practice are interwoven, as theoretical understanding is dependent upon practical experience, and vice-versa. © 2011 Blackwell Publishing Ltd.

EMS Response to Mass Casualty Incidents: The Critical Importance of Automatic Statewide Mutual Aid and MCI Training

DTIC Science & Technology

2008-09-01

difficulty in implementation for each case study. After an overview, each case study is given a score against each of the criteria of “meets” or “exceeds...While expectations may be different for different individuals, the narrative section provides supporting information for the assigned score , with...decrease in response time will improve patient outcome? The narrative discussing the score will give information from the case study on the specific

Evolving career choice narratives of new graduate nurses.

PubMed

Price, Sheri L; McGillis Hall, Linda; Murphy, Gail Tomblin; Pierce, Bridget

2018-01-01

This article describes findings from one stage of a longitudinal study of the professional socialization experiences of Millennial nurses as they prepared for graduation and transition to practice. This study employed an interpretive narrative methodology guided by Polkinghorne's theory of narrative identity. Analysis of face-to-face interviews and journal entries by Millennial nursing students uncovered the formal professional socialization experiences over four years of nursing education. Participants include six Millennial nursing student participants (born after 1980) interviewed approximately one-month aftergraduation. These six participants are a voluntary subset of twelve who were interviewed prior to beginning their nursing studies, the analysis of which is captured in Price et al. (2013a) and Price et al. (2013b). Narrative analysis of the post-graduation interviews resulted in three main themes: 'Real Nursing: Making a Difference', 'The Good Nurse: Defined by Practice' and 'Creating Career Life Balance'. Graduate nurses strive to provide excellent nursing care as they transition into the workforce and identify a need for ongoing peer and professional supports to assist their ongoing professional socialization. Ongoing formal socialization and professional development is required to support the transition and retention of new nurse graduates in the workplace and the profession. Millenial generation nurses seek opportunities for career mapping, goal setting and formal mentorship by role models and peers to actualize their professional aspirations. Copyright © 2017. Published by Elsevier Ltd.

THE USE OF NARRATIVES IN SCIENCE COMMUNICATION: An example of the use of comic strips (narratives) in communicating scientific information about sustainable development.

NASA Astrophysics Data System (ADS)

Negrete, Aquiles

2015-04-01

It is quite reasonable to claim that narratives can include, explain and recreate science and that this means of science communication is generally popular. This idea seems to be supported by the fact that many contemporary authors who include science as a theme in their work receive a good reception among the public (at least in Britain). Novels like Fermat's Last Theorem by Simon Singh, Longitude by Dava Sobel and Neuromancer by William Gibson stayed on the best seller lists for weeks. Plays like Copenhagen by Michael Frayn, Arcadia by Tom Stoppard, Oxigen by Carl Djerassi and Ronald Hoffmann, Diary of a steak by Deborah Levy as well as Blue heart by Caryl Churchill enjoyed complete sell-outs in London and other cities in Britain. The explanation for this popularity seems to be that narratives are amusing, attractive, and interesting. Therefore, we can maintain that they are popular. But are they also a long-lasting way of transmitting knowledge? Do people remember scientific information conveyed by this means better than they remember the traditional formats like paradigmatic textbooks? These are questions that need to be addressed. To understand how narratives organize, represent and convey information, it is an important task to evaluate the advantages that this media offers for the communication of science. Narratives include several characteristics that make them memorable, understandable, enjoyable and a good way to present and communicate knowledge. Some of these attributes are achieved through narrative structures, including literary devices. In this research I discuss how the general public is familiar with the narrative structure of a story, how schemas for these narrative structures allow identification, induce emotions and promote understanding - important elements for the learning and memory process. I also look at how individually the narrative resources (or literary devices), in addition to their aesthetic value, can also work as mnemonic structures and as conceptual models that enable us to perceive, apprehend, construct and communicate meaning out of reality. Finally I present an example of the use of comics (narratives) in communicating scientific information about the sustainable use of the Mayan Nut in rural areas in Mexico.

The Dhimmi Narrative: A Comparison between the Historical and the Actual in the Context of Christian-Muslim Relations in Modern Egypt

DTIC Science & Technology

2009-12-01

mandated millet citizenship. If a Christian or Jew committed a crime against a member of another community, the law of the injured party applied. However...was no longer a mere matter of belief; it was an act of sedition : As long as apostasy remains a private matter and does not disrupt the society at... sedition that causes discord and threatens the unity of Islamic community. 59 Hugh Goddard in his book A History of Christian –Muslim Relations notes that

Supporting the self-concept with memory: insight from amnesia

PubMed Central

Verfaellie, Mieke

2015-01-01

We investigated the extent to which personal semantic memory supports the self-concept in individuals with medial temporal lobe amnesia and healthy adults. Participants completed eight ‘I Am’ self-statements. For each of the four highest ranked self-statements, participants completed an open-ended narrative task, during which they provided supporting information indicating why the I Am statement was considered self-descriptive. Participants then completed an episodic probe task, during which they attempted to retrieve six episodic memories for each of these self-statements. Supporting information was scored as episodic, personal semantic or general semantic. In the narrative task, personal semantic memory predominated as self-supporting information in both groups. The amnesic participants generated fewer personal semantic memories than controls to support their self-statements, a deficit that was more pronounced for trait relative to role self-statements. In the episodic probe task, the controls primarily generated unique event memories, but the amnesic participants did not. These findings demonstrate that personal semantic memory, in particular autobiographical fact knowledge, plays a critical role in supporting the self-concept, regardless of the accessibility of episodic memories, and they highlight potential differences in the way traits and roles are supported by personal memory. PMID:25964501

The importance of providing scaffolding to support patient narratives when brain damage impairs storytelling ability.

PubMed

Hydén, Lars C

2011-01-01

Boundaries connected to illness are defined and redefined through new ways of interacting with other people and especially by storytelling and listening to the stories of others. Diseases or traumas that affect the brain can result in memory loss, impaired cognition, and difficulties in expressing oneself clearly, hence making it difficult to present and negotiate identities. In such situations, others often try to remedy the communicative problems by taking over those narrative functions that are lost or impaired and thereby scaffolding the injured person's storytelling capacity. This narrative scaffolding is directed at keeping interpersonal relationships functional and makes it possible for persons with communicative disabilities to continue to be participants in a shared life.

Effects of Age, Acoustic Challenge, and Verbal Working Memory on Recall of Narrative Speech.

PubMed

Ward, Caitlin M; Rogers, Chad S; Van Engen, Kristin J; Peelle, Jonathan E

2016-01-01

A common goal during speech comprehension is to remember what we have heard. Encoding speech into long-term memory frequently requires processes such as verbal working memory that may also be involved in processing degraded speech. Here the authors tested whether young and older adult listeners' memory for short stories was worse when the stories were acoustically degraded, or whether the additional contextual support provided by a narrative would protect against these effects. The authors tested 30 young adults (aged 18-28 years) and 30 older adults (aged 65-79 years) with good self-reported hearing. Participants heard short stories that were presented as normal (unprocessed) speech or acoustically degraded using a noise vocoding algorithm with 24 or 16 channels. The degraded stories were still fully intelligible. Following each story, participants were asked to repeat the story in as much detail as possible. Recall was scored using a modified idea unit scoring approach, which included separately scoring hierarchical levels of narrative detail. Memory for acoustically degraded stories was significantly worse than for normal stories at some levels of narrative detail. Older adults' memory for the stories was significantly worse overall, but there was no interaction between age and acoustic clarity or level of narrative detail. Verbal working memory (assessed by reading span) significantly correlated with recall accuracy for both young and older adults, whereas hearing ability (better ear pure tone average) did not. The present findings are consistent with a framework in which the additional cognitive demands caused by a degraded acoustic signal use resources that would otherwise be available for memory encoding for both young and older adults. Verbal working memory is a likely candidate for supporting both of these processes.

The differential influences of parenting and child narrative coherence on the development of emotion recognition.

PubMed

Berzenski, Sara R; Yates, Tuppett M

2017-10-01

The ability to recognize and label emotions serves as a building block by which children make sense of the world and learn how to interact with social partners. However, the timing and salience of influences on emotion recognition development are not fully understood. Path analyses evaluated the contributions of parenting and child narrative coherence to the development of emotion recognition across ages 4 through 8 in a diverse (50% female; 46% Hispanic, 18.4% Black, 11.2% White, .4% Asian, 24.0% multiracial) longitudinally followed sample of 250 caregiver-child dyads. Parenting behaviors during interactions (i.e., support, instructional quality, intrusiveness, and hostility) and children's narrative coherence during the MacArthur Story Stem Battery were observed at ages 4 and 6. Emotion recognition increased from age 4 to 8. Parents' supportive presence at age 4 and instructional quality at age 6 predicted increased emotion recognition at 8, beyond initial levels of emotion recognition and child cognitive ability. There were no significant effects of negative parenting (i.e., intrusiveness or hostility) at 4 or 6 on emotion recognition. Child narrative coherence at ages 4 and 6 predicted increased emotion recognition at 8. Emotion recognition at age 4 predicted increased parent instructional quality and decreased intrusiveness at 6. These findings clarify whether and when familial and child factors influence emotion recognition development. Influences on emotion recognition development emerged as differentially salient across time periods, such that there is a need to develop and implement targeted interventions to promote positive parenting skills and children's narrative coherence at specific ages. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Assessment of strategic processing during narrative comprehension in individuals with mild cognitive impairment.

PubMed

Schmitter-Edgecombe, Maureen; Creamer, Scott

2010-07-01

A think-aloud protocol was used to examine the strategies used by individuals with mild cognitive impairment (MCI) during text comprehension. Twenty-three participants with MCI and 23 cognitively healthy older adults (OA) read narratives, pausing to verbalize their thoughts after each sentence. The verbal protocol analysis developed by Trabasso and Magliano (1996) was then used to code participants' utterances into inferential and non-inferential statements; inferential statements were further coded to identify the memory operation used in their generation. Compared with OA controls, the MCI participants showed poorer story comprehension and produced fewer inferences. The MCI participants were also less skilled at providing explanations of story events and in using prior text information to support inference generation. Poorer text comprehension was associated with poorer verbal memory abilities and poorer use of prior text events when producing inferential statements. The results suggest that the memory difficulties of the MCI group may be an important cognitive factor interfering with their ability to integrate narrative events through the use of inferences and to form a global coherence to support text comprehension.

Narratives of empowerment and compliance: studies of communication in online patient support groups.

PubMed

Wentzer, Helle S; Bygholm, Ann

2013-12-01

New technologies enable new forms of patient participation in health care. The article discusses whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance. The discussion is based on a qualitative analysis of patient communication in two online groups on the Danish portal sundhed.dk, one for lung patients and one for women with fertility problems. The object of study is the total sum of postings during a specific period of time - a total of 4301 posts are included. The textmaterial was analyzed according to the textual paradigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysis moves from describing communicative characteristics of the site to a thorough semantic analysis of its narrative structure of construing meaning, interaction and collective identity, and finally as a source of collective action. The meta-narratives of the two groups confirm online patient support groups for individual empowerment, for collective group identity, but not for collective empowerment. The collective identities of patienthood on the two sites are created by the users (patients) through specific styles of communication and interaction, referred to as 'multi-logical narratives'. In spite of the potential of online communities of opening up health care to the critical voice of the public, the analysis points to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. On a collective level, the site is empowering the individual users to comply with 'doctor's recommendations' as a group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A qualitative study of shopper experiences at an urban farmers’ market using the Stanford Healthy Neighborhood Discovery Tool

PubMed Central

Buman, Matthew P; Bertmann, Farryl; Hekler, Eric B; Winter, Sandra J; Sheats, Jylana L; King, Abby C; Wharton, Christopher M

2015-01-01

Objective To understand factors which enhance or detract from farmers’ market shopper experiences to inform targeted interventions to increase farmers’ market utilization, community-building and social marketing strategies. Design A consumer-intercept study using the Stanford Healthy Neighborhood Discovery Tool to capture real-time perceptions via photographs and audio narratives. Setting An urban farmers’ market in a large metropolitan US city. Participants Thirty-eight farmers’ market shoppers, who recorded 748 unique coded elements through community-based participatory research methods. Results Shoppers were primarily women (65 %), 18–35 years of age (54 %), non-Hispanic (81 %) and white (73 %). Shoppers captured 291 photographs (7·9 (SD 6·3) per shopper), 171 audio narratives (5·3 (SD 4·7) per shopper), and ninety-one linked photograph + audio narrative pairs (3·8 (SD 2·8) per shopper). A systematic content analysis of the photographs and audio narratives was conducted by eight independent coders. In total, nine common elements emerged from the data that enhanced the farmers’ market experience (61·8 %), detracted from the experience (5·7 %) or were neutral (32·4 %). The most frequently noted elements were freshness/abundance of produce (23·3 %), product presentation (12·8 %), social interactions (12·4 %) and farmers’ market attractions (e.g. live entertainment, dining offerings; 10·3 %). Conclusions While produce quality (i.e. freshness/abundance) was of primary importance, other contextual factors also appeared important to the shoppers’ experiences. These results may inform social marketing strategies to increase farmers’ market utilization and community-building efforts that target market venues. PMID:24956064

Making electronic health records support quality management: A narrative review.

PubMed

Triantafillou, Peter

2017-08-01

Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). Undertake a narrative review of existing studies in order to identify and discuss the factors conducive to making EHR support three dimensions of QM: clinical outcomes, managerial monitoring and cost-effectiveness. A narrative review of Web of Science, Cochrane, EBSCO, ProQuest, Scopus and three Nordic research databases. most studies do not specify the type of EHR examined. 39 studies were identified for analysis. 10 factors were found to be conducive to make EHR support QM. However, the contribution of EHR to the three specific dimensions of QM varied substantially. Most studies (29) included clinical outcomes. However, only half of these reported EHR to have a positive impact. Almost all the studies (36) dealt with the ability of EHR to enhance managerial monitoring of clinical activities, the far majority of which showed a positive relationship. Finally, only five dealt with cost-effectiveness of which two found positive effects. The findings resonates well with previous reviews, though two factors making EHR support QM seem new, namely: political goals and strategies, and integration of guidelines for clinical conduct. Lacking EHR type specification and diversity in study method imply that there is a strong need for further research on the factors that may make EHR may support QM. Copyright © 2017 Elsevier B.V. All rights reserved.

Using Video Images to Improve the Accuracy of Surrogate Decision-Making: A Randomized Controlled Trial

PubMed Central

Volandes, Angelo E.; Mitchell, Susan L.; Gillick, Muriel R.; Chang, Yuchiao; Paasche-Orlow, Michael K.

2009-01-01

Introduction When patients are unable to make important end-of-life decisions, doctors ask surrogate decision makers to provide insight into patients’ preferences. Unfortunately, multiple studies have shown that surrogates’ knowledge of patient preferences is poor. We hypothesized that a video decision tool would improve concordance between patients and their surrogates for end-of-life preferences. Objective To compare the concordance of preferences among elderly patients and their surrogates listening to only a verbal description of advanced dementia or viewing a video decision support tool of the disease after hearing the verbal description. Methods This was a randomized controlled trial of a convenience sample of community-dwelling elderly subjects (≥65 years) and their surrogates, and was conducted at 2 geriatric clinics affiliated with 2 academic medical centers in Boston. The study was conducted between September 1, 2007, and May 30, 2008. Random assignment of patient and surrogate dyads was to either a verbal narrative or a video decision support tool after the verbal narrative. End points were goals of care chosen by the patient and predicted goals of care by the surrogate. Goals of care included life-prolonging care (CPR, mechanical ventilation), limited care (hospitalization, antibiotics, but not CPR), and comfort care (only treatment to relieve symptoms). The primary outcome measure was the concordance rate of preferences between patients and their surrogates. Results A total of 14 pairs of patients and their surrogates were randomized to verbal narrative (n = 6) or video after verbal narrative (n = 8). Among the 6 patients receiving only the verbal narrative, 3 (50%) preferred comfort care, 1 (17%) chose limited care, and 2 (33%) desired life-prolonging care. Among the surrogates for these patients, only 2 correctly chose what their loved one would want if in a state of advanced dementia, yielding a concordance rate of 33%. Among the 8 patients receiving the video decision support tool, all 8 chose comfort care. Among the surrogates for these patients, all 8 correctly chose what their loved one would want if in a state of advanced dementia, yielding a concordance rate of 100%. Conclusion Patients and surrogates viewing a video decision support tool for advanced dementia are more likely to concur about the patient’s end-of-life preferences than when solely listening to a verbal description of the disease. PMID:19808156

Do nurses' personal health behaviours impact on their health promotion practice? A systematic review.

PubMed

Kelly, Muireann; Wills, Jane; Sykes, Susie

2017-11-01

There is a growing expectation in national and international policy and from professional bodies that nurses be role models for healthy behaviours, the rationale being that there is a relationship between nurses' personal health and the adoption of healthier behaviours by patients. This may be from patients being motivated by, and modelling, the visible healthy lifestyle of the nurse or that nurses are more willing to promote the health of their patients by offering public health or health promotion advice and referring the patient to support services. An integrated systematic review was conducted to determine if nurses' personal health behaviour impacted on (1) their health promotion practices, and (2) patient responses to a health promotion message. Medline, CINAHL, SCOPUS, and PsycINFO databases were searched. A narrative synthesis was conducted. 31 studies were included in the review. No consistent associations were noted between nurses' weight, alcohol use, or physical activity level and their health promotion practice, although smoking appeared to negatively impact on the likelihood of discussing and engaging in cessation counselling. Nurses who reported confidence and skills around health promotion practice were more likely to raise lifestyle issues with patients, irrespective of their own personal health behaviours. The two studies included in the review that examined patient responses noted that the perceived credibility of a public health message was not enhanced by being delivered by a nurse who reported adopting healthy behaviours. Although it is assumed that nurses' personal health behaviour influences their health promotion practice, there is little evidence to support this. The assertion in health care policy that nurses should be role models for healthy behaviours assumes a causal relationship between their health behaviours and the patient response and adoption of public health messages that is not borne out by the research evidence. Copyright © 2017 Elsevier Ltd. All rights reserved.

Doctors' voices in patients' narratives: coping with emotions in storytelling.

PubMed

Lucius-Hoene, Gabriele; Thiele, Ulrike; Breuning, Martina; Haug, Stephanie

2012-09-01

To understand doctors' impacts on the emotional coping of patients, their stories about encounters with doctors are used. These accounts reflect meaning-making processes and biographically contextualized experiences. We investigate how patients characterize their doctors by voicing them in their stories, thus assigning them functions in their coping process. 394 narrated scenes with reported speech of doctors were extracted from interviews with 26 patients with type 2 diabetes and 30 with chronic pain. Constructed speech acts were investigated by means of positioning and narrative analysis, and assigned into thematic categories by a bottom-up coding procedure. Patients use narratives as coping strategies when confronted with illness and their encounters with doctors by constructing them in a supportive and face-saving way. In correspondence with the variance of illness conditions, differing moral problems in dealing with doctors arise. Different evaluative stances towards the same events within interviews show that positionings are not fixed, but vary according to contexts and purposes. Our narrative approach deepens the standardized and predominantly cognitive statements of questionnaires in research on doctor-patient relations by individualized emotional and biographical aspects of patients' perspective. Doctors should be trained to become aware of their impact in patients' coping processes.

Construction of suicidal ideation in medical records.

PubMed

Galasiński, Dariusz; Ziółkowska, Justyna

2017-09-01

In this article, the authors are interested in exploring discursive transformation of patients' stories of suicidal ideation into medical discourses. In other words, they focus on how the narrated experience of suicidal thoughts made during the psychiatric assessment interview is recorded in the patients' medical record. The authors' data come from recordings of psychiatric interviews, as well as the doctors' notes in the medical records made after the interviews, collected in psychiatric hospitals in Poland. Assuming a constructionist view of discourse, they demonstrate that lived experience of suicide ideation resulting in stories of a complex and homogeneous group of "thoughts" is reduced to brief statements of fact of presence/existence. Exploration of the relationship between the interviews and the notes suggest a stark imposition of the medical gaze upon them. The authors end with arguments that discursive practices relegating lived experience from the focus of clinical practice deprives it of information which is meaningful and clinically significant.

"Their Stories Have Changed My Life": Clinicians' Reflections on Their Experience with and Their Motivation to Conduct Asylum Evaluations.

PubMed

Mishori, Ranit; Hannaford, Alisse; Mujawar, Imran; Ferdowsian, Hope; Kureshi, Sarah

2016-02-01

Many clinicians perform asylum evaluations yet no studies describe the motivation to perform them or their perceived rewards. The number of asylum seekers in the US is increasing and more clinicians are needed as evaluators. A survey to an asylum evaluators' network asked participants to qualitatively reflect on their experience and motivation. Answers were analyzed for themes and sentiment. Respondents cited commitment to humanistic and moral values, noted personal and family experiences, having skills, expertise, and career interests as drivers. They found the experience very rewarding personally and professionally, and in their perceived benefit to asylees. Negative sentiment was less frequent and centered on emotions related to client narratives. Process-oriented frustrations were also noted. This is the first published study describing clinicians' motivation and experience with asylum evaluations. It may illuminate clinicians' drive to volunteer, and serve as a resource for organizations for recruitment and education.

Reducing Stigma and Punitive Attitudes Toward Pedophiles Through Narrative Humanization.

PubMed

Harper, Craig A; Bartels, Ross M; Hogue, Todd E

2016-12-01

Stigmatization and societal punitiveness about pedophilia have a range of potential consequences, such as the social isolation of people with sexual interest in children, and the formation of policies that are not consistent with empirical research findings. Previous research has shown that people with pedophilic sexual interests use societal thinking to self-stigmatize, which in turn may actually serve to increase their risk of committing a sexual offense. In this study, we compared two attitudinal interventions (first-person narrative vs. expert opinion) using a student sample ( N = 100). It was hypothesized that both interventions would lead to reductions in stigmatization and punitive attitudes about pedophiles on an explicit (self-report) level but that only the narrative intervention would lead to reductions of these constructs at the implicit level. Our findings supported both hypotheses. We further discuss the role of narrative humanization in this area and offer suggestions for further research based upon the theoretical and methodological implications of the findings.

The Role of Ventromedial Prefrontal Cortex in Text Comprehension Inferences: Semantic Coherence or Socio-Emotional Perspective?

PubMed Central

Burin, Debora I.; Acion, Laura; Kurczek, Jake; Duff, Melissa C.; Tranel, Daniel; Jorge, Ricardo E.

2015-01-01

Two hypotheses about the role of the ventromedial prefrontal cortex (vmPFC) in narrative comprehension inferences, global semantic coherence versus socio-emotional perspective, were tested. Seven patients with vmPFC lesions and seven demographically matched healthy comparison participants read short narratives. Using the consistency paradigm, narratives required participants to make either an emotional or visuo-spatial inference, in which a target sentence provided consistent or inconsistent information with a previous emotional state of a character or a visuo-spatial location of an object. Healthy comparison participants made the inferences both for spatial and emotional stories, as shown by longer reading times for inconsistent critical sentences. For patients with vmPFC lesions, inconsistent sentences were read slower in the spatial stories, but not in the emotional ones. This pattern of results is compatible with the hypothesis that vmPFC contributes to narrative comprehension by supporting inferences about socio-emotional aspects of verbally described situations. PMID:24561428

Does making meaning make it better? Narrative meaning-making and well-being in at-risk African-American adolescent females

PubMed Central

Sales, Jessica M.; Merrill, Natalie A.; Fivush, Robyn

2012-01-01

It has been argued that, for certain people, attempts at making meaning about past life events, especially challenging events, might be detrimental to well-being. In this study we explored the association between narrative indicators of meaning-making and psychological well-being, while also considering the role of individual level factors such as life history, personality characteristics and locus of control, among an at-risk sample of low socioeconomic status inner-city African-American adolescent females with challenging lives. We found that having a more external locus of control and including more cognitive processing language in narratives about a highly negative past experience were associated with increased depressive symptoms. Our findings suggest that certain types of narrative meaning-making language may reflect ongoing and unsuccessful efforts after meaning, and, may be more similar to rumination than to resolution. Additionally, they support claims that for certain individuals from challenging backgrounds, efforts after meaning might not be psychologically healthy. PMID:22897108

Patients' discharge experiences: returning home after open-heart surgery.

PubMed

Lapum, Jennifer; Angus, Jan E; Peter, Elizabeth; Watt-Watson, Judy

2011-01-01

This study explored patients' narratives of technology in heart surgery and recovery. A narrative inquiry was conducted with a sample of 16 individuals. Interviews were completed 2 to 4 days after transfer from cardiovascular intensive care, and 4 to 6 weeks after discharge. Participants completed journals between these 2 time periods. Discharge and the return home were highlighted as key transitions. These transitions were driven by a technological script that included teachings and texts provided upon discharge. Complicating participants' narratives were their own personal dramas and self-characterizations of vulnerability, as they struggled to incorporate this script into the particularities of their daily lives. Comprehensive conceptualizations of technology that involve the associated logics and pathways of recovery provide deep insights into patients' stories of recovery from heart surgery. It is salient that discharge programs consider the ways that technology enters into patients' narratives, and also consider dialogical approaches to communication, education, and supportive interventions that are offered at multiple intervals and continue in the home. Copyright © 2011 Elsevier Inc. All rights reserved.

Producing patient-avatar identification in animation video information on spinal anesthesia by different narrative strategies.

PubMed

Høybye, Mette Terp; Vesterby, Martin; Jørgensen, Lene Bastrup

2016-06-01

Visual approaches to health information reduce complexity and may bridge challenges in health literacy. But the mechanisms and meanings of using animated video in communication with patients undergoing surgery are not well described. By comparing two versions of a two-dimensional animated video on spinal anesthesia, this study tested the patient-avatar identification within two different narrative models. To explore the perspectives of total hip arthroplasty, we employed qualitative methods of interviews and ethnographic observation. The animated presentation of the spinal anesthesia procedure was immediately recognized by all participants as reflecting their experience of the procedure independent of the narrative form. The avatar gender did not affect this identification. We found no preference for either narrative form. This study supports the potential of animation video in health informatics as a didactic model for qualifying patient behavior. Animation video creates a high degree of identification that may work to reduce pre-surgical anxiety. © The Author(s) 2014.

A partnership model for a reflective narrative for researcher and participant.

PubMed

Murphy, Gill; Peters, Kath; Wilkes, Lesley; Jackson, Debra

2016-09-01

Background Conceptual frameworks are important to ensure a clear underpinning research philosophy. Further, the use of conceptual frameworks can support structured research processes. Aim To present a partnership model for a reflective narrative for researcher and participant. Discussion This paper positions the underpinning philosophical framework of the model in social constructionism (the idea that jointly constructed understandings form the basis for shared assumptions) and narrative enquiry. The model has five stages - study design, invitation to share a research space and partnership, a metaphorical research space, building a community story, and reading the community story to others. Core principles of the partnership model are continual reflection by the researcher, potential reflections by participants, reciprocal sharing, and partnership in research. Conclusion A 'trajectory of self' for both participants and researchers can be enhanced within reflective partnerships. Implications for practice This model can be applied to studies that use narrative enquiry and are seeking a humanistic approach with participant engagement.

Social engineering of societal knowledge in livestock science: Can we be more empathetic?

PubMed Central

Ravikumar, R. K.; Thakur, Devesh; Choudhary, Hardev; Kumar, Vivek; Kinhekar, Amol S.; Garg, Tushar; Ponnusamy, K.; Bhojne, G. R.; Shetty, Vasanth M.; Kumar, Vipin

2017-01-01

Questions are raised in effective utilization of farmer’s wisdom by communities in their farming. Planners support to livelihood emphasize mostly of inputs from outside and not setting up sustainable goals. Formal institutions and planners of program are finding constraints and sceptical in wider dissemination of indigenous knowledge research system (IKRS). This is in spite of evidence that considerable number of farmer’s in livestock sector depends on IKRS. In this context, it is pertinent to showcase dissemination potential of these knowledge system(s) in larger geographical areas. The review illustrates different challenges encountered while control of livestock ailments like ectoparasite infestation through IKRS. Several times, it was opinioned to provide or share IKRS to thwart ailments in a specific region. This is interesting as it was narrated how formal system is unable to recognize farmer’s problem and challenges in integrating these sustainable practices. It has to be noted that disseminating activities seldom takes into account the experimental potential of farmers. This review paper articulates various evidences generated in enhancing diffusion thereby dissemination of IKRS. The nature of support extended by IKRS in entrepreneurial activity of smallholder farming units did not get adequate recognition. There needs to be minimum standard protocol in deriving benefit from such low-cost alternative technologies. This will enrich incremental innovation activities as per location specific need and provide scope for wider dissemination. PMID:28246452

Social engineering of societal knowledge in livestock science: Can we be more empathetic?

PubMed

Ravikumar, R K; Thakur, Devesh; Choudhary, Hardev; Kumar, Vivek; Kinhekar, Amol S; Garg, Tushar; Ponnusamy, K; Bhojne, G R; Shetty, Vasanth M; Kumar, Vipin

2017-01-01

Questions are raised in effective utilization of farmer's wisdom by communities in their farming. Planners support to livelihood emphasize mostly of inputs from outside and not setting up sustainable goals. Formal institutions and planners of program are finding constraints and sceptical in wider dissemination of indigenous knowledge research system (IKRS). This is in spite of evidence that considerable number of farmer's in livestock sector depends on IKRS. In this context, it is pertinent to showcase dissemination potential of these knowledge system(s) in larger geographical areas. The review illustrates different challenges encountered while control of livestock ailments like ectoparasite infestation through IKRS. Several times, it was opinioned to provide or share IKRS to thwart ailments in a specific region. This is interesting as it was narrated how formal system is unable to recognize farmer's problem and challenges in integrating these sustainable practices. It has to be noted that disseminating activities seldom takes into account the experimental potential of farmers. This review paper articulates various evidences generated in enhancing diffusion thereby dissemination of IKRS. The nature of support extended by IKRS in entrepreneurial activity of smallholder farming units did not get adequate recognition. There needs to be minimum standard protocol in deriving benefit from such low-cost alternative technologies. This will enrich incremental innovation activities as per location specific need and provide scope for wider dissemination.

[The diagnostic usability of selected narrativity indices in stories about close relationships in the assessment of personality organization].

PubMed

Soroko, Emilia

2015-01-01

The aim of this study was to test the usability of selected narrativity indices identified from autobiographical accounts of important relationships in an assessment of neurotic (NPO) and borderline personality organization (BPO). Narrativity indices, both particular and generalized, were used to predict personality organization levels. Indices were derived from two separate layers of analysis: 1) lexical indices were counted with computer assistance; 2) evocative/reception indices dealing with coherence of the story were assessed using the competent judges method. It was found that the lexical narrativity index-the active "I"-was a good predictor of both BPO and NPO, while the human factor was a good predictor of BPO when low. Moreover, a generalized index was used to describe how stories are saturated with the narrativity indices of intentionality, concreteness, and active "I", but simultaneously deprived of human factor, and was found to be the best predictor of BPO. Furthermore, where the coherence of the story and of its subdimension (integration) rise, the probability of BPO diagnosis decreases. This research provides support for the thesis that surface narrativity indices may predict deeper personality structure. Its results are justified in the light of Kernberg's theory, and have the potential to become a useful tool in clinical practice as a supplementary source of information in diagnostic and psychotherapeutic processes.

Writing on the board as students' preferred teaching modality in a physiology course.

PubMed

Armour, Chris; Schneid, Stephen D; Brandl, Katharina

2016-06-01

The introduction of PowerPoint presentation software has generated a paradigm shift in the delivery of lectures. PowerPoint has now almost entirely replaced chalkboard or whiteboard teaching at the undergraduate and graduate levels. This study investigated whether undergraduate biology students preferred to have lectures delivered by PowerPoint or written on the board as well as the reasons behind their preference. Two upper-division physiology courses were surveyed over a period of 7 yr. A total of 1,905 students (86.7%) indicated they preferred lectures delivered by "writing on the board" compared to 291 students (13.3%) who preferred PowerPoint. Common themes drawn from explanations reported by students in favor of writing on the board included: 1) more appropriate pace, 2) facilitation of note taking, and 3) greater alertness and attention. Common themes in favor of PowerPoint included 1) increased convenience, 2) focus on listening, and 3) more accurate and readable notes. Based on the students' very strong preference for writing on the board and the themes supporting that preference, we recommend that instructors incorporate elements of the writing on the board delivery style into whatever teaching modality is used. If instructors plan to use PowerPoint, the presentation should be paced, constructed, and delivered to provide the benefits of lectures written on the board. The advantages of writing on the board can be also incorporated into instruction intended to occur outside the classroom, such as animated narrated videos as part of the flipped classroom approach. Copyright © 2016 The American Physiological Society.

Who Leaves Suicide Notes? An Exploration of Victim Characteristics and Suicide Method of Completed Suicides in Queensland.

PubMed

Carpenter, Belinda; Bond, Christine; Tait, Gordon; Wilson, Moira; White, Kris

2016-01-01

The objective of this study is to address the question: are those who leave suicide notes representative of the larger population of those who commit suicide? The method involves an analysis of a full population of suicides by residents of Queensland, Australia for the full year of 2004, with the information drawn from Coronial files. Our overall results suggest that, and in support of previous research, the population who leaves suicide notes are remarkably similar to those who do not. Differences are identified in four areas: first, and in contrast to prior research, females are less likely to leave a suicide note; second, and in support of previous research, Aboriginal Australians are less likely to leave suicide notes; third, and in support of some previous research, those who use gas as a method of suicide are more likely to leave notes, while those who use a vehicle or a train are less likely to leave notes; finally, our findings lend support to research which finds that those with a diagnosed mental illness are less likely to leave notes. The discussion addresses some of the reasons these disparities may have occurred, and continues the debate over the degree to which suicide notes give insight into the larger suicide population.

48 CFR 15.305 - Proposal evaluation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... comparative assessment of past performance information is separate from the responsibility determination... requirements; and (ii) A summary, matrix, or quantitative ranking, along with appropriate supporting narrative...

48 CFR 15.305 - Proposal evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... comparative assessment of past performance information is separate from the responsibility determination... requirements; and (ii) A summary, matrix, or quantitative ranking, along with appropriate supporting narrative...

48 CFR 15.305 - Proposal evaluation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... comparative assessment of past performance information is separate from the responsibility determination... requirements; and (ii) A summary, matrix, or quantitative ranking, along with appropriate supporting narrative...

48 CFR 15.305 - Proposal evaluation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... comparative assessment of past performance information is separate from the responsibility determination... requirements; and (ii) A summary, matrix, or quantitative ranking, along with appropriate supporting narrative...

48 CFR 15.305 - Proposal evaluation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... comparative assessment of past performance information is separate from the responsibility determination... requirements; and (ii) A summary, matrix, or quantitative ranking, along with appropriate supporting narrative...

Supported Decision-Making: The Expectations Held by People With Experience of Mental Illness.

PubMed

Knight, Fauzia; Kokanović, Renata; Ridge, Damien; Brophy, Lisa; Hill, Nicholas; Johnston-Ataata, Kate; Herrman, Helen

2018-05-01

Supported decision-making (SDM) is a principle guiding mental health service provision, which aims to improve people's ability to make informed decisions about their care. Understanding diverse individual needs is vital to its success. Based on 29 narrative interviews with people diagnosed with mental illness in Australia, we examine how participants reflected on their own experiences of SDM. We find that participants' conceptualization of mental health expertise, their own experiences and sense of agency, and their varying needs for dependence and independence influenced their relationships with mental health practitioners. These factors in turn shaped their expectations about SDM. Four narrative positions emerged: the "Inward Expert," the "Outward Entrustor," the "Self-Aware Observer," and the "Social Integrator." These positionings influenced the type or style of support that participants expected and considered most useful. Our findings are relevant to developing effective approaches to SDM that take into account service users' needs and preferences.

In for the Long Haul--Models of Sustained Graduate Support and Education

ERIC Educational Resources Information Center

McNeill, Tamara; Khatun, Afia; Giddens, Claire; Beaven, Zuleika; Shorley, Jennie

2014-01-01

This paper seeks to articulate the problem of lack of timeliness in the provision of support for graduating students. The authors demonstrate how drawing together employability and enterprise support in the period after graduation can address that problem and present a narrative of a knowledge exchange (KE), showing how KE has the potential to…

Narratives for Obesity: Effects of Weight Loss and Attribution on Empathy and Policy Support

ERIC Educational Resources Information Center

Thibodeau, Paul H.; Uri, Rachel; Thompson, Briana; Flusberg, Stephen J.

2017-01-01

Despite an urgent need to address the issue of obesity, little research has examined the psychological factors that influence support for obesity-related policy initiatives, which represent an important tool for addressing this complex health issue. In the present study, we measured the degree to which people supported obesity-related policy…

Schizophrenia, narrative, and neurocognition: The utility of life-stories in understanding social problem-solving skills.

PubMed

Moe, Aubrey M; Breitborde, Nicholas J K; Bourassa, Kyle J; Gallagher, Colin J; Shakeel, Mohammed K; Docherty, Nancy M

2018-06-01

Schizophrenia researchers have focused on phenomenological aspects of the disorder to better understand its underlying nature. In particular, development of personal narratives-that is, the complexity with which people form, organize, and articulate their "life stories"-has recently been investigated in individuals with schizophrenia. However, less is known about how aspects of narrative relate to indicators of neurocognitive and social functioning. The objective of the present study was to investigate the association of linguistic complexity of life-story narratives to measures of cognitive and social problem-solving abilities among people with schizophrenia. Thirty-two individuals with a diagnosis of schizophrenia completed a research battery consisting of clinical interviews, a life-story narrative, neurocognitive testing, and a measure assessing multiple aspects of social problem solving. Narrative interviews were assessed for linguistic complexity using computerized technology. The results indicate differential relationships of linguistic complexity and neurocognition to domains of social problem-solving skills. More specifically, although neurocognition predicted how well one could both describe and enact a solution to a social problem, linguistic complexity alone was associated with accurately recognizing that a social problem had occurred. In addition, linguistic complexity appears to be a cognitive factor that is discernible from other broader measures of neurocognition. Linguistic complexity may be more relevant in understanding earlier steps of the social problem-solving process than more traditional, broad measures of cognition, and thus is relevant in conceptualizing treatment targets. These findings also support the relevance of developing narrative-focused psychotherapies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Episodicity of Verbal Reports of Personally Significant Autobiographical Memories: Vividness Correlates with Narrative Text Quality More than with Detailedness or Memory Specificity

PubMed Central

Habermas, Tilmann; Diel, Verena

2013-01-01

How can we tell from a memory report whether a memory is episodic or not? Vividness is required by many definitions, whereas detailedness, memory specificity, and narrative text type are competing definitions of episodicity used in research. We explored their correlations with vividness in personally significant autobiographical memories to provide evidence to support their relative claim to define episodic memories. In addition, we explored differences between different memory types and text types as well as between memories with different valences. We asked a lifespan sample (N = 168) of 8-, 12-, 16-, 20-, 40-, and 65-year-olds of both genders (N = 27, 29, 27, 27, 28, 30) to provide brief oral life narratives. These were segmented into thematic memory units. Detailedness of person, place, and time did not correlate with each other or either vividness, memory specificity, or narrative text type. Narrative text type, in contrast, correlated both with vividness and memory specificity, suggesting narrative text type as a good criterion of episodicity. Emotionality turned out to be an even better predictor of vividness. Also, differences between narrative, chronicle, and argument text types and between specific versus more extended and atemporal memories were explored as well as differences between positive, negative, ambivalent, neutral, contamination, and redemption memory reports. It is concluded that temporal sequentiality is a central characteristic of episodic autobiographical memories. Furthermore, it is suggested that the textual quality of memory reports should be taken more seriously, and that evaluation and interpretation are inherent aspects of personally significant memories. PMID:23966918

The importance of stories in understanding people's relationship to food: narrative inquiry methodology has much to offer the public health nutrition researcher and practitioner.

PubMed

O'Kane, Gabrielle; Pamphilon, Barbara

2016-03-01

Despite the usefulness of quantitative research, qualitative research methodologies are equally needed to allow researchers to better understand the important social and environmental factors affecting food choice and eating habits. The present paper contributes insights from narrative inquiry, a well-established qualitative methodology, to a food-related doctoral research study. The connections between food shoppers and the producer, family, friends and others in the food system, between eaters and the earth, and how these connections affect people's meaning-making of food and pathways to food citizenship, were explored in the research. The research used narrative inquiry methodology and focus groups for data collection. Five different food-ways in the Canberra region of Australia were selected for the present research; that is, community gardens, community-supported agriculture, farmers' markets, fresh food markets and supermarkets. Fifty-two people voluntarily attended eight focus groups with four to nine participants in each. From a practical perspective, the present paper offers a guide to the way in which narrative inquiry has been applied to one research project. The paper describes the application of narrative inquiry methodology, revealing the important place of narratives in generating new knowledge. The paper further outlines how phased narrative analysis can lead to a defensible and rigorous interpretive framework grounded in the data generated from people's stories and meaning-making. We argue that individual, social and system change will not be possible without further rigorous qualitative studies to inform and complement the empirical basis of public health nutrition practice.

When static media promote active learning: annotated illustrations versus narrated animations in multimedia instruction.

PubMed

Mayer, Richard E; Hegarty, Mary; Mayer, Sarah; Campbell, Julie

2005-12-01

In 4 experiments, students received a lesson consisting of computer-based animation and narration or a lesson consisting of paper-based static diagrams and text. The lessons used the same words and graphics in the paper-based and computer-based versions to explain the process of lightning formation (Experiment 1), how a toilet tank works (Experiment 2), how ocean waves work (Experiment 3), and how a car's braking system works (Experiment 4). On subsequent retention and transfer tests, the paper group performed significantly better than the computer group on 4 of 8 comparisons, and there was no significant difference on the rest. These results support the static media hypothesis, in which static illustrations with printed text reduce extraneous processing and promote germane processing as compared with narrated animations.

Motives for secondary social sharing of emotions.

PubMed

Christophe, Véronique; Delelis, Gérald; Antoine, Pascal; Nandrino, Jean-Louis

2008-08-01

This study provides new evidence of motives of secondary social sharing of emotions. In a retrospective study, 140 female (Mage = 29.4 yr., SD=12.8) and 116 male (M = 29.5 yr., SD = 13.1) participants were asked to recall a recent situation in which they had talked to a third person about a positive or negative, low or high intensity emotional narrative they had heard. 70% of the respondents reported having secondarily shared the reported event rapidly after the narration with several persons and at several times. Moreover, they not only described the event, the speaker's reaction and their own reactions, but also revealed the identity of their first confidant. Participants reported having spread the emotional narrative more widely in the high negative condition in order to seek emotional support and social comparison.

A Difficult Journey: Reflections on Driving and Driving Cessation From a Team of Clinical Researchers.

PubMed

Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A

2017-02-01

Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Telecom 2-A (TC2A)

NASA Technical Reports Server (NTRS)

Dulac, J.; Latour, J.

1991-01-01

The DSN (Deep Space Network) mission support requirements for Telecom 2-A (TC2A) are summarized. The Telecom 2-A will provide high-speed data link applications, telephone, and television service between France and overseas territories. The mission objectives are outlined and the DSN support requirements are defined through the presentation of tables and narratives describing the spacecraft flight profile; DSN support coverage; frequency assignments; support parameters for telemetry, command and support systems; and tracking support responsibility.

View aft of compartment D23, aft steering station; note steering ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View aft of compartment D-23, aft steering station; note steering unit with crosshead and shaft bearing supports. Note framing supports for armored protective deck at top of photo. (p60) - USS Olympia, Penn's Landing, 211 South Columbus Boulevard, Philadelphia, Philadelphia County, PA

Psycho-social reactions of Palestinian families in Israel and the West Bank following war-related losses.

PubMed

Abu-Baker, Khwala

2012-01-01

to identify psycho-social reactions of Palestinian families to personal losses during the Second Intifada in the West Bank and the Second Lebanese war in Israel. Narratives were collected from support group participants in the west Bank and in individual and family therapy in Israel. the narratives were qualitatively analyzed to identify themes relating to psycho-social reactions to war losses. themes emerging from the west Bank support groups' narratives mostly mirrored those gathered in the therapy sessions in Israel. In both sites, bereaved families exhibited similar psycho-social reactions to war-related losses. Both groups coped with loss collectively and in congruence with their common ethno-cultural background. Also, religious beliefs provided explanations. the loss experiences were ongoing and accumulative for participants in the west Bank, while in Israel it was mostly a single event. Both studies referred solely to war-related losses. the relationships of each population group with the State of Israel shaped their political, national and personal reactions to the loss. Families of "shahids/martyrs" in the west Bank gained socio-political respect, while in Israel, Arab citizens suffering war-related losses did not receive the same political respect from Israeli society, but were awarded sympathy by their communities. In Israel the situation is further complicated since the State is both the enemy and provider of material support, comfort and rescue.

Independence Community College Property Appraisal/Assessment Program.

ERIC Educational Resources Information Center

Swender, Herbert J.

This report to the Kansas State Department of Education supports Independence Community College's (ICC's) request for approval of a new vocational education program in Property Appraisal/Assessment. The report begins with two letters of support and the application for new program approval. Next, a project narrative provides background information…

Pillars of Support: A Functional Asset-Based Framework for ABE Learners

ERIC Educational Resources Information Center

Reynolds, Sharon; Johnson, Jerry

2014-01-01

This paper reported results from a qualitative analysis of assets and supports disclosed in the narratives of adult basic education students. These students were identified as exemplary by their instructors for academic achievement, hours of program attendance, or community service. Themes were identified using the "Four Pillars"…

["I am nuts, but networking": the qualification process for peer support work with mental health users in the psychosocial care network of Rio de Janeiro].

PubMed

Magalhães Dahl, Catarina; de Araújo Carvalho, Maria C; Moscoso Teixeira de Mendonça, Joana; Mitkiewicz de Souza, Flávia; Wainstok Estivil Bustos, Mayra; Fernandes de Cintra Santos, Jacqueline; Marcos Lovisi, Giovani; Tavares Cavalcanti, Maria

2013-01-01

Peer support work has been increasingly incorporated by community services network in the context of mental health care paradigm shift; however, it is a relatively new device in Latin America. In this article, we will describe the qualification process of peer support workers for implementing a psychosocial intervention in the city of Rio de Janeiro. We use the following methodological strategies based on a narrative, participative and dialogical perspective: focus groups, knowledge transmission through a short course; visits to mental health services and field reports. We used a narrative analysis, building the following thematic categories: experience of the recovery process; what helps and what hinders in the recovery process; the role of the family; the role of community mental health services; prejudice among society and family members; the role of peer support work; challenges. From the users' perspective, recovery is tied to ups and downs and family can either help or disturb this process. Prejudice constitutes the main barrier for recovery. To have a social role and participating in training activities facilitate recovery. Users pointed out that it is necessary to have professional support for peer support work.

Fostering professional formation in residency: development and evaluation of the "forum" seminar series.

PubMed

Nothnagle, Melissa; Reis, Shmuel; Goldman, Roberta E; Anandarajah, Gowri

2014-01-01

Residency training is a critical time for physicians' professional formation. However, few structured interventions exist to support residents in this transformative process of integrating personal and professional values, a process that is essential to physician identity formation and preservation of core values such as service and compassion. The authors created a seminar series, the "Forum," to support resident professional formation and address the hidden curriculum as part of a larger intervention to support self-directed learning skills such as goal setting and reflection. Ninety-minute sessions with senior residents and faculty held every other month include opportunities for individual reflection, small- and large-group discussion, and brief didactic components focused on skills such as teaching and leadership. The qualitative program evaluation included analyses of individual semistructured interviews with resident and faculty participants from 2008 to 2011 and of notes recorded by an observer during the 1st year's sessions. Residents appreciated the focus on relevant issues, presence of faculty, opportunities for reflection and interactivity, and inclusion of practical skills. Effects attributed to the Forum included gaining practical skills, feeling a deeper connection to one another and a sense of community, and recognizing progress in their own professional development and growth. Elements described in the literature as essential to professional formation, including encouraging reflection, use of narrative, role modeling, addressing the hidden curriculum, and fostering an authentic community, were recognized by participants as integral to the Forum's success. A group forum for reflection and discussion with peers and role models, tailored to local needs, offers an effective structure to foster professional formation in residency.

Effective Information Extraction Framework for Heterogeneous Clinical Reports Using Online Machine Learning and Controlled Vocabularies

PubMed Central

Zheng, Shuai; Ghasemzadeh, Nima; Hayek, Salim S; Quyyumi, Arshed A

2017-01-01

Background Extracting structured data from narrated medical reports is challenged by the complexity of heterogeneous structures and vocabularies and often requires significant manual effort. Traditional machine-based approaches lack the capability to take user feedbacks for improving the extraction algorithm in real time. Objective Our goal was to provide a generic information extraction framework that can support diverse clinical reports and enables a dynamic interaction between a human and a machine that produces highly accurate results. Methods A clinical information extraction system IDEAL-X has been built on top of online machine learning. It processes one document at a time, and user interactions are recorded as feedbacks to update the learning model in real time. The updated model is used to predict values for extraction in subsequent documents. Once prediction accuracy reaches a user-acceptable threshold, the remaining documents may be batch processed. A customizable controlled vocabulary may be used to support extraction. Results Three datasets were used for experiments based on report styles: 100 cardiac catheterization procedure reports, 100 coronary angiographic reports, and 100 integrated reports—each combines history and physical report, discharge summary, outpatient clinic notes, outpatient clinic letter, and inpatient discharge medication report. Data extraction was performed by 3 methods: online machine learning, controlled vocabularies, and a combination of these. The system delivers results with F1 scores greater than 95%. Conclusions IDEAL-X adopts a unique online machine learning–based approach combined with controlled vocabularies to support data extraction for clinical reports. The system can quickly learn and improve, thus it is highly adaptable. PMID:28487265

A Qualitative Study to Understand Nativity Differences in Breastfeeding Behaviors Among Middle-Class African American and African-Born Women.

PubMed

Fabiyi, Camille; Peacock, Nadine; Hebert-Beirne, Jennifer; Handler, Arden

2016-10-01

Objective To explore nativity differences and the role of attitudes, social norms, and behavioral control perceptions surrounding breastfeeding initiation and duration among middle-class African-American (AA) and African-born (AB) mothers in the US. Methods Semi-structured individual interviews were conducted with 20 middle-class AA and AB mothers in central Ohio from December 2012 to February 2013. Interview questions were developed based on the Theory of Planned Behavior (TPB). Interviews were analyzed for salient themes by TPB constructs. Differences in themes were examined by nativity status. Results All study participants had initiated breastfeeding or bottle-feeding with expressed breast milk, noting the benefits it conferred as well as the persuasive encouragement they received from others. Persistent encouragement was often cited as a factor for sustaining breastfeeding. More AA mothers had discontinued breastfeeding by the time of the interview, which was often attributed to health, lactation, and work challenges. Inconsistent support from health providers, dissuasive remarks from others, ambivalent breastfeeding attitudes, and diminished family support led some mothers to begin formula supplementation. Analysis of maternal narratives revealed nativity differences across sources of encouragement. Specifically, important sources of encouragement were health providers for AA mothers and family, friends, partners and culture for AB mothers. Only AB mothers expressed concerns about difficulty they encountered with breastfeeding due to the lack of proximal family support. Conclusions Findings reveal that both groups of mothers may be susceptible to unsupportive breastfeeding norms in the US and also highlight the need for intervention in health care settings and workplaces to improve AA women's breastfeeding rates.

Supporting the self-concept with memory: insight from amnesia.

PubMed

Grilli, Matthew D; Verfaellie, Mieke

2015-12-01

We investigated the extent to which personal semantic memory supports the self-concept in individuals with medial temporal lobe amnesia and healthy adults. Participants completed eight 'I Am' self-statements. For each of the four highest ranked self-statements, participants completed an open-ended narrative task, during which they provided supporting information indicating why the I Am statement was considered self-descriptive. Participants then completed an episodic probe task, during which they attempted to retrieve six episodic memories for each of these self-statements. Supporting information was scored as episodic, personal semantic or general semantic. In the narrative task, personal semantic memory predominated as self-supporting information in both groups. The amnesic participants generated fewer personal semantic memories than controls to support their self-statements, a deficit that was more pronounced for trait relative to role self-statements. In the episodic probe task, the controls primarily generated unique event memories, but the amnesic participants did not. These findings demonstrate that personal semantic memory, in particular autobiographical fact knowledge, plays a critical role in supporting the self-concept, regardless of the accessibility of episodic memories, and they highlight potential differences in the way traits and roles are supported by personal memory. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

A research-based mantra for compassionate caring.

PubMed

Terry, Louise; Newham, Roger; Hahessy, Sinéad; Atherley, Siobhan; Babenko-Mould, Yolanda; Evans, Marilyn; Ferguson, Karen; Carr, Graham; Cedar, S H

2017-11-01

The United Kingdom introduced the Six C's strategy to help address deficits in approaching nursing care in a compassionate and caring manner. To identify the book, article, poem, film or play that most influenced nurse educators' understanding of care and compassion and to articulate a clearer understanding of compassionate caring. A qualitative study applying discourse analysis to respondents' questionnaires and their nominated narrative. 41 nurse educators working in 5 universities in the UK (n=3), Republic of Ireland and Canada participated. 39 items (10 books, 2 journal articles, 10 poems, 15 films and 2 plays) were nominated. The desire to understand others and how to care compassionately characterised choices. Three main themes emerged. Abandonment of, and failure to see, the suffering person was evident in 25 narratives. Connecting with others was shown in 25 narratives as being able to truly seeing the other person. Comforting others was supported by 37 narratives with examples of kindness and compassion. Published narratives are valuable in developing compassionate responses. An annotated list is provided with suggestions for educational uses to help develop compassionate caring in student nurses. Compassionate, caring nurses recognise that patients need them to: "See who I am; Be present with me; Do not abandon me." Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring the utility of narrative analysis in diagnostic decision making: picture-bound reference, elaboration, and fetal alcohol spectrum disorders.

PubMed

Thorne, John C; Coggins, Truman E; Carmichael Olson, Heather; Astley, Susan J

2007-04-01

To evaluate classification accuracy and clinical feasibility of a narrative analysis tool for identifying children with a fetal alcohol spectrum disorder (FASD). Picture-elicited narratives generated by 16 age-matched pairs of school-aged children (FASD vs. typical development [TD]) were coded for semantic elaboration and reference strategy by judges who were unaware of age, gender, and group membership of the participants. Receiver operating characteristic (ROC) curves were used to examine the classification accuracy of the resulting set of narrative measures for making 2 classifications: (a) for the 16 children diagnosed with FASD, low performance (n = 7) versus average performance (n = 9) on a standardized expressive language task and (b) FASD (n = 16) versus TD (n = 16). Combining the rates of semantic elaboration and pragmatically inappropriate reference perfectly matched a classification based on performance on the standardized language task. More importantly, the rate of ambiguous nominal reference was highly accurate in classifying children with an FASD regardless of their performance on the standardized language task (area under the ROC curve = .863, confidence interval = .736-.991). Results support further study of the diagnostic utility of narrative analysis using discourse level measures of elaboration and children's strategic use of reference.

Narratives of grieving African-Americans about racism in the lives of deceased family members.

PubMed

Rosenblatt, Paul C; Wallace, Beverly R

2005-04-01

As part of a comprehensive interview study on African-American grief, the authors explored how racism is incorporated into narratives about a deceased family member. To the extent that experiences of racism are pervasive in African-American life and to the extent that narratives about a person who has died generally account for the life experiences, achievements, character, and challenges faced by the deceased, the authors expected narratives about a deceased African-American to deal with the person's encounters with racism. In fact, most of the 26 African-Americans who were interviewed spoke about racism in the life of the deceased. Many talked about racism blocking the deceased from getting ahead occupationally and in other ways and about how the deceased resisted or stood up to racism. Some people spoke about the ways the deceased taught them to deal with racism. The narratives that indicated that the deceased had rarely or ever talked about racism still made clear that the deceased lived in a racist world but chose not to bring racism into family conversation. The findings suggest that a view of African-American grieving that is insensitive to racism in African-American experience may lead to unhelpful grief support or counseling.

The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior.

PubMed

Cohen, Lisa Janet; Gorman, Bernard; Briggs, Jessica; Jeon, Min Eun; Ginsburg, Tal; Galynker, Igor

2018-02-04

In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near-term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide-Severity Rating Scale (C-SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C-SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near-term suicidal risk factor. © 2018 The American Association of Suicidology.

The hidden effect of hearing acuity on speech recall, and compensatory effects of self-paced listening

PubMed Central

Piquado, Tepring; Benichov, Jonathan I.; Brownell, Hiram; Wingfield, Arthur

2013-01-01

Objective The purpose of this research was to determine whether negative effects of hearing loss on recall accuracy for spoken narratives can be mitigated by allowing listeners to control the rate of speech input. Design Paragraph-length narratives were presented for recall under two listening conditions in a within-participants design: presentation without interruption (continuous) at an average speech-rate of 150 words per minute; and presentation interrupted at periodic intervals at which participants were allowed to pause before initiating the next segment (self-paced). Study sample Participants were 24 adults ranging from 21 to 33 years of age. Half had age-normal hearing acuity and half had mild-to-moderate hearing loss. The two groups were comparable for age, years of formal education, and vocabulary. Results When narrative passages were presented continuously, without interruption, participants with hearing loss recalled significantly fewer story elements, both main ideas and narrative details, than those with age-normal hearing. The recall difference was eliminated when the two groups were allowed to self-pace the speech input. Conclusion Results support the hypothesis that the listening effort associated with reduced hearing acuity can slow processing operations and increase demands on working memory, with consequent negative effects on accuracy of narrative recall. PMID:22731919

Development of reading ability is facilitated by intensive exposure to a digital children's picture book.

PubMed

Masataka, Nobuo

2014-01-01

Here the author presents preliminary evidence supporting the possibility that the reading ability of 4-year-old children can be improved as a consequence of intensive exposure to the narrative in a digital picture book over a consecutive 5-day period. When creating the digital version used here, two additional functions were provided with it. First, the entire story was voice-recorded by a professional narrator and programmed so that it was played as narration from the speaker of an iPad. Next, as the narration of each digitized page proceeded, the character exactly corresponding to that pronounced by the narrator at that moment became highlighted in red. When the subjects' literacy capability with respect to the syllabic script of the Japanese language (kana) was evaluated before and after the exposure, their performance score was found to increase after the exposure to the digital book, whereas such a change was not recorded in children who experienced exposure to the printed version of the same picture book read to them by their mother. These effects were confirmed when the children were retested 4 weeks later. Although preliminary, the current study represents the first experimental evidence for a positive effect of exposure to digital books upon any aspect of child development.

Development of reading ability is facilitated by intensive exposure to a digital children's picture book

PubMed Central

Masataka, Nobuo

2014-01-01

Here the author presents preliminary evidence supporting the possibility that the reading ability of 4-year-old children can be improved as a consequence of intensive exposure to the narrative in a digital picture book over a consecutive 5-day period. When creating the digital version used here, two additional functions were provided with it. First, the entire story was voice-recorded by a professional narrator and programmed so that it was played as narration from the speaker of an iPad. Next, as the narration of each digitized page proceeded, the character exactly corresponding to that pronounced by the narrator at that moment became highlighted in red. When the subjects' literacy capability with respect to the syllabic script of the Japanese language (kana) was evaluated before and after the exposure, their performance score was found to increase after the exposure to the digital book, whereas such a change was not recorded in children who experienced exposure to the printed version of the same picture book read to them by their mother. These effects were confirmed when the children were retested 4 weeks later. Although preliminary, the current study represents the first experimental evidence for a positive effect of exposure to digital books upon any aspect of child development. PMID:24822051

Call It a Monster for Lack of Anything Else

PubMed Central

Roe, David; Hasson-Ohayon, Ilanit; Kravetz, Shlomo; Yanos, Phil T.; Lysaker, Paul H.

2011-01-01

Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include “narrative insight” may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiae between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness. PMID:19077852

Understanding Digital Note-Taking Practice for Visualization.

PubMed

Willett, Wesley; Goffin, Pascal; Isenberg, Petra

2015-05-13

We present results and design implications from a study of digital note-taking practice to examine how visualization can support revisitation, reflection, and collaboration around notes. As digital notebooks become common forms of external memory, keeping track of volumes of content is increasingly difficult. Information visualization tools can help give note-takers an overview of their content and allow them to explore diverse sets of notes, find and organize related content, and compare their notes with their collaborators. To ground the design of such tools, we conducted a detailed mixed-methods study of digital note-taking practice. We identify a variety of different editing, organization, and sharing methods used by digital note-takers, many of which result in notes becoming "lost in the pile''. These findings form the basis for our design considerations that examine how visualization can support the revisitation, organization, and sharing of digital notes.

Characterisation of mental health conditions in social media using Informed Deep Learning.

PubMed

Gkotsis, George; Oellrich, Anika; Velupillai, Sumithra; Liakata, Maria; Hubbard, Tim J P; Dobson, Richard J B; Dutta, Rina

2017-03-22

The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand the patients' own experiences, and only record cross-sectional, professional impressions at the point of care. Social media platforms have become a source of 'in the moment' daily exchange, with topics including well-being and mental health. In this study, we analysed posts from the social media platform Reddit and developed classifiers to recognise and classify posts related to mental illness according to 11 disorder themes. Using a neural network and deep learning approach, we could automatically recognise mental illness-related posts in our balenced dataset with an accuracy of 91.08% and select the correct theme with a weighted average accuracy of 71.37%. We believe that these results are a first step in developing methods to characterise large amounts of user-generated content that could support content curation and targeted interventions.

Characterisation of mental health conditions in social media using Informed Deep Learning

NASA Astrophysics Data System (ADS)

Gkotsis, George; Oellrich, Anika; Velupillai, Sumithra; Liakata, Maria; Hubbard, Tim J. P.; Dobson, Richard J. B.; Dutta, Rina

2017-03-01

The number of people affected by mental illness is on the increase and with it the burden on health and social care use, as well as the loss of both productivity and quality-adjusted life-years. Natural language processing of electronic health records is increasingly used to study mental health conditions and risk behaviours on a large scale. However, narrative notes written by clinicians do not capture first-hand the patients’ own experiences, and only record cross-sectional, professional impressions at the point of care. Social media platforms have become a source of ‘in the moment’ daily exchange, with topics including well-being and mental health. In this study, we analysed posts from the social media platform Reddit and developed classifiers to recognise and classify posts related to mental illness according to 11 disorder themes. Using a neural network and deep learning approach, we could automatically recognise mental illness-related posts in our balenced dataset with an accuracy of 91.08% and select the correct theme with a weighted average accuracy of 71.37%. We believe that these results are a first step in developing methods to characterise large amounts of user-generated content that could support content curation and targeted interventions.

Strengthening the U.S. Public Health Service Commissioned Corps: A View From The Assistant Secretary for Health.

PubMed

Koh, Howard K

2016-01-01

To summarize the results of the major management review of the U.S. Public Health Service Commissioned Corps (2009-2010) and note related outcomes. Narrative from the U.S. Assistant Secretary for Health, who directed and oversaw the management review. The management review led to 46 recommendations, all of which have since been implemented. The subsequent organizational and operational changes have unified reporting structures, streamlined the administrative Corps organizational structure, and transferred support services to providers with expertise in uniformed services to create a new integrated personnel and payroll system. Related processes have also prompted a systematic billet review as well as establishment of explicit criteria for eligibility to become a Corps officer. Corps leaders report improvements in recruiting talented officers, increased selectivity from the candidate pool, and enhanced matching of incoming officers with agency assignments. Furthermore, Corps activity has grown in both traditional and innovative ways. The Corps has enjoyed heightened activity and outcomes in the era of health reform. The management review and its implementation have strengthened the Corps, helping officers to do their job and achieve their mission. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Earthquake history of the Republic of Ragusa (today Dubrovnik, Croatia) (Invited)

NASA Astrophysics Data System (ADS)

Albini, P.; Rovida, A.; Locati, M.

2009-12-01

Among the towns constellating the Dalmatian coast, Ragusa (today Dubrovnik, Croatia), stands out, both because of its location in the middle of the Eastern Adriatic coast and its long-lasting, independent history of a Modern Age town and its small coastal territory. An important intelligence crossroads, squeezed as it was in between powerful and influential neighbours, such as the Ottoman Empire and the Republic of Venice, in its history (1358-1808) the Republic of Ragusa did experience heavily damaging earthquakes. We narrate the story of these earthquakes, which were recorded in the historical documentation of the Republic (today stored at the State Archives of Dubrovnik - Drzavni arhiv u Dubrovniku) as well as in documents from officers of other Mediterranean countries and letters of individuals. Of special note is the 6 April 1667 earthquake, which inflicted a permanent scar on the Republic. The earthquake's direct effects and their consequences caused a serious financial crisis, so critical that it took over 50 years for Ragusa to recover. This large earthquake is reappraised on the basis of newly investigated sources, and effects of the damage within the city walls are detailed. A seismic history of Ragusa is finally proposed, supported by full-text coeval records.

Historical mathematics in the French eighteenth century.

PubMed

Richards, Joan L

2006-12-01

At least since the seventeenth century, the strange combination of epistemological certainty and ontological power that characterizes mathematics has made it a major focus of philosophical, social, and cultural negotiation. In the eighteenth century, all of these factors were at play as mathematical thinkers struggled to assimilate and extend the analysis they had inherited from the seventeenth century. A combination of educational convictions and historical assumptions supported a humanistic mathematics essentially defined by its flexibility and breadth. This mathematics was an expression of l'esprit humain, which was unfolding in a progressive historical narrative. The French Revolution dramatically altered the historical and educational landscapes that had supported this eighteenth-century approach, and within thirty years Augustin Louis Cauchy had radically reconceptualized and restructured mathematics to be rigorous rather than narrative.

Occupational Therapy Home Safety Intervention via Telehealth

PubMed Central

BREEDEN, LORI E.

2016-01-01

Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist. In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety. After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions. Sessions were recorded and transcribed. Data were examined using content analysis. The content analysis identified the following themes: the value of photos to support learning; the value of narrative learning related to home safety education; and abstract versus concrete learners. Procedural findings are included to support future endeavors. Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention. PMID:27563389

Narrative Constructions for the Organization of Self Experience: Proof of Concept via Embodied Robotics

PubMed Central

Mealier, Anne-Laure; Pointeau, Gregoire; Mirliaz, Solène; Ogawa, Kenji; Finlayson, Mark; Dominey, Peter F.

2017-01-01

It has been proposed that starting from meaning that the child derives directly from shared experience with others, adult narrative enriches this meaning and its structure, providing causal links between unseen intentional states and actions. This would require a means for representing meaning from experience—a situation model—and a mechanism that allows information to be extracted from sentences and mapped onto the situation model that has been derived from experience, thus enriching that representation. We present a hypothesis and theory concerning how the language processing infrastructure for grammatical constructions can naturally be extended to narrative constructions to provide a mechanism for using language to enrich meaning derived from physical experience. Toward this aim, the grammatical construction models are augmented with additional structures for representing relations between events across sentences. Simulation results demonstrate proof of concept for how the narrative construction model supports multiple successive levels of meaning creation which allows the system to learn about the intentionality of mental states, and argument substitution which allows extensions to metaphorical language and analogical problem solving. Cross-linguistic validity of the system is demonstrated in Japanese. The narrative construction model is then integrated into the cognitive system of a humanoid robot that provides the memory systems and world-interaction required for representing meaning in a situation model. In this context proof of concept is demonstrated for how the system enriches meaning in the situation model that has been directly derived from experience. In terms of links to empirical data, the model predicts strong usage based effects: that is, that the narrative constructions used by children will be highly correlated with those that they experience. It also relies on the notion of narrative or discourse function words. Both of these are validated in the experimental literature. PMID:28861011

Narrative Constructions for the Organization of Self Experience: Proof of Concept via Embodied Robotics.

PubMed

Mealier, Anne-Laure; Pointeau, Gregoire; Mirliaz, Solène; Ogawa, Kenji; Finlayson, Mark; Dominey, Peter F

2017-01-01

It has been proposed that starting from meaning that the child derives directly from shared experience with others, adult narrative enriches this meaning and its structure, providing causal links between unseen intentional states and actions. This would require a means for representing meaning from experience-a situation model-and a mechanism that allows information to be extracted from sentences and mapped onto the situation model that has been derived from experience, thus enriching that representation. We present a hypothesis and theory concerning how the language processing infrastructure for grammatical constructions can naturally be extended to narrative constructions to provide a mechanism for using language to enrich meaning derived from physical experience. Toward this aim, the grammatical construction models are augmented with additional structures for representing relations between events across sentences. Simulation results demonstrate proof of concept for how the narrative construction model supports multiple successive levels of meaning creation which allows the system to learn about the intentionality of mental states, and argument substitution which allows extensions to metaphorical language and analogical problem solving. Cross-linguistic validity of the system is demonstrated in Japanese. The narrative construction model is then integrated into the cognitive system of a humanoid robot that provides the memory systems and world-interaction required for representing meaning in a situation model. In this context proof of concept is demonstrated for how the system enriches meaning in the situation model that has been directly derived from experience. In terms of links to empirical data, the model predicts strong usage based effects: that is, that the narrative constructions used by children will be highly correlated with those that they experience. It also relies on the notion of narrative or discourse function words. Both of these are validated in the experimental literature.

An Introduction to Natural Language Processing: How You Can Get More From Those Electronic Notes You Are Generating.

PubMed

Kimia, Amir A; Savova, Guergana; Landschaft, Assaf; Harper, Marvin B

2015-07-01

Electronically stored clinical documents may contain both structured data and unstructured data. The use of structured clinical data varies by facility, but clinicians are familiar with coded data such as International Classification of Diseases, Ninth Revision, Systematized Nomenclature of Medicine-Clinical Terms codes, and commonly other data including patient chief complaints or laboratory results. Most electronic health records have much more clinical information stored as unstructured data, for example, clinical narrative such as history of present illness, procedure notes, and clinical decision making are stored as unstructured data. Despite the importance of this information, electronic capture or retrieval of unstructured clinical data has been challenging. The field of natural language processing (NLP) is undergoing rapid development, and existing tools can be successfully used for quality improvement, research, healthcare coding, and even billing compliance. In this brief review, we provide examples of successful uses of NLP using emergency medicine physician visit notes for various projects and the challenges of retrieving specific data and finally present practical methods that can run on a standard personal computer as well as high-end state-of-the-art funded processes run by leading NLP informatics researchers.

Resignifying the sickle cell gene: Narratives of genetic risk, impairment and repair.

PubMed

Berghs, Maria; Dyson, Simon M; Atkin, Karl

2017-03-01

Connecting theoretical discussion with empirical qualitative work, this article examines how sickle cell became a site of public health intervention in terms of 'racialised' risks. Historically, sickle cell became socio-politically allied to ideas of repair, in terms of the state improving the health of a neglected ethnic minority population. Yet, we elucidate how partial improvements in care and education arose alongside preventative public health screening efforts. Using qualitative research based in the United Kingdom, we show how a focus on collective efforts of repair can lie in tension with how services and individuals understand and negotiate antenatal screening. We illustrate how screening for sickle cell disorder calls into question narrative identity, undoing paradigms in which ethnicity, disablement and genetic impairment become framed. Research participants noted that rather than 'choices', it is 'risks' and their negotiation that are a part of discourses of modernity and the new genetics. Furthermore, while biomedical paradigms are rationally and ethically (de)constructed by participants, this was never fully engaged with by professionals, contributing to overall perception of antenatal screening as disempowering and leading to disengagement.

Age, memory type, and the phenomenology of autobiographical memory: findings from an Italian sample.

PubMed

Montebarocci, Ornella; Luchetti, Martina; Sutin, Angelina R

2014-01-01

The present research explored differences in phenomenology between two types of memories, a general self-defining memory and an earliest childhood memory. A sample of 76 Italian participants were selected and categorised into two age groups: 20-30 years and 31-40 years. The Memory Experiences Questionnaire (MEQ) was administered, taking note of latency and duration times of the narratives. Consistent with the literature, the self-defining memory differed significantly from the earliest childhood memory in terms of phenomenology, with the recency of the memory associated with more intense phenomenological experience. The self-defining memory took longer to retrieve and narrate than the earliest childhood memory. Meaningful differences also emerged between the two age groups: Participants in their 30s rated their self-defining memory as more vivid, coherent, and accessible than participants in their 20s. According to latency findings, these differences suggest an expanded period of identity consolidation for younger adults. Further applications of the MEQ should be carried out to replicate these results with other samples of young adults.

Older women and sexuality: Narratives of gender, age, and living environment.

PubMed

Jen, Sarah

2017-01-01

Little research has explored the intersection of aging and sexuality. This qualitative study is informed by a life course approach and narrative gerontology methods. Semistructured interviews were conducted with 13 women age 55 and older to explore the effects of gender, aging, and living environment on past and current sexual experiences. Subthemes from each major theme are discussed, including: (a) messages about and perceived effects of gender, (b) perceived effects of aging, and (c) perceived effects of living environment. Findings support the use of dynamical systems theory to study women's sexual experiences.

NLM's Medical Library Resource Improvement Grant for Consortia Development: a proposed outline to simplify the application process.

PubMed

Kabler, A W

1980-01-01

The National Library of Medicine's Resource Improvement Grant for Consortia is available to assist with developing hospital library consortia, and to support the development of basic healthy information collections. In an effort to simplify the grant application process, this paper presents suggestions for writing the narrative section of the first budget-period application, using the outline in NLM's Application Instructions for Consortium Applicants. Suggestions for writing the narratives of the second budget-period application and the collection development application are also included.

Summary of Pellet Technology Program Activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gebhart, III, Gerald E.; Baylor, Larry R.; Bell, Gary L.

This report summarizes the activities and budget information of ORNL’s pellet technology program from the start of FY2014 through FY2017. Cost summaries are broken down by year and spending category. Milestone activities are outlined and described by year and further described in the project narrative. The project narrative outlines the main pellet injection technology advances enabled by the pellet technology program. A list of published research products is included, along with biographies of personnel involved. This document was prepared in support of the April 24, 2018, review of the pellet technology program at ORNL.

2013 RFP Ports Initiative Supporting Documents

EPA Pesticide Factsheets

Documents include: RFPs, Project Narrative, Application fleet description (AFD), Priority County List, Model years for eligible nonroad engines (nonroad remaining useful life), Sample Drayage, Marince Engine Eligibility, FAQs, and Webinar slides

2014 RFP Ports Initiative Supporting Documents

EPA Pesticide Factsheets

Documents include: RFPs, Project Narrative, Application fleet description (AFD), Priority County List, Model years for eligible nonroad engines (nonroad remaining useful life), Sample Drayage, Marince Engine Eligibility, FAQs, and Webinar slides

Jenny's story: reinventing oneself through occupation and narrative configuration.

PubMed

Price-Lackey, P; Cashman, J

1996-04-01

Two life history interviews were conducted to discover how one women, Jenny, experienced a traumatic head injury, rehabilitation, and recovery. Narrative analysis of the transcribed interviews revealed a rich story of how Jenny had fashioned her identity and character through childhood occupations, including studying classical literature and music, and of how she drew upon resources developed in childhood to engineer her recovery. It also illustrated how Jenny used a recursive process of narrative construction and engagement in self-devised graduated occupations, including studying, playing music, writing, computer graphics, and theater production, to create a new identity and develop capacities to process complex information and exercise creativity. Jenny's story illustrates the usefulness of gaining a perspective on patients as occupational beings through the gathering of life histories focused on occupation, the importance of collaborative patient-therapist goal setting, and the necessity for considering both the doing (practic) and the meaning (narrative) aspects of occupation. Her story supports many scholars' arguments that the therapeutic relationship, and thus occupational therapy practice, may be enhanced through the use of life history interviewing in occupational therapy evaluation and treatment.

Anticipating Needs at End of Life in Narratives Related by People Living With HIV/AIDS in Appalachia.

PubMed

Hall, Joanne; Hutson, Sadie P; West, Frankie

2018-07-01

As part of a mixed methods study determining end-of-life and advanced care planning needs in southern Appalachia, a narrative analysis was done of stories told in interviews of 8 selected participants using transcript data. Narratives were fraught with contradiction and paradox. Tensions were evident about living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The primary finding was that stigma, from several sources, and shrinking circles of social support for people living with HIV/AIDS, all of whom were in treatment, combined to create a sense of solitariness. Narratives were fraught with tensions, contradictions, and paradoxes. Living in Appalachia, the Bible Belt, and an area wherein distances are long and community rejection can occur as news travels quickly. The rejection-based religiously based stigma was often predicated on stereotypes about sexual behavior and illicit drug use. Diagnosis was a key turning point after which many spiraled downward financially and socially. Implications for research and advanced care planning are included.

Listening to the Narratives of Our Patients as Part of Holistic Nursing Care.

PubMed

Alicea-Planas, Jessica

2016-06-01

Nurses in all settings interact with individuals often identified as vulnerable or marginalized, and at times are frustrated by their own inability to "make a difference." By allowing oneself to listen, a fuller appreciation of the individual circumstance, or that which is unwritten, can be appreciated. Storytelling is a way to set the stage for experiences to be shared and can provide insight into lives. The narratives told by patients are often complex, affected by various influences of the environment, and personal, which in combination with nursing informs their individual healing journeys. Using a philosophy of nursing that encompasses all of the distinct influences on these narratives can allow nurses to more holistically care and advocate for their patients. As this case study shows, nursing plays a significant role in the narratives of others. Although many vulnerable populations live in a perpetual cycle of poverty and poor health, some nurses are able to assess the intricacies of a situation and facilitate understanding, as part of their support, caring, and advocacy for their patients. © The Author(s) 2015.

To regain participation in occupations through human encounters--narratives from women with spinal cord injury.

PubMed

Isaksson, Gunilla; Josephsson, Staffan; Lexell, Jan; Skär, Lisa

2007-11-30

To gain an understanding of how women with spinal cord injury (SCI) experienced human encounters in occupations and how these influenced their participation. The data were collected through two or three in-depth interviews with 13 women (age 25-61 years) with SCI. Data analysis was carried out by using a paradigmatic analysis of narrative data, followed by an interpretation based on a narrative theory. The results showed a complexity where the women's experiences and acting in human encounters changed over time. In these human encounters the women struggled with conflicts, supported other persons that were insecure and revaluated their apprehension about persons in their social network. These multidimensional human encounters thereby enabled them to regain participation in occupations. This shows that human encounters are important for persons with disabilities so they can restructure their occupational identity and their needs for participation in occupations. The study also showed that the use of narratives as a tool within rehabilitation could lead to an increased understanding of the subjective changes that occur over time for a person with a disability.

Note-Taking Habits of Online Students: Value, Quality, and Support

ERIC Educational Resources Information Center

Watkins, Ryan; Corry, Michael; Dardick, William; Stella, Julie

2015-01-01

Do online students take notes when reading lecture content or watching video lectures? Can they benefit from note-taking supports, such as graphic organizers, to improve their study skills? These are among the questions explored in a pilot study with student participants enrolled in a 100% online graduate program. Students were provided academic…

What Is Adolescence?: Adolescents Narrate Their Lives in Lima, Peru

PubMed Central

Bayer, Angela M.; Gilman, Robert H.; Tsui, Amy O.; Hindin, Michelle J.

2011-01-01

This study explores the lives of Peruvian adolescents in a low-income human settlement outside of Lima. Twenty 12–17 year olds were asked to narrate their own life stories using the life history narrative research method. Holistic content analysis was coupled with a grounded theory approach to explore these data. Intergenerational responsibility, family tensions, economic pressures, racism and violence emerged without prompting and dominated the narrators’ life stories, underscoring the degree to which these adolescents lack access to the supportive individuals and structures that are key to positive adolescent development. The challenges faced by these and the other 5.8 million 10 to 19 year olds in Peru requires increased attention to the role of families, peers and communities in ensuring that adolescents are able to maintain their well-being and achieve their future expectations. PMID:20207410

Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy.

PubMed

Malone, Tara C; Mennenga, Sarah E; Guss, Jeffrey; Podrebarac, Samantha K; Owens, Lindsey T; Bossis, Anthony P; Belser, Alexander B; Agin-Liebes, Gabrielle; Bogenschutz, Michael P; Ross, Stephen

2018-01-01

A growing body of evidence shows that existential and spiritual well-being in cancer patients is associated with better medical outcomes, improved quality of life, and serves as a buffer against depression, hopelessness, and desire for hastened death. Historical and recent research suggests a role for psilocybin-assisted psychotherapy in treating cancer-related anxiety and depression. A double-blind controlled trial was performed, where 29 patients with cancer-related anxiety and depression were randomly assigned to treatment with single-dose psilocybin (0.3 mg/kg) or niacin in conjunction with psychotherapy. Previously published results of this trial demonstrated that, in conjunction with psychotherapy, moderate-dose psilocybin produced rapid, robust, and enduring anxiolytic, and anti-depressant effects. Here, we illustrate unique clinical courses described by four participants using quantitative measures of acute and persisting effects of psilocybin, anxiety, depression, quality of life, and spiritual well-being, as well as qualitative interviews, written narratives, and clinician notes. Although the content of each psilocybin-assisted experience was unique to each participant, several thematic similarities and differences across the various sessions stood out. These four participants' personal narratives extended beyond the cancer diagnosis itself, frequently revolving around themes of self-compassion and love, acceptance of death, and memories of past trauma, though the specific details or narrative content differ substantially. The results presented here demonstrate the personalized nature of the subjective experiences elicited through treatment with psilocybin, particularly with respect to the spiritual and/or psychological needs of each patient.

Strategic stories: how 3M is rewriting business planning.

PubMed

Shaw, G; Brown, R; Bromiley, P

1998-01-01

Virtually all business plans are written as a list of bullet points. Despite the skill or knowledge of their authors, these plans usually aren't anything more than lists of "good things to do." For example: Increase sales by 10%. Reduce distribution costs by 5%. Develop a synergistic vision for traditional products. Rarely do these lists reflect deep thought or inspire commitment. Worse, they don't specify critical relationships between the points, and they can't demonstrate how the goals will be achieved. 3M executive Gordon Shaw began looking for a more coherent and compelling way to present business plans. He found it in the form of strategic stories. Telling stories was already a habit of mind at 3M. Stories about the advent of Post-it Notes and the invention of masking tape help define 3M's identity. They're part of the way people at 3M explain themselves to their customers and to one another. Shaw and his coauthors examine how business plans can be transformed into strategic narratives. By painting a picture of the market, the competition, and the strategy needed to beat the competition, these narratives can fill in the spaces around the bullet points for those who will approve and those who will implement the strategy. When people can locate themselves in the story, their sense of commitment and involvement is enhanced. By conveying a powerful impression of the process of winning, narrative plans can mobilize an entire organization.

Niyith NiyithWatmam [corrected] (the quiet story): exploring the experiences of Aboriginal women who give birth in their remote community.

PubMed

Ireland, Sarah; Wulili Narjic, Concepta; Belton, Suzanne; Kildea, Sue

2011-10-01

to investigate the beliefs and practices of Aboriginal women who decline transfer to urban hospitals and remain in their remote community to give birth. an ethnographic approach was used which included: the collection of birth histories and narratives, observation and participation in the community for 24 months, field notes, training and employment of an Aboriginal co-researcher, and consultation with and advice from a local reference group. a remote Aboriginal community in the Northern Territory, Australia. narratives were collected from seven Aboriginal women and five family members. findings showed that women, through their previous experiences of standard care, appeared to make conscious decisions and choices about managing their subsequent pregnancies and births. Women took into account their health, the baby's health, the care of their other children, and designated men with a helping role. narratives described a breakdown of traditional birthing practices and high levels of non-compliance with health-system-recommended care. standard care provided for women relocating for birth must be improved, and the provision of a primary maternity service in this particular community may allow Aboriginal Women's Business roles and cultural obligations to be recognised and invigorated. International examples of primary birthing services in remote areas demonstrate that they can be safe alternatives to urban transfer for childbirth. A primary maternity service would provide a safer environment for the women who choose to avoid standard care. Copyright © 2010 Elsevier Ltd. All rights reserved.

Centering Students in School-Based Support Processes: Critical Inquiries and Shifting Perspectives

ERIC Educational Resources Information Center

Brion-Meisels, Gretchen

2015-01-01

Drawing on data from two qualitative studies, this chapter argues that both school organizations and individual students will benefit from centering youth voices in student support systems. To do this, the author shares data from adolescents' narratives that demonstrate how young people's voices might (re)shape the central practices of…

How One Learning Community Approached Death

ERIC Educational Resources Information Center

Ungemah, Lori

2017-01-01

In this narrative piece, the author describes how a learning community was able to transfer their practices of care to support a colleague as he faced illness and death. The author chronicles how the learning community responded to support their team member, other members of the campus community, and the students. She reflects on this experience…

What Would Catherine of Sienna Do? Spiritual Formation and the Brains of Adolescent Girls

ERIC Educational Resources Information Center

Baker, Dori; Edwards, Ned

2012-01-01

This article explores how new knowledge about the adolescent female brain lends theoretical support to narrative and contemplative practices of spiritual formation of girls. Current brain research supports the use of particular methods of religious formation for teenagers in general, and teenage girls in particular. This article suggests that…

College Students with Disabilities' Motivation to Utilize Disability Support Services: A Qualitative Investigation

ERIC Educational Resources Information Center

Meyer, Rachel Heather

2012-01-01

The current study investigated the motivation of college students with disabilities to disclose their disability(s) to the university and to utilize disability support services. Eleven college students with a diversity of invisible disabilities from a large university were interviewed using a narrative approach. Analysis involved a combination of…

Countering the Narrative: A Layered Perspective on Supporting Black Males in Education

ERIC Educational Resources Information Center

Goings, Ramon B.; Smith, Aaron; Harris, Daniel; Wilson, Tanneshala; Lancaster, Demetrius

2015-01-01

The challenges facing Black males throughout the educational pipeline have been discussed by researchers in detail. However, missing from this research are discussions from the perspective of researchers, educators, and community members united on how to better support Black males. The purpose of this reflective piece is twofold. First, we address…

The Effect of Oral Feedback on Perceived Classroom Community in Undergraduate Students

ERIC Educational Resources Information Center

Boyles, Jennifer L.

2017-01-01

The ongoing trend in research regarding feedback has been to explore quantitative assessment. Garnering support more recently is qualitative narrative feedback in support of formative assessment. This type of feedback offers insight into expectations as well as offer additional knowledge gained. It enables students to improve their performance…

Narrative Review of the Educational, Vocational, and Financial Needs of Adolescents and Young Adults with Cancer: Recommendations for Support and Research.

PubMed

Fardell, Joanna E; Wakefield, Claire E; Patterson, Pandora; Lum, Alistair; Cohn, Richard J; Pini, Simon A; Sansom-Daly, Ursula M

2018-04-01

Adolescents and young adults (AYAs) with cancer have unique needs around education and vocation during and after treatment. This narrative review series aims at documenting the unique needs of AYAs from the current literature and at providing recommendations to inform an update of the Australian National Service Delivery Framework for AYAs with Cancer. AYAs with cancer may experience impairments to cognitive, physical, and psychological functioning and health, which can adversely affect their academic grades, peer relationships, and likelihood of entering the workforce. Treatment expenses and time off work can stifle AYAs' financial independence from their parents. The combined effect of disrupted education, vocation, and financial dependence can reduce AYAs' sense of identity. Although support is available in some countries, support efficacy is yet to be clearly established. Continued research is required to deliver successful education and work reintegration programs that build the confidence of AYAs with cancer to achieve their best. Educational and vocational support, as well as financial advice, may improve AYAs' financial security and quality of life during survivorship.

NLC Working Meetings

Science.gov Websites

TSETs Magnet Systems Cherrill Spencer Notes J C Vacuum Carl Rago Notes J C Supports & Movers Nancy Yu * Notes J C Installation Notes J C Manufacturing Morry Munro Notes J C Collimators & Dumps Eric Doyle Notes J C RF Distribution Engineering Notes M N Theory Perry Wilson - - Wednesday 10:30 A

Using the arts and humanities to promote a liberal nursing education: strengths and weaknesses.

PubMed

McKie, Andrew

2012-10-01

The requirement that all student nurses in the United Kingdom will be educated to degree level from 2013 permits a review of the current state of nursing education in university contexts. Recent educational standards for these new programmes (NMC, 2010) allow a liberal, or broad-based, education, with its features of breadth of knowledge, formativity, critical thinking and working with others, to be considered. Select narratives from a PhD study featuring student nurses and nurse teachers exploring the relationship between reading literature and poetry and ethical practice are presented to critically support the place of liberal education within these programmes. These narratives are drawn from a research study based upon the use of a narrative methodology. The study was set within the educational context of a school of nursing and midwifery in one Scottish university. Eight student nurses and four nurse teachers participated in the study. These narratives were constructed from data derived from focus groups and individual interviews. These narratives suggest that liberal education can be promoted within international curricula via careful positioning of, and student nurse engagement with, the arts and humanities. A liberal education can influence student nurses' sense of discernment, enhance their own responsibility for learning, support ethical regard for others, provide different perspectives on human experience and contribute to a balanced curriculum. Although a liberal education cannot guarantee fully skilled and ethically sensitive practitioners, it can contribute towards its achievement. The current university education climate presents obstacles to the promotion of liberal education. Nevertheless, the considerable professional and personal challenges of nursing practice in global terms make such an educational preparation essential. If nursing education to degree level is to commence from 2013, these principal features of liberal education, via these educational standards, must be embedded prominently into new programmes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using narrative-based design scaffolds within a mobile learning environment to support learning outdoors with young children

NASA Astrophysics Data System (ADS)

Seely, Brian J.

This study aims to advance learning outdoors with mobile devices. As part of the ongoing Tree Investigators design-based research study, this research investigated a mobile application to support observation, identification, and explanation of the tree life cycle within an authentic, outdoor setting. Recognizing the scientific and conceptual complexity of this topic for young children, the design incorporated technological and design scaffolds within a narrative-based learning environment. In an effort to support learning, 14 participants (aged 5-9) were guided through the mobile app on tree life cycles by a comic-strip pedagogical agent, "Nutty the Squirrel", as they looked to explore and understand through guided observational practices and artifact creation tasks. In comparison to previous iterations of this DBR study, the overall patterns of talk found in this study were similar, with perceptual and conceptual talk being the first and second most frequently coded categories, respectively. However, this study coded considerably more instances of affective talk. This finding of the higher frequency of affective talk could possibly be explained by the relatively younger age of this iteration's participants, in conjunction with the introduced pedagogical agent, who elicited playfulness and delight from the children. The results also indicated a significant improvement when comparing the pretest results (mean score of .86) with the posttest results (mean score of 4.07, out of 5). Learners were not only able to recall the phases of a tree life cycle, but list them in the correct order. The comparison reports a significant increase, showing evidence of increased knowledge and appropriation of scientific vocabulary. The finding suggests the narrative was effective in structuring the complex material into a story for sense making. Future research with narratives should consider a design to promote learner agency through more interactions with the pedagogical agent and a conditional branching scenario framework to further evoke interest and engagement.

Mental health nurses' experiences of managing work-related emotions through supervision.

PubMed

MacLaren, Jessica; Stenhouse, Rosie; Ritchie, Deborah

2016-10-01

The aim of this study was to explore emotion cultures constructed in supervision and consider how supervision functions as an emotionally safe space promoting critical reflection. Research published between 1995-2015 suggests supervision has a positive impact on nurses' emotional well-being, but there is little understanding of the processes involved in this and how styles of emotion interaction are established in supervision. A narrative approach was used to investigate mental health nurses' understandings and experiences of supervision. Eight semi-structured interviews were conducted with community mental health nurses in the UK during 2011. Analysis of audio data used features of speech to identify narrative discourse and illuminate meanings. A topic-centred analysis of interview narratives explored discourses shared between the participants. This supported the identification of feeling rules in participants' narratives and the exploration of the emotion context of supervision. Effective supervision was associated with three feeling rules: safety and reflexivity; staying professional; managing feelings. These feeling rules allowed the expression and exploration of emotions, promoting critical reflection. A contrast was identified between the emotion culture of supervision and the nurses' experience of their workplace cultures as requiring the suppression of difficult emotions. Despite this, contrast supervision functioned as an emotion micro-culture with its own distinctive feeling rules. The analytical construct of feeling rules allows us to connect individual emotional experiences to shared normative discourses, highlighting how these shape emotional processes taking place in supervision. This understanding supports an explanation of how supervision may positively influence nurses' emotion management and perhaps reduce burnout. © 2016 John Wiley & Sons Ltd.

Pragmatic phenomenological types.

PubMed

Goranson, Ted; Cardier, Beth; Devlin, Keith

2015-12-01

We approach a well-known problem: how to relate component physical processes in biological systems to governing imperatives in multiple system levels. The intent is to further practical tools that can be used in the clinical context. An example proposes a formal type system that would support this kind of reasoning, including in machines. Our example is based on a model of the connection between a quality of mind associated with creativity and neuropsychiatric dynamics: constructing narrative as a form of conscious introspection, which allows the manipulation of one's own driving imperatives. In this context, general creativity is indicated by an ability to manage multiple heterogeneous worldviews simultaneously in a developing narrative. 'Narrative' in this context is framed as the organizing concept behind rational linearization that can be applied to metaphysics as well as modeling perceptive dynamics. Introspection is framed as the phenomenological 'tip' that allows a perceiver to be within experience or outside it, reflecting on and modifying it. What distinguishes the approach is the rooting in well founded but disparate disciplines: phenomenology, ontic virtuality, two-sorted geometric logics, functional reactive programming, multi-level ontologies and narrative cognition. This paper advances the work by proposing a type strategy within a two-sorted reasoning system that supports cross-ontology structure. The paper describes influences on this approach, and presents an example that involves phenotype classes and monitored creativity enhanced by both soft methods and transcranial direct-current stimulation. The proposed solution integrates pragmatic phenomenology, situation theory, narratology and functional programming in one framework. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing the Readability of Medical Documents: A Ranking Approach.

PubMed

Zheng, Jiaping; Yu, Hong

2018-03-23

The use of electronic health record (EHR) systems with patient engagement capabilities, including viewing, downloading, and transmitting health information, has recently grown tremendously. However, using these resources to engage patients in managing their own health remains challenging due to the complex and technical nature of the EHR narratives. Our objective was to develop a machine learning-based system to assess readability levels of complex documents such as EHR notes. We collected difficulty ratings of EHR notes and Wikipedia articles using crowdsourcing from 90 readers. We built a supervised model to assess readability based on relative orders of text difficulty using both surface text features and word embeddings. We evaluated system performance using the Kendall coefficient of concordance against human ratings. Our system achieved significantly higher concordance (.734) with human annotators than did a baseline using the Flesch-Kincaid Grade Level, a widely adopted readability formula (.531). The improvement was also consistent across different disease topics. This method's concordance with an individual human user's ratings was also higher than the concordance between different human annotators (.658). We explored methods to automatically assess the readability levels of clinical narratives. Our ranking-based system using simple textual features and easy-to-learn word embeddings outperformed a widely used readability formula. Our ranking-based method can predict relative difficulties of medical documents. It is not constrained to a predefined set of readability levels, a common design in many machine learning-based systems. Furthermore, the feature set does not rely on complex processing of the documents. One potential application of our readability ranking is personalization, allowing patients to better accommodate their own background knowledge. ©Jiaping Zheng, Hong Yu. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 23.03.2018.

Validation of psoriatic arthritis diagnoses in electronic medical records using natural language processing

PubMed Central

Cai, Tianxi; Karlson, Elizabeth W.

2013-01-01

Objectives To test whether data extracted from full text patient visit notes from an electronic medical record (EMR) would improve the classification of PsA compared to an algorithm based on codified data. Methods From the > 1,350,000 adults in a large academic EMR, all 2318 patients with a billing code for PsA were extracted and 550 were randomly selected for chart review and algorithm training. Using codified data and phrases extracted from narrative data using natural language processing, 31 predictors were extracted and three random forest algorithms trained using coded, narrative, and combined predictors. The receiver operator curve (ROC) was used to identify the optimal algorithm and a cut point was chosen to achieve the maximum sensitivity possible at a 90% positive predictive value (PPV). The algorithm was then used to classify the remaining 1768 charts and finally validated in a random sample of 300 cases predicted to have PsA. Results The PPV of a single PsA code was 57% (95%CI 55%–58%). Using a combination of coded data and NLP the random forest algorithm reached a PPV of 90% (95%CI 86%–93%) at sensitivity of 87% (95% CI 83% – 91%) in the training data. The PPV was 93% (95%CI 89%–96%) in the validation set. Adding NLP predictors to codified data increased the area under the ROC (p < 0.001). Conclusions Using NLP with text notes from electronic medical records improved the performance of the prediction algorithm significantly. Random forests were a useful tool to accurately classify psoriatic arthritis cases to enable epidemiological research. PMID:20701955

Effects of Multimodal Mandala Yoga on Social and Emotional Skills for Youth with Autism Spectrum Disorder: An Exploratory Study.

PubMed

Litchke, Lyn Gorbett; Liu, Ting; Castro, Stephanie

2018-01-01

Youth with autism spectrum disorder (ASD) demonstrates impairment in the ability to socially and emotionally relate to others that can limit participation in groups, interaction with peers, and building successful life relationships. The aim of this exploratory study was to examine the effects of a novel multimodal Mandala yoga program on social and emotional skills for youth with ASD. Five males with ASD attended 1 h yoga sessions, twice a week for 4 weeks. Multimodal Mandala yoga comprised 26 circular partner/group poses, color and tracing sheets, rhythmic chanting, yoga cards, and games. Treatment and Research Institute for ASD Social Skills Assessment (TSSA) scores were collected before and after the eight yoga sessions. The Modified Facial Mood Scale (MFMS) was used to observe mood changes before and after each yoga class. Paired sample t -tests were conducted on TSSA and MFMS scores to compare social and emotional differences post the 4-week camp. Narrative field notes were documented after each of the eight yoga sessions. A significant improvement from pre- to post-test was found in overall TSSA ( t (4) = -5.744, P = 0.005) and on respondent to initiation ( t (4) = -3.726, P = 0.020), initiating interaction ( t (4) = -8.5, P = 0.039), and affective understanding and perspective taking subscales ( t (4) = -5.171 P = 0.007). Youth's MFMS scores increased from 80% to 100% at the end of eight yoga sessions demonstrating a pleasant or positive mood. Thematic analysis of the narrative notes identified three key factors associated with the yoga experience: (a) enhanced mood and emotional expression, (b) increased empathy toward others, and (c) improved teamwork skills. This multimodal Mandala yoga training has implication for developing positive social and emotional skills for youth with ASD.

Parental Grief Following the Death of a Child from Cancer: The Ongoing Odyssey.

PubMed

Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah; Baker, Justin N

2016-09-01

The death of a child is a devastating event that results in profound grief and significant psychosocial and physical morbidities in parents. The parental grief journey is a complex phenomenon necessitating the utilization of newer models of bereavement with a focus on relationships and exploration of parents' perceived meanings of the experience. To further characterize the grief journey of parents whose child died from cancer in order to better identify parents who can benefit from additional bereavement support and design strategies to improve bereavement services for these parents. We conducted focus group sessions with 11 bereaved parents. The parents were given two prompts to describe their grief journey before and after their child's death, and their responses in a narrative form were audio-recorded. The responses were coded and studied independently by semantic content analysis. Collation and analysis of the coded responses to both prompts results in the emergence of four concepts from the parental narratives: (1) description of the grief trajectory and evolution of grief over time, (2) mechanisms of parental coping throughout the grief journey, (3) factors that exacerbate parental grief, and (4) sources of parental support throughout the grief journey. The narratives highlighted that parents whose child died of cancer experience a unique and evolving form of grief and they wish to continue their bond with the deceased child. We recommend that healthcare providers and institutions incorporate support systems into a comprehensive bereavement program for families of children who die from cancer. © 2016 Wiley Periodicals, Inc.

Adult family member experiences during an older loved one's delirium: a narrative literature review.

PubMed

Day, Jenny; Higgins, Isabel

2015-06-01

To provide a narrative literature review about family experiences during older person delirium. Delirium is a common and serious condition which manifests when older people are unwell. Family members of older people are likely to encounter their loved one and become involved in care during delirium. Narrative literature review. Electronic database and Google Scholar(™) searches were conducted using search terms for delirium, family, experience and older people. Though family members are important partners in the care of older people, there has been little exploration of their experiences during delirium. Current literature identifies that family members experience unexpected, rapid and unpredictable changes in their older loved one, absence of the person they know, distress, not knowing about delirium nor how to help, and supportive and unsupportive relationships with health care staff. Health care staff need understanding about what it means for family to have someone close to them have delirium. Without understanding, it is difficult for staff to respond with compassion, provide support and appropriately include family in the older person's care. There is a need to mitigate family distress and provide support, including information which addresses family concerns. The distress family members experience, the impact of losing connection to their loved one, and the difficulty family face in sustaining hope for their loved one's return needs to be recognised and addressed by health care staff, particularly nurses, during the older person's care. © 2015 John Wiley & Sons Ltd.

Creating walking tracks to success: A narrative analysis of AustralianAboriginal and Torres Strait Islander nursing students’ stories ofsuccess.

PubMed

West, Roianne; Foster, Kim; Usher, Kim

2016-01-01

Australian Aboriginal and Torres Strait Islander people have higher rates of morbidity and mortality thanother Australians. One proposed strategy to improve this situation is to increase the participation ofAboriginal and Torres Strait Islander people, including Aboriginal and Torres Strait Islander nurses, inthe health workforce. Although the numbers of Aboriginal and Torres Strait Islander students under-taking tertiary nursing courses have increased, completion rates have not kept pace. The study aimedto describe Aboriginal and Torres Strait Islander nursing students’ experiences of enablers for successfulcourse completion and to develop a narrative of student experience. A qualitative study using a strengths-based approach with a narrative analysis of semi-structured interview data was conducted across fourschools of Nursing in Queensland, Australia. Eight final-year Aboriginal and Torres Strait Islander nursingstudents volunteered to participate in the study. A collective story with the overarching plotline Creatingwalking tracks to success was developed. Six threads of experience emerged: Making a difference, Valu-ing Indigeneity, Healing strength of connections, Resisting racism, Embracing support, and perseveringtowards completion. Key success factors included resilient attributes, building supportive connectionsand having positive expectations of the future, along with sustained institutional support from Aboriginaland Torres Strait Islander nurse academics and clinicians. Development of tailored resilience-buildingtraining for Aboriginal and Torres Strait Islander nursing students and appointment of Aboriginal andTorres Strait Islander academics in Schools of Nursing that include such students may facilitate futuresuccessful completions in other programs.

Adolescent Summaries of Narrative and Expository Discourse: Differences and Predictors.

PubMed

Lundine, Jennifer P; Harnish, Stacy M; McCauley, Rebecca J; Blackett, Deena Schwen; Zezinka, Alexandra; Chen, Wei; Fox, Robert A

2018-05-03

Summarizing expository passages is a critical academic skill that is understudied in language research. The purpose of this study was to compare the quality of verbal summaries produced by adolescents for 3 different discourse types and to determine whether a composite measure of cognitive skill or a test of expressive syntax predicted their performance. Fifty adolescents listened to, and then verbally summarized, 1 narrative and 2 expository lectures (compare-contrast and cause-effect). They also participated in testing that targeted expressive syntax and 5 cognitive subdomains. Summary quality scores were significantly different across discourse types, with a medium effect size. Analyses revealed significantly higher summary quality scores for cause-effect than compare-contrast summaries. Although the composite cognitive measure contributed significantly to the prediction of quality scores for both types of expository summaries, the expressive syntax score only contributed significantly to the quality scores for narrative summaries. These results support previous research indicating that type of expository discourse may impact student performance. These results also show, for the first time, that cognition may play a predictive role in determining summary quality for expository but not narrative passages in this population. In addition, despite the more complex syntax commonly associated with exposition versus narratives, an expressive syntax score was only predictive of performance on narrative summaries. These findings provide new information, questions, and directions for future research for those who study academic discourse and for professionals who must identify and manage the problems of students struggling with different types of academic discourse. https://doi.org/10.23641/asha.6167879.

Performing a Choice-Narrative: A qualitative study of the patterns in STEM students' higher education choices

NASA Astrophysics Data System (ADS)

Tolstrup Holmegaard, Henriette

2015-06-01

Students' science choices have long attracted attention in both public and research. Recently there has been a call for qualitative studies to explore how choices create a sense of fit for individual students. Therefore, this paper aims to study how science students' choices of higher education are performed and to uncover the patterns of students' construction of their choice-narratives. The paper is based on a qualitative study among 38 Danish upper secondary school students. The theoretical framework is narrative psychology combined with post-structural thinking. The study shows that constructing a choice-narrative is complicated identity-work. First, the students felt encouraged to identify their interests, not only the ones related to the subject matter, but also various interests that were equally negotiated in relation to each other. Second, the choice-narratives were personalised; on the one side articulated as not too predictable, and on the other side appearing realistic and adjusted to the students' sense of self. Third, the choice-narratives were informed, validated and adjusted in the students' social network providing the students with a repertoire of viable pathways. The study demonstrates how cultural discourses about how a proper choice is made set the scene for the students' choices. The study raises some concerns for science education. Improving students' interests in science alone might not lead to increased admission as several interests equally intervene. To attract more students to science, we must consider how to actively engage them in crafting their own education, as a way to support them in making personal sense.

Queer narratives and minority stress: Stories from lesbian, gay and bisexual individuals in Norway.

PubMed

Synnes, Oddgeir; Malterud, Kirsti

2018-03-01

This study aims to explore how minority stress related to sexual orientation is reflected in narratives from lesbian, gay and bisexual (LGB) individuals in Norway, with an impact for national public health policy. Arthur Frank's dialogical narrative analysis was applied to personal stories from 65 persons self-referring to different categories of queer identities, submitted online anonymously to a Norwegian national archive for queer history. A purposive sample of three different stories were selected due to their capacity to illuminate how various aspects of minority stress are narrated in diverse interplays between individual voices and resources, and cultural scripts and societal influences. Our analysis highlighted how stories may offer significant glimpses into the dynamic and complex fashioning of sexual identities, giving precious clues to the vulnerabilities and strengths of the narrator. Contemporary queer narratives from Norway reflect meaning-making related to sexual orientation that are influenced by, and expand upon, the classical scripts dominated by tragedy and tristesse, personal progress or simply no particular tension. LGB individuals of different ages and backgrounds had experienced aspects of minority stress related to their sexual orientation, with a substantial impact on identity, even when significant others were encouraging. The stories indicate that positive proximal processes, such as personal resilience and sympathetic environments, can support mental health and counteract negative effects of distal processes contributing to minority stress, such as heteronormativity and subtle microaggression. Public health strategies addressing attitudes to sexual orientation among the general population may contribute to diverse affirmative cultural scripts about queer lives, thereby enhancing queer mental health.

Clinicians with dyslexia: a systematic review of effects and strategies.

PubMed

Locke, Rachel; Scallan, Samantha; Mann, Richard; Alexander, Gail

2015-12-01

For educators, an awareness of the impact of dyslexia on learners in the clinical workplace is vital: first, to be able to identify whether dyslexia may underlie certain traits and behaviours; and second, to be able to provide appropriate advice and support when dyslexia is identified. We reviewed the primary research evidence concerning the effects of dyslexia on clinicians (in or after training) in the workplace, and adaptive strategies ('workarounds') that are presently in use. A systematic search of literature was undertaken, followed by a narrative review of studies selected as meeting the inclusion criteria. The review used a priori research questions and focused on studies based on primary research evidence. The review identified five key studies on qualified doctors or nurses with dyslexia. The impact of dyslexia on doctors can include: writing and calculating prescriptions, writing patient notes, and prioritising and making referrals. Strategies to minimise the effects of dyslexia include the use of adaptive technologies, the need for more time for mentors and supervisors, and an awareness of 'enabling' and 'disabling' environments. An awareness of the impact of dyslexia on learners in the clinical workplace is vital The difficulties associated with dyslexia are varied and may be unexpected. Medical educators must therefore be aware of dyslexia and its impact. When supporting a trainee with dyslexia, there is guidance available but educators may struggle to identify strategies and resources that are evidence based, so further research is required. © 2015 John Wiley & Sons Ltd.

Nihithewak Ithiniwak, Nihithewatisiwin and science education: An exploratory narrative study examining Indigenous-based science education in K--12 classrooms from the perspectives of teachers in Woodlands Cree community contexts

NASA Astrophysics Data System (ADS)

Michell, Herman Jeremiah

This study was guided by the following research questions: What do the stories of teachers in Nihithewak (Woodlands Cree) school contexts reveal about their experiences and tendencies towards cultural and linguistic-based pedagogical practices and actions in K-12 classrooms? How did these teachers come to teach this way? How do their beliefs and values from their experiences in science education and cultural heritage influence their teaching? Why do these teachers do what they do in their science classroom and instructional practices? The research explores Indigenous-based science education from the perspectives and experiences of science teachers in Nihithewak school contexts. Narrative methodology (Clandinin & Connelly, 2000) was used as a basis for collecting and analyzing data emerging from the research process. The results included thematic portraits and stories of science teaching that is connected to Nihithewak and Nihithewatisiwin (Woodlands Cree Way of Life). Major data sources included conversational interviews, out-of-class observations and occasional in-class observations, field notes, and a research journal. An interview guide with a set of open-ended and semi-structured questions was used to direct the interviews. My role as researcher included participation in storied conversations with ten selected volunteer teachers to document the underlying meanings behind the ways they teach science in Nihithewak contexts. This research is grounded in socio-cultural theory commonly used to support the examination and development of school science in Indigenous cultural contexts (Lemke, 2001; O'Loughlin, 1992). Socio-cultural theory is a framework that links education, language, literacy, and culture (Nieto, 2002). The research encapsulates a literature review that includes the history of Aboriginal education in Canada (Battiste & Barman, 1995; Kirkness, 1992; Perley, 1993), Indigenous-based science education (Cajete, 2000; Aikenhead, 2006a), multi-cultural science education (Hines, 2003), worldview theory (Cobern, 1996), personal practical knowledge (Clandinin, 1986), and narrative discourse as a way of knowing (Bruner, 1996) as the basis for examining the nature of science education in Nihithewak cultural contexts. Analysis of the data was compared to the literature under the rubric of Indigenous-based science education. The experiences of teachers and their patterns of responses in the interviews indicate teaching approaches used in Nihithewak cultural contexts are congruent with Indigenous-based science education discourse. In this study, teaching science revolves around connecting students with Nihithewatisiwin , Nihithewak Ithiniwak and their worldview, ways of knowing, culture, values, language, and traditional practices. Teachers shared the importance of connecting school science with the everyday world of students including with Khitiyak, the land, natural seasonal cycles/activities, the animals, and plants, and traditional technologies used for survival. This study is significant because it is the first to explore teacher stories in relation to Indigenous-based science education with a specific focus on the experiences of teachers in Nihithewak contexts. The findings have implications for (pre)(post) service teacher education as well as those who play a supportive role in the development of Indigenous-based science curriculum from place. Although the study revealed patterns of Indigenous based science education in Nihithewak contexts, the goal of narrative research is not to seek generalizations, nor to analyze teachers or the approaches they use.

Paediatric death and dying: exploring coping strategies of health professionals and perceptions of support provision.

PubMed

Forster, Elizabeth; Hafiz, Alaa

2015-06-01

Without question a child's death is a devastating event for parents and families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents and families on this painful journey. This is a delicate and sensitive area of practice and has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of wellbeing. To explore health professionals' perceptions of bereavement support surrounding the loss of a child. The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz's (2006) approach. For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs. Analysis of the narratives also revealed health professionals' perceptions of their support provision. Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

Learning to identify Protected Health Information by integrating knowledge- and data-driven algorithms: A case study on psychiatric evaluation notes.

PubMed

Dehghan, Azad; Kovacevic, Aleksandar; Karystianis, George; Keane, John A; Nenadic, Goran

2017-11-01

De-identification of clinical narratives is one of the main obstacles to making healthcare free text available for research. In this paper we describe our experience in expanding and tailoring two existing tools as part of the 2016 CEGS N-GRID Shared Tasks Track 1, which evaluated de-identification methods on a set of psychiatric evaluation notes for up to 25 different types of Protected Health Information (PHI). The methods we used rely on machine learning on either a large or small feature space, with additional strategies, including two-pass tagging and multi-class models, which both proved to be beneficial. The results show that the integration of the proposed methods can identify Health Information Portability and Accountability Act (HIPAA) defined PHIs with overall F 1 -scores of ∼90% and above. Yet, some classes (Profession, Organization) proved again to be challenging given the variability of expressions used to reference given information. Copyright © 2017. Published by Elsevier Inc.

Changing hospitals, choosing chemotherapy and deciding you've made the right choice: Understanding the role of online support groups in different health decision-making activities.

PubMed

Sillence, Elizabeth; Bussey, Lauren

2017-05-01

To investigate the ways in which people use online support groups (OSGs) in relation to their health decision-making and to identify the key features of the resource that support those activities. Eighteen participants who used OSGs for a range of health conditions participated in qualitative study in which they were interviewed about their experiences of using OSGs in relation to decision-making. Exploration of their experiences was supported by discussion of illustrative quotes. Across the health conditions OSGs supported two main decision-making activities: (i) prompting decision making and (ii) evaluating and confirming decisions already made. Depending on the activity, participants valued information about the process, the experience and the outcome of patient narratives. The importance of forum interactivity was highlighted in relation to advice-seeking and the selection of relevant personal experiences. People use OSGs in different ways to support their health related decision-making valuing the different content types of the narratives and the interactivity provided by the resource. Engaging with OSGs helps people in a number of different ways in relation to decision-making. However, it only forms one part of people's decision-making strategies and appropriate resources should be signposted where possible. Copyright © 2017 Elsevier B.V. All rights reserved.

Positioning, telling, and performing a male illness: Chronic prostatitis/chronic pelvic pain syndrome.

PubMed

Wood, Nicholas; Qureshi, Annum; Mughal, Fahim

2017-11-01

There is a paucity of illness accounts of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), despite a significant level of prevalence and burden of disease. This qualitative study thus elicited twelve accounts from men suffering with CP/CPPS. Narrative analysis was employed, focusing primarily on narrative content. Three major narrative themes were identified: (1) Medical stories: Blame and shame; (2) The Erratic nature of CP/CPPS; and (3) Ongoing struggles for coping and cures and the Search for meaning. Recommendations were made for health care providers and increasing the internal agency, support and activism of men with this debilitating condition. Statement of contribution What is already known on this subject? One qualitative account of this male illness (CP/CPPS) exists: an IPA study. Five cross-sectional themes: (1) Need for repeated confirmation - disease not life-threatening nor leading inexorably towards cancer; (2) Disturbed sleep and fatigue; (3) Concealing pain and problems - 'normalizing'; (4) Enduring pain by performing activities; and (5) Abrupt mood swings and limited sociality. What does this study add? Narrative analysis adds information as to how this illness is managed and survived over time. It challenges the findings (above) by providing an insider perspective. Novel narrative themes include meaning-making amongst others. Masculine performance and experiences are also crucial to this stigmatized illness. © 2017 The British Psychological Society.

Sex and the city in decline: Midnight Cowboy (1969) and Klute (1971).

PubMed

Corkin, Stanley

2010-01-01

This essay looks at two popular and influential films of the late 1960s and early 1970s, which were both shot in New York City: Midnight Cowboy (1969) and Klute (1971). It places them in film history, New York City history, and U.S. urban history more generally, finding that they offer an update on earlier century narratives of the connections between urban areas and deviant sexuality. In this modern version, it is not just a moral tale but also an economic one, where, because of the historical decline of the U.S. city and of New York in particular, sex work becomes a plausible, if unsettling means of support. These films find both narrative and spatial terms for advancing the contemporary antiurban narrative, envisioning New York as an impinging vertical space and seeing possible redemption only in the protagonists leaving the city.

2002 NASA Faculty Fellowship Program at Glenn Research Center

NASA Technical Reports Server (NTRS)

Prahl, Joseph M.; Heyward, Ann O.; Montegani, Francis J.

2003-01-01

While several objectives are served with this program, the central mechanism involved is the conduct of research assignments by faculty in direct support of NASA programs. In general, the results of the research will be assimilated by NASA program managers into an overall effort and will ultimately find their way into the literature. Occasionally, specific assignments result directly in reports for publication or conference presentation. Taken as a body, the assignments represent a large intellectual contribution by the academic community to NASA programs. It is appropriate therefore to summarize the research that was accomplished. The remainder of this report consists of research summaries arranged alphabetically by participant name. For each summary, the faculty fellow is briefly identified and the assignment prepared by the GRC host organization is given. This is followed by a brief narrative, prepared by the fellow, of the research performed. Narratives provided by the accompanying students immediately follow the narratives of their professors.

Automatically pairing measured findings across narrative abdomen CT reports.

PubMed

Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

2013-01-01

Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements.

Definitional ceremonies: narrative practices for psychologists to inform interdisciplinary teams' understanding of children's spirituality in pediatric settings.

PubMed

Moore, Kelsey; Talwar, Victoria; Moxley-Haegert, Linda

2015-03-01

In pediatric settings, parents and children often seek spiritual and religious support from their healthcare provider, as they try to find meaning in their illness. Narrative practices, such as definitional ceremonies, can provide a unique framework for psychologists to explore children's spirituality and its role in the midst of illness. In addition, definitional ceremonies can be used as a means for psychologists to inform interdisciplinary teams' understanding of children's spirituality and its relevance in pediatric treatment settings. In this article, our objectives are to (a) provide a brief overview of the literature on children's spirituality, (b) review some of the literature on childhood cancer patients' spirituality, (c) highlight the importance of whole-person care for diverse pediatric patients, and (d) introduce definitional ceremonies as appropriate narrative practices that psychologists can use to both guide their therapy and inform interdisciplinary teams' understanding of children's spirituality. © The Author(s) 2015.

Automated Assessment of Patients' Self-Narratives for Posttraumatic Stress Disorder Screening Using Natural Language Processing and Text Mining.

PubMed

He, Qiwei; Veldkamp, Bernard P; Glas, Cees A W; de Vries, Theo

2017-03-01

Patients' narratives about traumatic experiences and symptoms are useful in clinical screening and diagnostic procedures. In this study, we presented an automated assessment system to screen patients for posttraumatic stress disorder via a natural language processing and text-mining approach. Four machine-learning algorithms-including decision tree, naive Bayes, support vector machine, and an alternative classification approach called the product score model-were used in combination with n-gram representation models to identify patterns between verbal features in self-narratives and psychiatric diagnoses. With our sample, the product score model with unigrams attained the highest prediction accuracy when compared with practitioners' diagnoses. The addition of multigrams contributed most to balancing the metrics of sensitivity and specificity. This article also demonstrates that text mining is a promising approach for analyzing patients' self-expression behavior, thus helping clinicians identify potential patients from an early stage.

System Architecture for Temporal Information Extraction, Representation and Reasoning in Clinical Narrative Reports

PubMed Central

Zhou, Li; Friedman, Carol; Parsons, Simon; Hripcsak, George

2005-01-01

Exploring temporal information in narrative Electronic Medical Records (EMRs) is essential and challenging. We propose an architecture for an integrated approach to process temporal information in clinical narrative reports. The goal is to initiate and build a foundation that supports applications which assist healthcare practice and research by including the ability to determine the time of clinical events (e.g., past vs. present). Key components include: (1) a temporal constraint structure for temporal expressions and the development of an associated tagger; (2) a Natural Language Processing (NLP) system for encoding and extracting medical events and associating them with formalized temporal data; (3) a post-processor, with a knowledge-based subsystem to help discover implicit information, that resolves temporal expressions and deals with issues such as granularity and vagueness; and (4) a reasoning mechanism which models clinical reports as Simple Temporal Problems (STPs). PMID:16779164

Structure and strategies in children's educational television: the roles of program type and learning strategies in children's learning.

PubMed

Linebarger, Deborah L; Piotrowski, Jessica Taylor

2010-01-01

Educational TV has been consistently linked to children's learning. In this research, educational TV characteristics were identified, coded, and tested for their influence on children's program-specific comprehension and vocabulary outcomes. Study 1 details a content analysis of TV features including a program's macrostructure (i.e., narrative or expository) and learning strategies embedded in the macrostructure that support learning in print-based contexts. In Study 2, regression analyses were used to predict outcomes involving 71 second and third graders (average age=7.63 years). Strategies were categorized as organizing, rehearsing, elaborating, or affective in function. Outcomes were uniformly higher for narrative macrostructures. Strategies used in narratives predicted relatively homogenous relations across outcomes, whereas strategies in expositories predicted quite heterogeneous relations across outcomes. © 2010 The Authors. Child Development © 2010 Society for Research in Child Development, Inc.

Awareness and Awakening: A Narrative-Oriented Inquiry of Undergraduate Students' Development of Mindful Agency in China

PubMed Central

Wang, Qing; Law, Ho Chung; Li, Yan; Xu, Zhanfei; Pang, Weiguo

2017-01-01

The article explores undergraduate students' experiences of developing mindful agency as a positive learning disposition, their perceived change as a learner, and the possible impact of mindful agency coaching on students' learning and personal growth, using a narrative research method. Seventy Chinese undergraduate students generated personal reflective journals and eight participants' journals were selected to enter into the narrative-oriented inquiry. Our analysis revealed a number of primary themes based on which we produced a meta-story. The supplements of the story were exacted for further critical cross-case discussion. The finding indicated that the multifaceted development of mindful agency involved learning methods, emotional regulation, strategic thinking, and awareness of planning, openness to experience, self-acceptance and self-esteem, and learning engagement, with enhanced sense of personal awareness and awakening. The coaching was supportive for students to foster positive self-identities and become more reflective, mindful, and self-determined. PMID:29209260

Reproduction of cultural values: a cross-cultural examination of stories people create and transmit.

PubMed

Imada, Toshie; Yussen, Steven R

2012-01-01

Narratives are one of the oldest and universal forms of communication in human societies. In the present research, the authors hypothesized that narratives play an important role in the reproduction of cultural values. To test this idea, Study 1 examined the contents of stories created by American and Japanese participants for their reflection of individualistic and collectivistic values, and Study 2 examined whether information consistent with cultural values would be more likely to be retained and passed onto others. The studies found that American participants created stories that reflected individualistic values and retained more individualistic information than collectivistic information when they transmitted a story to others. In contrast, Japanese participants created stories that reflected collectivistic values and retained more collectivistic information than individualistic information when they transmitted a story to others. These findings support the idea that narrative communication is an important part of cultural reproduction mechanism.

Hidden Voices in Higher Education: Inclusive Policies and Practices in Social Science and Law Classrooms

ERIC Educational Resources Information Center

López Gavira, Rosario; Moriña, Anabel

2015-01-01

This paper pertains to a broader biographical-narrative research project which studies barriers and support as identified by students with disabilities at a Spanish University ["Barriers and Support That Disabled Students Identify in the University". Project funded by the Spanish Ministry of Science and Innovation (Dir. Dr Anabel Moriña;…

Youth Rising: Centering Youth Voice in the Quest for Equitable and Inclusive Schools. Equity by Design

ERIC Educational Resources Information Center

Gonzalez, Taucia; Love, Larry D.; Johnson, Mary L.; Picón, Ninoska; Velázquez, Josué

2017-01-01

This Equity Brief focuses on disrupting the dominant narratives around inclusion by asking the question, "Whose Voice Matters" in creating inclusive schools. Ensuring that youth from historically marginalized groups have leadership opportunities and have their voices heard is one way to support and empower them. Supporting students of…

Using Modeled Writing to Support English-Only and English-Learner Second-Grade Students

ERIC Educational Resources Information Center

Mohr, Kathleen A. J.

2017-01-01

This study compared 70 English learners (ELs) and English-only (EO) second-grade students' writing samples before and after a yearlong writing program. The school utilized Write From the Beginning (J. Buckner, 2006) and focused on personal narratives. A subgroup of students also participated in an intervention supporting expository writing on…

Using Narrative-Based Design Scaffolds within a Mobile Learning Environment to Support Learning Outdoors with Young Children

ERIC Educational Resources Information Center

Seely, Brian J.

2015-01-01

This study aims to advance learning outdoors with mobile devices. As part of the ongoing Tree Investigators design-based research study, this research investigated a mobile application to support observation, identification, and explanation of the tree life cycle within an authentic, outdoor setting. Recognizing the scientific and conceptual…

Advancing Development of Intercultural Competence through Supporting Predictions in Narrative Video

ERIC Educational Resources Information Center

Ogan, Amy; Aleven, Vincent; Jones, Christopher

2009-01-01

Most successes in intelligent tutoring systems have come in well-defined domains like algebra or physics. We investigate how to support students in acquiring ill-defined skills of intercultural competence using an online environment that employs clips of feature films from a target culture. To test the effectiveness of a set of attention-focusing…

Participation of Internationally-Educated Professionals in an Initial Teacher Education Bachelor of Education Degree Program: Challenges and Supports

ERIC Educational Resources Information Center

Chassels, Caroline

2010-01-01

This paper examines challenges and supports experienced by internationally educated immigrants who participated as adult students in an Initial Teacher Education Bachelor of Education degree program in Ontario as part of their strategy to begin new careers as teachers. The narrative of one participant, a Chinese-educated meteorologist and…

An Exploration of Support Factors Available to Higher Education Students with High Functioning Autism or Asperger Syndrome

ERIC Educational Resources Information Center

Rutherford, Emily N.

2013-01-01

This qualitative phenomenological research study used narrative inquiry to explore the support factors available to students with High Functioning Autism or Asperger Syndrome in higher education that contribute to their success as perceived by the students. Creswell's (2009) six step method for analyzing phenomenological studies was used to…

Examining the Role of Web 2.0 Tools in Supporting Problem Solving during Case-Based Instruction

ERIC Educational Resources Information Center

Koehler, Adrie A.; Newby, Timothy J.; Ertmer, Peggy A.

2017-01-01

As learners solve complex problems, such as the ones present in case narratives, they need instructional support. Potentially, Web 2.0 applications can be useful to learners during case-based instruction (CBI), as their affordances offer creative and collaborative opportunities. However, there is limited research available on how the affordances…

Teachers' Experiences of Induction Coaching: A Narrative Retrospective Inquiry

ERIC Educational Resources Information Center

Clark, Jodi L.

2017-01-01

It is well established that beginning teachers need support to bridge the gap from college teacher preparation to the classroom setting (Fletcher & Strong, 2009; Wong, 2003). In fact, lack of support in this transition has been identified as a leading factor that causes beginning teachers to leave the profession at high rates early in their…

A Guide for Designing and Implementing a Case Processing System for Child Support Enforcement.

ERIC Educational Resources Information Center

Office of Child Support Enforcement (DHHS), Washington, DC.

This document was written to provide state and local child support offices with help in refining their case processing systems. The guide is divided into five chapters. Chapter I, Case Processing Overview, defines case processing and the case processing functions and provides a narrative description and graphic illustration of the processes…

Geoscience Videos and Their Role in Supporting Student Learning

ERIC Educational Resources Information Center

Wiggen, Jennifer; McDonnell, David

2017-01-01

A series of short (5 to 7 minutes long) geoscience videos were created to support student learning in a flipped class setting for an introductory geology class at North Carolina State University. Videos were made using a stylus, tablet, microphone, and video editing software. Essentially, we narrate a slide, sketch a diagram, or explain a figure…

What's in a story? A text analysis of burn survivors' web-posted narratives.

PubMed

Badger, Karen; Royse, David; Moore, Kelly

2011-01-01

Story-telling has been found to be beneficial following trauma, suggesting a potential intervention for burn survivors who frequently make use of? telling their story? as part of their recovery. This study is the first to examine the word content of burn survivors' Web-posted narratives to explore their perceptions of the event, supportive resources, their post-burn well-being, and re-integration using a comparison group and a text data analysis software developed by the widely recognized James Pennebaker. Suggestions for using expressive writing or story-telling as a guided psychosocial intervention with burn survivors are made.

Markup of temporal information in electronic health records.

PubMed

Hyun, Sookyung; Bakken, Suzanne; Johnson, Stephen B

2006-01-01

Temporal information plays a critical role in the understanding of clinical narrative (i.e., free text). We developed a representation for marking up temporal information in a narrative, consisting of five elements: 1) reference point, 2) direction, 3) number, 4) time unit, and 5) pattern. We identified 254 temporal expressions from 50 discharge summaries and represented them using our scheme. The overall inter-rater reliability among raters applying the representation model was 75 percent agreement. The model can contribute to temporal reasoning in computer systems for decision support, data mining, and process and outcomes analyses by providing structured temporal information.

[Learning by doing? The restructuring of nursing education after 1945].

PubMed

Kreutzer, Susanne

2007-01-01

This study deals with the reform of nursing education on a day-to-day level and exemplifies the dramatic change in the image of nursing in the 1960s, when the erstwhile religious calling was transformed into a modern-day female profession. The analysis is based on interviews with two different groups of nurses who were educated between the 1930s and 1960s. The first group is composed of the deaconesses of a Protestant mother-house in Hannover (Henriettenstiftung). The second group is formed by nurses who were noted for their important role in the professionalisation of nursing in West Germany. The methodology of this study draws on the experiences of the practice of oral history which reflects the actual context of the narratives, the problem of commemoration and the relationship between individual and collective memory. Nursing education, as late as the 1950s, was based on practical experience. The nursing students were responsible for a certain number of patients from the very first day of their training. Comparison of the different narratives shows that such an experience-based training principle was bound to a specific, family-like concept of nursing which was supported by the sisterhoods. This traditional system of nursing education changed essentially in the 1960s when knowledge based on experience lost a great deal of its meaning, while a theory-based training took preference. Furthermore, the regulation and fragmentation of nursing education increased significantly. The outcome was that continuity in caring for patients decreased dramatically in the 1960s and it became much more difficult to learn how to observe the sick and to demand confidence in dealing with patients. The reform of nursing education also had far-reaching consequences for the construction of everyday life in the wards as the students had previously undertaken a major part of the work.

A recipe for mealtime resilience for families living with dementia.

PubMed

Wong, Fiona; Keller, Heather H; Schindel Martin, Lori; Sutherland, Olga

2015-09-01

To date, research delving into the narratives of persons living with dementia is limited. Taking part in usual mealtime activities such as preparing food can sustain the identity of persons living with dementia. Yet if capacity for mealtime activities changes, this can put a strain or demand on the family, which must adjust and adapt to these changes. The aim of this study was to develop an in-depth story of resilience in one family living with dementia that was experiencing mealtime changes. Thematic narrative analysis following the elements of Clandinin and Connelly's (2000) 3D narrative inquiry space was used. One family's dementia journey was highlighted using the metaphor of a baking recipe to reflect their story of resilience. Developing positive strategies and continuing to learn and adapt were the two approaches used by this resilient family. Reminiscing, incorporating humour, having hope and optimism, and establishing social support were specific strategies. This family continued to learn and adapt by focusing on their positive gains and personal growth, accumulating life experiences, and balancing past pleasures while adapting to the new normal. Future work needs to further conceptualise resilience and how it can be supported in families living with dementia. © 2014 Nordic College of Caring Science.

“To Work Just Like Anyone Else”—A Narrative from a Man Aging with Spinal Cord Injury

PubMed Central

Lilja, Margareta; Isaksson, Gunilla

2017-01-01

People aging with spinal cord injury (SCI) develop medical problems commonly associated with the aging process at a younger age than the general population. However, research about how the life story changes and how meaning will be experienced in occupations is lacking. The aim was to describe and offer an explanation of how a man experienced meaning in everyday occupations while aging with an SCI. Four narrative interviews were performed over a four-year period, with a man in his fifties, who lived with SCI for 39 years. The narrative analysis generated an overall plot, named “To Work Just Like Anyone Else,” and gives a picture of his experiences, thoughts, and reflections about meaning in occupations, from when he became injured to the present, and in relation to his future. His life story is characterized by secondary health complications, and his experiences of negotiating with the aging body and making choices to continue working. Further, how occupational risk factors, e.g., imbalance, alienation, and deprivation, occur as a result of lack of rehabilitation and support from social systems is addressed. Future research should explore how rehabilitation and social systems can support people aging with SCI to experience meaning in everyday occupations and to have balance in everyday life. PMID:29120355

"To Work Just Like Anyone Else"-A Narrative from a Man Aging with Spinal Cord Injury.

PubMed

Lundström, Ulrica; Lilja, Margareta; Isaksson, Gunilla

2017-11-09

People aging with spinal cord injury (SCI) develop medical problems commonly associated with the aging process at a younger age than the general population. However, research about how the life story changes and how meaning will be experienced in occupations is lacking. The aim was to describe and offer an explanation of how a man experienced meaning in everyday occupations while aging with an SCI. Four narrative interviews were performed over a four-year period, with a man in his fifties, who lived with SCI for 39 years. The narrative analysis generated an overall plot, named "To Work Just Like Anyone Else," and gives a picture of his experiences, thoughts, and reflections about meaning in occupations, from when he became injured to the present, and in relation to his future. His life story is characterized by secondary health complications, and his experiences of negotiating with the aging body and making choices to continue working. Further, how occupational risk factors, e.g., imbalance, alienation, and deprivation, occur as a result of lack of rehabilitation and support from social systems is addressed. Future research should explore how rehabilitation and social systems can support people aging with SCI to experience meaning in everyday occupations and to have balance in everyday life.

Informativeness ratings of messages created on an AAC processing prosthesis

PubMed Central

Bartlett, Megan R.; Fink, Ruth B.; Schwartz, Myrna F.; Linebarger, Marcia

2008-01-01

Background SentenceShaper™ (SSR) is a computer program that supports spoken language production in aphasia by recording and storing the fragments that the user speaks into the microphone, making them available for playback and allowing them to be combined and integrated into larger structures (i.e., sentences and narratives). A prior study that measured utterance length and grammatical complexity in story-plot narratives produced with and without the aid of SentenceShaper demonstrated an “aided effect” in some speakers with aphasia, meaning an advantage for the narratives that were produced with the support of this communication aid (Linebarger, Schwartz, Romania, Kohn, & Stephens, 2000). The present study deviated from Linebarger et al.’s methods in key respects and again showed aided effects of SentenceShaper in persons with aphasia. Aims Aims were (1) to demonstrate aided effects in “functional narratives” conveying hypothetical real-life situations from a first person perspective; (2) for the first time, to submit aided and spontaneous speech samples to listener judgements of informativeness; and (3) to produce preliminary evidence on topic-specific carryover from SentenceShaper, i.e., carryover from an aided production to a subsequent unaided production on the same topic. Methods & Procedures Five individuals with chronic aphasia created narratives on two topics, under three conditions: Unaided (U), Aided (SSR), and Post-SSR Unaided (Post-U). The 30 samples (5 participants, 2 topics, 3 conditions) were randomised and judged for informativeness by graduate students in speech-language pathology. The method for rating was Direct Magnitude Estimation (DME). Outcomes & Results Repeated measures ANOVAs were performed on DME ratings for each participant on each topic. A main effect of Condition was present for four of the five participants, on one or both topics. Planned contrasts revealed that the aided effect (SSR >U) was significant in each of these cases. For two participants, there was also topic-specific carryover (Post-U >U). Conclusions Listeners judged functional narratives generated on SentenceShaper to be more informative than comparable narratives spoken spontaneously. This extends the evidence for aided effects of SentenceShaper. There was also evidence, albeit weaker, for topic-specific carryover, suggesting that the program might be used effectively to practise for upcoming face-to-face interactions. PMID:18648580

The Persistence of the Self over Time in Mild Cognitive Impairment and Alzheimer's Disease

PubMed Central

Tippett, Lynette J.; Prebble, Sally C.; Addis, Donna Rose

2018-01-01

Diachronic unity is the belief that, despite changes, we are the same person across the lifespan. We propose that diachronic unity is supported by the experience of remembering the self over time during episodic recall (i.e., phenomenological continuity). However, we also predict that diachronic unity is also possible when episodic memory is impaired, as long as the ability to construct life narratives from semantic memory (i.e., semantic continuity) is intact. To examine this prediction, we investigated diachronic unity in Alzheimer's Disease (AD) and amnestic mild cognitive impairment (aMCI), two conditions characterised by disrupted phenomenological continuity. If semantic continuity is also altered in these conditions, there should be an associated deterioration in diachronic unity. Participants with AD, aMCI, and healthy controls (HC) completed a self-persistence interview measuring diachronic unity (beliefs about self-persistence, explanations for stability/change). Semantic continuity was assessed with a life-story interview measuring autobiographical reasoning (self-event connections), and coherence (temporal/thematic/causal) of narratives. Our results highlight a complex relationship between semantic continuity and diachronic unity and revealed a divergence between two aspects of diachronic unity: AD/aMCI groups did not differ from HC in continuity beliefs, but AD explanations for self-persistence were less sophisticated. Semantic continuity was most impaired in AD: their narratives had fewer self-event connections (vs. HCs) and lower temporal/thematic coherence (vs. HC/aMCI), while both AD/aMCI groups had lower causal coherence. Paradoxically AD participants who scored higher on measures of beliefs in the persistence of the core self, provided less sophisticated explanations for their self-persistence and were less able to explore persistence in their life narratives. These findings support the importance of semantic continuity to diachronic unity, but suggest a more nuanced and multifaceted relationship than originally proposed in our model. In AD, diminished life narratives that retain features of cultural life scripts are sufficient for strong subjective beliefs of self-persistence, but not for sophisticated explanations about persistence. Better semantic continuity, with the ability to weave high-quality life narratives, may scaffold the capacity to understand and explain one's diachronic unity, but this produces less surety about self-persistence. PMID:29515473

"A cool little buzz": alcohol intoxication in the dance club scene.

PubMed

Hunt, Geoffrey; Moloney, Molly; Fazio, Adam

2014-06-01

In recent years, there has been increasing concern about youthful "binge" drinking and intoxication. Yet the meaning of intoxication remains under-theorized. This paper examines intoxication in a young adult nightlife scene, using data from a 2005-2008 National Institute on Drug Abuse-funded project on Asian American youth and nightlife. Analyzing in-depth qualitative interview data with 250 Asian American young adults in the San Francisco area, we examine their narratives about alcohol intoxication with respect to sociability, stress, and fun, and their navigation of the fine line between being "buzzed" and being "wasted." Finally, limitations of the study and directions for future research are noted.

Inviting the breach: confronting homophobia in the name of social justice.

PubMed

Robinson, Subrina J; Johnson, Julia R; Rich, Marc D

2015-01-01

In 2008 California was divided over Proposition 8, a measure designed to prohibit same-sex marriage. In this article, we focus on a university classroom setting to explore how discussions about Proposition 8 and homophobia led to what Turner (1986) termed a social drama. Drawing on student personal narratives as they moved through the stages of social drama, we provide a poignant example of the conflict that may erupt when homophobia and heteronormativity are part of the curriculum. After documenting the social drama, we offer pedagogical strategies and note the strategic ways Christian, hegemonic discourse is utilized during discussions about homophobia.

Arts, literature and reflective writing as educational strategies to promote narrative reasoning capabilities among physiotherapy students.

PubMed

Caeiro, Carmen; Cruz, Eduardo Brazete; Pereira, Carla Mendes

2014-11-01

The use of arts, literature and reflective writing has becoming increasingly popular in health professionals education. However, research examining its contribution as an educational strategy to promote narrative reasoning capabilities is limited, particularly from the students' perspective. This study aimed to explore the final year physiotherapy students' perspectives about the contribution of arts, literature and reflective writing in facilitating narrative reasoning capabilities. Three focus group meetings using a semi-structured interview schedule were carried out to collect data. Focus group sessions were audiotaped and transcribed verbatim. Interpretative phenomenological analysis was used to conduct the study and analyze the transcripts. Three themes emerged: (1) developmental understanding of the patients' experiences; (2) developmental understanding about the self; and (3) embedding reflection in clinical practice. Students emphasized an increasing capability to be sensitive and vicariously experience the patient's experience. Through reflective writing, students reported they became more capable of thinking critically about their practice and learning needs for continuous professional development. Finally, students highlighted the contribution of these strategies in making reflection part of their practice. Final year physiotherapy students reported enhanced skills of narrative reasoning. The findings support the inclusion of these strategies within the undergraduate physiotherapy curricula.

Adding Audio Supported Smartboard Lectures to an Introductory Astronomy Online Laboratory

NASA Astrophysics Data System (ADS)

Lahaise, U. G. L.

2003-12-01

SMART Board(TM) and RealProducer(R) Plus technologies were used to develop a series of narrated pre-lab introductory online lectures. Smartboard slides were created by capturing images from internet pages and power point slides, then annotated and saved as web pages using smartboard technology. Short audio files were recorded using the RealProducer Plus software which were then linked to individual slides. WebCT was used to deliver the online laboratory. Students in an Introductory Astronomy of the Solar System Online laboratory used the lectures to prepare for laboratory exercises. The narrated pre-lab lectures were added to six out of eight suitable laboratory exercises. A survey was given to the students to research their online laboratory experience, in general, and the impact of the narrated smartboard lectures on their learning success, specifically. Data were collected for two accelerated sessions. Results show that students find the online laboratory equally hard or harder than a separate online lecture. The accelerated format created great time pressure which negatively affected their study habits. About half of the students used the narrated pre-lab lectures consistently. Preliminary findings show that lab scores in the accelerated sessions were brought up to the level of full semester courses.

Using a Narrative Film to Increase Knowledge and Interpersonal Communication About Psychosis Among Latinos.

PubMed

Hernandez, Maria Y; Mejia, Yesenia; Mayer, Doe; Lopez, Steven R

2016-12-01

Narrative communication is effective in increasing public awareness while generating dialogue about varied health topics. The current study utilized narrative communication in the form of a 15-minute motivational film titled La CLAve to help Latinos recognize symptoms of psychosis and begin a discussion about serious mental illness. The study aimed to explore the participants' response to the film and whether the film led to further dialogue about psychosis. Four focus groups were conducted with 40 Spanish-speaking participants, mostly foreign-born Latinas, with a mean age of 49 years. Results indicate that participants engaged with the film as reflected in their ability to recall the storyline in detail. Reports of psychosis knowledge gains included recognition of key symptoms, such as hallucinations and disorganized speech. Participants attributed symptoms of psychosis, observed in a film character, to social stressors and other previously constructed views of mental illness. Many participants discussed the content of the film within their immediate social networks. Other findings include discussions of key barriers and facilitators to seeking mental health treatment among Latino families, such as denial and family support. Results suggest that narrative films offer a promising strategy to stimulate dialogue about serious mental illness among Latinos.

Experienced speech-language pathologists' responses to ethical dilemmas: an integrated approach to ethical reasoning.

PubMed

Kenny, Belinda; Lincoln, Michelle; Balandin, Susan

2010-05-01

To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.

Factors influencing return to work: a narrative study of women treated for breast cancer.

PubMed

Johnsson, A; Fornander, T; Rutqvist, L E; Olsson, M

2010-05-01

The purpose of this qualitative study was to identify factors contributing to a successful return to the labour market after treatment for breast cancer from the women's own perspective. The study is based on 16 narratives - open-ended, in-depth interviews - about women's experiences and thoughts from the period after breast cancer surgery when they focused on their return to work. The women were recruited from participants of a multicentre trial, which allowed comparisons across a range of adjuvant therapies. The narratives of women who worked full time at a cut-off point of 1 year after surgery are analysed separately from the narratives of women still sick-listed at that point of time. The findings show that while all the women strove to belong to the labour market, the study also reveals changes in women's perceptions of the value of employment. The quality of social support received from employers and coworkers differed between women who returned to work and those still sick-listed 1 year after breast cancer treatment. A need to design interventions focusing on the work arena of women treated for breast cancer is pointed out.

Searching the ASRS Database Using QUORUM Keyword Search, Phrase Search, Phrase Generation, and Phrase Discovery

NASA Technical Reports Server (NTRS)

McGreevy, Michael W.; Connors, Mary M. (Technical Monitor)

2001-01-01

To support Search Requests and Quick Responses at the Aviation Safety Reporting System (ASRS), four new QUORUM methods have been developed: keyword search, phrase search, phrase generation, and phrase discovery. These methods build upon the core QUORUM methods of text analysis, modeling, and relevance-ranking. QUORUM keyword search retrieves ASRS incident narratives that contain one or more user-specified keywords in typical or selected contexts, and ranks the narratives on their relevance to the keywords in context. QUORUM phrase search retrieves narratives that contain one or more user-specified phrases, and ranks the narratives on their relevance to the phrases. QUORUM phrase generation produces a list of phrases from the ASRS database that contain a user-specified word or phrase. QUORUM phrase discovery finds phrases that are related to topics of interest. Phrase generation and phrase discovery are particularly useful for finding query phrases for input to QUORUM phrase search. The presentation of the new QUORUM methods includes: a brief review of the underlying core QUORUM methods; an overview of the new methods; numerous, concrete examples of ASRS database searches using the new methods; discussion of related methods; and, in the appendices, detailed descriptions of the new methods.

Effective Information Extraction Framework for Heterogeneous Clinical Reports Using Online Machine Learning and Controlled Vocabularies.

PubMed

Zheng, Shuai; Lu, James J; Ghasemzadeh, Nima; Hayek, Salim S; Quyyumi, Arshed A; Wang, Fusheng

2017-05-09

Extracting structured data from narrated medical reports is challenged by the complexity of heterogeneous structures and vocabularies and often requires significant manual effort. Traditional machine-based approaches lack the capability to take user feedbacks for improving the extraction algorithm in real time. Our goal was to provide a generic information extraction framework that can support diverse clinical reports and enables a dynamic interaction between a human and a machine that produces highly accurate results. A clinical information extraction system IDEAL-X has been built on top of online machine learning. It processes one document at a time, and user interactions are recorded as feedbacks to update the learning model in real time. The updated model is used to predict values for extraction in subsequent documents. Once prediction accuracy reaches a user-acceptable threshold, the remaining documents may be batch processed. A customizable controlled vocabulary may be used to support extraction. Three datasets were used for experiments based on report styles: 100 cardiac catheterization procedure reports, 100 coronary angiographic reports, and 100 integrated reports-each combines history and physical report, discharge summary, outpatient clinic notes, outpatient clinic letter, and inpatient discharge medication report. Data extraction was performed by 3 methods: online machine learning, controlled vocabularies, and a combination of these. The system delivers results with F1 scores greater than 95%. IDEAL-X adopts a unique online machine learning-based approach combined with controlled vocabularies to support data extraction for clinical reports. The system can quickly learn and improve, thus it is highly adaptable. ©Shuai Zheng, James J Lu, Nima Ghasemzadeh, Salim S Hayek, Arshed A Quyyumi, Fusheng Wang. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 09.05.2017.

Using voice to create hospital progress notes: Description of a mobile application and supporting system integrated with a commercial electronic health record.

PubMed

Payne, Thomas H; Alonso, W David; Markiel, J Andrew; Lybarger, Kevin; White, Andrew A

2018-01-01

We describe the development and design of a smartphone app-based system to create inpatient progress notes using voice, commercial automatic speech recognition software, with text processing to recognize spoken voice commands and format the note, and integration with a commercial EHR. This new system fits hospital rounding workflow and was used to support a randomized clinical trial testing whether use of voice to create notes improves timeliness of note availability, note quality, and physician satisfaction with the note creation process. The system was used to create 709 notes which were placed in the corresponding patient's EHR record. The median time from pressing the Send button to appearance of the formatted note in the Inbox was 8.8 min. It was generally very reliable, accepted by physician users, and secure. This approach provides an alternative to use of keyboard and templates to create progress notes and may appeal to physicians who prefer voice to typing. Copyright © 2017 Elsevier Inc. All rights reserved.

Creating stories for learning about the neonatal care experience through the eyes of student nurses: An interpretive, narrative study.

PubMed

Petty, Julia

2017-01-01

Storytelling is an increasingly well recognised and valued platform to learn about the human experience within healthcare. Little is known however about how stories can enhance understanding in neonatal care, a specialised field offering rich opportunities for learning. This study focuses on the creation of stories based on the experiences of student nurses to inform teaching and learning strategies in the neonatal field. The study aimed to create stories from the narratives of student nurses working within the neonatal field and identify what key themes for learning emerged in order to develop a storytelling resource to share experiences with their peers. An interpretive, constructivist approach was used to collect, analyse and create stories from student nurse's experiences, in line with narrative inquiry. Six pre-registration children's nursing students were selected by purposive sampling. Interviews were undertaken within six weeks following placement completion in an agreed location. Narratives were obtained by semi-structured interviews. Narrative analysis and core story creation was undertaken to construct stories and key learning themes emerged which provided the pedagogical basis for subsequent digital resource development. Key themes emerged relating to the insight and observances of student nurses and the neonatal journey they had experienced, including the nature of neonatal care, experiences of the neonate and parents, the environment and their own learning transition. Preliminary peer evaluation of the storytelling resource revealed storytelling as an interesting and novel approach to teaching & learning, learning from ones' peers, preparation for practice and a valuable insight into a new specialist area. The study has value to teaching and learning by enabling an appreciation of how narrative can be used to portray the experiences of learners. Findings also support an approach to analysing narrative to create stories for learning and inform subsequent digital resource development. Copyright © 2016 Elsevier Ltd. All rights reserved.