Sun, Weiyi; Rumshisky, Anna; Uzuner, Ozlem
Temporal information in clinical narratives plays an important role in patients' diagnosis, treatment and prognosis. In order to represent narrative information accurately, medical natural language processing (MLP) systems need to correctly identify and interpret temporal information. To promote research in this area, the Informatics for Integrating Biology and the Bedside (i2b2) project developed a temporally annotated corpus of clinical narratives. This corpus contains 310 de-identified discharge summaries, with annotations of clinical events, temporal expressions and temporal relations. This paper describes the process followed for the development of this corpus and discusses annotation guideline development, annotation methodology, and corpus quality. Copyright © 2013 Elsevier Inc. All rights reserved.
Cross-border reproductive care has been thrust under the international spotlight by a series of recent scandals. These have prompted calls to develop more robust means of assessing the exploitative potential of such practices and the need for overarching and normative forms of national and international regulation. Allied theorisations of the emergence of forms of clinical labour have cast the outsourcing of reproductive services such as gamete donation and gestational surrogacy as artefacts of a wider neoliberalisation of service provision. These accounts share with many other narratives of neoliberalism a number of key assertions that relate to the presumed organisation of labour relations within this paradigm. This article critically engages with four assumptions implicit in these accounts: that clinical labourers constitute a largely homogeneous underclass of workers; that reproductive labour has been contractualised in ways that disembed it from wider social and communal relations; that contractualisation can provide protection for clinical labour lessening the need for formal regulatory oversight; and that the transnationalisation of reproductive service labour is largely unidirectional and characterised by a dynamic of provision in which 'the rest' services 'the West'. Drawing on the first findings of a large-scale ethnographic research project into assisted reproduction in India I provide evidence to refute these assertions. In so doing the article demonstrates that while the outsourcing and contractualisation of reproductive labour may be embedded in a wider neoliberal paradigm these practices cannot be understood nor their impacts be fully assessed in isolation from their social and cultural contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Narrative Based Medicine (NBM) can be defined as follows; a) It views the patient's illness as an unfolding story within the wider story of the patient's life and life-world; b) It acknowledges the patient as the narrator of the story and the subject of the tale; c) It recognizes that all medical theories, hypothesis and pathophysiologies as socially constructed narratives and accepts the coexistence of multiple different narratives; d) It regards the emergence of new stories from dialogue and discourse between patients and healthcare professionals as part of the treatment. Because psychiatry is the only area of specialist medicine where talking and listening are explicitly understood to be therapeutic, NBM can be adopted an effective perspective and method in psychiatry.
Bliss, Lynn S.; McCabe, Allyssa
A study was conducted to examine the misdiagnosis of cultural difference deficits and how mistaking deficits in narrative production for cultural differences can be avoided. Findings reveal the implications for intervention.
Sun, Weiyi; Rumshisky, Anna; Uzuner, Ozlem
To improve the normalization of relative and incomplete temporal expressions (RI-TIMEXes) in clinical narratives. We analyzed the RI-TIMEXes in temporally annotated corpora and propose two hypotheses regarding the normalization of RI-TIMEXes in the clinical narrative domain: the anchor point hypothesis and the anchor relation hypothesis. We annotated the RI-TIMEXes in three corpora to study the characteristics of RI-TMEXes in different domains. This informed the design of our RI-TIMEX normalization system for the clinical domain, which consists of an anchor point classifier, an anchor relation classifier, and a rule-based RI-TIMEX text span parser. We experimented with different feature sets and performed an error analysis for each system component. The annotation confirmed the hypotheses that we can simplify the RI-TIMEXes normalization task using two multi-label classifiers. Our system achieves anchor point classification, anchor relation classification, and rule-based parsing accuracy of 74.68%, 87.71%, and 57.2% (82.09% under relaxed matching criteria), respectively, on the held-out test set of the 2012 i2b2 temporal relation challenge. Experiments with feature sets reveal some interesting findings, such as: the verbal tense feature does not inform the anchor relation classification in clinical narratives as much as the tokens near the RI-TIMEX. Error analysis showed that underrepresented anchor point and anchor relation classes are difficult to detect. We formulate the RI-TIMEX normalization problem as a pair of multi-label classification problems. Considering only RI-TIMEX extraction and normalization, the system achieves statistically significant improvement over the RI-TIMEX results of the best systems in the 2012 i2b2 challenge. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Reimer Kirkham, Sheryl; Van Hofwegen, Lynn; Hoe Harwood, Catherine
The nursing profession has renewed its commitment to social and political mandates, resulting in increasing attention to issues pertaining to diversity, vulnerable populations, social determinants of health, advocacy and activism, and social justice in nursing curricula. Narratives from a qualitative study examining undergraduate nursing student learning in five innovative clinical settings (corrections, international, parish, rural, and aboriginal) resonate with these curricular emphases. Data were derived from focus groups and interviews with 65 undergraduate nursing students, clinical instructors, and RN mentors. Findings of this study reveal how students in innovative clinical placements bear witness to poverty, inequities, and marginalization (critical awareness), often resulting in dissonance and soul-searching (critical engagement), and a renewed commitment to social transformation (social change). These findings suggest the potential for transformative learning in these settings.
Bhuvaneswar, Chaya; Shafer, Audrey
Narratives by survivors of abuse offer compelling entries into the experiences of abuse and its effects on health. Reading such stories can enlarge the clinician's understanding of the complexities of abuse. Furthermore, attention to narrative can enhance the therapeutic options for abuse victims not only in mental health arenas, but also in other medical contexts. In this article we define the genre of survivor narratives, examine one such narrative in particular (Push by Sapphire, 1996), and explore the clinical implications of narrative in abuse victims' clinical care.
Moen, Hans; Peltonen, Laura-Maria; Koivumäki, Mikko; Suhonen, Henry; Salakoski, Tapio; Ginter, Filip; Salanterä, Sanna
We report on the development and evaluation of a prototype tool aimed to assist laymen/patients in understanding the content of clinical narratives. The tool relies largely on unsupervised machine learning applied to two large corpora of unlabeled text - a clinical corpus and a general domain corpus. A joint semantic word-space model is created for the purpose of extracting easier to understand alternatives for words considered difficult to understand by laymen. Two domain experts evaluate the tool and inter-rater agreement is calculated. When having the tool suggest ten alternatives to each difficult word, it suggests acceptable lay words for 55.51% of them. This and future manual evaluation will serve to further improve performance, where also supervised machine learning will be used.
Tao, Cui; Wei, Wei-Qi; Solbrig, Harold R; Savova, Guergana; Chute, Christopher G
Using Semantic-Web specifications to represent temporal information in clinical narratives is an important step for temporal reasoning and answering time-oriented queries. Existing temporal models are either not compatible with the powerful reasoning tools developed for the Semantic Web, or designed only for structured clinical data and therefore are not ready to be applied on natural-language-based clinical narrative reports directly. We have developed a Semantic-Web ontology which is called Clinical Narrative Temporal Relation ontology. Using this ontology, temporal information in clinical narratives can be represented as RDF (Resource Description Framework) triples. More temporal information and relations can then be inferred by Semantic-Web based reasoning tools. Experimental results show that this ontology can represent temporal information in real clinical narratives successfully.
Walker, Rachel; Cooke, Marie; Henderson, Amanda; Creedy, Debra K
Leadership has been consistently implied in fostering clinical learning. However there is a lack of clarity about the form leadership should take. Limited quantitative research indicated a narrative approach to review literature from a broad perspective. A framework to guide the synthesis was developed to ensure a rigorous review process. Preliminary reading and review of papers using search terms nursing and leadership and clinical learning and learning culture narrowed the inclusion criteria to 245 papers published between 2000 and 2010. Given the diversity of the papers' focus, aim and context, a refined screening process justified the inclusion of twenty-six papers in the review. A critical appraisal of these peer-reviewed quantitative, qualitative and commentary papers identified factors/elements integral to effective leadership. Across the literature leadership was discussed in relation to two broad themes: influence of leadership on organisational learning and development and; influence of leadership on undergraduate clinical education. The factors central to leadership emerged as transformative principles, the role of the nurse unit/ward manager, collaboration and relationship building and role-modelling. The review has raised some suggestions for future research aimed at examining the impact of a leadership capacity building intervention that supports clinical learning. Copyright Â© 2010 Elsevier Ltd. All rights reserved.
Cross-border reproductive care has been thrust under the international spotlight by a series of recent scandals. These have prompted calls to develop more robust means of assessing the exploitative potential of such practices and the need for overarching and normative forms of national and international regulation. Allied theorisations of the emergence of forms of clinical labour have cast the outsourcing of reproductive services such as gamete donation and gestational surrogacy as artefacts of a wider neoliberalisation of service provision. These accounts share with many other narratives of neoliberalism a number of key assertions that relate to the presumed organisation of labour relations within this paradigm. This article critically engages with four assumptions implicit in these accounts: that clinical labourers constitute a largely homogeneous underclass of workers; that reproductive labour has been contractualised in ways that disembed it from wider social and communal relations; that contractualisation can provide protection for clinical labour lessening the need for formal regulatory oversight; and that the transnationalisation of reproductive service labour is largely unidirectional and characterised by a dynamic of provision in which ‘the rest’ services ‘the West’. Drawing on the first findings of a large-scale ethnographic research project into assisted reproduction in India I provide evidence to refute these assertions. In so doing the article demonstrates that while the outsourcing and contractualisation of reproductive labour may be embedded in a wider neoliberal paradigm these practices cannot be understood nor their impacts be fully assessed in isolation from their social and cultural contexts. PMID:26052118
Porz, R.; Landeweer, E.G.M.; Widdershoven, G.A.M.
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
Ejbye-Ernst, Ditte; Jørring, Nina Tejs
suggest that involving narrative clinicians and clients in the development of a research design in the local clinical context might be helpful in overcoming narrative skepticism and criticism towards quantitative effect research. It is our hope that this article will inspire more narrative therapists...... in a local clinical context. The article offers a detailed case description of implementing psychometric effect measurements on narrative family therapy and of creating a shared collaborative stance for researchers using quantitative effect measurements and clinicians using narrative therapy. Our findings......This article suggests an approach for addressing the dilemmas narrative therapists face, wanting to make narrative therapy accessible to people seeking help in contexts favoring evidence-based therapy. The approach is inspired by participatory action research and involves clinicians and clients...
John H. Davidson
Full Text Available The “curative potential” in almost any clinical setting depends on a caregiver establishing and maintaining an empathic connection with patients so as to achieve “narrative competence” in discerning and acting in accord with their preferences and best interests. The “narrative medicine” model of shared “close reading of literature and reflective writing” among clinicians as a means of fostering a capacity for clinical empathy has gained validation with recent empirical studies demonstrating the enhancement of theory of mind (ToM, broadly conceived as empathy, in readers of literary fiction. Talmudic legends, like that of Rabbi Judah’s death, are under-appreciated, relevant sources of literary fiction for these efforts. The limitations of narrative medicine are readily counterbalanced by simultaneously practiced attention to traditional bioethical principles, including—especially—beneficence, non-maleficence, and autonomy.
Mun, Mi Suk
The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.
Davidson, John H
The "curative potential" in almost any clinical setting depends on a caregiver establishing and maintaining an empathic connection with patients so as to achieve "narrative competence" in discerning and acting in accord with their preferences and best interests. The "narrative medicine" model of shared "close reading of literature and reflective writing" among clinicians as a means of fostering a capacity for clinical empathy has gained validation with recent empirical studies demonstrating the enhancement of theory of mind (ToM), broadly conceived as empathy, in readers of literary fiction. Talmudic legends, like that of Rabbi Judah's death, are under-appreciated, relevant sources of literary fiction for these efforts. The limitations of narrative medicine are readily counterbalanced by simultaneously practiced attention to traditional bioethical principles, including-especially-beneficence, non-maleficence, and autonomy.
Lin, Yu-Kai; Chen, Hsinchun; Brown, Randall A
Temporal information extraction from clinical narratives is of critical importance to many clinical applications. We participated in the EVENT/TIMEX3 track of the 2012 i2b2 clinical temporal relations challenge, and presented our temporal information extraction system, MedTime. MedTime comprises a cascade of rule-based and machine-learning pattern recognition procedures. It achieved a micro-averaged f-measure of 0.88 in both the recognitions of clinical events and temporal expressions. We proposed and evaluated three time normalization strategies to normalize relative time expressions in clinical texts. The accuracy was 0.68 in normalizing temporal expressions of dates, times, durations, and frequencies. This study demonstrates and evaluates the integration of rule-based and machine-learning-based approaches for high performance temporal information extraction from clinical narratives. Copyright © 2013 Elsevier Inc. All rights reserved.
Baker, Martyn; Nash, Jen
The great majority of the UK clinical psychology workforce is female, and this fact prompted an examination of the various ways clinical psychology might be seen as attractive to women – a neglected research topic. Female clinical psychology trainees from a variety of training programmes Q-sorted statements of potential job attractors. The process of analysis is outlined, before most of the article is devoted to explicating the five narratives of attraction generated: making a difference, wai...
Song, Dezhao; Chute, Christopher G; Tao, Cui
To facilitate clinical research, clinical data needs to be stored in a machine processable and understandable way. Manual annotating clinical data is time consuming. Automatic approaches (e.g., Natural Language Processing systems) have been adopted to convert such data into structured formats; however, the quality of such automatically extracted data may not always be satisfying. In this paper, we propose Semantator, a semi-automatic tool for document annotation with Semantic Web ontologies. With a loaded free text document and an ontology, Semantator supports the creation/deletion of ontology instances for any document fragment, linking/disconnecting instances with the properties in the ontology, and also enables automatic annotation by connecting to the NCBO annotator and cTAKES. By representing annotations in Semantic Web standards, Semantator supports reasoning based upon the underlying semantics of the owl:disjointWith and owl:equivalentClass predicates. We present discussions based on user experiences of using Semantator.
Naber, Jessica L; Hall, Joanne; Schadler, Craig Matthew
This study sought to identify characteristics of clinically situated critical thinking in nursing students' reflections, originally part of a study guided by Richard Paul's model of critical thinking. Nurses are expected to apply critical thinking in all practice situations to improve health outcomes, including patient safety and satisfaction. In a previous study, Paul's model of critical thinking was used to develop questions for reflective writing assignments. Within that study, 30 nursing students completed six open-ended narratives of nurse-patient clinical encounters during an 8-week period. Improvements were seen in critical thinking scores after the intervention. This article reports the qualitative analysis of the content of six open-ended narratives. Six overarching themes were identified and combined into a tentative conceptual model. Faculty's understanding of the characteristics of critical thinking in the context of clinical education will help them to teach and evaluate students' progress and competencies for future practice.
Weinstein, Michael S
Contrasting traditional and common forms of ethics consultation with bioethics mediation, I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, led to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
Ashwini Tumkur Shivakumar
Full Text Available The relationship between periodontal health and the restoration of teeth is intimate and inseparable. Human teeth are designed in such a way that the individual tooth contributes significantly to their own support as well as collectively the teeth in the arch. Decay on the proximal surfaces occurs mainly due to the faulty interrelationship between the contact area, marginal ridge, the embrasures and the gingiva. An adequate understanding of the relationship between periodontal tissues and restorative dentistry is paramount to ensure an adequate form, function, aesthetics and comfort of the dentition. For long-term survival of restoration, both functionally and esthetically, certain biological considerations are very critical to preserve the health of the periodontium and thus must be given due importance in clinical practice. While most clinicians are aware of this important relationship, uncertainly remains regarding specific concept such as biologic width and its maintainces.
Lindsay, Gail M; Mior, Silvano A; Côté, Pierre; Carroll, Linda J; Shearer, Heather M
The purpose of this narrative inquiry was to explore the experiences of persons who were injured in traffic collisions and seek their recommendations for the development of clinical practice guideline (CPG) for the management of minor traffic injuries. Patients receiving care for traffic injuries were recruited from 4 clinics in Ontario, Canada resulting in 11 adult participants (5 men, 6 women). Eight were injured while driving cars, 1 was injured on a motorcycle, 2 were pedestrians, and none caused the collision. Using narrative inquiry methodology, initial interviews were audiotaped, and follow-up interviews were held within 2 weeks to extend the story of experience created from the first interview. Narrative plotlines across the 11 stories were identified, and a composite story inclusive of all recommendations was developed by the authors. The research findings and composite narrative were used to inform the CPG Expert Panel in the development of new CPGs. Four recommended directions were identified from the narrative inquiry process and applied. First, terminology that caused stigma was a concern. This resulted in modified language ("injured persons") being adopted by the Expert Panel, and a new nomenclature categorizing layers of injury was identified. Second, participants valued being engaged as partners with health care practitioners. This resulted in inclusion of shared decision-making as a foundational recommendation connecting CPGs and care planning. Third, emotional distress was recognized as a factor in recovery. Therefore, the importance of early detection and the ongoing evaluation of risk factors for delayed recovery were included in all CPGs. Fourth, participants shared that they were unfamiliar with the health care system and insurance industry before their accident. Thus, repeatedly orienting injured persons to the system was advised. A narrative inquiry of 11 patients' experiences with traffic collision and their recommendations for clinical
Anthony Pak Hin Kong
Full Text Available Background Analysis of aphasic narratives can be a challenge for clinicians. Previous studies have mainly employed measures that categorized speech samples at the word level. They included quantification of the use and misuse of different word classes, presence and absence of narrative contents and errors, paraphasias, and perseverations, as well as morphological structures and errors within a narrative. In other words, a great amount of research has been conducted in the aphasiology literature focusing on micro-linguistic structures of oral narratives. Aspects of macro- linguistic structures, such as the analysis of content information by a speaker, consistency of using cohesive devices to present information within a narrative, and order of presenting information necessary to form a coherent discourse, have not been extensively investigated. The current investigation proposes a clinical analytic system to target three aspects of macro-linguistic structures in narratives among speakers with aphasia. Specifically, (1 the presence of search events (i.e., the mentioning of key events that allow the listener to understand; Capilouto, Wright, &Wagovich, 2006 within a narrative, (2 the sequence of the mentioned events, and (3 the informativeness (i.e., the fulfillment of lexical items that allow the user to understand what the event is detailing of the event contents, were focused in the proposed framework. Method Ten controls transcripts from were selected from the AphasiaBank (MacWhinney, Fromm, Forbes, & Holland, 2011. Three narrative tasks, including sequential picture description of ‘Refused Umbrella’, procedural narrative of making a ‘Peanut Butter and Jelly Sandwich’, and telling of ‘Cinderella’ story, were used to establish normative data for the basis of analysis. Specifically, the Search Events (e and Informative Words (i used by at least 70% of the speakers were listed for each genre. The sequential order of mentioning the
... Collection; Comment Request; Customer and Other Partners Satisfaction Surveys SUMMARY: In compliance with the... Satisfaction Surveys. Type of Information Collection Request: Extension request. Need and Use of Information... evaluate the satisfaction of various Clinical Center customers and other partners with Clinical Center...
Porz, Rouven; Landeweer, Elleke; Widdershoven, Guy
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.
The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery. Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles. Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery. Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective. Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor. RELEVANCE TO NURSE MANAGERS: Public health nurses are well placed to shape and influence health service culture through effective clinical leadership.
... subsequent comment concerning corruption in clinical trials conducted by large pharmaceutical companies. The... Collection: Title: Clinical Trials Reporting Program (CTRP) Database. Type of Information Collection Request... institutions. Type of Respondents: Clinical research administrators on behalf of clinical investigators. The...
Baker, Martyn; Nash, Jen
The great majority of the UK clinical psychology workforce are women, and this fact prompted an examination of the various ways clinical psychology might be seen as attractive to women--a neglected research topic. Female clinical psychology trainees from a variety of training programmes Q-sorted statements of potential job attractors. The process of analysis is outlined before most of the article is devoted to explicating the five narratives of attraction generated: making a difference, waiting for what I want, idealising challenge, identifying with distress and acknowledging power and privilege. Two super-ordinate 'stories' spanning the narratives are suggested--an over-riding attraction to the profession and a rebuttal of the suggestion that this attraction may be based on any overtly gendered grounds. In the absence of previous empirical data of women's attraction to clinical psychology, the small but significant contribution to understanding the profession made by the analysis is acknowledged--as is the need for further research to confirm and develop the findings. Copyright © 2011 John Wiley & Sons, Ltd.
Habermas, Tilmann; Ott, Lisa-M; Schubert, Merve; Schneider, Beatrix; Pate, Anna
This study attempted to replicate negative bias and depressive explanatory style in depression using life narratives. The two central aspects of narrative, temporal succession and evaluation, were also explored. These aspects were tested for the first time using entire life narratives of 17 depressed inpatients and non-depressed controls matched for sex and educational level. Negative bias and depressive explanatory style were replicated as typical for the depressed group. Life narratives of depressed patients also deviated more from a linear temporal order and compared less frequently the past with the present. Contrary to expectations, the depressed did not differ in the overall frequency of evaluations. However, they used more past than present evaluations and more experience-near evaluations than cognitive evaluations, suggesting that they are more immersed in past experiences. It is concluded that negative bias and depressive explanatory style can be found also in a naturalistic narrative measure, and that depression affects the two major aspects of narrative. It is argued that life narratives, as measures close to everyday clinical practice and as the most encompassing form of self-representation, should complement more experimental procedures in the study of cognitive and communicative processes in psychopathology. 2007 Wiley-Liss, Inc.
Eriksson, Robert; Jensen, Peter Bjødstrup; Frankild, Sune; Jensen, Lars Juhl; Brunak, Søren
Drugs have tremendous potential to cure and relieve disease, but the risk of unintended effects is always present. Healthcare providers increasingly record data in electronic patient records (EPRs), in which we aim to identify possible adverse events (AEs) and, specifically, possible adverse drug events (ADEs). Based on the undesirable effects section from the summary of product characteristics (SPC) of 7446 drugs, we have built a Danish ADE dictionary. Starting from this dictionary we have developed a pipeline for identifying possible ADEs in unstructured clinical narrative text. We use a named entity recognition (NER) tagger to identify dictionary matches in the text and post-coordination rules to construct ADE compound terms. Finally, we apply post-processing rules and filters to handle, for example, negations and sentences about subjects other than the patient. Moreover, this method allows synonyms to be identified and anatomical location descriptions can be merged to allow appropriate grouping of effects in the same location. The method identified 1 970 731 (35 477 unique) possible ADEs in a large corpus of 6011 psychiatric hospital patient records. Validation was performed through manual inspection of possible ADEs, resulting in precision of 89% and recall of 75%. The presented dictionary-building method could be used to construct other ADE dictionaries. The complication of compound words in Germanic languages was addressed. Additionally, the synonym and anatomical location collapse improve the method. The developed dictionary and method can be used to identify possible ADEs in Danish clinical narratives.
Conde-Taboada, A; Aranegui, B; García-Doval, I; Dávila-Seijo, P; González-Castro, U
Systematic reviews -the most comprehensive type of literature review-should be taken into account before a clinical trial or a narrative review on a topic is undertaken. The objective of this study was to describe the use of systematic reviews in clinical trials and narrative reviews in dermatology. This was a descriptive cross-sectional study. We selected randomized clinical trials and narrative reviews from the dermatological clinical research journals identified as most important (according to impact factor) and from Actas Dermosifiliográficas, and studied the bibliographies to ascertain whether the authors made reference to existing systematic reviews and Cochrane reviews. Of the 72 clinical trials for which a systematic review was available, 24 (33.3%) cited at least 1 review; reference was made to relevant Cochrane reviews in 15.6% of cases and to non-Cochrane reviews in 32%. In the case of the 24 narrative reviews for which a review was available, 10 (41.7%) cited at least 1 review; Cochrane reviews were cited in 20% and non-Cochrane reviews in 35.3%.In the case of Actas Dermosifiliográficas, very few clinical trials were found and the findings for narrative review articles were similar to those observed for the other journals. Systematic reviews are not often taken into account by the authors of clinical trials and narrative reviews and this may lead to redundant studies and publications. Authors appear to use Cochrane reviews even less than non-Cochrane reviews and are therefore ignoring one of the main sources of available evidence. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.
O'Byrne, Louise; Smith, Sheree
To identify models used as local initiatives to build capability and capacity in clinical nurses. The National Health Service, Nursing and Midwifery Council and the United Kingdom Clinical Research Collaboration all support the development of the building of research capability and capacity in clinical nurses in the UK. Narrative review. A literature search of databases (including Medline and Pubmed) using the search terms nursing research, research capacity and research capability combined with building, development, model and collaboration. Publications which included a description or methodological study of a structured initiative to tackle research capacity and capability development in clinical nurses were selected. Three models were found to be dominant in the literature. These comprised evidence-based practice, facilitative and experiential learning models. Strong leadership, organisational need and support management were elements found in all three models. Methodological issues were evident and pertain to small sample sizes, inconsistent and poorly defined outcomes along with a lack of data. Whilst the vision of a research ready and active National Health Service is to be applauded to date, there appears to be limited research on the best approach to support local initiatives for nurses that build research capability and capacity. Future studies will need to focus on well-defined objectives and outcomes to enable robust evidence to support local initiatives. To build research capability and capacity in clinical nurses, there is a need to evaluate models and determine the best approach that will provide clinical nurses with research opportunities. © 2010 Blackwell Publishing Ltd.
Miller, Kristen; Mosby, Danielle; Capan, Muge; Kowalski, Rebecca; Ratwani, Raj; Noaiseh, Yaman; Kraft, Rachel; Schwartz, Sanford; Weintraub, William S; Arnold, Ryan
Provider acceptance and associated patient outcomes are widely discussed in the evaluation of clinical decision support systems (CDSSs), but critical design criteria for tools have generally been overlooked. The objective of this work is to inform electronic health record alert optimization and clinical practice workflow by identifying, compiling, and reporting design recommendations for CDSS to support the efficient, effective, and timely delivery of high-quality care. A narrative review was conducted from 2000 to 2016 in PubMed and The Journal of Human Factors and Ergonomics Society to identify papers that discussed/recommended design features of CDSSs that are associated with the success of these systems. Fourteen papers were included as meeting the criteria and were found to have a total of 42 unique recommendations; 11 were classified as interface features, 10 as information features, and 21 as interaction features. Features are defined and described, providing actionable guidance that can be applied to CDSS development and policy. To our knowledge, no reviews have been completed that discuss/recommend design features of CDSS at this scale, and thus we found that this was important for the body of literature. The recommendations identified in this narrative review will help to optimize design, organization, management, presentation, and utilization of information through presentation, content, and function. The designation of 3 categories (interface, information, and interaction) should be further evaluated to determine the critical importance of the categories. Future work will determine how to prioritize them with limited resources for designers and developers in order to maximize the clinical utility of CDSS. This review will expand the field of knowledge and provide a novel organization structure to identify key recommendations for CDSS.
Chao, Yu-Mei Y; Chiang, Hsien-Hsien
Clinical nursing process recording (CNPR) has been shown to be an effective tool for facilitating student-centered teaching and learning in nursing education. Yet, the essence and process of this tool have yet to be sufficiently explored and clarified. To explore the essence of CNPR in the contexts of clinical teaching and learning. Reflective analysis was used as the phenomenological approach to analyze the qualitative data, which were transcribed from the oral responses of the six participants who were attending the Clinical Nursing Education Forum. A total of five sessions of the Clinical Nursing Education Forums were conducted. The content of the Clinical Nursing Education Forums consisted of a series of 12 narrative writings of CNPR that were written by a senior student and read and commented on by the student's clinical instructor. Three groups of the essence and process of clinical teaching and learning were inductively identified as: (a) mobilizing autonomous, self-directed learning behavior from self-writing and re-storying; (b) establishing the student-instructor dialogical relationship from mutual localization; and (c) co-creating a learning environment in education and in clinical practice. When used as an interactive teaching and learning tool, CNPR promotes mutual understanding by re-locating the self in the coexisting roles of student nurse, instructor, and patient in a series of nursing care situations. This re-location facilitates students' self-directed learning, enhances the abilities of asking question, waiting for and accompany with the instructor; and promotes the self-care capabilities of patients.
Eriksson, Robert; Jensen, Peter Bjødstrup; Frankild, Sune; Jensen, Lars Juhl; Brunak, Søren
Objective Drugs have tremendous potential to cure and relieve disease, but the risk of unintended effects is always present. Healthcare providers increasingly record data in electronic patient records (EPRs), in which we aim to identify possible adverse events (AEs) and, specifically, possible adverse drug events (ADEs). Materials and methods Based on the undesirable effects section from the summary of product characteristics (SPC) of 7446 drugs, we have built a Danish ADE dictionary. Starting from this dictionary we have developed a pipeline for identifying possible ADEs in unstructured clinical narrative text. We use a named entity recognition (NER) tagger to identify dictionary matches in the text and post-coordination rules to construct ADE compound terms. Finally, we apply post-processing rules and filters to handle, for example, negations and sentences about subjects other than the patient. Moreover, this method allows synonyms to be identified and anatomical location descriptions can be merged to allow appropriate grouping of effects in the same location. Results The method identified 1 970 731 (35 477 unique) possible ADEs in a large corpus of 6011 psychiatric hospital patient records. Validation was performed through manual inspection of possible ADEs, resulting in precision of 89% and recall of 75%. Discussion The presented dictionary-building method could be used to construct other ADE dictionaries. The complication of compound words in Germanic languages was addressed. Additionally, the synonym and anatomical location collapse improve the method. Conclusions The developed dictionary and method can be used to identify possible ADEs in Danish clinical narratives. PMID:23703825
Sohn, Sunghwan; Kocher, Jean-Pierre A; Chute, Christopher G; Savova, Guergana K
To extract physician-asserted drug side effects from electronic medical record clinical narratives. Pattern matching rules were manually developed through examining keywords and expression patterns of side effects to discover an individual side effect and causative drug relationship. A combination of machine learning (C4.5) using side effect keyword features and pattern matching rules was used to extract sentences that contain side effect and causative drug pairs, enabling the system to discover most side effect occurrences. Our system was implemented as a module within the clinical Text Analysis and Knowledge Extraction System. The system was tested in the domain of psychiatry and psychology. The rule-based system extracting side effects and causative drugs produced an F score of 0.80 (0.55 excluding allergy section). The hybrid system identifying side effect sentences had an F score of 0.75 (0.56 excluding allergy section) but covered more side effect and causative drug pairs than individual side effect extraction. The rule-based system was able to identify most side effects expressed by clear indication words. More sophisticated semantic processing is required to handle complex side effect descriptions in the narrative. We demonstrated that our system can be trained to identify sentences with complex side effect descriptions that can be submitted to a human expert for further abstraction. Our system was able to extract most physician-asserted drug side effects. It can be used in either an automated mode for side effect extraction or semi-automated mode to identify side effect sentences that can significantly simplify abstraction by a human expert.
Adler, Jonathan M; Harmeling, Luke H; Walder-Biesanz, Ilana
The present study had two aims: (a) to replicate previous findings regarding the characteristics of sudden gains (SGs) in psychotherapy under routine clinical conditions and (b) to examine whether clients' narrative meaning-making processes were associated with SGs in mental health. 54 psychotherapy clients completed the Systemic Therapy Inventory of Change (Pinsof et al., 2009) and wrote private narratives prior to beginning treatment and between every session for 12 assessment points over the course of psychotherapy for a variety of presenting problems. Clients' narratives were coded using existing systems (Adler, 2012; A. M. Hayes, Feldman, & Goldfried, 2006) to assess their content in eight themes: processing, avoidance, coherence, positive self, negative self, agency, hope, and hopelessness. The prevalence, magnitude, and timing of SGs in mental health observed in the present study were similar to those observed in prior research. Two narrative meaning-making processes-processing and coherence-were significantly associated with SGs in mental health. The present study significantly extends prior research on SGs, replicating the characteristics of these gains in routine clinical conditions with a measure of general functioning and identifying two narrative meaning-making processes that are associated with SGs in mental health.
Kennedy, Tara J T; Regehr, Glenn; Baker, G Ross; Lingard, Lorelei
To develop a conceptual framework of the influences on medical trainees' decisions regarding requests for clinical support from a supervisor. Phase 1: members of teaching teams in internal and emergency medicine were observed during regular clinical activities (216 hours) and subsequently completed brief interviews. Phase 2: 36 in depth interviews were conducted using videotaped vignettes to probe tacit influences on decisions to request support. Data collection and analysis used grounded theory methods. Three teaching hospitals in an urban setting in Canada. 124 members of teaching teams on general internal medicine wards and in the emergency department, comprising 31 attending physicians, 57 junior and senior residents, 28 medical students, and eight nurses. Purposeful sampling to saturation was conducted. Trainees' decisions about whether or not to seek clinical support were influenced by three issues: the clinical question (clinical importance, scope of practice), supervisor factors (availability, approachability), and trainee factors (skill, desire for independence, evaluation). Trainees perceived that requesting frequent/inappropriate support threatened their credibility and used rhetorical strategies to preserve credibility. These strategies included building a case for the importance of requests, saving requests for opportune moments, making a plan before requesting support, and targeting requests to specific team members. Trainees consider not only clinical implications but also professional credibility when requesting support from clinical supervisors. Exposing the complexity of this process provides the opportunity to make changes to training programmes to promote timely supervision and provides a framework for further exploration of the impact of clinical training on quality of care of patients.
MacRae, Jayden; Love, Tom; Baker, Michael G; Dowell, Anthony; Carnachan, Matthew; Stubbe, Maria; McBain, Lynn
We designed and validated a rule-based expert system to identify influenza like illness (ILI) from routinely recorded general practice clinical narrative to aid a larger retrospective research study into the impact of the 2009 influenza pandemic in New Zealand. Rules were assessed using pattern matching heuristics on routine clinical narrative. The system was trained using data from 623 clinical encounters and validated using a clinical expert as a gold standard against a mutually exclusive set of 901 records. We calculated a 98.2 % specificity and 90.2 % sensitivity across an ILI incidence of 12.4 % measured against clinical expert classification. Peak problem list identification of ILI by clinical coding in any month was 9.2 % of all detected ILI presentations. Our system addressed an unusual problem domain for clinical narrative classification; using notational, unstructured, clinician entered information in a community care setting. It performed well compared with other approaches and domains. It has potential applications in real-time surveillance of disease, and in assisted problem list coding for clinicians. Our system identified ILI presentation with sufficient accuracy for use at a population level in the wider research study. The peak coding of 9.2 % illustrated the need for automated coding of unstructured narrative in our study.
Gehrmann, Sebastian; Dernoncourt, Franck; Li, Yeran; Carlson, Eric T; Wu, Joy T; Welt, Jonathan; Foote, John; Moseley, Edward T; Grant, David W; Tyler, Patrick D; Celi, Leo A
In secondary analysis of electronic health records, a crucial task consists in correctly identifying the patient cohort under investigation. In many cases, the most valuable and relevant information for an accurate classification of medical conditions exist only in clinical narratives. Therefore, it is necessary to use natural language processing (NLP) techniques to extract and evaluate these narratives. The most commonly used approach to this problem relies on extracting a number of clinician-defined medical concepts from text and using machine learning techniques to identify whether a particular patient has a certain condition. However, recent advances in deep learning and NLP enable models to learn a rich representation of (medical) language. Convolutional neural networks (CNN) for text classification can augment the existing techniques by leveraging the representation of language to learn which phrases in a text are relevant for a given medical condition. In this work, we compare concept extraction based methods with CNNs and other commonly used models in NLP in ten phenotyping tasks using 1,610 discharge summaries from the MIMIC-III database. We show that CNNs outperform concept extraction based methods in almost all of the tasks, with an improvement in F1-score of up to 26 and up to 7 percentage points in area under the ROC curve (AUC). We additionally assess the interpretability of both approaches by presenting and evaluating methods that calculate and extract the most salient phrases for a prediction. The results indicate that CNNs are a valid alternative to existing approaches in patient phenotyping and cohort identification, and should be further investigated. Moreover, the deep learning approach presented in this paper can be used to assist clinicians during chart review or support the extraction of billing codes from text by identifying and highlighting relevant phrases for various medical conditions.
Full Text Available Martin Bystad,1,2 Camilla Bystad,3 Rolf Wynn1,3 1Division of Addictions and Specialized Psychiatric Services, University Hospital of North Norway, 2Institute of Psychology, 3Institute of Clinical Medicine, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway Abstract: Placebo effects are documented in a number of clinical and experimental studies. It is possible to benefit from placebo effects in clinical practice by using them as effects additive to those of documented and effective treatments. The purpose of this paper is to discuss how doctors and other health workers may benefit from placebo effects within an ethical framework. A narrative review of the literature relating to placebo effects in clinical practice was performed. We searched PubMed and selected textbooks on placebo effects for articles and book chapters relating to placebo effects in clinical practice. By drawing on placebo effects, doctors may access patients’ self-healing potentials. In practice, doctors may best benefit from placebo effects by influencing the patient’s expectations through communication. An important principle is to give the patient information stating that a particular treatment is effective, as long as this is based on realistic optimism. A patient-centered style involving elements such as developing trust and respect, exploring the patient’s values, speaking positively about treatments, and providing reassurance and encouragement might aid in activating placebo effects. The total effect of a documented treatment will partly depend on how well the placebo effects have been activated. Thus, placebo effects can be understood as a form of supplemental treatment. Keywords: placebo effects, doctor-patient communication, expectations, biopsychosocial model
... Notice Request: Application Process for Clinical Research Training and Medical Education at the Clinical... Research Training and Medical Education, NIH Clinical Center, 10 Center Drive, MSC 1158, Bethesda, MD 20892... Process for Clinical Research Training and Medical Education at the Clinical Center and its Impact on...
...; 30-Day Comment Request: Application Process for Clinical Research Training and Medical Education at..., MD, Deputy Director, Office of Clinical Research Training and Medical Education, NIH Clinical Center... Clinical Research Training and Medical Education at the Clinical Center and its Impact on Course and...
Stubbs, Amber; Uzuner, Özlem
The 2014 i2b2/UTHealth natural language processing shared task featured a track focused on identifying risk factors for heart disease (specifically, Cardiac Artery Disease) in clinical narratives. For this track, we used a "light" annotation paradigm to annotate a set of 1304 longitudinal medical records describing 296 patients for risk factors and the times they were present. We designed the annotation task for this track with the goal of balancing annotation load and time with quality, so as to generate a gold standard corpus that can benefit a clinically-relevant task. We applied light annotation procedures and determined the gold standard using majority voting. On average, the agreement of annotators with the gold standard was above 0.95, indicating high reliability. The resulting document-level annotations generated for each record in each longitudinal EMR in this corpus provide information that can support studies of progression of heart disease risk factors in the included patients over time. These annotations were used in the Risk Factor track of the 2014 i2b2/UTHealth shared task. Participating systems achieved a mean micro-averaged F1 measure of 0.815 and a maximum F1 measure of 0.928 for identifying these risk factors in patient records. Copyright © 2015 Elsevier Inc. All rights reserved.
Boerma, Tessel; Leseman, Paul; Timmermeister, Mona; Wijnen, Frank; Blom, Elma
Background: Understanding and expressing a narrative's macro-structure is relatively independent of experience in a specific language. A narrative task is therefore assumed to be a less biased method of language assessment for bilingual children than many other norm-referenced tests and may thus be particularly valuable to identify language…
Saint Arnault, Denise M
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.
Schmidt, Henk G; Mamede, Sílvia
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.
Ferraro, Jeffrey P; Daumé, Hal; Duvall, Scott L; Chapman, Wendy W; Harkema, Henk; Haug, Peter J
Natural language processing (NLP) tasks are commonly decomposed into subtasks, chained together to form processing pipelines. The residual error produced in these subtasks propagates, adversely affecting the end objectives. Limited availability of annotated clinical data remains a barrier to reaching state-of-the-art operating characteristics using statistically based NLP tools in the clinical domain. Here we explore the unique linguistic constructions of clinical texts and demonstrate the loss in operating characteristics when out-of-the-box part-of-speech (POS) tagging tools are applied to the clinical domain. We test a domain adaptation approach integrating a novel lexical-generation probability rule used in a transformation-based learner to boost POS performance on clinical narratives. Two target corpora from independent healthcare institutions were constructed from high frequency clinical narratives. Four leading POS taggers with their out-of-the-box models trained from general English and biomedical abstracts were evaluated against these clinical corpora. A high performing domain adaptation method, Easy Adapt, was compared to our newly proposed method ClinAdapt. The evaluated POS taggers drop in accuracy by 8.5-15% when tested on clinical narratives. The highest performing tagger reports an accuracy of 88.6%. Domain adaptation with Easy Adapt reports accuracies of 88.3-91.0% on clinical texts. ClinAdapt reports 93.2-93.9%. ClinAdapt successfully boosts POS tagging performance through domain adaptation requiring a modest amount of annotated clinical data. Improving the performance of critical NLP subtasks is expected to reduce pipeline error propagation leading to better overall results on complex processing tasks.
... Request: Impact of Clinical Research Training and Medical Education at the Clinical Center on Physician Careers in Academia and Clinical Research SUMMARY: In compliance with the requirement of Section 3506(c)(2... approval. Proposed Collection Title: The Impact of Clinical Research Training and Medical Education at the...
Hege, Inga; Dietl, Anita; Kiesewetter, Jan; Schelling, Jörg; Kiesewetter, Isabel
Virtual patients (VPs) are narrative-based educational activities to train clinical reasoning in a safe environment. Our aim was to explore the influence of the design of the narrative and level of difficulty on the clinical reasoning process, diagnostic accuracy and time-on-task. In a randomized controlled trial, we analyzed the clinical reasoning process of 46 medical students with six VPs in three different variations: (1) patients showing a friendly behavior, (2) patients showing a disruptive behavior and (3) a version without a patient story. For easy VPs, we did not see a significant difference in diagnostic accuracy. For difficult VPs, the diagnostic accuracy was significantly higher for participants who worked on the friendly VPs compared to the other two groups. Independent from VP difficulty, participants identified significantly more problems and tests for disruptive than for friendly VPs; time on task was comparable for these two groups. The extrinsic motivation of participants working on the VPs without a patient story was significantly lower than for the students working on the friendly VPs. Our results indicate that the measured VP difficulty has a higher influence on the clinical reasoning process and diagnostic accuracy than the variations in the narratives.
Kobra Shiasi Arani
Full Text Available Context: Cartilage-hair hypoplasia is a rare hereditary cause of short stature. The aim of this study was to familiarize physicians with this rare but important disease. Evidence Acquisition: This article is a narrative review of the scientific literature to inform about clinical features and management of Cartilage-hair hypoplasia. A systematic search identified 127 papers include original and review articles and case reports. Results: Cartilage-Hair Hypoplasia characterized by short-limb dwarfism associated with metaphyseal chondrodysplasia. The inheritance is autosomal recessive. Other findings include hair hypoplasia, anemia, immunodeficiency, propensity to infections, gastrointestinal disorders (Hirschsprung disease, anal stenosis, esophageal atresia and malabsorption, defective spermatogenesis, increased risk of malignancies and higher rate of mortality. Immunodeficiency in cartilage-hair hypoplasia may be an isolated B-cell or isolated T-cell immunodeficiency or combined B and T-cell immunodeficiency; however, severe combined immunodeficiency is rare. There is no known treatment for hair hypoplasia. Growth hormone was used with conflicting results for short stature in children with Cartilage-hair hypoplasia. Skeletal problems must be managed with physiotherapy and appropriate orthopedic interventions. Hirschsprung disease, anal stenosis and esophageal atresia should be surgically corrected. Patients with severe hypoplastic anemia require repeated transfusions. Bone marrow transplantation may be required for patients with severe combined immunodeficiency or severe persistent hypoplastic anemia. Treatment with G-CSF is useful for neutropenia. Patients should be monitored closely for developing malignancy such as skin neoplasms, lymphomas and leukemias. Conclusions: Cartilage-hair hypoplasia is an important hereditary disease with different medical aspects. The high rate of consanguineous marriages in Iran necessitates considering CHH in any
Bartels, Josef; Mooney, Christopher John; Stone, Robert Thompson
Medical school evaluations typically rely on both language-based narrative descriptions and psychometrically converted numeric scores to convey performance to the grading committee. We evaluated inter-rater reliability and correlation of numeric versus narrative evaluations for students on their Neurology Clerkship. 50 Neurology Clerkship in-training evaluation reports completed by their residents and faculty members at the University of Rochester School of Medicine were dissected into narrative and numeric components. 5 Clerkship grading committee members retrospectively gave new narrative scores (NNS) while blinded to original numeric scores (ONS). We calculated intra-class correlation coefficients (ICC) and their associated confidence intervals for the ONS and the NNS. In addition, we calculated the correlation between ONS and NNS. The ICC was greater for the NNS (ICC = .88 (95% CI = .70-.94)) than the ONS (ICC = .62 (95% CI = .40-.77)) Pearson correlation coefficient showed that the ONS and NNS were highly correlated (r = .81). Narrative evaluations converted by a small group of experienced graders are at least as reliable as numeric scoring by individual evaluators. We could allow evaluators to focus their efforts on creating richer narrative of greater value to trainees.
...In compliance with the requirement of Section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, for opportunity for public comment on proposed data collection projects, the National Institutes of Health (NIH) will publish periodic summaries of proposed projects to be submitted to the Office of Management and Budget (OMB) for review and approval. Proposed Collection: Title: Clinical Mythteries: A Video Game About Clinical Trials. Type of Information Collection Request: NEW. Need and Use of Information Collection: New England Research Institutes as a contractor for the National Heart Lung and Blood Institute is planning to create an engaging, informational ``serious video game'' for adolescents about clinical studies which: (1) Incorporates core learning objectives; and (2) dispels misconceptions. Two types of information collection are planned: usability testing to understand game-play/usability. This information will be collected by focus group and will be digitally recorded 90 minute groups. A pre/post randomized trial to measure change in knowledge. This information will be collected electronically through on-line questionnaire. The game will be incorporated with a larger initiative to provide information about clinical research (http://www.nhlbi.nih.gov/ childrenandclinicalstudies/index.php). Frequency of Response: Once. Affected Public: Individuals. Type of Respondents: Adolescents--aged 8- 14. The annual reporting burden is as follows: Estimated Number of Respondents: 6,148; Estimated Number of Responses per Respondent: 1; Average Burden Hours Per Response: 1.321; and Estimated Total Annual Burden Hours Requested: 370. The annualized cost to respondents is estimated at: $3,700. There are no Capital Costs to report. The Operating Costs to collect this information is estimated at $38,642.
Rodriguez-Borja, Enrique; Villalba-Martinez, Celia; Barba-Serrano, Esther; Carratala-Calvo, Arturo
Failure to follow-up laboratory test results has been described as one of the major processes contributing to unsafe patient care. Currently, most of the laboratories do not know with certainty not only their rate of missed (or unreviewed) requests but the economical cost and impact that this issue implies. The aim of our study was to measure that rate and calculate the resulting costs. In January 2015, we checked in our Laboratory Information Management System (LIMS) for every emergency request from 1(st) July 2011 to 30(th) June 2014, if they had been reviewed by any allowed user or not. 319,064 requests were ordered during that period of time. Results were expressed as "ordered requests", "missed requests" and its percentage. Additionally, total cost of missed requests was calculated in euros (€). "Non-productive days" were theorised (as the days producing requests that were not reviewed) based on these results. 7924 requests (2.5%) were never reviewed by clinicians. This represented a total cost of 203,039 € and 27 "non-productive" days in three years. Significant differences between inpatients, outpatients and emergency department as well as different emergencies units were found after application of statistical analysis. In terms of resources, never reviewed or missed requests appear to be a not negligible problem for the clinical laboratory management. Electronic result delivery, with electronic endorsement to indicate follow-up of requests along with better systems of electronic requesting should be investigated as a way of improving patient outcomes and save unnecessary expenses.
Gerrits, T.; Reis, R.; Braat, D.D.M.; Kremer, J.A.M.; Hardon, A.P.
This article provides insight into how ethically sensitive requests for the use of assisted reproductive technologies (ARTs) are dealt within the daily practice of a Dutch fertility clinic. The findings presented are part of an ethnographic study conducted in this clinic from September 2003 until
Sidebottom, Abbey; Harrison, Patricia A.; Amidon, Donna; Finnegan, Katie
Background: Little is known about the circumstances that prompt teenagers to request emergency contraception (EC). This evaluation was designed to refine the EC clinical protocol and improve pregnancy prevention efforts in high school-based clinics by analyzing information on EC use and subsequent contraception use of EC patients. Methods: Sites…
kapitlet omhandler Narrative psykologiske teorier i et personlighedspsykologisk og socio-kulturelt perspektiv.......kapitlet omhandler Narrative psykologiske teorier i et personlighedspsykologisk og socio-kulturelt perspektiv....
I denne power point gennem grundtrækkene i den narrative vending og der kommes med eksempler på narrative undervisningsformer.......I denne power point gennem grundtrækkene i den narrative vending og der kommes med eksempler på narrative undervisningsformer....
... consent or the interactive computer-based program, will be assessed by face-to-face interview. In addition... Comment Request: Interactive Informed Consent for Pediatric Clinical Trials SUMMARY: In compliance with... other technological collection techniques or other forms of information technology. To Submit Comments...
Narrative permeates health care--from patients' stories taken as medical histories to the development of health policy. The narrative approach to health care has involved the move from narratives in health care as objects of study to the lens through which health care is studied and, more recently, to narrative as a form of care. In this paper, I argue that narrative care requires a move in the field of ethics--from a position where narratives are used to inform ethical decision making to one in which narrative is the form and process of ethical decision making. In other words, I argue for a narrative ethics for narrative care. The argument is relatively straightforward. If, as I argue, humans are narrative beings who make sense of themselves, others, and the world in and through narrative, we need to see our actions as both narratively based and narratively contextual and thus understanding the nature, form, and content of the narratives of which we are a part, and the process of narrativity, provides an intersubjective basis for ethical action. Copyright © 2015 Elsevier Inc. All rights reserved.
Janice Lynn Hanson
Full Text Available Background: In medical education, evaluation of clinical performance is based almost universally on rating scales for defined aspects of performance and scores on examinations and checklists. Unfortunately, scores and grades do not capture progress and competence among learners in the complex tasks and roles required to practice medicine. While the literature suggests serious problems with the validity and reliability of ratings of clinical performance based on numerical scores, the critical issue is not that judgments about what is observed vary from rater to rater but that these judgments are lost when translated into numbers on a scale. As the Next Accreditation System of the Accreditation Council on Graduate Medical Education (ACGME takes effect, medical educators have an opportunity to create new processes of evaluation to document and facilitate progress of medical learners in the required areas of competence.Proposal and initial experience: Narrative descriptions of learner performance in the clinical environment, gathered using a framework for observation that builds a shared understanding of competence among the faculty, promise to provide meaningful qualitative data closely linked to the work of physicians. With descriptions grouped in categories and matched to milestones, core faculty can place each learner along the milestones’ continua of progress. This provides the foundation for meaningful feedback to facilitate the progress of each learner as well as documentation of progress toward competence.Implications: This narrative evaluation system addresses educational needs as well as the goals of the Next Accreditation System for explicitly documented progress. Educators at other levels of education and in other professions experience similar needs for authentic assessment and, with meaningful frameworks that describe roles and tasks, may also find useful a system built on descriptions of learner performance in actual work settings
Geertz, Armin W.
Denne artikel er en introduktion til et temanummer i religionslærernes tidsskrift i USA. Den er et udtræk af mit kapitel "Religious Narrative, Cognition and Culture: Approaches and Definitions" udgivet i Religious Narrative, Cognition and Culture: Image and Word in the mind of Narrative, redigeret...
Zinken, Jörg; Blakemore, Caroline; Zinken, Katarzyna
Psychological research has emphasized the importance of narrative for a person's sense of self. Building a coherent narrative of past events is one objective of psychotherapy. However, in guided self-help therapy the patient has to develop this narrative autonomously. Identifying patients......' narrative skills in relation to psychological distress could provide useful information about their suitability for self-help. The aim of this study was to explore whether the syntactic integration of clauses into narrative in texts written by prospective psychotherapy patients was related to mild...... to moderate psychological distress. Cross-clausal syntax of texts by 97 people who had contacted a primary care mental health service was analyzed. Severity of symptoms associated with mental health difficulties was assessed by a standardized scale (Clinical Outcomes in Routine Evaluation outcome measure...
Hijazi, Alaa M; Lumley, Mark A; Ziadni, Maisa S; Haddad, Luay; Rapport, Lisa J; Arnetz, Bengt B
Many Iraqi refugees suffer from posttraumatic stress. Efficient, culturally sensitive interventions are needed, and so we adapted narrative exposure therapy into a brief version (brief NET) and tested its effects in a sample of traumatized Iraqi refugees. Iraqi refugees in the United States reporting elevated posttraumatic stress (N = 63) were randomized to brief NET or waitlist control conditions in a 2:1 ratio; brief NET was 3 sessions, conducted individually, in Arabic. Positive indicators (posttraumatic growth and well-being) and symptoms (posttraumatic stress, depressive, and somatic) were assessed at baseline and 2- and 4-month follow-up. Treatment participation (95.1% completion) and study retention (98.4% provided follow-up data) were very high. Significant condition by time interactions showed that those receiving brief NET had greater posttraumatic growth (d = 0.83) and well-being (d = 0.54) through 4 months than controls. Brief NET reduced symptoms of posttraumatic stress (d = -0.48) and depression (d = -0.46) more, but only at 2 months; symptoms of controls also decreased from 2 to 4 months, eliminating condition differences at 4 months. Three sessions of brief NET increased growth and well-being and led to symptom reduction in highly traumatized Iraqi refugees. This preliminary study suggests that brief NET is both acceptable and potentially efficacious in traumatized Iraqi refugees. Copyright © 2014 International Society for Traumatic Stress Studies.
Whalen, Kimberly; Bavuso, Karen; Bouyer-Ferullo, Sharon; Goldsmith, Denise; Fairbanks, Amanda; Gesner, Emily; Lagor, Charles; Collins, Sarah
To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs. We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making. A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. "Risk Assessments/Risk Reduction/Promotion of Healthy Habits" (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse. Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan.
Clarke, Amy L; Yates, Thomas; Smith, Alice C; Chilcot, Joseph
Patients with chronic kidney disease (CKD) form organized beliefs regarding their illness and treatment. These perceptions influence the coping strategies employed by an individual to manage his/her illness and may act as a predictor for his/her willingness to engage in self-management behaviours. While illness perceptions have been identified as predictors of non-adherence, depression and mortality in dialysis patients, there is a paucity of research in CKD patients not requiring renal replacement therapy. This narrative review synthesizes the existing literature regarding the role of illness perceptions and associated clinical and psychosocial outcomes in non-dialysis CKD patients. Studies were identified following database searches of AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsycINFO and Google Scholar in January 2016. Despite the small evidence base, existing studies indicate that negative illness perceptions are associated with disease progression and a number of psychosocial outcomes in non-dialysis CKD patients. Evidence from other clinical populations suggests that illness perceptions are modifiable through psychological intervention, which may be most effective if delivered early before beliefs have the chance to become more established. Therefore, targeting illness perceptions in the earlier stages of CKD may be optimal. Further studies are now required to ascertain the mechanisms through which illness perceptions predict psychosocial and clinical outcomes in CKD patients and to ultimately test the efficacy of illness perception-based interventions.
Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul
Hypertension, a common cardiovascular disease (CVD) risk factor, is usually diagnosed and treated based on blood pressure readings obtained in the clinic setting. Blood pressure may differ considerably when measured in the clinic versus outside of the clinic setting. Over the past several decades, evidence has accumulated on two approaches for measuring out-of-clinic blood pressure: ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM). Blood pressure measures on ABPM and HBPM each have a stronger association with CVD outcomes than clinic blood pressure. Controversy exists whether ABPM or HBPM is superior for estimating CVD risk, and under what circumstances these methods should be used in clinical practice for assessing out-of-clinic blood pressure. This review describes ABPM and HBPM procedures, the blood pressure phenotypic measures that can be ascertained, and the evidence that supports the use of each approach to measure out-of-clinic blood pressure. This review also describes barriers to the successful implementation of ABPM and HBPM in clinical practice, proposes core competencies for the conduct of these procedures, and highlights important areas for future research. PMID:26457954
Vergnes, Jean-Noel; Apelian, Nareg; Bedos, Christophe
Narrative medicine strives toward a humanized form of medicine in which empathy and the ability to listen are developed with the same emphasis as scientific rigor. We hypothesize that the adoption of narrative medicine in dentistry would be an excellent method to cultivate the philosophy behind the emerging clinical concept of patient-centered dentistry. Reading literary works, reflective writing, and creative writing would sensitize practitioners to the daily lives of people, human uniqueness, and alterity. Narrative dentistry could lead to more empathic and self-aware practices, and improve dental professionals' observational abilities by making them more perceptive and more attentive to image, metaphor, and meaning. The introduction of narrative dentistry would enrich the clinical clerkship of dentists by bringing the often-missing humanities to the dental professional, academic, and scientific environment. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
Nicholls, Emily; Robinson, Victoria; Farndon, Lisa; Vernon, Wesley
This narrative review explores the ways in which drawing on theories and methods used in sociological work on footwear and identity can contribute to healthcare research with podiatrists and their patients, highlighting recent research in this field, implications for practice and potential areas for future development.Traditionally, research within Podiatry Services has tended to adopt a quantitative, positivist focus, developing separately from a growing body of sociological work exploring the importance of shoes in constructing identity and self-image. Bringing qualitative research drawing on sociological theory and methods to the clinical encounter has real potential to increase our understanding of patient values, motivations and - crucially - any barriers to adopting 'healthier' footwear that they may encounter. Such work can help practitioners to understand why patients may resist making changes to their footwear practices, and help us to devise new ways for practitioners to explore and ultimately break down individual barriers to change (including their own preconceptions as practitioners). This, in turn, may lead to long-term, sustainable changes to footwear practices and improvements in foot health for those with complex health conditions and the wider population. A recognition of the complex links between shoes and identity is opening up space for discussion of patient resistance to footwear changes, and paving the way for future research in this field beyond the temporary 'moment' of the clinical encounter.
Daum, Corinna; Hubschmid, Monica; Aybek, Selma
Experts in the field of conversion disorder have suggested for the upcoming DSM-V edition to put less weight on the associated psychological factors and to emphasise the role of clinical findings. Indeed, a critical step in reaching a diagnosis of conversion disorder is careful bedside neurological examination, aimed at excluding organic signs and identifying 'positive' signs suggestive of a functional disorder. These positive signs are well known to all trained neurologists but their validity is still not established. The aim of this study is to provide current evidence regarding their sensitivity and specificity. We conducted a systematic search on motor, sensory and gait functional signs in Embase, Medline, PsycINfo from 1965 to June 2012. Studies in English, German or French reporting objective data on more than 10 participants in a controlled design were included in a systematic review. Other relevant signs are discussed in a narrative review. Eleven controlled studies (out of 147 eligible articles) describing 14 signs (7 motor, 5 sensory, 2 gait) reported low sensitivity of 8-100% but high specificity of 92-100%. Studies were evidence class III, only two had a blinded design and none reported on inter-rater reliability of the signs. Clinical signs for functional neurological symptoms are numerous but only 14 have been validated; overall they have low sensitivity but high specificity and their use should thus be recommended, especially with the introduction of the new DSM-V criteria.
Full Text Available Patricia RE Harris,1 Claire E Sommargren,2 Phyllis K Stein,3 Gordon L Fung,4,5 Barbara J Drew6,7 1ECG Monitoring Research Lab, 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA; 3Heart Rate Variability Laboratory, School of Medicine, Washington University, St Louis, MO, USA; 4Asian Heart & Vascular Center at Mount Zion, Division of Cardiology, University of California, 5Cardiology Consultation Service, Cardiac Noninvasive Laboratory, and The Enhanced External Counterpulsation Unit, Department of Medicine, University of California, San Francisco Medical Center, 6Division of Cardiology, 7Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA Aim: We aimed to explore links between heart rate variability (HRV and clinical depression in patients with acute coronary syndrome (ACS, through a review of recent clinical research literature. Background: Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function. Methods: A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search terms “heart rate variability” and “depression” were used in conjunction with “acute coronary syndrome”, “unstable angina”, or “myocardial infarction” to find clinical studies published within the past 10 years related to HRV and clinical depression, in patients with an ACS episode. Studies were included if HRV measurement and depression screening were undertaken during an ACS hospitalization or within 2 months of hospital discharge. Results: Nine clinical studies met the inclusion criteria. The
Stenner, Shane P; Doan, Son; Johnson, Kevin B; Waitman, Lemuel R; Denny, Joshua C
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
Narrative coaching is representative of the new wave – or third generation – of coaching practice . The theory and practice of narrative coaching takes into account the social and cultural conditions of late modern society, and must be seen as intertwined with them. Some initial conceptualizations...... of narrative coaching were developed by David Drake (2006, 2007, 2008, 2009) in the USA and Australia, by Ho Law in the UK (Law, 2007a + b; Law & Stelter, 2009) and by Reinhard Stelter (2007, 2009, 2012, in preparation; Stelter & Law, 2010) in Denmark. In the following chapter the aim is to present coaching...... as a narrative-collaborative practice, an approach that is based on phenomenology, social constructionism and narrative theory. Seeing narrative coaching as a collaborative practice also leads to reflecting on the relationship between coach and coachee(s) in a new way, where both parts contribute to the dialogue...
Tewes, Mitra; Rettler, Teresa; Wolf, Nathalie; Hense, Jörg; Schuler, Martin; Teufel, Martin; Beckmann, Mingo
Early integration of palliative care (PC) is recommended. The determination of predictors for patients' request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC. Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters. Additionally, patients' request for palliative and psychosocial support was assessed. Groups of patients with PC request were compared to patients without PC request regarding their symptom clusters. Logistic regression analysis was applied to discover significant predictors for the requested inclusion of PC. A total of 159 patients (25.5%) requested additional support by PC. Moderate and severe tiredness (40.3%), weakness (37.9%), pain (25.0%), loss of appetite (22.3%), and dyspnea (19.1%) were the most frequent symptoms. The group of patients requesting PC differed significantly in terms of pain, nausea, dyspnea, constipation, weakness, loss of appetite, tiredness, depression, and anxiety from patients without request for PC (p < .01). The perceived need for PC was identified by the significant predictors "depression," "anxiety," and "weakness" with an explained variance of 22%. Combining a standardized screening questionnaire and the assessment of patients' request for PC allows systematic monitoring for patients' need for PC in a large Medical Oncology clinic. Depression, anxiety, and weakness are predictors of requesting PC service by patients receiving outpatient cancer treatment.
Munkhdalai, Tsendsuren; Liu, Feifan; Yu, Hong
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
Driscoll, Mary C. [St. Bonaventure University, St Bonaventure, NY(United States)
The Project Narrative describes how the funds from the DOE grant were used to purchase equipment for the biology, chemistry, physics and mathematics departments. The Narrative also describes how the equipment is being used. There is also a list of the positive outcomes as a result of having the equipment that was purchased with the DOE grant.
Dette pilotstudies ambition er at undersøge, hvordan og hvorfor narrative elementer lejlighedsvist aktiveres af aktører i deres kontakt med bibliotekarer i folkebiblioteker. Ved hjælp af en kulturanalytisk tilgang studeres forskellige aktørers narrative udvidelser af referenceinterviewet. Teoretisk....... Pilotstudiet bekræfter de 2 indledende antagelser: 1) at nogle aktører anvender narrative udvidelser, fordi de vælger at betone den mellemmenneskelige relation mellem aktør og bibliotekar, som om det var enhver anden social relation og derved ignorerer andre, mere repræsentative dele af bibliotekarernes...... funktioner. Og 2) at nogle aktører anvender narrative udvidelser i bestræbelserne på at legitimere egne sociale positioner og identitetsdannelse gennem kritisk refleksion over bibliotekarernes og folkebibliotekets institutionelle position og magt. Gennem den narrative udvidelse formår disse aktører...
Tai, Joanna; Molloy, Elizabeth; Haines, Terry; Canny, Benedict
Peer-assisted learning (PAL) is increasingly used in medical education, and the benefits of this approach have been reported. Previous reviews have focused on the benefits of peer tutoring of junior students by senior students. Forms of PAL such as discussion groups and role-playing have been neglected, as have alternative teacher-learner configurations (e.g. same-level PAL) and the effects on other stakeholders, including clinician educators and patients. This review examines the benefits of same-level PAL for students, clinician educators and patients in pre-registration clinical medical education. Medline, PsycINFO, CINAHL and ERIC were searched in March 2014. A total of 1228 abstracts were retrieved for review; 64 full-text papers were assessed. Data were extracted from empirical studies describing a same-level PAL initiative in a clinical setting, focusing on effects beyond academic performance and student satisfaction. Qualitative thematic analysis was employed to identify types of PAL and to cluster the reported PAL effects. Forty-three studies were included in the review. PAL activities were categorised into role-play, discussion, teaching and assessment. Only 50% of studies reported information beyond self-report and satisfaction with the PAL intervention. Benefits for students (including development of communication and professional skills) and clinician educators (developing less-used facilitation skills) were reported. Direct patient outcomes were not identified. Caveats to the use of PAL emerged, and guidelines for the use of PAL were perceived as useful. Many student-related benefits of PAL were identified. PAL contributes to the development of crucial skills required for a doctor in the workplace. Vertical integration of learning and teaching skills across the curriculum and tools such as feedback checklists may be required for successful PAL in the clinical environment. Benefits for patients and educators were poorly characterised within the
Alyson J. McGregor
Full Text Available The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. This move has resulted in a rapidly increasing body of literature on SABV with important implications for changing the clinical practice of emergency medicine (EM. Translation of this new knowledge to the bedside requires an understanding of how sex-based research will ultimately impact patient care. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled.
Marcum, Zachary A; Vande Griend, Joseph P; Linnebur, Sunny A
The US Food and Drug Administration (FDA) has new regulatory authorities intended to enhance drug safety monitoring in the postmarketing period. This has resulted in an increase in communication from the FDA in recent years about the safety profile of certain drugs. It is important to stay abreast of the current literature on drug risks to effectively communicate these risks to patients, other health care providers, and the general public. To summarize 4 new FDA drug safety communications by describing the evidence supporting the risks and the clinical implications for older adults. The FDA Web site was reviewed for new drug safety communications from May 2011 to April 2012 that would be relevant to older adults. Approved labeling for each drug or class was obtained from the manufacturer, and PubMed was searched for primary literature that supported the drug safety concern. FDA drug safety communications for 4 drugs were chosen because of the potential clinical importance in older adults. A warning for citalopram was made because of potential problems with QT prolongation in patients taking less than 40 mg per day. The evidence suggests minor changes in QT interval. Given the flat dose-response curve in treating depression with citalopram, the new 20-mg/d maximum dose in older adults is sensible. Another warning was made for proton pump inhibitors (PPIs) and an increased risk of Clostridium difficile infection. A dose-response relationship was found for this drug risk. With C. difficile infections on the rise in older adults, along with other safety risks of PPI therapy, PPIs should only be used in older adults indicated for therapy for the shortest duration possible. In addition, a warning about dabigatran was made. There is strong evidence from a large clinical trial, as well as case reports, of increased bleeding risk in older adults taking dabigatran, especially in older adults with decreased renal function. This medication should be used with caution in older
Anderson, Claire; Kirkpatrick, Susan
Introduction Narrative interviews place the people being interviewed at the heart of a research study. They are a means of collecting people's own stories about their experiences of health and illness. Narrative interviews can help researchers to better understand people's experiences and behaviours. Narratives may come closer to representing the context and integrity of people's lives than more quantitative means of research. Methodology Researchers using narrative interview techniques do not set out with a fixed agenda, rather they tend to let the interviewee control the direction, content and pace of the interview. The paper describes the interview process and the suggested approach to analysis of narrative interviews, We draw on the example from a study that used series of narrative interviews about people's experiences of taking antidepressants. Limitations Some people may find it particularly challenging to tell their story to a researcher in this way rather than be asked a series of questions like in a television or radio interview. Narrative research like all qualitative research does not set out to be generalisable and may only involve a small set of interviews.
...Under the provisions of Section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the National Institutes of Health (NIH) has submitted to the Office of Management and Budget (OMB) a request for review and approval of the information collection listed below. This proposed information collection was previously published in the Federal Register on June 13, 2012, page 35407 and allowed 60-days for public comment. No public comments were received. The purpose of this notice is to allow an additional 30 days for public comment. The National Institutes of Health may not conduct or sponsor, and the respondent is not required to respond to, an information collection that has been extended, revised, or implemented on or after October 1, 1995, unless it displays a currently valid OMB control number. Proposed Collection: Title: Clinical Mythteries: A Video Game About Clinical Trials. Type of Information Collection Request: NEW. Need and Use of Information Collection: New England Research Institutes as a contractor for the National Heart Lung and Blood Institute is planning to create an engaging, informational ``serious video game'' for adolescents about clinical studies which: (1) Incorporates core learning objectives; and (2) dispels misconceptions. Two types of information collection are planned: Usability testing to understand game-play/usability. This information will be collected by focus group and will be digitally recorded 90 minute groups. A pre/post randomized trial to measure change in knowledge. This information will be collected electronically through on-line questionnaire. The game will be incorporated with a larger initiative to provide information about clinical research (http://www.nhlbi.nih.gov/ childrenandclinicalstudies/index.php). Frequency of Response: Once. Affected Public: Individuals. Type of Respondents: Adolescents--aged 8- 14. The annual reporting burden is as follows: Estimated Number of Respondents: 280; Estimated Number of Responses per
Kristiansen, Claus Krogholm
The dissertation deals with narrative as a cognitive structure - as a way of handling experience in the modern world. The question is: What is man when he is not created in god's image. Some recent scandinavian novels are analysed as examples.......The dissertation deals with narrative as a cognitive structure - as a way of handling experience in the modern world. The question is: What is man when he is not created in god's image. Some recent scandinavian novels are analysed as examples....
Keasberry, Justin; Scott, Ian A; Sullivan, Clair; Staib, Andrew; Ashby, Richard
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes. Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool. Outcome measures were benefits and harms relating to electronic medical records (EMRs), computerised physician order entry (CPOE), electronic prescribing (ePrescribing) and computerised decision support systems (CDSS). Results are presented as a narrative overview given marked study heterogeneity. Results Nineteen systematic reviews and two reviews of systematic reviews were included from 1197 abstracts, nine rated as high quality. For EMR functions, there was moderate-quality evidence of reduced hospitalisations and length of stay and low-quality evidence of improved organisational efficiency, greater accuracy of information and reduced documentation and process turnaround times. For CPOE functions, there was moderate-quality evidence of reductions in turnaround times and resource utilisation. For ePrescribing, there was moderate-quality evidence of substantially fewer medications errors and adverse drug events, greater guideline adherence, improved disease control and decreased dispensing turnaround times. For CDSS, there was moderate-quality evidence of increased use of preventive care and drug interaction reminders and alerts, increased use of diagnostic aids, more appropriate test ordering with fewer tests per patient, greater guideline adherence, improved processes of care and less disease morbidity. There was conflicting evidence regarding effects on in-patient mortality and overall costs. Reported harms were
Full Text Available Introduction: Troponin test is one of the methods for diagnosing acute coronary syndrome, but the overuse and misuse of this test has increased the costs imposed on the health system and the patients. Objective: The present study was conducted to investigate the veracity of troponin test requests for patients presenting to an emergency department with chest pain and examine the effectiveness of training emergency medicine assistants in reducing unnecessary and inappropriate requests in emergency departments. Methods: This clinical audit was conducted in the emergency department of Imam Hossein Hospital, Tehran, Iran, in 2014. Sampling was carried out using the census method and all the cases presenting to the emergency department for whom a troponin test was requested by the emergency medical assistants were included in the research. First, the veracity of the current troponin test requests was assessed; then, training was given to the personnel, and the veracity of the troponin test requests was once again verified after the training was completed. The rate of veracious troponin requests for the patients was measured based on two factors, including the interval between the patients’ admission and the troponin test request, and the interval between the onset of pain and the troponin test request. The veracity of the troponin test request was compared before and after training using the Phi test and Cramer’s V test in IBM SPSS-21. Results: This study examined a total of 500 patients (250 before training and 250 after, who had a mean age of 57.65±18.15 years, including 51.6% men. Significant differences were observed between the mean time of the patients’ admission and the overall and post-training troponin test results (P=0.000, and also between the mean time of the onset of pain and the overall and post-training troponin test results (P=0.000. The number of positive troponin test results did not differ significantly between the patients
Narrative Absorption brings together research from the social sciences and Humanities to solve a number of mysteries: Most of us will have had those moments, of being totally absorbed in a book, a movie, or computer game. Typically we do not have any idea about how we ended up in such a state. No...
examples of successful refugee resettlement and national self-assertion. Within the master narrative of Partition migration history, however, the experiences of forced movement and resettlement suffered by the ‘Untouchables' are obscured. Popular accounts of violence, forced movement and suffering...
is presented to give a concrete example of this narrative, community psychological oriented intervention, a process which helps people to develop a sense of personal or cultural identity and an understanding of their doing as being in correspondence with their values and intentions. The overarching focus...
Maria Helena Cabral de Almeida Cardoso
Full Text Available Este trabalho objetiva contribuir para a discussão acerca das características narrativas do discurso clínico. Para tanto parte de uma revisão bibliográfica e da análise semiótica de prontuários do Centro de Genética Médica José Carlos Cabral de Almeida, do Departamento de Genética, do Instituto Fernandes Figueira, unidade materno-infantil da Fundação Oswaldo Cruz. Todos os prontuários utilizados são referentes a portadores da síndrome de Down atendidos no Ambulatório Especializado de Síndrome de Down da referida unidade. O artigo aborda: a questão da possível oposição entre narrativa e ciência; a apresentação dos principais autores e de seus trabalhos que versam sobre narrativa e conhecimento médico; a exemplificação da epistemologia narrativa embutida no discurso médico, via a apresentação de um prontuário, assim como de um heredograma. A conclusão enfatiza a importância da narrativa para o processo de diagnose e tratamento, assim como a construção de um enredo por parte do médico onde se fazem presentes complexas interações biológicas, culturais e sociais.This study aims to discuss the narrative epistemology contained in the medical practice. It was based upon a bibliographic review and a semiotic analysis of medical charts belonging to The Medical Genetic Center José Carlos Cabral de Almeida/Genetic Department/Fernandes Figueira Institute, a maternal-infant care unity of The Oswaldo Cruz Foundation. All the analysed charts referred to children diagnosed with Down syndrome that are being or were attended in the Down's Syndrome Outpatient of the above cited unity. The article appraises: the question concerning the possible opposition between narrative and science; a review of multiple authors and their works about narrative and medical knowledge; the narrative epistemology contained in the clinical discourse, using as example of such assumption one chart and one pedigree. The conclusion highlights how
Stubbs, Amber; Kotfila, Christopher; Uzuner, Özlem
The 2014 i2b2/UTHealth Natural Language Processing (NLP) shared task featured four tracks. The first of these was the de-identification track focused on identifying protected health information (PHI) in longitudinal clinical narratives. The longitudinal nature of clinical narratives calls particular attention to details of information that, while benign on their own in separate records, can lead to identification of patients in combination in longitudinal records. Accordingly, the 2014 de-identification track addressed a broader set of entities and PHI than covered by the Health Insurance Portability and Accountability Act - the focus of the de-identification shared task that was organized in 2006. Ten teams tackled the 2014 de-identification task and submitted 22 system outputs for evaluation. Each team was evaluated on their best performing system output. Three of the 10 systems achieved F1 scores over .90, and seven of the top 10 scored over .75. The most successful systems combined conditional random fields and hand-written rules. Our findings indicate that automated systems can be very effective for this task, but that de-identification is not yet a solved problem. Copyright © 2015 Elsevier Inc. All rights reserved.
universal dimensions of human life and cultural differences in a more and more mediatized global media culture. How do individuals and groups imagine each other in this new, global media culture, in what Appadurai (1996) has called a new post-national political world with an emerging diasporic public sphere......Cosmopolitan Narratives: Documentary Perspectives on Afghanistan Cosmopolitanism is a concept discussed in relation to globalization in contemporary societies by sociologists, anthropologists and media scholars (Beck 2006, Delanty 2006, Appadurai 1996). The concept indicates the dialectic between...... close others in our everyday life. But the media play an increasingly strong and important role in developing a cosmopolitan imaginary through narratives that bring us closer to the various distant, global others. Through migration those earlier distant others are also more and more mixed in our daily...
Background Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Methods Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs’ request forms. Results Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p < 0.001); 2) the provisional diagnosis on the request forms was 52.8% in the trial district and 42% in the control district (P < 0.001); 3) the decrease of the number of tests on each request form was much more marked in the trial district (8.73 vs. 10.77; p < 0.001). Conclusions The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the
thought. Furthermore, it is argued that a central role in the structuring of this mental text is played by an overwhelming amount of brackets. The article suggests a categorisation of the different types of parenthetic remarks in the novel according to their function in the textual, would-be narrative...... construct, and concludes that Makanin's use of brackets in Andegraund, the most extensive use in his oeuvre so far, is crucial to the extreme processuality of the novel's text and its paradoxical, solipsistic addressivity. Udgivelsesdato: October...
In an effort to provide well-characterized monoclonal antibodies to the scientific community, NCI's Antibody Characterization Program requests cancer-related protein targets for affinity production and distribution. Submissions will be accepted through July 11, 2014.
In an effort to provide well-characterized monoclonal antibodies to the scientific community, NCI's Antibody Characterization Program requests cancer-related protein targets for affinity production and distribution. Submissions will be accepted through July 9, 2012.
a functional framework for these concepts, but tries increasingly to endow the main idea of the cultural project with a spatially aesthetic expression - a shift towards “experience architecture.” A great number of these projects typically recycle and reinterpret narratives related to historical buildings......In this essay, I focus on the combination of programs and the architecture of cultural projects that have emerged within the last few years. These projects are characterized as “hybrid cultural projects,” because they intend to combine experience with entertainment, play, and learning. This essay...... and architectural heritage; another group tries to embed new performative technologies in expressive architectural representation. Finally, this essay provides a theoretical framework for the analysis of the political rationales of these projects and for the architectural representation bridges the gap between...
Anmeldelse af Anne Mangen: New Narrative Pleasures? A Cognitive-Phenomenological Study of the Experience of Reading Digital Narrative Fictions.......Anmeldelse af Anne Mangen: New Narrative Pleasures? A Cognitive-Phenomenological Study of the Experience of Reading Digital Narrative Fictions....
Armine Kotin Mortimer
Full Text Available The cloturai device of narration as salvation represents the lack of finality in three novels. In De Beauvoir's Tous les hommes sont mortels an immortal character turns his story to account, but the novel makes a mockery of the historical sense by which men define themselves. In the closing pages of Butor's La Modification , the hero plans to write a book to save himself. Through the thrice-considered portrayal of the Paris-Rome relationship, the ending shows the reader how to bring about closure, but this collective critique written by readers will always be a future book. Simon's La Bataille de Pharsale , the most radical attempt to destroy finality, is an infinite text. No new text can be written. This extreme of perversion guarantees bliss (jouissance . If the ending of De Beauvoir's novel transfers the burden of non-final world onto a new victim, Butor's non-finality lies in the deferral to a future writing, while Simon's writer is stuck in a writing loop, in which writing has become its own end and hence can have no end. The deconstructive and tragic form of contemporary novels proclaims the loss of belief in a finality inherent in the written text, to the profit of writing itself.
Habermas, Tilmann; Diel, Verena
Out of the complex influences of event, narrative and listener characteristics on narrative emotions, this paper focuses on event severity, narrative perspectives, mood, and dispositions for emotion regulation and empathy. Event severity and perspective representation were systematically varied in sad autobiographical narratives to study their influence on quantity and quality of readers' emotional response. Each of three stories were manipulated to contain elaborated perspectives, only the past protagonists' perspective (dramatic narration), and very little perspectives at all (impersonal narration). We predicted that event severity influences the quantity of emotional response, while degree of perspective representation influences plausibility and whether emotional responses are sympathetic or interactional, that is, directed against the narrator. Hypotheses were confirmed except for plausibility, and perspective representation had an effect only on anger against and dislike of the narrator. In a second study, impersonal narration evoked anger at and negative evaluations of the narrator which were related to blaming the narrator for showing too little emotional involvement. The generalizability of findings across emotions and implications for sharing of emotions in everyday and clinical settings are discussed.
Ewertsson, Mona; Bagga-Gupta, Sangeeta; Allvin, Renée; Blomberg, Karin
Clinical practice is a pivotal part of nursing education. It provides students with the opportunity to put the knowledge and skills they have acquired from lectures into practice with real patients, under the guidance of registered nurses. Clinical experience is also essential for shaping the nursing students' identity as future professional nurses. There is a lack of knowledge and understanding of the ways in which students learn practical skills and apply knowledge within and across different contexts, i.e. how they apply clinical skills, learnt in the laboratory in university settings, in the clinical setting. The aim of this study was therefore to explore how nursing students describe, and use, their prior experiences related to practical skills during their clinical practice. An ethnographic case study design was used. Fieldwork included participant observations (82 h), informal conversations, and interviews ( n = 7) that were conducted during nursing students' ( n = 17) clinical practice at an emergency department at a university hospital in Sweden. The overarching theme identified was "Learning about professional identities with respect to situated power". This encompasses tensions in students' learning when they are socialized into practical skills in the nursing profession. This overarching theme consists of three sub-themes: "Embodied knowledge", "Divergent ways of assessing and evaluating knowledge" and "Balancing approaches". Nursing students do not automatically possess the ability to transfer knowledge from one setting to another; rather, their development is shaped by their experiences and interactions with others when they meet real patients. The study revealed different ways in which students navigated tensions related to power differentials. Reflecting on actions is a prerequisite for developing and learning practical skills and professional identities. This highlights the importance of both educators' and the preceptors' roles for
Mantzorou, Maria; Pavlidou, Eleni; Vasios, George; Tsagalioti, Eftychia; Giaginis, Constantinos
Numerous clinical trials have investigated the potential beneficial effects of curcumin supplementation against several human chronic diseases. Up to now, it has been claimed that curcumin consumption may exert beneficial effects against several chronic diseases by promoting human health and preventing diseases. In this aspect, the present review aims to critically collect and in-depth summarize the most recent, well-designed clinical studies evaluating the potential beneficial effects of curcumin consumption on human health promotion and disease prevention. According to recent and well-designed clinical studies, curcumin consumption may benefit against obesity, metabolic syndrome, and diabetes. Moreover, curcumin consumption seems to exert a positive effect on people suffering from various types of cancer, fatty liver disease, depression, arthritis, skin diseases, gut inflammation, and symptoms of premenstrual syndrome. Due to the strong heterogeneity among the clinical studies concerning the exact effective curcumin dose and formulation, as well as the recommended treatment duration for each chronic disease, no precise and definitive conclusions could be drawn. Further large-scale prospective studies are strongly recommended, being well-designed as far as follow-up times, dosage, formulation, and duration of curcumin supplementation are concerned. Moreover, potential confounders in each specific chronic disease should carefully be taken into account in future studies. Copyright © 2018 John Wiley & Sons, Ltd.
Oerlemans, M.; Dielissen, P.W.; Timmerman, A.; Ram, P.; Maiburg, B.; Muris, J.; Vleuten, C. van der
BACKGROUND: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral
Recent work on the relation between narrative and selfhood has emphasized embodiment as an indispensable foundation for selfhood. This has occasioned an interesting debate on the relation between embodiment and narrative. In this paper, I attempt to mediate the range of conflicting intuitions......) strictly is or is not; rather, we need to see narrative as an attribute admitting of degrees. I suggest that the relation between narrative and embodiment should be seen along these lines, proposing three levels of the narrativity of embodied experiencing: 1) the unnarratable, 2) the narratable and 3...
Hauer, Karen E; Cate, Olle Ten; Boscardin, Christy K; Iobst, William; Holmboe, Eric S; Chesluk, Benjamin; Baron, Robert B; O'Sullivan, Patricia S
Background The expectation for graduate medical education programs to ensure that trainees are progressing toward competence for unsupervised practice prompted requirements for a committee to make decisions regarding residents' progress, termed a clinical competency committee (CCC). The literature on the composition of these committees and how they share information and render decisions can inform the work of CCCs by highlighting vulnerabilities and best practices. Objective We conducted a narrative review of the literature on group decision making that can help characterize the work of CCCs, including how they are populated and how they use information. Methods English language studies of group decision making in medical education, psychology, and organizational behavior were used. Results The results highlighted 2 major themes. Group member composition showcased the value placed on the complementarity of members' experience and lessons they had learned about performance review through their teaching and committee work. Group processes revealed strengths and limitations in groups' understanding of their work, leader role, and information-sharing procedures. Time pressure was a threat to the quality of group work. Conclusions Implications of the findings include the risks for committees that arise with homogeneous membership, limitations to available resident performance information, and processes that arise through experience rather than deriving from a well-articulated purpose of their work. Recommendations are presented to maximize the effectiveness of CCC processes, including their membership and access to, and interpretation of, information to yield evidence-based, well-reasoned judgments.
Describes "impersonal narration," an approach that defends the concept of the cinematic narrator as a logical and pragmatic necessity. Compares this approach with existing theories of the cinematic narrator, addressing disagreements in the field of film narrative theory. (MM)
Dalla Vestra, Michele; Grolla, Elisabetta; Bonanni, Luca; Pesavento, Raffaele
The use of inferior vena cava filters to prevent pulmonary embolism is increasing mainly because of indications that appear to be unclearly codified and recommended. The evidence supporting this approach is often heterogeneous, and mainly based on observational studies and consensus opinions, while the insertion of an IVC filter exposes patients to the risk of complications and increases health care costs. Thus, several proposed indications for an IVC filter placement remain controversial. We attempt to review the proof on the efficacy and safety of IVC filters in several "special" clinical settings, and assess the robustness of the available evidence for any specific indication to place an IVC filter.
Guillemin, Marilys; Gillam, Lynn
Clinical care is laden with emotions, from the perspectives of both clinicians and patients. It is important that emotions are addressed in health professions curricula to ensure that clinicians are humane healers as well as technical experts. Emotions have a valuable and generative role in health professional ethics education.The authors have previously described a narrative ethics pedagogy, the aim of which is to develop ethical mindfulness. Ethical mindfulness is a state of being that acknowledges everyday ethics and ethically important moments as significant in clinical care, with the aim of enabling ethical clinical practice. Using a sample narrative, the authors extend this concept to examine five features of ethical mindfulness as they relate to emotions: (1) being sensitized to emotions in everyday practice, (2) acknowledging and understanding the ways in which emotions are significant in practice, (3) being able to articulate the emotions at play during ethically important moments, (4) being reflexive and acknowledging both the generative aspects and the limitations of emotions, and (5) being courageous.The process of writing and engaging with narratives can lead to ethical mindfulness, including the capacity to understand and work with emotions. Strategies for productively incorporating emotions in narrative ethics teaching are described. This can be a challenging domain within medical education for both educators and health care students and thus needs to be addressed sensitively and responsibly. The potential benefit of educating health professionals in a way which addresses emotionality in an ethical framework makes the challenges worthwhile.
Eva Laass: Broken Taboos, Subjective Truths. Forms and Functions of Unreliable Narration in Contemporary American Cinema. A Contribution to Film NarratologyVolker Ferenz: Don’t believe his lies. The unreliable narrator in contemporary American cinema
The current policy interest in early childhood education and care is driven by an investment narrative, a story of quality and high returns emerging from a dominant neoliberal political economy. This short note expresses deep reservations about this narrative, and hints at another narrative that foregrounds democracy, experimentation and…
Finney, Mark David
This dissertation focuses on the place of narrative in the transformational encounter that can take place between hearers of sermons and God. Chapter 1 surveys the history and development of contemporary scholarship related to narrative preaching. It argues that most homileticians consider narrative either as a way of structuring sermons, or as a…
Elson, David K.
This thesis describes new approaches to the formal modeling of narrative discourse. Although narratives of all kinds are ubiquitous in daily life, contemporary text processing techniques typically do not leverage the aspects that separate narrative from expository discourse. We describe two approaches to the problem. The first approach considers…
Heilmann, John; Miller, Jon F.; Nockerts, Ann; Dunaway, Claudia
Purpose: To evaluate the clinical utility of the narrative scoring scheme (NSS) as an index of narrative macrostructure for young school-age children. Method: Oral retells of a wordless picture book were elicited from 129 typically developing children, ages 5-7. A series of correlations and hierarchical regression equations were completed using…
Guiahi, Maryam; Teal, Stephanie B; Swartz, Maryke; Huynh, Sandy; Schiller, Georgia; Sheeder, Jeanelle
Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments. Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion. Chi-square and Fisher's exact tests assessed potential correlates of appointment availability, and multivariable logistic regressions were computed if bivariate testing suggested multiple correlates. Although 95% of clinics would schedule birth control appointments, smaller proportions would schedule appointments for copper IUDs (68%) or tubal ligation (58%); only 2% would schedule an abortion. Smaller proportions of Catholic-owned than of Catholic-affiliated clinics would schedule appointments for birth control (84% vs. 100%), copper IUDs (4% vs. 97%) and tubal ligation (29% vs. 72%); for birth control and copper IUD services, no other clinic characteristics were related to appointment availability. Multivariable analysis confirmed that tubal ligation appointments were less likely to be offered at Catholic-owned than at Catholic-affiliated clinics (odds ratio. 0.1); location and association with one of the top 10 Catholic health care systems also were significant. Adherence to church directives is inconsistent at Catholic-associated clinics. Women visiting such clinics who want highly effective methods may need to rely on less effective methods or delay method uptake while seeking services elsewhere. Copyright © 2017 by the Guttmacher Institute.
Vyacheslav V. Volchik
Full Text Available This article addresses a range of questions associated with the occurrence of a new field of study – narrative economics, which is considered in the context of modern institutionalism. Pioneering works of R. Shiller, G. Akerlof and D. Snower spotlighted the importance of analyzing narratives and narrative influence when studying economic processes. In this paper, a qualitative study of narratives is seen through the prism of an answer to the question: «How do prescribed narratives influence institutions and change them? ». Narratives have much in common with institutions since very often, explicitly or implicitly, they contain value judgements about social interactions or normative aspects shaping behavioral patterns. The identification of dominating narratives enables us to understand better how institutions influence economic (social action. Repeated interactions among social actors are structured through understanding and learning the rules. Understanding of social rules comes from the language – we articulate and perceive the rules drawing on common narratives. Narratives and institutions are helpful when actors gain knowledge about various forms of social communication. Digital technologies, mass media and social networking sites facilitate the spread of narratives, values and beliefs; this process is characterized by increasing returns. Studying narratives and institutions is crucial for modern economic theory because it helps to improve qualitative and quantitative methods of analyzing empirical evidence and enables researchers to understand complex economic processes.
... need for such products to assist clinical laboratories in performing this testing. FDA has been working... this workshop include: (1) Overview of Quality control and standardization issues associated with Clinical Flow Cytometry (FCM), including discussion of a NIST traceable standard; (2) Biological controls...
Marconi, M; Almini, D; Pizzi, M N; Riccardi, D; Bergamaschi, W; Giovanetti, A M; Rebulla, P; Sirchia, G
Guidelines, algorithms and recommendations have been issued in the attempt to ensure appropriateness of transfusion practice, but the results are less than satisfactory, mainly due to the difficulty to turn paper procedures into actual practice. In our hospital we have tried to overcome this difficulty through the implementation of a quality assurance programme which includes giving the privilege of nonurgent blood prescription to a limited number of physicians and a computerized prospective audit of blood requests. The latter is performed through verification of the compliance of blood requests, which are designed to include a patient's laboratory and clinical data, with hospital guidelines for the proper use of blood. In the 12 months since implementation of the computerized prospective audit the transfusion service has evaluated 7884 requests. Of these, 63.4% (n = 4998) were for red blood cells, 21.1% (n = 1664) for platelets and 15.5% (n = 1222) for fresh frozen plasma. The prospective audit showed that 96.8% and 98.1% of requests for red units and platelets were appropriate, respectively. Conversely, approximately 27% of plasma requests did not comply with guidelines, mainly because the evidence of coagulopathy was missing. However, inappropriateness of plasma requests for elective general surgery decreased from 39% at the onset of the programme to 14% in the last trimester considered. Moreover, the evaluation by retrospective audit of the proportion of patients transfused with both red blood cells and plasma in the perioperative period out of those transfused with red blood cells only, as an indicator of unwanted reconstitution of whole blood, showed that this proportion decreased from 47.6% (320/672) in the 12 months before implementation of computerized audit to 37.8% (244/646) in the following 12 months (difference = -9.8%, 95% confidence interval of the difference from -4.5% to -15.1%; P audit is a useful tool for assuring the quality of blood requesting.
J. Woudenberg; L. Bobbink; E. Geurts; M. Pelzer; H. Degen-Nijeboer
This book is about narrative methods and narrative research. The word narrativity derives from the Latin word narrare, which means ‘to tell’. Narratives are present everywhere. They come in the form of fairy tales, drama, drawings, art, history, biography, myths and legends. Narratives can be found
de Vries Martine C
Full Text Available Abstract Background Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences of the unprecedented integration of research and care in pediatric oncology from the perspective of parents and physicians. Methodology An empirical ethical approach, combining (1 a narrative review of (primarily qualitative studies on parents' and physicians' experiences of the pediatric oncology research practice, and (2 comparison of these experiences with existing theoretical ethical concepts about (pediatric research. The use of empirical evidence enriches these concepts by taking into account the peculiarities that ethical challenges pose in practice. Results Analysis of the 22 studies reviewed revealed that the integration of research and care has consequences for the informed consent process, the promotion of the child's best interests, and the role of the physician (doctor vs. scientist. True consent to research is difficult to achieve due to the complexity of research protocols, emotional stress and parents' dependency on their child's physician. Parents' role is to promote their child's best interests, also when they are asked to consider enrolling their child in a trial. Parents are almost never in equipoise on trial participation, which leaves them with the agonizing situation of wanting to do what is best for their child, while being fearful of making the wrong decision. Furthermore, a therapeutic misconception endangers correct assessment of participation, making parents inaccurately attribute therapeutic intent to research procedures. Physicians prefer the perspective of a therapist over a researcher. Consequently they may truly believe that in the research setting they promote the child's best interests, which maintains the
Narratives are an integral part of human expression. In the graphic form, they range from cave paintings to Egyptian hieroglyphics, from the Bayeux Tapestry to modern day comic books (Kunzle, 1973; McCloud, 1993). Yet not much research has addressed the structure and comprehension of narrative images, for example, how do people create meaning out of sequential images? This piece helps fill the gap by presenting a theory of Narrative Grammar. We describe the basic narrative categories and their relationship to a canonical narrative arc, followed by a discussion of complex structures that extend beyond the canonical schema. This demands that the canonical arc be reconsidered as a generative schema whereby any narrative category can be expanded into a node in a tree structure. Narrative "pacing" is interpreted as a reflection of various patterns of this embedding: conjunction, left-branching trees, center-embedded constituencies, and others. Following this, diagnostic methods are proposed for testing narrative categories and constituency. Finally, we outline the applicability of this theory beyond sequential images, such as to film and verbal discourse, and compare this theory with previous approaches to narrative and discourse. Copyright © 2012 Cognitive Science Society, Inc.
Musacchio Adorisio, Anna Linda
This article focuses on organizational remembering in banking. To provide an alternative to the repository image of memory in organization, organizational remembering is conceptualized as narrative, where narrative represents a way to organize the selection and interpretation of the past....... The narrative perspective deals with both the experiential and contextual nature of remembering by addressing concerns raised by critiques of organizational memory studies, namely, the subjective experience of remembering and the social and historical context in which remembering takes place. Antenarrative...... the narrative perspective reveals ruptures and ambiguities that characterize organizational remembering that would remain hidden in the organizational memory studies approach....
Vanheule, Stijn; Hauser, Stuart T
The transcripts of semistructured clinical interviews with forty psychiatrically hospitalized adolescents were subjected to narrative analysis in an effort to map the logic of their explanations as they spontaneously talked about helplessness experiences, and to determine how helplessness is embedded in broader story lines. Three types of narrative composition were discerned, and are discussed by means of excerpts from the interviews. In a first and predominant type of narrative, a disturbing confrontation with another is pivotal: the other's intentions are obscure; this frightens the narrator, who does not know what to do. Helplessness arises as a direct result of not knowing how to manage the "unbearable riddle" of the other's intentions. In the second, more marginal type of narrative, helplessness is embedded in an account of emptiness and boredom. The protagonist relates enduring experiences of emptiness due to loss and the suffering consequent on it. In the third, also more marginal type of narrative, helplessness is framed in a context of failure: the protagonist adheres to strict standards, feels he or she has fallen short, and concludes that he or she is a failure. Only the first type of narrative is significantly related to the psychiatric diagnoses of mood disorder and major depression.
Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta
To report on the development of a framework of narrative practice, in residential care settings for older people. Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. A hermeneutic approach incorporating narrative methods was used. Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. © 2013 John Wiley & Sons Ltd.
... conducted under an IND as support for an IND or application for marketing approval for a drug or biological... and approval by an independent ethics committee (IEC). Under Sec. 312.120(a), FDA accepts as support for an IND or application for marketing approval a well-designed and well-conducted foreign clinical...
...) approaches. b. External Beam Radiotherapy, including standard therapy and therapies designed to decrease..., learning curve)? Key Question 4 How do tumor characteristics (e.g., Gleason score, tumor volume, screen-detected vs. clinically detected tumors, and PSA levels) affect the outcomes of these therapies overall and...
Studies using narratives with children and parents offer ways to study affective meaning-making processes that are central in many theories of developmental psychopathology. This paper reviews theory regarding affective meaning making, and argues that narratives are particularly suited to examine such processes. The review of narrative studies and methods is organized into three sections according to the focus on child, parent, and parent-child narratives. Within each focus three levels of analysis are considered: (a) narrative organization and coherence, (b) narrative content, and (c) the behavior/interactions of the narrator(s). The implications of this research for developmental psychopathology and clinical work are discussed with an emphasis on parent-child jointly constructed narratives as the meeting point of individual child and parent narratives.
There is a strong tradition in psychology and philosophy, claiming that the self is a narrative construction. The paper examines this idea and concludes that the narrative self is not a viable theoretical construct, but that we should opt for an adjacent idea of a historical self. The aim is to e...
Poulsen, Jens Aage
Analyse af narrative strukturer i nordiske læremidler om historie- og nordiske læreres forståelse og brug af læremidlerne i undervisningen......Analyse af narrative strukturer i nordiske læremidler om historie- og nordiske læreres forståelse og brug af læremidlerne i undervisningen...
Aerts, Walter; Clubb, C.; Imam, S.
Narrative accounting disclosures are an integral part of the corporate financial reporting package. They are deemed to provide a view of the company “through the eyes of management”. The narratives represent management's construal of corporate events and are largely discretionary. Research in
Mulvaney, Matthew Keefe
According to the narrative perspective on personality development, personality is constructed largely by interpreting and representing experience in story format (scripts) over the course of the lifespan. The focus of this paper is to describe briefly the narrative perspective on personality development during childhood and adolescence, to discuss…
Raises issues involved in the study and teaching of narrative, with reference to both literature and film. Considers the function of realism in narrative fiction and the teaching of theory and practice of those writers and filmmakers who have challenged the realist text by alternative strategies. (JMF)
Narratives are an integral part of human expression. In the graphic form, they range from cave paintings to Egyptian hieroglyphics, from the Bayeux Tapestry to modern day comic books (Kunzle, 1973; McCloud, 1993). Yet not much research has addressed the structure and comprehension of narrative images, for example, how do people create meaning out…
In Narrating Peoplehood amidst Diversity, 16 internationally renowned scholars reflect on the nature and history of peoplehood and discuss how narratives inform national identities, public culture and academic historiography. The book is a timely contribution to the ongoing debate on belonging...
Tamura, Eileen H.
While narrative history has been the prevailing mode in historical scholarship, its preeminence has not gone unquestioned. In the 1980s, the role of narrative in historical writing was "the subject of extraordinarily intense debate." The historical backdrop of this debate can be traced to the preceding two decades, when four groups of thinkers…
I argue for a broad education in narratives as a way to address several problems found in moral psychology and social cognition. First, an education in narratives will address a common problem of narrowness or lack of diversity, shared by virtue ethics and the simulation theory of social cognition. Secondly, it also solves the "starting…
on a distinction between history and narrative, I outline an account of historical becoming through a process of sedimentation and a rich notion of what I call historical selfhood on an embodied level. Five embodied existentials are suggested, sketching a preliminary understanding of how selves are concretely......Narrative theories currently dominate our understanding of how selfhood is constituted and concretely individuated throughout personal history. Despite this success, the narrative perspective has recently been exposed to a range of critiques. Whilst these critiques have been effective in pointing...... out the shortcomings of narrative theories of selfhood, they have been less willing and able to suggest alternative ways of understanding personal history. In this article, I assess the criticisms and argue that an adequate phenomenology of personal history must also go beyond narrative. Drawing...
Herron, Mark A.
. The use of narratives of and by presidents in the White House can be seen as an essential part of the ceremonial role of the presidency. This use of narratives in epideictic speech has increased with modern day interests in the domestic life of the president, and the use of visual mass media......The dissertation Narrator-in-Chief: The Narrative Rhetoric of Barack Obama seeks to show how the concept of “narrative” can be used in rhetorical criticism of presidential speeches, particularly when considering the speeches and the biographical text, Dreams from My Father (1995), of Barack Obama...... as a communication platform for the president. While this has been described as a negative development (Stuckey, 1991; Salmon, 2010) this dissertation argues that narrative rhetoric should not be seen only as a negative part of political rhetoric, but also as a possibly vital way to educate the audience on issues...
Claret, Pierre-Géraud; Bobbia, Xavier; Macri, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean-Paul; de La Coussaye, Jean-Emmanuel
The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department. This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study. Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (pmedical imaging did not vary between the two periods. Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Moss, Hilary; O'Neill, Desmond
Introduction This paper presents three artists' residencies in a geriatric medicine unit in a teaching hospital. The aim of the residencies was creation of new work of high artistic quality reflecting the lived experience of the person with dementia and greater understanding of service user experience of living with dementia. This paper also explores arts-based research methodologies in a medical setting. Method Arts-based research and narrative enquiry were the method used in this study. Artists had extensive access to service users with dementia, family carers and clinical team. Projects were created through collaboration between clinical staff, arts and health director, artist, patients and family carers. Each performance was accompanied by a public seminar discussing dementia. Evaluations were undertaken following each residency. The process of creating artistic responses to dementia is outlined, presented and discussed. Results The artworks were well received with repeat performances and exhibitions requested. Evaluations of each residency indicated increased understanding of dementia. The narratives within the artworks aided learning about dementia. The results are a new chamber music composition, a series of visual artworks created collaboratively between visual artist and patients and family carers and a dance film inspired by a dancer's residency, all created through narrative enquiry. These projects support the role of arts-based research as creative process and qualitative research method which contributes to illuminating and exploring the lived experience of dementia. The arts act as a reflective tool for learning and understanding a complex health condition, as well as creating opportunities for increased understanding and public awareness of dementia. Issues arising in arts-based research in medical settings are highlighted, including ethical issues, the importance of service user narrative and multidisciplinary collaboration in arts and health
Graaf, A.M.; Hoeken, J.A.L.; Sanders, J.M.; Beentjes, J.W.J.
Several models of narrative persuasion posit that a reader's phenomenological experience of a narrative plays a mediating role in the persuasive effects of the narrative. Because the narrative reading experience is multi-dimensional, this experiment investigates which dimensions of this experience -
Graaf, A. de; Hoeken, J.A.L.; Sanders, J.M.; Beentjes, J.W.J.
Several models of narrative persuasion posit that a reader's phenomenological experience of a narrative plays a mediating role in the persuasive effects of the narrative. Because the narrative reading experience is multi-dimensional, this experiment investigates which dimensions of this experience –
is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through e.g. psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important...... role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing...
The dissertation, consisting of an introductory essay and four independent articles, provides phenomenological investigations into the relation between embodied selfhood and narrative. More precisely, it investigates this relation in regards to three specifying questions: (1) What is the relation...
This paper uses discussion of Edmund Spenser's "The Faerie Queene" to present a theoretical framework for explaining the semantics of narrative discourse. The algebraic theory of finite automata is used. (CK)
Donzelli, Gianpaolo; Paddeu, Erika Maria; D'Alessandro, Francesca; Nanni Costa, Alessandro
Narrative medicine allows professionals from all fields of medical sciences to understand the patient's total experience of illness, and meet his/her needs in an empathetic environment. Narrative medicine helps spread holistic knowledge of a multitude of complex clinical conditions, including transplantation. To underline the role of narrative medicine in women who become pregnant after a liver transplant by using their narrations of this very special experience. We describe our study with narration and listening to the stories of three women expecting their first child after a liver transplant, by analysing the structure and role of narration in the context of relationships between patients and caregivers. The narrations were transcribed verbatim with the main plot analysed in order to address all the aspects of this rare clinical condition and the transition to parenthood. The women narrated this experience in three phases: transplantation, pregnancy and delivery, and post-partum. They described all phases of pregnancy as stressful but satisfying, whereas the fact of becoming a mother was perceived as a victory both as a woman and as a transplant patient. Our results suggest that narrative medicine represents a significant professional tool for caring for transplant patients during pregnancy.
Steinhardt, Joseph; Shapiro, Michael A
Narrative messages are increasingly popular in health and risk campaigns, yet gain/loss framing effects have never been tested with such messages. Three experiments examined framing in narrative messages. Experiment 1 found that only the character's decision, not framing, influenced judgments about characters in a narrative derived from a prospect theory context. Experiment 2 found that a framing effect that occurred when presented in a decision format did not occur when the same situation was presented as a narrative. Using a different story/decision context, Experiment 3 found no significant difference in preference for surgery over radiation therapy in a narrative presentation compared to a non-narrative presentation. The results suggest that health and risk campaigns cannot assume that framing effects will be the same in narrative messages and non-narrative messages. Potential reasons for these differences and suggestions for future research are discussed. © 2015 Society for Risk Analysis.
Nahari, Galit; Glicksohn, Joseph; Nachson, Israel
Two experiments were conducted in order to find out whether textual features of narratives differentially affect credibility judgments made by judges having different levels of absorption (a disposition associated with rich visual imagination). Participants in both experiments were exposed to a textual narrative and requested to judge whether the narrator actually experienced the event he described in his story. In Experiment 1, the narrative varied in terms of language (literal, figurative) and plausibility (ordinary, anomalous). In Experiment 2, the narrative varied in terms of language only. The participants' perceptions of the plausibility of the story described and the extent to which they were absorbed in reading were measured. The data from both experiments together suggest that the groups applied entirely different criteria in credibility judgments. For high-absorption individuals, their credibility judgment depends on the degree to which the text can be assimilated into their own vivid imagination, whereas for low-absorption individuals it depends mainly on plausibility. That is, high-absorption individuals applied an experiential mental set while judging the credibility of the narrator, whereas low-absorption individuals applied an instrumental mental set. Possible cognitive mechanisms and implications for credibility judgments are discussed.
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Coulter, Cathy A.
The author responds to comments by Barone (2009), Clandinin and Murphy (2009), and M. W. Smith (2009) on "The Construction Zone: Literary Elements in Narrative Research" (Coulter & M. L. Smith, 2009). She clarifies issues regarding point of view, authorial surplus, narrative coherence, and the relational qualities of narrative research. She…
Popova, Yanna B
This paper proposes an understanding of literary narrative as a form of social cognition and situates the study of such narratives in relation to the new comprehensive approach to human cognition, enaction. The particular form of enactive cognition that narrative understanding is proposed to depend on is that of participatory sense-making, as developed in the work of Di Paolo and De Jaegher. Currently there is no consensus as to what makes a good literary narrative, how it is understood, and why it plays such an irreplaceable role in human experience. The proposal thus identifies a gap in the existing research on narrative by describing narrative as a form of intersubjective process of sense-making between two agents, a teller and a reader. It argues that making sense of narrative literature is an interactional process of co-constructing a story-world with a narrator. Such an understanding of narrative makes a decisive break with both text-centered approaches that have dominated both structuralist and early cognitivist study of narrative, as well as pragmatic communicative ones that view narrative as a form of linguistic implicature. The interactive experience that narrative affords and necessitates at the same time, I argue, serves to highlight the active yet cooperative and communal nature of human sociality, expressed in the many forms than human beings interact in, including literary ones.
Yanna B. Popova
Full Text Available This paper proposes an understanding of literary narrative as a form of social cognition and situates the study of such narratives in relation to the new comprehensive approach to human cognition, enaction. The particular form of enactive cognition that narrative understanding is proposed to depend on is that of participatory sense-making, as developed in the work of Di Paolo and De Jaegher. Currently there is no consensus as to what makes a good literary narrative, how it is understood, and why it plays such an irreplaceable role in human experience. The proposal thus identifies a gap in the existing research on narrative by describing narrative as a form of intersubjective process of sense-making between two agents, a teller and a reader. It argues that making sense of narrative literature is an interactional process of co-constructing a story-world with a narrator. Such an understanding of narrative makes a decisive break with both text-centered approaches that have dominated both structuralist and early cognitivist study of narrative, as well as pragmatic communicative ones that view narrative as a form of linguistic implicature. The interactive experience that narrative affords and necessitates at the same time, I argue, serves to highlight the active yet cooperative and communal nature of human sociality, expressed in the many forms than human beings interact in, including literary ones.
Narratives may be easy to come by, but not everything is worth narrating. What merits a narrative? Here, I follow the lead of narratologists and literary theorists, and focus on one particular proposal concerning the elements of a story that make it narrative-worthy. These elements correspond to features of the natural world addressed by the historical sciences, where narratives figure so prominently. What matters is contingency. Narratives are especially good for representing contingency and accounting for contingent outcomes. This will be squared with a common view that narratives leave no room for chance. On the contrary, I will argue, tracing one path through a maze of alternative possibilities, and alluding to those possibilities along the way, is what a narrative does particularly well. Copyright © 2016 Elsevier Ltd. All rights reserved.
Calleja, Gordon; Digital Games Research Association (DiGRA) 2009 Conference
This paper explores the contentious notion of experiential narrative and proposes the first step in a narrative framework for game environment. It argues for a shift in emphasis from story-telling, the dominant mode of narrative in literature and cinema, to story generation. To this effect the paper forwards a perspective on experiential narrative that is grounded in the specific qualities of the game. This avoids the over-generalization that tends to accompany discussions of experiential nar...
This talk will focus on cognitive processes between conscious and subconscious awareness in order to present a slightly different definition of narrative. Rather than simply accepting that narrative is a conscious selection of stories subject to bias, I will argue that biases are the primary structure of narrative and that their success is explained in painfully simple terms.
design ideas. The concept of engaging personas and narrative scenario explores personas in the light of what what it is to identify with and have empathy with a character. The concept of narrative scenarios views the narrative as aid for exploration of design ideas. Both concepts incorporate...... a distinktion between creating, writing and reading. Keywords: personas, scenarios, user-centered design, HCI...
In this paper, the author aims to substantiate Freud's claim that neurotic illness creates gaps in autobiographical narratives in terms of the narrator's stating and inducing perspectives. He sketches out the role of narrative perspective and the joint taking of a shared perspective by analyst and patient in psychoanalytic therapy. He introduces four ways of representing perspectives in narratives. Three degrees of narrative distortion are exemplified by three excerpts from life narratives and explored in terms of narrative perspective representation. The most comprehensive perspective representation is achieved in the first example by explicitly stating the present perspective of the narrator as well as the past perspective of the story's protagonist by use of mental verbs. In the second narrative, exclusive use of linguistic forms for inducing the protagonist's perspective both overwhelms the narrator and gives the listener an incomplete picture of what happened. Inconsistent motives, denial of responsibility and omission of detail render the third narrative even more difficult to follow. The author discusses the clinical significance of this exploratory analysis of perspectives in narratives in terms of claiming responsibility for one's past action and of level of defence mechanisms, and by highlighting the emotional impact on listeners, which the author suggests is the stronger the more perspectives are left out. He discusses analogies to countertransference. The analysis of narrative perspectives offers an approach for systematic research in psychoanalytic practice.
Søndergaard Jakobsen, Nina; Kaufmann, Lisbeth; Hennesser, Yvonne
Using cases and empirical data from a research and development project at a Danish prevention center, this study explores whether and how the use of narrative dietary counseling can strengthen dietitians' relationships and collaboration with clients who are chronically ill. The results of the study...... dietary counseling empowered clients and improved relationship building and collaboration between client and dietitian....
Home; Journals; Resonance – Journal of Science Education; Volume 3; Issue 1. Special Relativity – An Exoteric Narrative ! S R Madhu Rao. Classroom Volume 3 Issue 1 January 1998 pp 61-66. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/003/01/0061-0066 ...
Lodi-Smith, Jennifer; Geise, Aaron C; Roberts, Brent W; Robins, Richard W
The present research investigated the longitudinal relations between personality traits and narratives. Specifically, the authors examined how individual differences in 170 college students' narratives of personality change (a) were predicted by personality traits at the beginning of college, (b) related to actual changes and perceived changes in personality traits during college, and (c) related to changes in emotional health during college. Individual differences in narratives of personality trait change told in the 4th year of college fell into 2 dimensions: affective processing, characterized by positive emotions, and exploratory processing, characterized by meaning making and causal processing. Conscientious, open, and extraverted freshmen told exploratory stories of change as seniors. Emotionally healthy freshmen told stories of change that were high in positive affect. Both positive affective and exploratory stories corresponded to change in emotional stability and conscientiousness during college above and beyond the effects of perceived changes in these traits. In addition, both positive affective and exploratory narratives corresponded to increases in emotional health during college independent of the effects of changes in personality traits. These findings improve our understanding of how individuals conceptualize their changing identity over time.
(co-editor with Carly McLaughlin and Wladyslaw Witalisz) This book presents articles resulting from joint research on the representations of migration conducted in connection with the Erasmus Intensive Programme entitled «Migration and Narration» taught to groups of international students over...
Hansen, Per Krogh
to the position of A. Nünning. In the final section, a four-category taxonomy for the different textual strategies that establishes unreliable narration is suggested. The headlines for the taxonomy are intranarrational unreliability, internarrational unreliability, intertextual unreliability, and extratextual...
NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited BATTLE OF NARRATIVES...from the NAVAL POSTGRADUATE SCHOOL June 2012 Author: Lars Ruth Approved by: Prof. Sean F. Everton Thesis Advisor Dr. Hy...are more important than are others. For example, for some, social security and taxes are very important while gun control and LGBT are not. For
Møller-Jensen, Lasse; Jeppesen, Henrik; Kofie, Richard Y.
on the thematically and narrative linking of a set of locations within an area. A spatial narrative that describes the - largely unsuccessful - history of Danish plantations on the Gold Coast (1788-1850) is implemented through the Google Earth client. This client is seen both as a type of media in itself for ‘home......-based' exploration of sites related to the narrative and as a tool that facilitates the design of spatial narratives before implementation within portable GIS devices. The Google Earth-based visualization of the spatial narrative is created by a Python script that outputs a web-accessible KML format file. The KML...
Drukteinis, Albert M
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.
What are the links between narrative theories and computing? Narrative works are countless in the digital world: narrative hypertext and hypermedia, interactive fiction, video games, blogs, location-based narrative, etc. They not only form new analytical objects for narrative theories, but also may extend existing narrative theories. One specific type of digital narratives, AI-based Interactive Digital Narrative (IDN), plays a special role in this landscape because it makes use of narrative t...
Engaging in self-narrative is often touted as a powerful antidote to the bad effects of illness. However, there are various examples of what may broadly be termed "aversion" to illness narrative. I group these into three kinds: aversion to certain types of illness narrative; aversion to illness narrative as a whole; and aversion to illness narrative as an essentially therapeutic endeavor. These aversions can throw into doubt the advantages claimed for the illness narrator, including the key benefits of repair to the damage illness does to identity and life-trajectory. Underlying these alleged benefits are two key presuppositions: that it is the whole of one's life that is narratively unified, and that one's identity is inextricably bound up with narrative. By letting go of these assumptions, illness narrative advocates can respond to the challenges of narrative aversions. © The Author 2016. Published by Oxford University Press, on behalf of The Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Lasiter, Sue; Marchiondo, Lisa; Marchiondo, Kathleen
Academic incivility remains a problem on college campuses. Nursing research has refocused from student impropriety to aberrant faculty behaviors. Our original study using the Nursing Education Environment Survey showed that 133 of 152 student participants experienced uncivil treatment. Latent, inductive content analysis was undertaken to analyze narratives about their "worst experience" of negative faculty behavior. Four categories were identified: "In front of someone," "Talked to others about me," "Made me feel stupid," and "I felt belittled." Incivility had a profound effect on students and is problematic because it increases already significant academic pressure; it interferes with learning and safe clinical performance; it is contrary to caring, a central nursing concept; and it decreases program satisfaction and retention. Few nursing schools have civility policies for faculty behavior. Formal procedures that promote professional interaction should be crafted and implemented. Equally important is creating ways for nursing students to document incivility without fear of retaliation. Copyright © 2012 Elsevier Inc. All rights reserved.
Full Text Available This paper discusses the expressions used to refer to the experience of immersive in narrative games. The starting point is a review of the meanings associated with the suspension of disbelief in literature, cinema and television, challenging the myth of the naïve audience that cannot distinguish between representation and reality. Two characteristics of interactive media narratives – the possibility of agency and the disparities between hardware and software interfaces – reveal the active nature of the audience’s involvement with media representations. It is proposed that, in the case of games, this ability, which allows for simultaneous actions in the world of games and in the real world, is better described as a performance of belief.
Bo, Inger Glavind
I kapitlet gennemgås en socialkonstruktivistisk forståelse af narrativer. I kapitlet vil jeg gennemgå centrale teoretiske pointer, der samlet set er grundlæggende for en social konstruktivistisk forståelse af narrativer for herved at udfolde forståelsen af den narrative tilgang og desuden...... tydeliggøre, hvordan tilgangen er forbundet med en særlig forståelse af identitetsskabelse. Der er tale om pointer der almindeligvis forbindes med ”små fortællinger” i form af længere identitetsfortællinger og narrative interviews. Kapitlet gennemgår således centrale inspirationskilder og teoretiske pointer...
Reddy, Rajakumari P.; Hirisave, Uma
Play has been recognized as an essential component to children's healthy development. Schools of play therapy differ philosophically and technically, but they all embrace the therapeutic and developmental properties of play. This case report is an illustration of how a 6-year-old child with emotional disorder was facilitated to express concerns in child-centered play therapy. The paper discusses the therapist's narration of the child's play. PMID:24860228
This paper provides a general overview of theories and tools to model individual and collective decision-making. In particular, stress is laid on the interaction of several decision-makers. A substantial part of this paper is devoted to utility maximization and its application to collective decision-making, Game Theory. However, the pitfalls of utility maximization are thoroughly discussed, and the radically alternative approach of viewing decision-making as constructing narratives is pre...
De Silveira, Cybèle; Habermas, Tilmann
Adolescence is a passage from dependence to adult responsibility. Alongside identity development, social-cognitive development, and the ability to construct a life story, adolescents become increasingly aware of both their potential responsibility in an expanded sphere of life and of complex, contextual influences on their lives. This was partially tested in a cross-sectional study, both in terms of linguistic means and content expressed in life narratives. Indicators were defined for narrative agency, grading of responsibility, serendipity, and turning points, and tested for age differences in relative frequencies in 102 life narratives from age groups of 8, 12, 16, and 20 years, balanced for gender. Narrative grading of responsibility, serendipity, and turning points increased throughout adolescence. The relative frequency of narrative agency, in contrast, remained constant across age groups. Results are interpreted in the context of adolescent development of narrative identity.
Full Text Available Narrative is one of many qualitative methodologies that can be brought to bear in collecting and analysing data and reporting results, though it is not as frequently used as say in case studies. This article provides a window into its use, from the perspective of a researcher who has used it consistently over the past decade to examine early career researcher experience – doctoral students, and those who have completed their degrees and are advancing their careers. This experience has contributed to a robust understanding of the potential of narrative, as well as its limitations. This paper first lays out the broad landscape of narrative research and then makes transparent the thinking, processes and procedures involved in the ten-year narrative study including the potential for creativity that narrative invites. The goal is to engage other researchers to consider exploring the use of narrative – if it aligns with their epistemological stance.
Habermas, Tilmann; Meier, Michaela; Mukhtar, Barbara
Two studies test the assertion that anger, sadness, fear, pride, and happiness are typically narrated in different ways. Everyday events eliciting these 5 emotions were narrated by young women (Study 1) and 5- and 8-year-old girls (Study 2). Negative narratives were expected to engender more effort to process the event, be longer, more grammatically complex, more often have a complication section, and use more specific emotion labels than global evaluations. Narratives of Hogan's (2003) juncture emotions anger and fear were expected to focus more on action and to contain more core narrative sections of orientation, complication, and resolution than narratives of the outcome emotions sadness and happiness. Hypotheses were confirmed for adults except for syntactic complexity, whereas children showed only some of these differences. Hogan's theory that juncture emotions are restricted to the complication section was not confirmed. Finally, in adults, indirect speech was more frequent in anger narratives and internal monologue in fear narratives. It is concluded that different emotions should be studied in how they are narrated, and that narratives should be analyzed according to qualitatively different emotions.
Vries, M.C. de; Houtlosser, M.; Wit, J.M.; Engberts, D.P.; Bresters, D.; Kaspers, G.J.L.; Leeuwen, E. van
BACKGROUND: Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences
Van Herwaarden, Noortje; Van Den Bemt, Bart J F; Wientjes, Maike H M; Kramers, Cornelis; Den Broeder, Alfons A
Biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) have improved the treatment outcomes of inflammatory rheumatic diseases including Rheumatoid Arthritis and spondyloarthropathies. Inter-individual variation exists in (maintenance of) response to bDMARDs. Therapeutic Drug Monitoring (TDM) of bDMARDs could potentially help in optimizing treatment for the individual patient. Areas covered: Evidence of clinical utility of TDM in bDMARD treatment is reviewed. Different clinical scenarios will be discussed, including: prediction of response after start of treatment, prediction of response to a next bDMARD in case of treatment failure of the first, prediction of successful dose reduction or discontinuation in case of low disease activity, prediction of response to dose-escalation in case of active disease and prediction of response to bDMARD in case of flare in disease activity. Expert opinion: The limited available evidence does often not report important outcomes for diagnostic studies, such as sensitivity and specificity. In most clinical relevant scenarios, predictive value of serum (anti-) drug levels is absent, therefore the use of TDM of bDMARDs cannot be advocated. Well-designed prospective studies should be done to further investigate the promising scenarios to determine the place of TDM in clinical practice.
Hansen, Per Krogh
Per Krogh Hansen brings attention to one of the most discussed narratological concepts in recent years, the ‘unreliable narrator’. In the article »The Dynamics of Unreliable Narration«, Hansen is considering to what extent the question of authorial control or intention is relevant when analysing...... and interpreting unreliable narrators. In the first part of the article, he questions this claimed essentiality of an authorial agent from three different angles: One concerning the border between diegetic and extradiegetic issues. Another with specific focus on unreliable simultaneous narration (first person......, present tense). And a third with attention paid to the role of unreliable narrators in factual narratives. In the article, he proposes a model for describing the different dynamic roles the authorial agent, as well as the empirical reader, plays in different forms of unreliable narration. Here, terms like...
Full Text Available This thematic issue addresses how strategic narratives affect international order. Strategic narratives are conceived of as stories with a political purpose or narratives used by political actors to affect the behavior of others. The articles in this issue address two significant areas important to the study of international relations: how strategic narratives support or undermine alliances, and how they affect norm formation and contestation. Within a post-Cold War world and in the midst of a changing media environment, strategic narratives affect how the world and its complex issues are understood. This special issue speaks to the difficulties associated with creating creative and committed international cooperation by noting how strategic narratives are working to shape the Post-Cold War international context.
Full Text Available The present study aimed to review and discuss the recommended and recently suggested protocols by Iranian researchers for a long-term treatment of delayed complications of sulfur mustard (DCSM in veterans. As indicated clinically, patients who suffer from delayed ocular complications of sulfur mustard (DOCS benefit from treatments for dry eyes, therapeutic contact lenses, amniotic membrane transplantation; blepharorrhaphy, tarsorrhaphy, limbal stem cell transplantation; corneal transplantation, topical steroids, and immunosuppressive. In spite of penetrating keratoplasty, lamellar keratoplasty and keratolimbal allograft had a good long-term survival. Delayed respiratory complications (DRCS are the most common effects and life-threatening in Iranian veterans. The recommended treatment protocols include regular clinical evaluations, respiratory physiotherapy and rehabilitation, N-acetyl cysteine; warm humidified air, long-acting 2-agonists, and inhaled corticosteroids. Azithromycin has also been effective in improving clinical conditions, pulmonary function tests, inflammatory indexes, and life quality of the veterans. Interferon gamma (IFN-γ and helium: oxygen combination were also used in severe DRCS with good results. Some of the delayed cutaneous complications (DCCS such as itching affects the quality of life of victims. Regular but not frequent showering and bathing, applying sunscreen compounds, topical corticosteroids, and systemic antihistamines reduce the problems of DCCS patients. Several compounds such as capsaicin cream, pimecrolimus, IFN-γ, phenol-menthol; Aloe vera/olive oil cream, cetirizine, doxepine, and hydroxyzine were evaluated in DCCS patients with some benefits. The physicians in charge of veterans emphasize the importance of a healthy lifestyle, appropriate financial/social/cultural supports, and a degree of reassurance and supportive care on the clinical improvement of patients.
Full Text Available The article presents the different types of narratives in marketing communications. Presented essence of thesignr in the narrative, the power of myth, power of archetype and consistency of monomith in marketing. It is discussed on the advertising message perceived through the prism of commercial semiotics. The strength of the narrative is presented in the context of storytelling. The paper also presents a case study of marketing communications.
... (PRCs) have become an important quality standard in clinical trials and research involving human... study protocols developed under NHLBI funded Clinical Trial Networks. These committees are composed of... research areas. The NHLBI is charged with ensuring the highest quality of each Institute-funded clinical...
Habermas, Tilmann; Döll-Hentschker, Susanne
We ask which are the clinically relevant qualities of narratives in psychotherapy and how they can be measured. On the background of psychoanalytic assumptions and narrative theory, we propose to measure formal narrative processes which stay close to the linguistic surface, because these escape conscious control. We propose five aspects of narratives to be especially sensitive to distortions and therefore prone to change in successful therapies: (1) The actual chronological, stepwise narrating of events, (2) the intentional structuring of events, or emplotment, (3) the immediate evaluation, (4) the reflected interpretation of events, and finally (5) the consistency and completeness of the narrative. For each aspect we discuss ways to measure them. Finally the aspects are illustrated with excerpts from a series of diagnostic interviews. Implications for the analysis of the co-narrative role of the therapist are suggested.
Mordhorst, Mads; Schwarzkopf, Stefan
’ of the 1970s. It then compares the different conceptualisations of narrative analysis that have emerged in historical research and in management and organisational studies. Finally, this introduction points out various ways in which business history can become enriched if its practitioners become more aware......This article, and the special issue that it introduces, encourages business historians to reflect on the narrative nature of the work they produce. The articles provides an overview of how and why narratives came to occupy such a prominent status during the linguistic and narrative ‘turns...
Curtò, L; Trimarchi, F
Hypopituitarism is an uncommon and under-investigated endocrine disorder in old age since signs and symptoms are unspecific and, at least in part, can be attributed to the physiological effects of aging and related co-morbidities. Clinical presentation is often insidious being characterized by non-specific manifestations, such as weight gain, fatigue, low muscle strength, bradipsychism, hypotension or intolerance to cold. In these circumstances, hypopituitarism is a rarely life-threatening condition, but evolution may be more dramatic as a result of pituitary apoplexy, or when a serious condition of adrenal insufficiency suddenly occurs. Clinical presentation depends on the effects that each pituitary deficit can cause, and on their mutual relationship, but also, inevitably, it depends on the severity and duration of the deficit itself, as well as on the general condition of the patient. Indeed, indications and methods of hormone replacement therapy must include the need to normalize the endocrine profile without contributing to the worsening of intercurrent diseases, such as those of glucose and bone metabolism, and the cardiovascular system, or to the increasing cancer risk. Hormonal requirements of elderly patients are reduced compared to young adults, but a prompt diagnosis and appropriate treatment of pituitary deficiencies are strongly recommended, also in this age range.
Afifi, Ladan; Shinkai, Kanade
Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.
Full Text Available The purpose of the present study was to compare the effects of two different teaching methods on students' comprehension during Physical Education lesson: narration versus animation with concurrent narration, during teaching shot put event. Thirty primary school children (boys and girls volunteered to participate in this study. In experiment students listened (narration and viewed (animation with narration the presentation of two shot putting styles. A problem-solving and a retention test were used to evaluate students' comprehension. Results showed that students' comprehension was better when shot putting styles were presented through a mixed model (animation and narration group than a single (narration. The animation with concurrent narration group performed better than the narration group, in problem-solving (M = 4.91, SD = 1.36 and in retention test (M = 5.98, SD = 1.28 t(28 = 1.89 p<0.01. An instructional implication is that pictures with words is more effective way of teaching when they occur continuingly in time, than only words during Physical Education lesson.
This article is a tribute to Michael White, co-founder of narrative therapy, who passed away on 5 April 2008. Michael White and David Epston founded a substantial and ground-breaking psychological movement based on narrative therapy. Michael touched with dignity and changed for the better the lives of thousands.
Dallos, Rudi; Vetere, Arlene
This article outlines an integration of attachment theory with narrative theory and systemic theory and practice: Attachment Narrative Therapy (ANT). This integration offers a more powerful explanatory formulation of the development and maintenance of human distress in relationships, families and communities, and gives direction to psychotherapeutic intervention. © The Author(s) 2014.
This paper argues that the representation of psychiatric malingering in literary and cinematographic narratives informs societal stereotypes, and thus influences the clinical phenomenology of malingering. The study aims to identify sociocultural models of malingering in contemporary Western society based on the narrative analysis of about 60 fictional and non-fiction texts. Two behavioural patterns derived from the Foucauldian categories folly and madness are recognisable in naïve conceptualisations of fake insanity. Fabricated significations of deviation originate in grand societal narratives rather than in medical discourse, and construct characters such as animal like underdeveloped simpletons or detached, irrational, violent madmen. Each pattern stems from its own archaic conceptual basis and dictates a distinct framework for strategies of malingering. The semiotic structure of artistic narratives of malingering is discussed in comparison with the symptomatology of existing psychiatric models.
... (specialty) health care: At your clinical facility, how is the patient's work information collected... the Clinical Setting: Electronic Health Records AGENCY: The National Institute for Occupational Safety... Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), Department of...
Treloar, Anna; Stone, Teresa Elizabeth; McMillan, Margaret; Flakus, Kirstin
Research papers present us with the summaries of scholars' work; what we readers do not see are the struggles behind the decision to choose one methodology over another. A student's mental health portfolio contained a narrative that led to an exploration of the most appropriate methodology for a projected study of clinical anecdotes told by nurses who work in mental health settings to undergraduates and new recruits about mental health nursing. This paper describes the process of struggle, beginning with the student's account, before posing a number of questions needing answers before the choice of the most appropriate methodology. We argue, after discussing the case for the use of literary analysis, discourse analysis, symbolic interactionism, hermeneutics, and narrative research, that case study research is the methodology of choice. Case study is frequently used in educational research and is sufficiently flexible to allow for an exploration of the phenomenon. © 2014 Wiley Periodicals, Inc.
This paper considers how the integral theory model of Nancy Davis and Laurie Callihan might be enacted using a different qualitative methodology, in this case the narrative methodology. The focus of narrative research is shown to be on "what meaning is being made" rather than "what is happening here" (quadrant 2 rather than…
Bavelas, J B; Coates, L; Johnson, T
A collaborative theory of narrative story-telling was tested in two experiments that examined what listeners do and their effect on the narrator. In 63 unacquainted dyads (81 women and 45 men), a narrator told his or her own close-call story. The listeners made 2 different kinds of listener responses: Generic responses included nodding and vocalizations such as "mhm." Specific responses, such as wincing or exclaiming, were tightly connected to (and served to illustrate) what the narrator was saying at the moment. In experimental conditions that distracted listeners from the narrative content, listeners made fewer responses, especially specific ones, and the narrators also told their stories significantly less well, particularly at what should have been the dramatic ending. Thus, listeners were co-narrators both through their own specific responses, which helped illustrate the story, and in their apparent effect on the narrator's performance. The results demonstrate the importance of moment-by-moment collaboration in face-to-face dialogue.
Reese, Elaine; Fivush, Robyn; Merrill, Natalie; Wang, Qi; McAnally, Helena
Adolescents' intergenerational narratives--the stories they tell about their mothers' and fathers' early experiences--are an important component of their identities (Fivush & Merrill, 2016; Merrill & Fivush, 2016). This study explored adolescents' intergenerational narratives across cultures. Adolescents aged 12 to 21 from 3 cultural…
Narrative inquiry is gaining momentum in the field of nursing. As a research approach it does not have any single heritage of methodology and its practitioners draw upon diverse sources of influence. Central to all narrative inquiry however, is attention to the potential of stories to give meaning to people's lives, and the treatment of data as stories. This is the first of two papers on the topic and addresses the theoretical influences upon a particular narrative inquiry into nursing scholars and scholarship. The second paper, Conducting a narrative analysis, describes the actual narrative analysis as it was conducted in this same study. Together, the papers provide sufficient detail for others wishing to pursue a similar approach to do so, or to develop the ideas and procedures according to their own way of thinking. Within this first theoretical paper, perspectives from Jerome Bruner (1987) and Wade Roof (1993) are outlined. These relate especially to the notion of stories as 'imaginative constructions' and as 'cultural narratives' and as such, highlight the profound importance of stories as being individually and culturally meaningful. As well, perspectives on narrative inquiry from nursing literature are highlighted. Narrative inquiry in this instance lies within the broader context of phenomenology.
Bruni, Luis Emilio; Baceviciute, Sarune; Arief, Mohammed
In this article we explore some of the methodological problems related to characterizing cognitive aspects of involvement with interactive narratives using well known EEG/ERP techniques. To exemplify this, we construct an experimental EEG-ERP set-up with an interactive narrative that considers th...
Wilson, Andrew T. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Pattengale, Nicholas D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Forsythe, James C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Carvey, Bradley John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
In cybersecurity forensics and incident response, the story of what has happened is the most important artifact yet the one least supported by tools and techniques. Existing tools focus on gathering and manipulating low-level data to allow an analyst to investigate exactly what happened on a host system or a network. Higher-level analysis is usually left to whatever ad hoc tools and techniques an individual may have developed. We discuss visual representations of narrative in the context of cybersecurity incidents with an eye toward multi-scale illustration of actions and actors. We envision that this representation could smoothly encompass individual packets on a wire at the lowest level and nation-state-level actors at the highest. We present progress to date, discuss the impact of technical risk on this project and highlight opportunities for future work.
Full Text Available This article describes the methodology and the outcomes of an empirical study of conflict narratives. The narratological analysis deployed narratological categories in the structuralist tradition based on Genette and was conducted with the help of the text annotation tool CATMA. The analysis aimed at covering as many narratological phenomena as possible by establishing 14 fields of narratological phenomena that were annotated in a corpus of 39 factual narratives about situations at the workplace with and without conflicts. The evaluation of approximately 28,000 annotations brought to light a series of interrelations between narratological phenomena and the presence or absence of conflicts in the narratives. Additionally, this approach led to the identification of some oversights of narrative theory by detecting hitherto unnoticed interrelations among narratological concepts.
... specific bioethical, legal, and social issues related to potential scientific and technological advances... related areas of science and technology. The Bioethics Commission is charged with identifying and... establishing ``no return'' policies, or stipulations in advance of clinical intervention, research, and/or...
Edwards, Sharon Lorraine
To describe and recommend a variety of data analysis methods when engaging in narrative research using story as an aid to nursing students' learning. Narrative research methodology is used in many nursing research studies. However, narrative research reports are generally unspecific regarding the analysis and interpretive process. This article examines the qualitative analytical approaches of Lieblich et al's ( 1998 ) narrative processes of holistic content and analysis of form, incorporated as overarching theories. To support these theories and to provide a more rounded analytical process, other authors' work is included. Approaching narrative analysis from different perspectives is recommended. For each cycle of analysis, it is important to conceptualise the analysis using descriptors drawn from the initial literature review and the initial text. Rigour and transparency are foremost, and tables are generated that reflect each stage of the analysis. The final stage of analysis is to clearly report, organise and present findings to reflect the richly varied and diverse potential of stories. Engaging in narrative research and then dealing with the large quantities of data to analyse can be daunting, difficult to manage and appear complex. It is also challenging and rewarding. With clear descriptors, examining the data using multiple lenses can serve to develop a greater level of insight into understanding nursing students' learning from their clinical experiences, presented as stories, when involved in the care of individuals. There are many approaches to narrative analysis in nursing research and it can be difficult to establish the main research approach best suited to the study. There is no single way to define narrative analysis and a combination of strategies can be applied.
Avdi, Evrinomy; Georgaca, Eugenie
This paper is a review of studies which utilise the notion of narrative to analyse psychotherapy. Its purpose is to systematically present this diverse field of research, to highlight common themes and divergences between different strands and to further the development and integration of narrative research in psychotherapy. The paper reviews studies which employ an applied textual analysis of narratives produced in the context of psychotherapy. Criteria for inclusion of studies are, firstly, the analysis of therapeutic and therapy-related texts and, secondly, the adoption of a narrative psychological perspective. The studies were examined on the basis of the notion of narrative they employ and the aspects of client narratives they focus on, and were grouped accordingly in the review. The majority of the studies reviewed assume a constructivist approach to narrative, adopt a representational view of language, focus primarily on client micro-narratives and relate to cognitive-constructivist and process-experiential psychotherapeutic approaches. A smaller group of studies assume a social constructionist approach to narrative and a functional view of language, focus on micro-narratives, highlight the interactional and wider social aspects of narrative and relate to postmodern trends in psychotherapy. The range of conceptualisations of narrative in the studies reviewed, from a representational psychological view to a constructionist social view, reflects tensions within narrative psychology itself. Moreover, two trends can be discerned in the field reviewed, narrative analysis of therapy, which draws from narrative theory and utilises the analytic approaches of narrative research to study psychotherapy, and analyses of narrative in therapy, which study client narratives using non-narrative qualitative methods. Finally, the paper highlights the need for integration of this diverse field of research and urges for the development of narrative studies of psychotherapy
Full Text Available Counter-terrorist practitioners and policy makers appear to be very interested in narrative. They often describe the worldview of violent Islamist groups and movements as the ‘jihadi narrative’, while their efforts to confront terrorist propaganda are usually labelled as ‘counter-narrative’ or ‘alternative narrative’. However, while the counter-narrative approach has gained widespread acceptance in governments, think-tanks and civil society organisations, it is built on very shaky theoretical and empirical foundations. Some valuable theoretical contributions to the study of violent extremist narrative have been made by psychologists in particular, but there is one discipline which is conspicuous by its absence from the field: literary studies. This paper makes a case for the value of studying violent extremist narratives as narratives in the literary sense. By employing the tools and techniques of literary criticism, violent extremist communication can be revealed as not only potentially persuasive, but also creative and aesthetically appealing: terrorists inspire their followers, they don’t merely persuade them. Understanding the creative sources of this inspiration is vital if counter-narrative is to succeed in presenting an alternative to the propaganda of violent extremist groups.
This article analysed the different narratives implied in Philemon by utilising the narrative therapeutic approach, as developed by Epston and White (1990). A dominant narrative (the harsh treatment of slaves in the early Christian environment) and a challenging narrative (a more humane conduct of slaves) were clearly ...
Fujii, Satoshi; Hasegawa, Taiki; Nakano, Takeshi; Hatori, Tsuyoshi
In human and society science, narrative is regarded as an important issue to understand dynamic actions of human being and society. Therefore, narrative is also expected to be important for public policies that try to improve dynamic actions of human being and society. In th is study, we review academic genealogies with respect to narratives including western philosophy, hermeneutics, historical science, historical philosophy, literary criticism, clinical psychology and sociology, narrative psychology and folklore. Then we discuss how narrative can be pragmatically applied for public policies.
Bronner, Anne; Hénaux, Viviane; Fortané, Nicolas; Hendrikx, Pascal; Calavas, Didier
Background Since 2005, France has been officially free of brucellosis, an infectious disease that causes abortion in cattle and can be transmitted from cattle to humans. Recent animal and human cases have drawn attention to the need to prevent infection of humans and animals from any primary outbreaks. In order to detect any new outbreaks as soon as possible, a clinical surveillance system requires farmers and veterinarians to report each abortion and to test the aborting cow for brucello...
Jul 1, 2017 ... conservation narratives and resource conflicts and degradation in Zambia‟s .... protection without being subject to human competition and exploitation. ..... guard was retrenched as part of the SAP process leaving the reserve ...
Full Text Available Narrative journalism is a method to craft stories worth reading about real people. In this article, we explore the ability of that communicative power to produce insights complementary to those obtainable through traditional qualitative and quantitative research methods. With examples from a study of journalistic narrative as patient involvement in professional rehabilitation, interview data transcribed as stories are analyzed for qualities of heterogeneity, sensibility, transparency, and reflexivity. Building on sociological theories of thinking with stories, writing as inquiry, and public journalism as ethnography, we suggest that narrative journalism as a common practice might unfold dimensions of subjective otherness of the self. Aspiring to unite writing in both transparently confrontational and empathetically dialogic ways, the narrative journalistic method holds a potential to expose dynamics of power within the interview.
Cort, Pia; Thomsen, Rie
on flexicurity and its implications for labour market transitions, little attention has been paid to the views and experiences of the individuals concerned. The aim of this article is to connect the grand narrative with individual narratives about labour market transitions in the Danish flexicurity system....... On the basis of narrative interviews with skilled workers, this article explores how labour market transitions are experienced by the individual and the role played by national support structures in the individual narratives. The article shows how, for the individual, a transition may prove to be a valuable...... learning experience during which radical career decisions are taken, and how support structures may work to the detriment of such learning and of the principles behind flexicurity. The article points to a reconceptualisation of transitions as important learning opportunities during which (more) adequate...
In this article I present a narrative theory of games, building on standard narra-tology, as a solution to the conundrum that has haunted computer game studies from the start: How to approach software that combines games and stories?......In this article I present a narrative theory of games, building on standard narra-tology, as a solution to the conundrum that has haunted computer game studies from the start: How to approach software that combines games and stories?...
Krenzen, Anette Elisabeth
Rapporten er en del af kandidatspeciale, der empirisk undersøger børns narrative kompetencer i skolestarten på Egumsvejens skole i Fredericia samt tilknyttede børneinstitutioner.......Rapporten er en del af kandidatspeciale, der empirisk undersøger børns narrative kompetencer i skolestarten på Egumsvejens skole i Fredericia samt tilknyttede børneinstitutioner....
mechanisms associated with storytelling .2 This is in contrast to the actual use of narrative terminology used in U.S. military lexicon, which connotes a...A spoken or written account of connected events, a Story; (2) The narrated part of literary work, as distinct from dialogue; and (3) the practice or...difficult task as emotional scenes of violence and destruction move quickly from mobile phones to the news media.5 Although application of the story form
De Haene, L.; Dalgård, Nina Thorup; Montgomery, E.
J Trauma Stress. 2013 Jun;26(3):413-7. doi: 10.1002/jts.21820. Attachment narratives in refugee children: interrater reliability and qualitative analysis in pilot findings from a two-site study.......J Trauma Stress. 2013 Jun;26(3):413-7. doi: 10.1002/jts.21820. Attachment narratives in refugee children: interrater reliability and qualitative analysis in pilot findings from a two-site study....
Full Text Available The research work done by the author investigates a phenomenological field—the subjective experience of chronic illness and disability—by means of a specific research instrument, the autobiographical narrative interview. It focuses on the concept of narrative identity and its empirical substrate in the scientifically generated texts. Narrative identity is regarded as a situated, pragmatic, autoepistemic and interactive activity drawing on culturally transmitted narrative conventions which is performed within the research context. We have been working with a systematic analytic approach which covers interactive and contextual aspects of the interview situation as well as rhetoric and positioning strategies in the act of telling. Other research questions concern the concept of "narrative coping" and the comparison of partner's narratives on problems of illness and disability, especially on scrutinizing aspects of identity and alterity (self and other in the texts. This work can be understood as combining aspects of the research domains of narratology, identity and coping on the background of a qualitative methodology. URN: urn:nbn:de:0114-fqs0002189
Bronner, Anne; Hénaux, Viviane; Fortané, Nicolas; Hendrikx, Pascal; Calavas, Didier
Since 2005, France has been officially free of brucellosis, an infectious disease that causes abortion in cattle and can be transmitted from cattle to humans. Recent animal and human cases have drawn attention to the need to prevent infection of humans and animals from any primary outbreaks. In order to detect any new outbreaks as soon as possible, a clinical surveillance system requires farmers and veterinarians to report each abortion and to test the aborting cow for brucellosis. However, under-reporting limits the sensitivity of this system. Our objective was to identify the barriers and motivations influencing field actors in their decision to report or not to report bovine abortions. We used a qualitative approach with semi-structured interviews of 12 cattle farmers and their eight veterinarians. Our analysis showed that four main themes influence the decision-making process of farmers and veterinarians: 1) the perceived risk of brucellosis and other abortive diseases; 2) the definition of a suspected case of brucellosis and other abortive diseases adopted by field actors, which is less sensitive than the mandatory definition; 3) the cost-benefit analysis conducted by actors, taking into account regulatory and health aspects, economic and financial losses, technical and practical factors; 4) the level of cooperation within the socio-technical network. We discussed how early detection may be improved by revising the definition of abortion, extending the time frame for notification and generalising the differential diagnosis of the causes of abortion. In contrast to quantitative approaches, qualitative studies can identify the factors (including unknown factors) influencing the decision-making process of field actors and reveal why they take those factors into consideration. Our qualitative study sheds light on the factors underlying the poor sensitivity of clinical brucellosis surveillance system for cattle in France, and suggests that early detection may be
Recognizing clinical medicine as a narrative undertaking fortified by learnable skills in understanding stories has helped doctors and teachers to face otherwise vexing problems in medical practice and education in the areas of professionalism, medical interviewing, reflective practice, patient-centered care, and self-awareness. The emerging practices of narrative medicine give clinicians fresh methods with which to make contact with patients and to come to understand their points of view. This essay provides a brief review of narrative theory regarding the structure of stories, suggesting that clinical texts contain and can reveal information in excess of their plots. Through close reading of the form and content of two clinical texts—an excerpt from a medical chart and a portion of an audio-taped interview with a medical student—and a reflection on a short section of a modernist novel, the author suggests ways to expand conventional medical routines of recognizing the meanings of patients' situations. The contributions of close reading and reflective writing to clinical practice may occur by increasing the capacities to perceive and then to represent the perceived, thereby making available to a writer that which otherwise might remain out of awareness. A clinical case is given to exemplify the consequences in practices of adopting the methods of narrative medicine. A metaphor of the activated cellular membrane is proposed as a figure for the effective clinician/patient contact. PMID:22373630
Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Pettigrew, Jonathan; Shin, YoungJu; Graham, John
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
This study has explored the related teaching of "narrative creation" and "narrative reading". For this study, I hypothesized as follows. There is "the method of narrative" in "narrative creation" and "narrative reading" as a common element. By this related teaching that used "the method of narrative" as a common element, children’s ability of "narrative creation" and "narrative reading" will increase. As a result of this study, the following conclusions were obtained. Children surely make use...
Min, Yul Ha; Park, Hyeoun-Ae; Lee, Joo Yun; Jo, Soo Jung; Jeon, Eunjoo; Byeon, Namsoo; Choi, Seung Yong; Chung, Eunja
The aim of this study is to develop and evaluate a natural language generation system to populate nursing narratives using detailed clinical models. Semantic, contextual, and syntactical knowledges were extracted. A natural language generation system linking these knowledges was developed. The quality of generated nursing narratives was evaluated by the three nurse experts using a five-point rating scale. With 82 detailed clinical models, in total 66,888 nursing narratives in four different types of statement were generated. The mean scores for overall quality was 4.66, for content 4.60, for grammaticality 4.40, for writing style 4.13, and for correctness 4.60. The system developed in this study generated nursing narratives with different levels of granularity. The generated nursing narratives can improve semantic interoperability of nursing data documented in nursing records.
Singer, Jefferson A; Blagov, Pavel; Berry, Meredith; Oost, Kathryn M
An integrative model of narrative identity builds on a dual memory system that draws on episodic memory and a long-term self to generate autobiographical memories. Autobiographical memories related to critical goals in a lifetime period lead to life-story memories, which in turn become self-defining memories when linked to an individual's enduring concerns. Self-defining memories that share repetitive emotion-outcome sequences yield narrative scripts, abstracted templates that filter cognitive-affective processing. The life story is the individual's overarching narrative that provides unity and purpose over the life course. Healthy narrative identity combines memory specificity with adaptive meaning-making to achieve insight and well-being, as demonstrated through a literature review of personality and clinical research, as well as new findings from our own research program. A clinical case study drawing on this narrative identity model is also presented with implications for treatment and research. © 2012 Wiley Periodicals, Inc.
Walker, Allison S.
This is a snapshot of a service learning course founded on narrative medicine, a clinical practice designed to replace impersonal care with empathic listening. By utilizing poetry therapy techniques among nursing home populations, a program called "HPU LifeLines" promotes a community literacy of illness and provides psychological and…
Veglia, Fabio; Di Fini, Giulia
What makes unique and unrepeatable individuals is their ability to write their own story attributing meaning, sharing it through narration, giving coherence to the information related to the interpersonal motivational systems, and creating alternative hierarchies to those biologically provided by the genetic code. Through clinical narratives and narrative literature, we can observe the recurrence of specific topics, across time and different cultures. Hence, we wondered whether there are some evolutionary suggestions that guide us in the construction of the narrative-autobiographical contents. In this article we proposed a theoretical-clinical hypothesis about the existence of a biological disposition to identify as fundamental six Life Themes (LTs) that contribute to defining the image of the self and the world: Love, Personal Value, Power, Justice, Truth, and Freedom. Besides the innumerable narratives dependent upon context, there may be many ways of telling stories that, instead, would be reported to these few essential themes. A narrative review of the literature about these concepts follows the systematic explanation of the perspective about the LTs as attractors of meaning. The manuscript considers also the process of co-construction of meanings within the interpersonal relationships and the influences of these on the narratives. In particular, we focused on the importance of episodic and autobiographical memory related to the attachment and significant figures, in the construction of the personal story and the LTs. We also explained the possible clinical implications of the theoretical hypothesis of LTs. Within clinical conversations, the LTs could be expressed rigidly or, otherwise, in a confused way. The lack of narrative integration may lead to the dominance of chaos or rigidity that generates suffering. A better comprehension of the LTs in patients’ narrations could be useful to identify a narrative profile about the areas of greatest suffering
Manners, Ian James; Murray, Philomena
the construction and application of an analytical framework drawing on different theoretical perspectives. This framework is then applied to six European integration narratives to demonstrate the value of a narrative approach. The article concludes that narrative analysis provides a means of understanding both EU......, the Nobel Prize and the search for a ‘new narrative for Europe’ demonstrate that the processes of European integration are always narrated as sense-making activities – stories people tell to make sense of their reality. This article argues in favour of a narrative approach to European integration through...
Please note that starting from 1 March 2007, the shuttle requests: for official visits or bidders' conferences on the CERN site; towards/from the airport or central Geneva; for long distances, shall be made via Fm.Support@cern.ch or by calling 77777. The radio taxi will still be reachable at 76969. TS/FM Group
Gillam, Sandra Laing; Hartzheim, Daphne; Studenka, Breanna; Simonsmeier, Vicki; Gillam, Ronald
This study was conducted to determine whether a narrative intervention program that targeted the use of mental state and causal language resulted in positive gains in narrative production for children with autism spectrum disorder (ASD). Five children (2 girls and 3 boys) who had been diagnosed with ASD participated in the study. Children ranged in age from 8 to 12 years and were recruited through an autism clinic. Intervention was provided for two 50-min individual sessions per week for a total of 21-33 sessions (depending on the student). Children's spontaneous stories, collected weekly, were analyzed for overall story complexity, story structure, and the use of mental state and causal language. Following a multiple-baseline across-participants design, data were collected for lagged baseline and intervention phases over a 6-month period. All of the children made gains on all 3 measures of narration after participating in the instruction, with clear changes in level for all 5 children and changes in trend for 4 of the 5 children. The gains were maintained after intervention was discontinued. The results demonstrate the efficacy of the 3-phase narrative instruction program for improving the fictional narration abilities of children with ASD.
Bond, Jennifer Lauren
Purpose: This work investigated the narratives of development extensionists in relation to natural resource conflict, in order to understand the competing discourses surrounding the wicked problems of natural resource management in Laikipia County, Kenya. Methodology: Q methodology was used...... to elicit the conflict narratives present among extension professionals. A concourse of 221 statements were devised from interviews and group discussions with key informants and a final sample of 49 statements was used for the sorting. Thirteen Q-sorts were undertaken with among rural extension...... professionals from government, non-government, faith-based and private organizations. Findings: Four factors were elicited from the data, labelled—A: ‘Improved Leadership’; B: ‘Resource-centred conflict’; C: ‘Improved Governance’; and D: ‘Improved Management’. Practical Implications: Narratives of neo...
Conlan, Owen; Staikopoulos, Athanasios; Hampson, Cormac; Lawless, Séamus; O'keeffe, Ian
This article describes the narrative approach to personalisation. This novel approach to the generation of personalised adaptive hypermedia experiences employs runtime reconciliation between a personalisation strategy and a number of contextual models (e.g. user and domain). The approach also advocates the late binding of suitable content and services to the generated personalised pathway resulting in an interactive composition that comprises services as well as content. This article provides a detailed definition of the narrative approach to personalisation and showcases the approach through the examination of two use-cases: the personalised digital educational games developed by the ELEKTRA and 80Days projects; and the personalised learning activities realised as part of the AMAS project. These use-cases highlight the general applicability of the narrative approach and how it has been applied to create a diverse range of real-world systems.
Lisa C. Yamagata-Lynch
Full Text Available The goal of this article is to introduce activity systems as a methodological tool in narrative inquiry to gain a holistic understanding of socially shared experiences from an examination of documents. The research question was how can qualitative researchers use activity systems as a tool for engaging in narrative inquiry of socially shared experiences to uncover new meanings by constructing a story? In this article, we share a sample analysis of our experience relying on documents and media as a form of narrative to begin to understand the socially shared human activity associated with net neutrality and its potential impact on U.S. residents. We end this article with reflections of lessons learned from our activity systems guided story construction process.
Noel, Melanie; Beals-Erickson, Sarah E.; Law, Emily F.; Alberts, Nicole; Palermo, Tonya M.
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
Narrative pedagogy is an approach to midwifery education which can promote strategies for teaching and learning which effectively prepare graduates for the complex nature of midwifery practice. Knowledge and skills are fundamental to midwifery practice, but knowing about how to use them is the art of practice. Teaching and learning midwifery skills and competencies is straight forward in comparison to teaching and learning about the art of midwifery, yet both are essential for safe practice. Narrative pedagogy may be one way that enhances undergraduate midwifery students' learning about the art of practice.
PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN ... This paper argues that the Setswana storytelling session is a highly participatory event. The paper ... Keywords: performance, storytelling, narrator, audience, narrative, Setswana ...
Deconstruction of conservative cinematic narratives on women's identity: an urging ... of regular but infamous dictates of culture and gender themes in film narratives. ... film criticism, women filmmakers, manipulation, Stereotype, deconstruction ...
Azmitia, Margarita; Ittel, Angela; Radmacher, Kimberley
Gender and self-esteem provide lenses through which early and late adolescents construct their narratives of ideal and actual friendships. These narratives provide a unique window into the dynamics of adolescents' friendships during school transitions.
Lammers, J.; Proulx, T.
Two experiments show that writing chronological autobiographical narratives increases political conservatism, defined as an ideology of resistance to social change. When writing chronological autobiographical narratives, we hypothesized that people would re-experience the events of their life in a
Kim, Young-Suk Grace
Purpose: The primary aim of the present study was to examine whether different ways of presenting narrative stimuli (i.e., live narrative stimuli versus audio-recorded narrative stimuli) influence children's performances on narrative comprehension and oral-retell quality. Method: Children in kindergarten (n = 54), second grade (n = 74), and fourth…
Su, I-Ru; Chou, Yi-Chun
Most of the research on second language (L2) narratives has focused on whether or how L2 learners carry their L1 narrative styles into L2 narration; few studies have explored whether L2 learners' knowledge of the L2 also in turn affects their L1 narrative performance. The present study attempted to probe the issue of cultural transfer in narrative…
Mages, Wendy K.
This article proposes a cognitive theory of how drama affects two aspects of language development: narrative comprehension and narrative production. It is a theoretical model that explicitly posits the role of the imagination in drama's potential to enhance the development of both narrative comprehension and narrative production. (Contains 2…
Fivush, Robyn; Bohanek, Jennifer G.; Zaman, Widaad; Grapin, Sally
In this study, the authors examined gender differences in narratives of positive and negative life experiences during middle adolescence, a critical period for the development of identity and a life narrative (Habermas & Bluck, 2000; McAdams, 2001). Examining a wider variety of narrative meaning-making devices than previous research, they found…
Nafziger, Jacinta; DeKruyf, Lorraine
This article introduces narrative counseling concepts and techniques for professional school counselors. The authors provide a case study of narrative school counseling with an elementary student struggling with selective mutism. Examples also demonstrate how a narrative approach could be used at elementary, middle, and high school levels within…
In this paper, I give an account of the ways in which narratives and identities change over space and time. I give an account of a mobile and changing human subject, one who does not simply express or represent her- or himself through narrative, but is constructed and reconstructed through narrative. I draw on Paul Ricoeur's concepts of "narrative…
The work of Carol Berkenkotter and others who have expanded the realm of personal narrative studies over the past several decades would not have been possible without the pioneering efforts of those who first brought the study of narrative to nonliterary discourses. By revisiting what personal narratives were to these pioneers-working outward from…
available to him, but it is interrupted by yet another unforeseen event: an earthquake which buries him alive in the sotterraneo where he lives. The story, and with it, the manuscript Tommaso has been composing, ends with the death of the narrator: a triple ending, where writing, narration and narrato coincide. The narrator is ...
Principles of a mobile gps-enabled gis acting as a tourist information system are discussed and exemplified with special focus on the narrative aspects of tourist guidance. Flexible adaptation to user movements is accomplished by providing information about objects that the user passes as well...
This essay reconsiders the importance of performativity to scholarship on life writing by exploring the potential of Eve Sedgwick's concept of the periper-formative utterance for reading queer life narratives. Taking the documentary Tarnation (2003) as an example, I argue that a range of life
The book welcomes proposals for chapter contributions on a wide array of topics related to the narratological notion of counter-narratives. By way of example, the topic has hitherto been treated by disciplines and subjects such as literature studies, organization studies, corporate communication...
Rowlinson, Michael; Casey, Andrea; Hansen, Per H.
Organizations remember through narratives and storytelling. The articles in this Special Issue explore the interface between organization studies, memory studies, and historiography. They focus on the practices for organizational remembering. Taken together, the articles explore the similarities...... and differences between ethnographic and historical methods for studying memory in organizations, which represents a contribution to the historic turn in organization studies....
The conception of the good life in theoretical texts and adult learners' written narratives depicts well-being in terms of aesthetic experiences, values, existential experiences, autonomy, and significant others. Future prospects for adult education as legislative practice, as therapy and as commitment are derived from the discussion. (SK)
Daugbjerg, Peer Schrøder
The neoliberal restructuring of the welfare state has changed the conditions for teacher practice. Teachers’ narratives have been collected in the western part of Denmark. They give insight in teacher practice and how teachers’ conditions for working have changed. 3 themes are discussed to illust...
Bodei, Chiara; Buchholtz, Mikael; Degano, Pierpablo
We perform a systematic expansion of protocol narrations into terms of a process algebra in order to make precise some of the detailed checks that need to be made in a protocol. We then apply static analysis technology to develop an automatic validation procedure for protocols. Finally, we...
Carbone, Claudia; Toft, Anne Elisabeth
Den følgende tekst består af to dele. Begge dele omhandler workshoppen The Making of London Narratives, der var et undervisningsforløb for 52 studerende fra Arkitektskolen Aarhus og School of Architecture and the Visual Arts University of East London. I den første del perspektiveres workshoppens...
Troy, Lisa M; Kietzman, Kathryn G
Academic researchers and clinicians have a critical role in shaping public policies to improve the health of an aging America. Policy narratives that pair personal stories with research statistics are a powerful tool to share knowledge generated in academic and clinical settings with policymakers. Effective policy narratives rely on a trustworthy and competent narrator and a compelling story that highlights the personal impact of policies under consideration and academic research that bolsters the story. Awareness of the cultural differences in the motivations, expectations, and institutional constraints of academic researchers and clinicians as information producers and U.S. Congress and federal agencies as information users is critical to the development of policy narratives that impact policy decisions. The current article describes the development and use of policy narratives to bridge cultures and enhance evidence-based public health policies that better meet the needs of older adults. [Journal of Gerontological Nursing, 42(6), 11-17.]. Copyright 2016, SLACK Incorporated.
Please note that, to improve the service we provide, a new telephone number - 72500 - has been set up for all shuttle requests concerning: journeys within the CERN site, i.e. official visits or bidders' conferences; journeys to or from the airport or city centre; long-distance journeys. However, it will still be possible to submit requests in writing to Fm.Support@cern. The radio taxi can also still be reached on 76969. The TS/FM group would also like to inform you that details of all light logistics services (transport of persons, distribution and collection of parcels up to 1 tonne, distribution and collection of mail) can be found on the group's website: http://ts-dep.web.cern.ch/ts-dep/groups/fm/fm.htm TS/FM Group 160239
Miller-Day, Michelle; Hecht, Michael L.
This paper describes a Narrative Engagement Framework (NEF) for guiding communication-based prevention efforts. This framework suggests that personal narratives have distinctive capabilities in prevention. The paper discusses the concept of narrative, links narrative to prevention, and discusses the central role of youth in developing narrative interventions. As illustration, the authors describe how the NEF is applied in the keepin’ it REAL adolescent drug prevention curriculum, pose theoretical directions, and offer suggestions for future work in prevention communication. PMID:23980613
This article explores the four Matthean stories wherein an individual supplicant requests a healing on behalf of someone else: the centurion for his paralyzed servant, the ruler for his dead daughter, the Canaanite woman for her demon-possessed daughter, and the man for his epileptic son. The paper proposes a methodology of narrative microeconomic analysis. By applying the method to the stories, a pattern of three primary exchanges is observed: the locational, healing and conflict exchanges. ...
Background: Clinical audit is one approach to improve the quality of patient care, completion of request form inclusive. Radiology request forms are essential communication tools between the clinician and the radiologist. The aim of this study is to audit the adequacy of completion of X-ray request forms. Methodology: A ...
Full Text Available The use of Evidence Based Medicine (EBM has progressively lead doctors to focus their practice on the disease and not on the patient anymore. They consider a sick body or a sick part rather than a sick person. Such an attitude results in a progressive process of alienation or “unauthentic experience”. On the contrary the Medical Humanities represents a strong reaction to this state of things, and for Medicine a chance to embrace again its humanistic “vocation”. Narrative Based Medicine (NBM places at the center of the clinical practice the communicative and relational dimension. This study deepen the application of NBM to the scope of neonatal care. As a result of our work, we have identified in the NBM applied to the neonatal area a fundamental characteristic, the Neonatal Triangle (doctors, patient, parents, and a triple functionality (diagnostic, ethical and educational placed in three different ideal chronological moments (before, during and after. We explore the close connection between these functions and the clinical work and how the NBM model, through these same functions, enhance the opportunity of care and relationship. The main assumption is obviously the Doctors ability to build a shared narrative relation with the Parents of the little Patients, that in the technical terms of the Narrative Based Medicine is called co-construction of the illness history. We can remark that with the NBM we understand (the narrative frame, build (the therapeutic alliance and share (decisions.
Clark, Phillip G
Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.
The author proposes a new model for the assessment of decision-making capacity based on the principles of narrative medicine. The narrative method proposed by the author addresses the hidden power realtionships implicit in the current model of capacity assessment. Sample cases are reviewed using the traditional model in comparison with the narrative model. Narrative medicine provides an effective model for the assessment of decision-making capacity. Deficiencies in the traditional model capacity assessment can be effectively addressed using narrative strategies. © 2015 John Wiley & Sons, Ltd.
Musacchio Adorisio, Anna Linda
In this paper I will discuss the possibility offered by the “linguistic turn” for narrative research in the realm of financial communication. I will propose three categories by which a narrative interpretive approach can be applied to financial communication: narrative-as-artifacts, narrative......-as-practice and narrative-as-method. Such a constitutive communication approach challenges a mechanistic and functionalist view of communication as a tool to represent social realities in favor of an interpretive view that could remain sensitive to the production and reproduction of meaning by the actors involved....
Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann
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.
Angus, Lynne E; Boritz, Tali; Bryntwick, Emily; Carpenter, Naomi; Macaulay, Christianne; Khattra, Jasmine
Recent studies suggest that it is not simply the expression of emotion or emotional arousal in session that is important, but rather it is the reflective processing of emergent, adaptive emotions, arising in the context of personal storytelling and/or Emotion-Focused Therapy (EFT) interventions, that is associated with change. To enhance narrative-emotion integration specifically in EFT, Angus and Greenberg originally identified a set of eight clinically derived narrative-emotion integration markers were originally identified for the implementation of process-guiding therapeutic responses. Further evaluation and testing by the Angus Narrative-Emotion Marker Lab resulted in the identification of 10 empirically validated Narrative-Emotion Process (N-EP) markers that are included in the Narrative-Emotion Process Coding System Version 2.0 (NEPCS 2.0). Based on empirical research findings, individual markers are clustered into Problem (e.g., stuckness in repetitive story patterns, over-controlled or dysregulated emotion, lack of reflectivity), Transition (e.g., reflective, access to adaptive emotions and new emotional plotlines, heightened narrative and emotion integration), and Change (e.g., new story outcomes and self-narrative discovery, and co-construction and re-conceptualization) subgroups. To date, research using the NEPCS 2.0 has investigated the proportion and pattern of narrative-emotion markers in Emotion-Focused, Client-Centered, and Cognitive Therapy for Major Depression, Motivational Interviewing plus Cognitive Behavioral Therapy for Generalized Anxiety Disorder, and EFT for Complex Trauma. Results have consistently identified significantly higher proportions of N-EP Transition and Change markers, and productive shifts, in mid- and late phase sessions, for clients who achieved recovery by treatment termination. Recovery is consistently associated with client storytelling that is emotionally engaged, reflective, and evidencing new story outcomes and self-narrative
Uddholm, Mats; Nilsson, Bo
involving music therapists or music educators, such as: with clients, students, children, elder people; among nurses, deacons, social workers, preschools teachers or care assistants. The field of Music and Health is not necessarily about illness or care, but can as well be understood as an aspect of quality......Narratives about music and health Dr Bo Nilsson, Kristianstad University, Sweden Dr Mats Uddholm, University College Nordjylland, Denmark Music is used in many professional contexts that are not associated with music therapy or music education in a traditional sense. How do professionals...... in different contexts use music and how do they describe their thoughts about music in their professional work? Those are the main questions in our study focusing on narratives about music and health in professional relations. In a pilot study six strategically chosen participants from Sweden and Denmark...
Bailey, P H
Many nurse-researchers using qualitative strategies have been concerned with assuring quality in their work. The early literature reveals that the concepts of validity and reliability, as understood from the positivist perspective, are somehow inappropriate and inadequate when applied to interpretive research. More recent literature suggests that because of the positivist and interpretive paradigms are epistemologically divergent, the transfer of quality criteria from one perspective to the other is not automatic or even reasonable. The purpose of this article, therefore, is to clarify what the terms quality, trustworthiness, credibility, authenticity, and goodness mean in qualitative research findings. The process of assuring quality, validation, in qualitative research will be discussed within the context of the interpretive method, narrative analysis. A brief review of quality in narrative analysis nursing research will also be presented.
Lysgaard, Jonas Andreasen; Kronlid, David
and fiction. By opposing the classic anthropocentric ontological split between human (discourse) and object, fiction and Reality, OOO opens up for a new understanding of the role of narratives as independent objects on the same scale as grains of sand, universities, axolotls and planets. In short...... of speed, acceleration, the rhythm of technogenic moving and mooring, which can be translated into an understanding of our own movements and moorings through life and how we engage with new things, such as mediating new information through a certain pace, rhythm, movement, acceleration, slowing down....... This fictive/Real example of a narrative object illustrates that regardless of the metaphysical status of what/who we encounter in education and throughout life, if this experience becomes meaningful to us, we are navigating around them, towards them, and enmesh with them in the same principle ways...
Nobaew, Banphot; Ryberg, Thomas
on the micro story level of storytelling structure (Begin-Middle-End). This paper describes the framework for a games writer in MMORPGs as a non-linear narrative, in which a gameplayer takes the role of a digital story writer in a magic cycle. It proposes an extended storytelling framework to a games writer....... The framework is developed based on 3 prior theoretical notions: the Story structure, Dramatic structure (Freytag's Pyramid), and Hero’s Journey model (Campbell). The story structure is founded by Aristotle in his Poetics (c. 335 BC), but is now considered the basis of digital narrative. Hero’s Journey model......-story and develops further to the multi-plot point structure. To analyze the gameplay data in this study, the emotional experience and learning content are considered for the plot investigation. This study is sets out to examine the assumption that, when players play games in a semiotic domain of visual grammar...
Nielsen, Jakob Isak
section unearths what characterizes the literature on camera movement. The second section of the dissertation delineates the history of camera movement itself within narrative cinema. Several organizational principles subtending the on-screen effect of camera movement are revealed in section two...... but they are not organized into a coherent framework. This is the task that section three meets in proposing a functional taxonomy for camera movement in narrative cinema. Two presumptions subtend the taxonomy: That camera movement actively contributes to the way in which we understand the sound and images on the screen......, commentative or valuative manner. 4) Focalization: associating the movement of the camera with the viewpoints of characters or entities in the story world. 5) Reflexive: inviting spectators to engage with the artifice of camera movement. 6) Abstract: visualizing abstract ideas and concepts. In order...
Principles of a mobile gps-enabled gis acting as a tourist information system are discussed and exemplified with special focus on the narrative aspects of tourist guidance. Flexible adaptation to user movements is accomplished by providing information about objects that the user passes as well......-study of H.C. Andersen's residences in Copenhagen...
Ambler, Tim; Neely, Andrew
Companies are being pressed to be more transparent in their annual reporting and, at the same time,interest is moving from the formal accounts to the narrative sections, partly in response to the increasing importance of the intangible assets not on the balance sheet. The paper sets out the changes in UK requirements, ummarised in a Framework provided by the Worshipful Company of Marketors, and company practice. The two weakest areas in relation to the Accounting Standards B...
Jacobus J. (Jakkie Strachan
Full Text Available As an Afrikaner man doing research on ubuntu, what are the possibilities for meaningful research? In this article, some aspects of the difficulties and possibilities that may be encountered in such a research programme will be explored. Within a postmodern worldview, and framed within postfoundational practical theology, social-constructionism, a narrative hermeneutic metaphor and autoethnography will be used as tools to explore some difficulties and possibilities of such a research undertaking.
This paper aims to tackle the subtle relation between autobiographical narratives and identity construction, from a non essentialist conception of identity. In a perspective that articulates philosophy of language, psychoanalysis, semiotics and literary critique, we posit the concept of biographical space as an analytical instrument to make a critical update of the reconfiguration of identities and subjectivities in contemporary culture, marked by the predominance of the biographical, the private and a kind of "public intimacy". This look is more symptomatic than descriptive: it intends to account for the rise of auto/biographical narratives and life-stories, from canonic genres to their multiple derivations in the media, social networks and the most diverse artistic practices, a phenomenon that seems to reaffirm the notion of narrative identities by Ricoeur. Our analysis here, from an ethic, aesthetic and political point of view, will focus on two visual arts experiences that have recently taken place for the first time in Buenos Aires: Christian Boltanski's and Tracey Emin's, solo exhibitions, each of them with a different biographical approach.
Full Text Available In this article, I look back in an art/research experiment of convening an exhibition of women artists and inviting them to a round-table discussion in the context of a sociological conference. The artists who took part in this event had been previously interviewed for a feminist research project, entitled "In the Fold Between Life and Art, a Genealogy of Women Artists". The conference exhibition gave the artists the opportunity to appear to an academic audience and present their work while the round-table discussion created a forum for a narrative event where all women were invited to recount stories of becoming an artist. In looking at this event I want to explore questions around the possibilities and limitations of narratives in microsociological inquiries. In following trails of ARENDT's theorisation of stories, I explore connections and tensions between social, political and cultural entanglements in narrative research. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1501193
The past 10-15 years have seen a rapid increase in the study of narrative across all the social sciences. It is sometimes assumed that narrative has the same meaning irrespective of the context in which it is expressed. This article considers different levels of narrative analysis within health psychology. Specifically, it considers the character of health and illness narratives as a function of the personal, interpersonal, positional and societal levels of analysis. At the personal level of analysis narratives are portrayed as expressions of the lived experience of the narrator. At the interpersonal level of analysis the narrative is one that is co-created in dialogue. At the positional level of analysis the analysis considers the differences in social position between the narrator and the listener. The societal level of analysis is concerned with the socially shared stories that are characteristic of certain communities or societies. The challenge is to articulate the connections between these different levels of narrative analysis and to develop strategies to promote emancipatory narratives.
Full Text Available This essay argues for narrative competence as an underlying skill neglected in educational policy makers’ calls for enhanced literacy through improved reading, writing, numeracy and working with digital technology. This argument is presented in three parts. First, a genealogy of the narrative is presented by looking at understandings of narratives with respect to changes in technology and socio-cultural relations. Three technological forms of the narrative are examined: the oral, written and image based narrative. Second, revisiting Bernstein, narrative competency is connected to pedagogic practice. The focus is upon code recognition and the rhythm of narrative in a classroom context. Third, a proposal is made to develop narrative competence as a research programme capable of exploring literacy in an age of open learning. The core assertion of this essay is that when narrative is understood in a multi-directional, multi-voiced and multi-punctual sense, opportunities are created for a pedagogic practice that is in tune with the demands placed upon youth and their relationship to changing technologies. This makes the exploration of connections between narrative competence, pedagogic practice and technology the central focus of this essay.
Healthcare organisations, medical knowledge and clinical practice are among the contexts that have most strongly felt the impact of the over 75 population. This is a population of multimorbidity and polypharmacy patients. They are often seen as a conglomeration of juxtaposed guidelines resulting in the intake of more than 10 drugs a day, with absolutely no certainty of their efficacy. The scientific community is increasingly calling into question the current disease-focused approach. Narrative medicine can provide the tools for a treatment plan which is instead more patient-centred. Narrative medicine can promote the development of a systemic, integrated and multi-disciplinary approach to elderly patients. The stories of patients and caregivers, their representations, perceptions, experiences and preferences can reduce the risk of inappropriate tests and treatments. They can promote deprescribing procedures based on a careful analysis of a specific patient's needs. Narration time is treatment time which does not necessarily create a burden on organisations and caregivers. Quite the contrary since by facilitating adherence and team work, it can significantly reduce time and costs. Given their training and the importance of their relationship with elderly patients, internists, together with geriatricians, can play a key role in promoting and coordinating a narrative medicine approach. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Full Text Available Lindsay Holmgren’s “Empathic Communications and Narrative Competence in Contemporary Medical Education” reviews the teaching of narrative competency in medical education, arguing that these practices must engage postclassical approaches to narrative studies while attending to the concept of empathy as it is deployed in various disciplines, including narratology, cognitive science, and psychology. With an emphasis on the formation of professional identity in medical practice, Holmgren explores the relationship between professional identity in a multi-ethnic, gender-neutral, demographically and culturally diverse medical education context, and the complex arena of narrative empathy. Hinging her argument on the reciprocal nature of identity that emerges at the intersections of various versions of the self and others, Holmgren’s article aligns the empathy developed by reading fiction with that which develops in the clinical encounter. Finally, the article understands these various, evolving subject positions rhetorically, arguing that the comportments of medical educators in the humanities should be such that their students will want to emulate them.
Catalano, Ralph; Bruckner, Tim; Avalos, Lyndsay A; Stewart, Holly; Karasek, Deborah; Kariv, Shachar; Gemmill, Alison; Saxton, Katherine; Casey, Joan
Periviable infants (i.e., those born in the 20th through 26th weeks of gestation) suffer much morbidity and approximately half die in the first year of life. Attempts to explain and predict these births disproportionately invoke a "dysregulation" narrative. Research inspired by this narrative has not led to efficacious interventions. The clinical community has, therefore, urged novel approaches to the problem. We aim to provoke debate by offering the theory, inferred from microeconomics, that risk tolerant women carry, without cognitive involvement, high risk fetuses farther into pregnancy than do other women. These extended high-risk pregnancies historically ended in stillbirth but modern obstetric practices now convert a fraction to periviable births. We argue that this theory deserves testing because it suggests inexpensive and noninvasive screening for pregnancies that might benefit from the costly and invasive interventions clinical research will likely devise. Copyright © 2017. Published by Elsevier Ltd.
Full Text Available This article is a proposal of identity research through its process and narrative character. As a starting point I present a definition of identity understood as the whole life process of finding identification. Next I present my own model of auto/biography-narrative research inspired by hermeneutic and phenomenological traditions of thinking about experiencing reality. I treat auto/biography-narrative research as a means of exploratory conduct, based on the narrator’s biography data, also considering the researcher’s autobiographical thought. In the final part of the article I focus on showing the narrative structure of identity and autobiography. I emphasise this relation in definitions qualifying autobiography as written life narration and identity as a narration of autobiography.
Dahl, Kari Kragh Blume
Narratives of being ‘a good teacher’: everyday life, morality and teachers’ narratives in a Kenyan village This paper explores how Kenyan school teachers narrate and practise professional work in their everyday lives in an educational context shaped by global and local narratives of education...... or her ideas about the world, which is used to organise experiences (Høyen, 2016). The study also draws on everyday life learning (Schütz, 1973; Heller, 1984) and the social anthropology of morality (Kleinman, 1992) to explore how teachers’ narrative learning comprises processes that are not only...... in western Kenya provided a framework for observing how teachers’ narratives as professionals became mediated through sociocultural forces and everyday life in school, at home and during their spare time. Empirically, the study explores four school teachers and their unique and diverse understandings of what...
Kurby, Christopher A; Asiala, Lillian K E; Mills, Steven R
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.
schema within continental semiotics, and through an interpretation of Heider & Simmel’s study on apparent behavior it establishes the cognitive import of the narrative schema and its origin in visual perception; finally it gives examples of the meaning organizing import of the narrative schema.......This paper aims at establishing the origin of the narrative schema in the perception of intentional movements. The distinction between mechanical and intentional movements is vital for human beings, and the narrative schema, which is underpinned by this distinction, is therefore a basic cognitive...... principle of intelligibility. This is the reason why the narrative schema is by no means confined to the domain of the literary work of art. It is rather a major principle for the combination of partial significations in many other domains. The paper explores the role traditionally assigned to the narrative...
Edwards, Sharon Lorraine
To offer dramatic poetry as representing findings from narrative research that is more accessible. This article is drawn from the author's doctorate work on how students' stories about their 'clinical' experiences can aid learning. Nursing students' stories of clinical practice experiences when engaged in the care of patients represented as dramatic poetry. Qualitative analytical approaches in narrative data analysis to provide a review of student stories from a variety of perspectives. This article illustrates a method for converting story data to poetry. It suggests that a range of audiences can learn from nursing students' stories of clinical practice when translated into dramatic poetry. Audiences can come close to understanding what students are experiencing in practice when engaged in the care of patients and learning from their practice experiences, when these experiences are expressed as dramatic poetry. Representing findings from narrative research as dramatic poetry can help audiences engage with nursing students' experiences at an emotional level. Enabling researchers and readers to become immersed in the poem transforming their understanding of what the students have learned.
van der Leeuw, Renée M.; Overeem, Karlijn; Arah, Onyebuchi A.; Heineman, Maas Jan; Lombarts, Kiki M. J. M. H.
Physicians involved in residency training often receive feedback from residents on their teaching. Research shows that learners value narrative feedback, but knowledge of the frequency and determinants of narrative feedback in teaching performance evaluation is lacking. This study aims to
Hatavara, Mari Annukka; Mildorf, Jarmila
This article discusses the recent trends in Fictionality Studies and argues for a point of view focusing more on the narrative dimension of fictionality than on the fictive story content. With the analysis of two case studies, where a non-fictional third person narrator represents the experience...... with other minds travel between fictional and nonfictional narratives, and between stories artistically designed and those occurring in conversational or documentary environments....
By coining the term “unreliable narrator” Wayne Booth hypothesized another agent in his model besides the author, the implicit author, to explain the double coding of narratives where a distorted view of reality and the exposure of this distortion are presented simultaneously. The article deals with the applicability of the concept in visual narratives. Since unreliability is traditionally considered to be intertwined with first person narratives, it works through subjective mediators. Accord...
Comparcini, Dania; Simonetti, Valentina; Lupo, Roberto; Cicolini, Giancarlo
This narrative review aimed to synthetize the results of the main studies analysing nurses' experience of stalking in different clinical settings. We searched the electronic databases MEDLINE (through PubMed), CINAHL (through EBSCOhost) and the search engine "Google Scholar". Searches were limited to articles published in English and Italian, and published between 1999 and 2013. Stalking refers to a behavioural pattern characterized by persistent unwanted communications and contacts imposed to another person, which, consequently suffer from distress, fear, and anxiety. Several studies explored the risk of stalking in healthcare system, especially in doctors and psychiatrists. Some authors analysed nurses' experience of stalking with particular attention to mental health professionals as a group category with an increased risk of stalking by patients. Results of some studies carried out in different clinical settings (medical and surgical areas, and other healthcare settings) also revealed, even if in a minority, the presence of this phenomenon, showing the presence of staking's behaviours by patients and healthcare colleagues too. However, more researches with large sample size are needed to better understand the phenomenon of stalking in nurses working in different clinical areas.
Narrative embedding is a common narrative structural device. Genette (1980, 1988) distinguished among various diegetic levels to explain the discrete narrative levels in embedded narratives and he defined metalepsis as the deliberate disturbing or breaking of narrative boundaries. Metalepsis, described by Malina (2002) as a mutinous narrative…
Caine, Vera; Estefan, Andrew; Clandinin, D. Jean
In the 25 years since narrative inquiry emerged as a social science research methodology, it has been rapidly taken up in the social sciences. In what is sometimes called a "narrative revolution," researchers with diverse understandings have co-opted the concept of narrative inquiry and used narrative inquiry or narrative research to…
principle of intelligibility. This is the reason why the narrative schema is by no means confined to the domain of the literary work of art. It is rather a major principle for the combination of partial significations in many other domains. The paper explores the role traditionally assigned to the narrative...... schema within continental semiotics, and through an interpretation of Heider & Simmel’s study on apparent behavior it establishes the cognitive import of the narrative schema and its origin in visual perception; finally it gives examples of the meaning organizing import of the narrative schema....
Full Text Available By coining the term “unreliable narrator” Wayne Booth hypothesized another agent in his model besides the author, the implicit author, to explain the double coding of narratives where a distorted view of reality and the exposure of this distortion are presented simultaneously. The article deals with the applicability of the concept in visual narratives. Since unreliability is traditionally considered to be intertwined with first person narratives, it works through subjective mediators. According to scholarly literature on the subject, the narrator has to be strongly characterized, or in other words, anthropomorphized. In the case of film, the main problem is that the narrator is either missing or the narration cannot be attributed entirely to them. There is a medial rupture where the apparatus mediates the story instead of a character’s oral or written discourse. The present paper focuses on some important but overlooked questions about the nature of cinematic storytelling through a re-examination of |the lying flashback in Alfred Hitchcock's Stage Fright. Can a character-narrator control the images the viewer sees? How can the filmic image still be unreliable without having an anthropomorphic narrator? How useful is the term focalization when we are dealing with embedded character-narratives in film?
Gillam, Sandra Laing; Olszewski, Abbie; Fargo, Jamison; Gillam, Ronald B
This nonrandomized feasibility study was designed to provide a preliminary assessment of the impact of a narrative and vocabulary instruction program provided by a speech-language pathologist (SLP) in a regular classroom setting. Forty-three children attending 2 first-grade classrooms participated in the study. Children in each classroom were divided into high- and low-risk subgroups on the basis of their performance on a narrative test. Narrative and vocabulary instruction was provided by an SLP in 1 classroom for three 30-min periods per week for 6 weeks. The children in the experimental classroom made clinically significant improvements on narrative and vocabulary measures; children in the comparison classroom did not. Within the experimental classroom, children in the high-risk subgroup demonstrated greater gains in narration and fewer gains in vocabulary than children in the low-risk subgroup. There were no subgroup differences in the comparison classroom. These preliminary results provide early evidence of the feasibility of implementing a narrative instruction program in a classroom setting. Children at a high risk for language difficulties appeared to profit more from the narrative instruction than from the embedded vocabulary instruction. More extensive research on this instructional program is warranted.
Miller, Eliza; Balmer, Dorene; Hermann, Nellie; Graham, Gillian; Charon, Rita
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. 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. 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. 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.
Miller, Eliza; Balmer, Dorene; Hermann, Nellie; Graham, Gillian; Charon, Rita
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
The purpose of this study is to assess issues that arise in the context of epistemological claims in narrative educational research by means of narrative analysis and epistemological evaluation. The research questions which guided the study were: 1) To what extent is epistemology considered by narrative educational researchers?; 2) What issues do…
Miller, Peggy J.; Chen, Eva Chian-Hui; Olivarez, Megan
Although very young children are unable to formulate a personal narrative of the life course, their everyday lives are steeped in narratives. Drawing on ethnographic studies in diverse sociocultural worlds, we argue that the early years of life form a vital preamble to the personal narrative. In this phase of life, the universal predisposition to…
Lim, T.; Louchart, S.; Suttie, N.; Baalsrud Hauge, J.; Stanescu, I.A.; Ortiz, I.M.; Moreno-Ger, P.; Bellotti, F.; Brandao Carvalho, M.; Earp, J.; Ott, M.; Arnab, S.; Berta, R.; Göbel, S.; Wiemeyer, J.
Narratives are used to construct and deconstruct the time and space of events. In games, as in real life, narratives add layers of meaning and engage players by enhancing or clarifying content. From an educational perspective, narratives are a semiotic conduit for evoking critical thinking skills
Coulter, Cathy A.; Smith, Mary Lee
Narrative research has become part of the landscape of education inquiry, yet its theory and practice are still debated and evolving. This article addresses the construction of narratives using literary elements common to nonfiction and fiction writings. The authors discuss these elements and use four narratives to illustrate them. They address…
Hart, Curtis W
Creative nonfiction and the illness narrative are recently identified approaches to literary expression. They are particularly well suited to the genre of memoir where psychological issues such as mourning and attachment and loss may be explored. The recent memoirs of Sue Erikson Bloland and Honor Moore fulfill the description of creative nonfiction. They offer their readers an opportunity to explore with them the theological and existential issues of revelation, reconciliation, and forgiveness. This paper was first presented for the Working Group on Psychoanalysis and the Arts of the Richardson Research Seminar in the History of Psychiatry at Weill Cornell Medical College.
Waitzkin, H; Magaña, H
Stimulated by our clinical work with patients who manifest unexplained "somatoform" symptoms in the primary care setting, this article addresses a theoretical black box in our understanding of somatization: how does culture mediate severe stress to produce symptoms that cannot be explained by the presence of physical illness? Despite various problems in his explanation of hysteria, Freud broke new ground by emphasizing narratives of traumatic experiences in the development and treatment of unexplained physical symptoms. Except in anthropologically oriented cultural psychiatry, contemporary psychiatry has traveled away from a focus on narrative in the study of somatization. On the other hand, recent interest in narrative has spread across many intellectual disciplines, including the humanities and literary criticism, psychology, history, anthropology, and sociology. We operationally define narratives as attempts at storytelling that portray the interrelationships among physical symptoms and the psychologic, social, or cultural context of these symptoms. Regarding somatization and trauma, we focus on the ways that narrative integrates the cultural context with traumatic life events. In explaining the black box, we postulate that extreme stress (torture, rape, witnessing deaths of relatives, forced migration, etc.) is processed psychologically as a terrible, largely incoherent narrative of events too awful to hold in consciousness. Culture patterns the psychologic and somatic expression of the terrible narrative. Methodologically, we have developed some techniques for eliciting narratives of severe stress and somatic symptoms, which we illustrate with observations from an ongoing research project. In designing interventions to improve the care of somatizing patients, we are focusing on the creation of social situations where patients may feel empowered to express more coherent narratives of their prior traumatic experiences.
Full Text Available The aim of this paper is to explore what is performed in students’ and teachers’ actions in physical education practice in terms of “didactic irritations,” through an analysis of YouTube clips from 285 PE lessons from 27 different countries. Didactic irritations are occurrences that Rønholt describes as those demanding “didactic, pedagogical reflections and discussions, which in turn could lead to alternative thinking and understanding about teaching and learning.” Drawing on Barad’s ideas of performativity to challenge our habitual anthropocentric analytical gaze when looking at educational visual data, and using narrative construction, we also aim to give meaning to actions, relations, and experiences of the participants in the YouTube clips. To do this, we present juxtaposing narratives from teachers and students in terms of three “didactic irritations”: (a stories from a track, (b, stories from a game, and (c, stories from a bench. The stories re-present events-of-moving in the data offering insights into embodied experiences in PE practice, making students’ as well as teachers’ actions in PE practice understandable.
Alayrac, Jean-Baptiste; Bojanowski, Piotr; Agrawal, Nishant; Sivic, Josef; Laptev, Ivan; Lacoste-Julien, Simon
Automatic assistants could guide a person or a robot in performing new tasks, such as changing a car tire or repotting a plant. Creating such assistants, however, is non-trivial and requires understanding of visual and verbal content of a video. Towards this goal, we here address the problem of automatically learning the main steps of a task from a set of narrated instruction videos. We develop a new unsupervised learning approach that takes advantage of the complementary nature of the input video and the associated narration. The method sequentially clusters textual and visual representations of a task, where the two clustering problems are linked by joint constraints to obtain a single coherent sequence of steps in both modalities. To evaluate our method, we collect and annotate a new challenging dataset of real-world instruction videos from the Internet. The dataset contains videos for five different tasks with complex interactions between people and objects, captured in a variety of indoor and outdoor settings. We experimentally demonstrate that the proposed method can automatically discover, learn and localize the main steps of a task input videos.
Full Text Available This article is a more general "companion" to the subsequent, Brian ROBERTS (2011 "Interpreting Photographic Portraits: Autobiography, Time Perspectives and Two School Photographs". The article seeks to add to the growing awareness of the importance of visual materials and methods in qualitative social research and to give an introduction to the "photographic self image"—self-portraits and portraits. It focuses on time and memory, including the experiential associations (in consciousness and the senses that the self engenders, thus linking the "visual" (photographic and "auto/biographical". The article attempts to "map" a field—the use of portraiture within social science—drawing on narrative and biographical research, on one side, and photographic portraiture, on the other. In supporting the use of photography in qualitative research it points to the need for researchers to have a greater knowledge of photographic (and art criticism and cognisance of photographic practices. The article does not intend to give a definitive account of photographic portraiture or prescribe in detail how it may be used within social science. It is an initial overview of the development and issues within the area of photographic portraiture and an exploration of relevant methodological issues when images of individuals are employed within social science—so that "portraiture" is better understood and developed within biographical and narrative research. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs110263
Iotzov, Ivan; Fidali, Brian C; Petroni, Agustin; Conte, Mary M; Schiff, Nicholas D; Parra, Lucas C
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.
Samuel, Sophia; Advocat, Jenny; Russell, Grant
Sri Lankan Tamil refugees are among the largest group of refugees to resettle in Australia in the last decade. The aim of this study is to characterise the narratives of health-seeking among unwell Sri Lankan Tamil refugees in Melbourne, Victoria, Australia. Drawing on a qualitative, phenomenological perspective, we conducted in-depth interviews in Tamil and English with 12 participants who identified as being unwell for 6 months or more. Findings revealed three narratives of health-seeking: the search for the 'good life' that was lost or never experienced, seeking help from familiar channels in an unfamiliar context, and the desire for financial and occupational independence. These three narratives are undergirded by the metanarrative of a hope-filled recovery. These narratives of Tamil refugees' lived experience provide new insights into clinical care and health service delivery.
Smithson, Lisa; Nicoladis, Elena
Physiological arousal that occurs during narrative production is thought to reflect emotional processing and cognitive effort (Bar-Haim et al. in Dev Psychobiol 44:238-249, 2004). The purpose of this study was to determine whether individual differences in visuospatial working memory and/or verbal working memory capacity predict physiological arousal in a narrative task. Visuospatial working memory was a significant predictor of skin conductance level (SCL); verbal working memory was not. When visuospatial working memory interference was imposed, visuospatial working memory was no longer a significant predictor of SCL. Visuospatial interference also resulted in a significant reduction in SCL. Furthermore, listener ratings of narrative quality were contingent upon the visuospatial working memory resources of the narrator. Potential implications for educators and clinical practitioners are discussed.
Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William
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.
In recent years, we have witnessed an increase in media attention on the subject of mental illness, which mass media frequently portray as a new phenomenon affecting large sections of the population. Reports about people suffering from mental disorders and on psychiatric or psychotherapeutic clinics, however, are often characterised by their emphasis on stereotypes and one-sided invariably negative attributes both in the choice of wording and the images used. This paper is an attempt to elucidate this apparent contradiction from both a narrative and a socio-historical perspective. In view of the development of modern moving image formats and storytelling techniques, it seeks to identify possible ways of harnessing the media to present a more considered and differentiated picture of psychiatric disorders and mental illnesses. Professionally moderated discussion forums based on social media techniques are to serve just as well as stories that take account of the narrative universals such as reward, success and human relations.
Firstly, we analyse the design of this sociolinguistics unit within the framework of theories of narrative and multicultural education. Secondly, we analyse three language biographies produced by students in this course in terms of student learning, identity issues and sociolinguistic themes. The narratives provided an ...
Landau, Dana; Drori, Israel; Terjesen, Siri
This article explores the cultural narratives through which members of organizations define legitimacy during prolonged periods of change. We view legitimacy work as a cultural practice and interpretive process that takes the form of organizational narratives. We show how the shifting configurations
Compares narrative approaches to Kohlberg's theory of moral development along five dimensions: values relevance, legitimacy, universality, rationality, and commensurability. Argues that, contrary to Kohlberg's theory, narrative approaches may lead to contradiction in epistemology, nihilism in moral choices, and opportunism in relationships.…
Çirakli, Mustafa Zeki
The present paper explores the implications of parallel narrative structure in Paul Harding's "Tinkers" (2009). Besides primarily recounting the two sets of parallel narratives, "Tinkers" also comprises of seemingly unrelated fragments such as excerpts from clock repair manuals and diaries. The main stories, however, told…
Full Text Available As fighting between Russian backed rebels and government forces is taking place in eastern Ukraine, it is all the more apparent the existing political divide that exists in the country. The complex history of being subjugated by surrounding countries and major resettlements of Ukrainians is testing the country in a major way. Historically, emphasis on understanding the Soviet Union was focused on the Soviet perspective — the Soviet narratives, and most recently on reemerging Russia. As a result, little attention is placed on Ukraine’s history. In order to understand the Ukrainian identity, it’s necessary to know the narratives that encompass Ukraine’s history. As freedom and liberty exemplifies American identity and ideology, the history of Ukraine also contains a system of stories that support Ukrainian culture. This paper, the first chapter of my dissertation, details the sources I’ve used to develop my methodology for understanding and analyzing narratives. As I began my research I soon realized the complexity of narratives leading me to explore the elements contained in narratives such as story, plot, character, archetypes, and the Hero’s Journey or Monomyth. I will explain how I understand the meaning of narrative and master narrative, supported by relevant sources, and conclude with the methodology I will use for analysis of the master narratives that envelope the major historical events of Ukraine
Manners, Ian James; Murray, Philomena
of the forerunner to the current EU we ask if this noble narrative of war and peace, which is at the heart of European integration, at an end. We argue that this principled account is likely to remain just one of several narratives of European integration, but with its reputation somewhat tarnished. Fresh...
Christopher R Stones
Oct 2, 2014 ... ... analysis. Likewise, it is argued that Ricoeur's work on narrativity and narrative ... method of Husserl's static phenomenological analysis .... the possibility of description in a qualitative research ... theoretical perspective, assumption, hypothesis, and so on” .... every case the noetic constitution of the object is.
Mønsted, Troels; Reddy, Madhu; Bansler, Jørgen P.
that displays narrative rather than scientific characteristics. While the qualities of the medical record as a repository of information or as a coordinative tool are well known, the role it plays in the unfolding of narratives in medical reasoning is less discussed. This paper examines this issue through...
Marini, Andrea; Galetto, Valentina; Zampieri, Elisa; Vorano, Lorenza; Zettin, Marina; Carlomagno, Sergio
Persons with traumatic brain injury (TBI) often show impaired linguistic and/or narrative abilities. The present study aimed to document the features of narrative discourse impairment in a group of adults with TBI. 14 severe TBI non-aphasic speakers (GCS less than 8) in the phase of neurological stability and 14 neurologically intact participants…
Gregory, Robert J.; Mustata, Georgian T.
Adolescents sometimes cut themselves to relieve distress; however, the mechanism is unknown. Previous studies have linked self-injury to deficits in processing emotions symbolically through language. To investigate expressive language of adolescent cutters, the authors analyzed 100 narratives posted on the Internet. Most narratives (n = 66)…
Rasmussen, Lauge Baungaard
The application of narrative scenarios in engineering or socio-technical systems provides an important link between general ideas and specification of technical system requirements. The chapter explores how the narrative approach can enrich the scenario 'skeleton. In addition, criteria are sugges...
Rynearson, E. K.
This essay outlines the dynamics of retelling the violent death of a loved one and the narrative "dilemma" of vulnerable family members fixated on retelling. To counter this fixation, the author presents a mythic retelling of violent death (the Myth of Theseus) as narrative basis for developing a restorative retelling. The essay begins by…
Gaydos, H Lea
This paper explores the need for and nature of personal narratives and their relevance to nursing practice. It proposes that the co-creative aesthetic process can be used to understand and co-create personal narratives through an emphasis on self-defining memories and metaphor. Many authors in nursing and other human sciences have recognized the need for and importance of personal narrative, its relationship to aesthetic knowing and its value in qualitative research and in practice. The role of memory and metaphor in the creation of meaning in personal narratives, however, has not been sufficiently explored in nursing literature. The nature of personal narrative is explored, focusing on the way meaning is created from self-defining memories using metaphor. Then, the importance of personal narratives in nursing practice is considered, followed by discussion about how meaning in personal narratives may be co-created between clients and nurses using an aesthetic process developed by the author. The co-creative aesthetic process is an example of nursing as art and can be used to co-create personal narratives in practice. The experience of co-creating a self story with a nurse can be healing, as the self story is heard by a caring person, memories are understood in new ways, and the self story is both confirmed and recreated.
Bruni, Luis Emilio; Baceviciute, Sarune
In this article we define various aspects, or parameters, of interactive narrative systems and present them as a framework that can help authors, creators and designers to conceive, analyze, or prioritize the narrative goals of a given system. We start by defining the Author-Audience distance (AA...
Larsen, Bjarke Alexander; Schoenau-Fog, Henrik
This paper will introduce and discuss a new model for understanding the relation between narrative and games, by looking at the narrative quality of game mechanics. First, a review of the terms ”Narrative” and ”Game Mechanics” is made, and defined in this context, before a literature review, base...
Losh, Molly; Gordon, Peter C
Autism is a neurodevelopmental disorder characterized by serious difficulties with the social use of language, along with impaired social functioning and ritualistic/repetitive behaviors (American Psychiatric Association in Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Association, Arlington, 2013). While substantial heterogeneity exists in symptom expression, impairments in language discourse skills, including narrative (or storytelling), are universally observed in autism (Tager-Flusberg et al. in Handbook on autism and pervasive developmental disorders, 3rd edn. Wiley, New York, pp 335-364, 2005). This study applied a computational linguistic tool, Latent Semantic Analysis (LSA), to objectively characterize narrative performance in high-functioning individuals with autism and typically-developing controls, across two different narrative contexts that differ in the interpersonal and cognitive demands placed on the narrator. Results indicated that high-functioning individuals with autism produced narratives comparable in semantic content to those produced by controls when narrating from a picture book, but produced narratives diminished in semantic quality in a more demanding narrative recall task. This pattern is similar to that detected from analyses of hand-coded picture book narratives in prior research, and extends findings to an additional narrative context that proves particularly challenging for individuals with autism. Results are discussed in terms of the utility of LSA as a quantitative, objective, and efficient measure of narrative ability.
Full Text Available This paper demonstrates that digital tools provide opportunities for new storytelling techniques. To take full advantage of the new media resources and to establish an innovative news narrative structure, the existing research limit and the relationship between narrative and the media were examined. This paper progresses from a discussion on the narrative structure to how the plot of a story is influenced by its discourse, and then to how different media characteristics can change the structure and voice of the involved narrative. A new narrative structure that can be used to explore the hypertext and interactivity of Internet news is described. Finally, this paper discusses the cultivation of news storytelling in the digital age.
Pereles, Laurie; Jackson, Roberta; Rosenal, Tom; Nixon, Lara
To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly. Qualitative study of interviews. A fall prevention clinic in Calgary, Alta. Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them. Participants' stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients' additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed. The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues. The addition of patient narratives to clinical assessments offers clinicians an understanding of patients' perspectives, which can be used to better engage patients in rehabilitation. Copyright© the College of Family Physicians of Canada.
G Pitman, Alexander
Referral to a clinical radiologist is the prime means of communication between the referrer and the radiologist. Current Australian and New Zealand government regulations do not prescribe what clinical information should be included in a referral. This work presents a qualitative compilation of clinical radiologist opinion, relevant professional recommendations, governmental regulatory positions and prior work on diagnostic error to synthesise recommendations on what clinical information should be included in a referral. Recommended requirements on what clinical information should be included in a referral to a clinical radiologist are as follows: an unambiguous referral; identity of the patient; identity of the referrer; and sufficient clinical detail to justify performance of the diagnostic imaging examination and to confirm appropriate choice of the examination and modality. Recommended guideline on the content of clinical detail clarifies when the information provided in a referral meets these requirements. High-quality information provided in a referral allows the clinical radiologist to ensure that exposure of patients to medical radiation is justified. It also minimises the incidence of perceptual and interpretational diagnostic error. Recommended requirements and guideline on the clinical detail to be provided in a referral to a clinical radiologist have been formulated for professional debate and adoption. © 2017 The Royal Australian and New Zealand College of Radiologists.
Arenas F, Javier F.
All human society has depended on the energy to subsist and to evolve. Because of this, the industrial revolution can be seen as the result of an environmental crisis after the deforestation in Europe. Nevertheless,at the present time, petroleum is expending so that there have appeared alternative to maintain the energetic system that the world has being using since the XVIII century. The present text exposes arguments that have been raised so much to defend their implementation as a dedicated industry that will produce bioagrocombustibles, like those employees against it. For these expositions the author uses different perspectives, like the economic, political, legal and physical. It is a narration in first person of the Sun, as well as of the human conscience that exposes the mentioned arguments and intents a different approach, less technician, to a problematic that concerns to all the people of the planet.
Full Text Available This article forms part of a study which was inspired by the ever-growing need for significance expressed both by my life coaching and pastoral therapy clients as well as the need for existential meaning reported both in the lay press and academic literature. The study reflected on a life that matters with a group of co-researchers in a participatory action research relationship. The study has been positioned within pastoral theology and invited the theological discourse into a reflection of existential meaning. Adopting a critical relational constructionist epistemology, the research was positioned within a postmodern paradigm. The implications for meaning and research were explored and described. This article tells the story of how spirituality was positioned in the narratives of meaning by my fellow researchers.
of genre and are written not by the victims but by ‘spectators’, political or human rights agents, historians or literary writers who are in a distanced position from the actual slavery. In order to understand the role of sentimentalism in slave narratives, I will discuss the sentimental novel by Gertrudis...... Gómez de Avellaneda: Sab (the Cuban/Spanish equivalent of Uncle Tom’s Cabin), written between 1836 and 1839 and published 1841 in Spain. I will argue that the sentimentalism of Sab is of a revolutionary kind, based in a conception of natural law and that its aim is a radical transformation of social...... hierarchies. The paper will be divided into three parts: 1. First I will discuss what sentimentalism is and its relation to politics and especially abolitionism in the 19th century. 2. Then I will analyze Sab’s genre trying to establish the different functions of sentimentality, discussing the tragic modes...
Full Text Available Machado showed a fascination with homeopathic medicine, an indirect form of treatment that uses agents to stimulate reactions similar to the symptoms of the condition to be cured. Several of the author’s texts show a pattern of projects realized by indirect means, by "like curing like", which suggests a homeopathic logic in Machado’s worldview. Certain narrators, such as those inMemórias póstumas de Brás Cubas, Dom Casmurro, and in short stories such as "O segredo do bonzo" and "Adão e Eva", are notable for denouncing themselves, that is, for undermining their own validity. This curious situation has implications for Machado’s overall project, which seems more interested in posing questions than providing answers. It also suggests a particular relationship with the reader, which affords as much independence as possible.
GABAS JÚNIOR Nilson
Full Text Available This paper looks at two verbal descriptions of the Pear film and characterizes them according to the analysis proposed by Downing (1980 for factors influencing lexical choice. The two descriptions, one short and one long, were told by my Karo consultant, Mário Jorge Arara, after the exhibition of the film. Generally, the present article looks at Downing's assertion that "if the description is to be brief, words of broad referential scope are likely to be chosen (.... If the speaker opts for a more detailed description, more lexemes of narrower referential scope are likely to appear" (1980:90 and sees how this assertion applies to the two narratives. Specifically, it looks at each of the versions of the story and tries to explain the mentions of the referents by either basic or non-basic level categories in terms of cognitive, textual and contextual factors.
Full Text Available This study looks at demonstrative descriptions, regarding them as text-deictic procedures which contribute to weave discourse reference. Text deixis is thought of as a metaphorical referential device which maps the ground of utterance onto the text itself. Demonstrative expressions with textual antecedent-triggers, considered as the most important text-deictic units, are identified in a narrative corpus consisting of J. M. Barrie’s Peter Pan and its translation into Catalan. Some linguistic and discourse variables related to DemNPs are analysed to characterise adequately text deixis. It is shown that this referential device is usually combined with abstract nouns, thus categorising and encapsulating (non-nominal complex discourse entities as nouns, while performing a referential cohesive function by means of the text deixis + general noun type of lexical cohesion.
Holmegaard, Henriette Tolstrup
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...... 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...
Hansen, Mette Sanne; Ladeby, Klaes Rohde; Rasmussen, Lauge Baungaard
for decision makers to systematically test several different outputs of possible solutions in order to prepare for future consequences. The CSA can be a way to evaluate risks and address possible unforeseen problems in a more methodical way than either guessing or forecasting. This paper contributes...... to the decision making in operations and production management by providing new insights into modelling and simulation based on the combined narrative and numerical simulation approach as a tool for strategy making. The research question asks, “How can the CSA be applied in a practical context to support strategy...... making?” The paper uses a case study where interviews and observations were carried out in a Danish corporation. The CSA is a new way to address decision making and has both practical value and further expands the use of strategic simulation as a management tool....
Full Text Available The aim of this paper is to map out - by analysing the film Son of Saul, but also by its comparison with two other films dealing with the topic, Himmelkommando and The Grey Zone, the narrative mechanism that satisfies the complex ethical and aesthetical demands imposed by the theme of Sonderkommando as the particular episode of the Holocaust. The key element of the narrative structure is the construction of the Levi’s “dead and drowned” witness who “resurrected” through the narrative intervention becomes the only reliable and credible narrator of the historical trauma. The prerequisite for his emergence is the narration and representation of the death which makes but also solves the traumatised - understood as multiple, fragmented, opposed - identities of the members of the special squad. Their entangled identity involves the simultaneous presence of a victim, perpetrator, witness and the authentic narrator of the trauma of the death camp. The death of the perpetrator is the condition sina qua non for the emergence of the figure of the victim-witness narrator but also for making of narrative which overcomes the initial trauma of the Holocaust. The detailed analysis of the film Son of Saul confirms and identifies these narratives as the modernist narration of the post-traumatic film.
Full Text Available With its capacity to unharness the power of narrative to promote meaning-making of lived experience, narrative inquiry is developing as a credible approach to research in several areas in the field of language teaching (Johnson, 2006. This article tells the story of two narrative researchers working in language teacher education who engaged in a collaborative narrative inquiry as both participants and inquirers, in order to learn more about narrative inquiry. The ‘bounded’ nature of their inquiry design provided a feasible way for them to explore their focus of research (i.e. their learning about narrative inquiry, and led them, through an iterative and reflexive process of analysing their narrative data, to formulate what they believe are essential ingredients of principled narrative inquiry work. Four narrative inquiry variables became the scaffolding which enabled them to answer their research questions, and are offered here as a heuristic for teaching practitioners, whether they be teachers, teacher educators or researchers, to guide them in narrative inquiries into their own work.
Full Text Available This article explores the four Matthean stories wherein an individual supplicant requests a healing on behalf of someone else: the centurion for his paralyzed servant, the ruler for his dead daughter, the Canaanite woman for her demon-possessed daughter, and the man for his epileptic son. The paper proposes a methodology of narrative microeconomic analysis. By applying the method to the stories, a pattern of three primary exchanges is observed: the locational, healing and conflict exchanges. By examining how the stories conform to and deviate from this pattern, a complex picture of the textual microeconomies emerges, one that contradicts the unitary macro-narrative of healing. The microeconomic analysis reveals Jesus to be a complex, ambivalent figure: He creates conflicts that hinder the healing process and invariably excludes someone or some group before completing any healing. The pedagogical, formational and theological implications of these omplexities are briefly considered in local and global contexts.
Vromans, Lynette P; Schweitzer, Robert D
This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder.
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.
Full Text Available This research aimed to reveal creative accounting practices in the form of narrative accounting occuring in companies in Indonesia. Using content analysis, this research analyzed the management discussion and analysis section in the annual report on the group of companies whose performance had increased and declined in several companies listed on the Indonesian Stock Exchange. This research finds that the narrative accounting practices are applied in these companies. The four methods of accounting narratives are found in both groups of companies. There are stressing the positive and downplaying the negative, baffling the readers, differential reporting, and attribution.
Brom, Cyril; Bída, Michal; Gemrot, Jakub; Kadlec, Rudolf; Plch, Tomáš
We report on the progress we have achieved in development of Emohawk, a 3D virtual reality application with an emergent narrative for teaching high-school students and undergraduates the basics of virtual characters control, emotion modelling, and narrative generation. Besides, we present a new methodology, used in Emohawk, for purposeful authoring of emergent narratives of Façade's complexity. The methodology is based on massive automatic search for stories that are appealing to the audience whilst forbidding the unappealing ones during the design phase.
Koenitz, Hartmut; Haahr, Mads; Sezen, Digdem; Sezen, Tonguç Ibrahim
The book is concerned with narrative in digital media that changes according to user input-Interactive Digital Narrative (IDN). It provides a broad overview of current issues and future directions in this multi-disciplinary field that includes humanities-based and computational perspectives. It assembles the voices of leading researchers and practitioners like Janet Murray, Marie-Laure Ryan, Scott Rettberg and Martin Rieser. In three sections, it covers history, theoretical perspectives and varieties of practice including narrative game design, with a special focus on changes in the power rela
Boeijinga, A.; Hoeken, Hans; Sanders, José
Objective: To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research. Method: Development work was guided by essential narrative characteristics as
... 7 Agriculture 15 2010-01-01 2010-01-01 false National need narrative. 3402.13 Section 3402.13... narrative. HEP will determine the composition of the narrative for each competition, including page limits.... Detailed instructions for preparing the narrative will be published in the solicitation. ...
Dickstein, Susan; St. Andre, Martin; Sameroff, Arnold; Seifer, Ronald; Schiller, Masha
Investigated differences in family narratives between mothers with and those without current depressive symptoms as an indicator of family functioning. Found that Family Narrative Consortium measures of narrative coherence distinguished level of symptom severity. Found that more coherent narratives were associated with marital satisfaction,…
Townsend, Jane S.; Ryan, Patrick A.
Non-print media of radio, television, and film tell narratives about the image and practice of teachers, but how might these media narratives shape conceptions of teachers as well as teachers' conceptions of themselves? What elements of the media narratives do we incorporate and reject in the narratives that we construct about their professional…
Full Text Available This article seeks to understand and explain the relationship between lifestyle reality television programs and consumers. Specifically, this article outlines this relationship from a critical narrative perspective by interrogating two common story structures within lifestyle reality programming. By analyzing these narratives, conclusions are drawn about the role of story in consumer behavior. Additionally, this article argues that through the combination of the rhetorical situation of the housing collapse and narrative storytelling, consumers are taught how to perceive and interact when considering the purchase of a house. Finally, this article synthesizes Social Cognitive theory (Bandura, 1986 in conjunction with Narrative theory (Fisher, 1984 to explore how rhetorical criticism can use social science to better understand lived, mediated, experience.
Full Text Available The present study intends to investigate the relationship between English as a Foreign Language (EFL teachers’ narrative intelligence and their pedagogical success. Eighty EFL teachers along with 673 EFL learners participated in this study. Narrative Intelligence Scale (NIS and the Characteristics of the Successful Teachers Questionnaire (CSTQ were utilized to gather data in this study. The results revealed that there exists a significant association between EFL teachers’ pedagogical success and their narrative intelligence. Moreover, Genre-ation, among the subscales of narrative intelligence, was found to be the best predictor of teacher success. Finally, the results were discussed and pedagogical implications were provided in the context of language learning and teaching
Stec, Kashmiri; Huiskes, Mike; Redeker, Gisela
We investigate direct speech quotation in informal oral narratives by analyzing the contribution of bodily articulators (character viewpoint gestures, character facial expression, character intonation, and the meaningful use of gaze) in three quote environments, or quote sequences – single quotes,
Scirea, Marco; Cheong, Yun-Gyung; Nelson, Mark
undergraduate and graduate students participated in the study. Statistical analyses suggest that the use of musical cues for narrative foreshadowing induces a better perceived consistency between music and game narrative. Surprisingly, false foreshadowing was found to enhance the player's enjoyment.......We experiment with mood-expressing, procedurally generated music for narrative foreshadowing in videogames, investigating the relationship between music and the player's experience of narrative events in a game. We designed and conducted a user study in which the game's music expresses true...... foreshadowing in some trials (e.g. foreboding music before a negative event) and false foreshadowing in others (e.g. happy music that does not lead to a positive event). We observed players playing the game, recorded analytics data, and had them complete a survey upon completion of the gameplay. Thirty...
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)
Full Text Available Review of Bruce Clarke, Posthuman Metamorphosis: Narrative and Systems, New
York: Fordham University Press, 2008. 242 pages.
van Leeuwen, L.; van den Putte, B.; Renes, R.J.; Leeuwis, C.
Previous research suggests that narrative engagement (NE) in entertainment-education (E-E) narratives reduces counterarguing, thereby leading to E-E impact on behavior. It is, however, unclear how different NE processes (narrative understanding, attentional focus, emotional engagement, narrative
Kim, Young-Suk Grace
Purpose: The primary aim of the present study was to examine whether different ways of presenting narrative stimuli (i.e., live narrative stimuli versus audio-recorded narrative stimuli) influence children's performances on narrative comprehension and oral-retell quality. Method: Children in kindergarten (n = 54), second grade (n = 74), and fourth…
Hovland, Brit Marie
The article discusses changes and revisions of the Norwegian official Grand Narrative, as portrayed in primary school history textbooks. The selected corpus of textbooks of 1885-1940 shows narrative and historiographical changes supporting a hypothesis of a development from a "Narrative of Suffering" towards a "Narrative of…
Bignold, Wendy; Su, Feng
This paper explores narratives as an effective means of capturing multiple identities of research participants in complex social environments in education research. In doing so, it explores the role of the narrator in two case studies in two modes of narrative inquiry. Both studies present narratives of young people, focusing on multiple…
This collection analyzes how narrative technique developed from the late Middle Ages to the beginning of the 18th century. Taking Chaucer’s influential Middle English works as the starting point, the original essays in this volume explore diverse aspects of the formation of early modern prose nar......, Pepys, Behn, and Defoe. Written by an international group of scholars, it investigates the transformations of narrative form from medieval times through the Renaissance and the early modern period, and into the eighteenth century....
descriptive of a culture or society’s ideology. Narratives are descriptive, a cognitive tool for the commander...commander’s organization. It is a cognitive planning tool that helps the organization understand, visualize, and describe the operational environment in its...addition to being largely explicitly unstated to the target population, the dissonance between Westmoreland’s narrative to superiors and actual use of
Melanson, Stacy E F; Lindeman, Neal I; Jarolim, Petr
Laboratory automation proposes to improve the quality and efficiency of laboratory operations, and may provide a solution to the quality demands and staff shortages faced by today's clinical laboratories. Several vendors offer automation systems in the United States, with both subtle and obvious differences. Arriving at a decision to automate, and the ensuing evaluation of available products, can be time-consuming and challenging. Although considerable discussion concerning the decision to automate has been published, relatively little attention has been paid to the process of evaluating and selecting automation systems. To outline a process for evaluating and selecting automation systems as a reference for laboratories contemplating laboratory automation. Our Clinical Chemistry Laboratory staff recently evaluated all major laboratory automation systems in the United States, with their respective chemistry and immunochemistry analyzers. Our experience is described and organized according to the selection process, the important considerations in clinical chemistry automation, decisions and implementation, and we give conclusions pertaining to this experience. Including the formation of a committee, workflow analysis, submitting a request for proposal, site visits, and making a final decision, the process of selecting chemistry automation took approximately 14 months. We outline important considerations in automation design, preanalytical processing, analyzer selection, postanalytical storage, and data management. Selecting clinical chemistry laboratory automation is a complex, time-consuming process. Laboratories considering laboratory automation may benefit from the concise overview and narrative and tabular suggestions provided.
Dahlstrom, Michael F
Although storytelling often has negative connotations within science, narrative formats of communication should not be disregarded when communicating science to nonexpert audiences. Narratives offer increased comprehension, interest, and engagement. Nonexperts get most of their science information from mass media content, which is itself already biased toward narrative formats. Narratives are also intrinsically persuasive, which offers science communicators tactics for persuading otherwise resistant audiences, although such use also raises ethical considerations. Future intersections of narrative research with ongoing discussions in science communication are introduced.
Krogh, Ellen; Piekut, Anke
This paper investigates issues of voice and narrative in L1 writing. Three branches of research are initial-ly discussed: research on narratives as resources for identity work, research on writer identity and voice as an essential aspect of identity, and research on Bildung in L1 writing. Subsequ...... training of voice and narratives as a resource for academic writing, and that the Bildung potential of L1 writing may be tied to this issue.......This paper investigates issues of voice and narrative in L1 writing. Three branches of research are initial-ly discussed: research on narratives as resources for identity work, research on writer identity and voice as an essential aspect of identity, and research on Bildung in L1 writing...... in lower secondary L1, she found that her previous writing strategies were not rewarded in upper secondary school. In the second empiri-cal study, two upper-secondary exam papers are investigated, with a focus on their approaches to exam genres and their use of narrative resources to address issues...
Aldrich, Naomi J; Tenenbaum, Harriet R; Brooks, Patricia J; Harrison, Karine; Sines, Jennie
This study explored relationships between perspective-taking, emotion understanding, and children's narrative abilities. Younger (23 5-/6-year-olds) and older (24 7-/8-year-olds) children generated fictional narratives, using a wordless picture book, about a frog experiencing jealousy. Children's emotion understanding was assessed through a standardized test of emotion comprehension and their ability to convey the jealousy theme of the story. Perspective-taking ability was assessed with respect to children's use of narrative evaluation (i.e., narrative coherence, mental state language, supplementary evaluative speech, use of subjective language, and placement of emotion expression). Older children scored higher than younger children on emotion comprehension and on understanding the story's complex emotional theme, including the ability to identify a rival. They were more advanced in perspective-taking abilities, and selectively used emotion expressions to highlight story episodes. Subjective perspective taking and narrative coherence were predictive of children's elaboration of the jealousy theme. Use of supplementary evaluative speech, in turn, was predictive of both subjective perspective taking and narrative coherence. ©2010 The British Psychological Society.
Full Text Available The paper presents research conducted within the narrative psychology paradigm. Its main purpose was to explore the relationships between features of adolescents’ identity narratives and their assessments of family functioning and themselves as family members. The choice of subject was motivated by current reports on identity formation difficulties in adolescence. Adolescents’ narratives were subjected to quantitative and qualitative analysis. Associations between specific aspects of self-narratives and participants’ perceptions of how their families functioned and how they functioned in the family system were evaluated. The results confirm the hypothesized relationships between the features of adolescents’ narratives and evaluations of their families and self-assessments of their own functioning in those families. Multi-thematic, content-rich and positively evaluated self-narratives are associated with positive assessments of selected aspects of family functioning and adolescents’ own functioning within the family. The following aspects of family assessment are significant: affective expression, level of emotional involvement in the family, level of control, family role performance and communication. Important factors in the self-assessment were: sense of competence in family role performance, assessment of one’s communication, behavior control and affective expression.
Yelle, Maria T; Stevens, Patricia E; Lanuza, Dorothy M
Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman's concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients' stories and hear what is most meaningful in their lives.
Maria T. Yelle
Full Text Available Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman’s concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients’ stories and hear what is most meaningful in their lives.
This paper is a personal narrative from the perspective of one teacher in Toronto who participated in the Canada-China Reciprocal Learning in Teacher Education and School Education Partnership Grant Project.I took part in a Sister School partnership between 2013 and 2017.Over the four years,I came to understand relationships in an international professional learning community.Participating in the project gave me the benefit of seeing my practice through an international lens.For my students,it offered a global citizenship experience.Although there are numerous professional development opportunities in Toronto,this partnership extends beyond a lunch and learn,or a full day professional learning.The commitment to my partners has fueled my desire to incorporate new teaching ideas and has required ongoing reflection on my own teaching practice.In this article,I will explain some of the challenges,stages of development,reciprocal learning,and implications for future international professional learning communities.
Sarkar, Siddharth; Varshney, Mohit
Yoga has been utilized for promotion of health and alleviating distress. It has also been used as a therapeutic measure in the field of mental health, including substance use disorders. This narrative review discusses the literature pertaining to use of yoga in the treatment of substance use disorders. The evidence base especially with regards to randomized trials is presented. The possible mechanisms how yoga might be helpful in the treatment of substance use disorders are explored. Subsequently, implications of yoga in clinical practice are elaborated, followed by examination of the issues in interpretation of the literature of published yoga related studies. Copyright © 2016 Elsevier B.V. All rights reserved.
Recent research has highlighted how parental narratives can be important in the resistance against disabling processes. This article contains analyses of enabling language in narratives published by Scandinavian disability rights organizations. First, drawing on the work of Fisher and Goodley, I point out that the material constitute a threefold: normality narratives, resistance narratives, and narratives that demonstrate an appreciation of the present and the child's individual alterity. Second, I demonstrate that the last narrative draws on Romanticism rather than linguistic resources from disability culture. Third, I show that these narratives are hyperboles - texts that strengthen and emphasise the valuation to the point where the narrative structure transcends narrative consistency. Fourth, drawing on the work of Kristeva, I argue that this form of narration constitutes an intimate politics of love. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.
Smorti, Andrea; Fioretti, Chiara
This paper aims to reflect on the relation between autobiographical memory (ME) and autobiographical narrative (NA), examining studies on the effects of narrating on the narrator and showing how studying these relations can make more comprehensible both memory's and narrating's way of working. Studies that address explicitly on ME and NA are scarce and touch this issue indirectly. Authors consider different trends of studies of ME and NA: congruency vs incongruency hypotheses on retrieving, the way of organizing memories according to gist or verbatim format and their role in organizing positive and negative emotional experiences, the social roots of ME and NA, the rules of conversation based on narrating. Analysis of investigations leads the Authors to point out three basic results of their research. Firstly, NA transforms ME because it narrativizes memories according to a narrative format. This means that memories, when are narrated, are transformed in stories (verbal language) and socialised. Secondly, the narrativization process is determined by the act of telling something within a communicative situation. Thus, relational situation of narrating act, by modifying the story, modifies also memories. The Authors propose the RE.NA.ME model (RElation, NArration, MEmory) to understand and study ME and NA. Finally, this study claims that ME and NA refer to two different types of processes having a wide area of overlapping. This is due to common social, developmental and cultural roots that make NA to include part of ME (narrative of memory) and ME to include part of NA (memory of personal events that have been narrated).
Mellis, Alexandra M; Snider, Sarah E; Bickel, Warren K
Reading experimenter-provided narratives of negative income shock has been previously demonstrated to increase impulsivity, as measured by discounting of delayed rewards. We hypothesized that writing these narratives would potentiate their effects of negative income shock on decision-making more than simply reading them. In the current study, 193 cigarette-smoking individuals from Amazon Mechanical Turk were assigned to either read an experimenter-provided narrative or self-generate a narrative describing either the negative income shock of job loss or a neutral condition of job transfer. Individuals then completed a task of delay discounting and measures of affective response to narratives, as well as rating various narrative qualities such as personal relevance and vividness. Consistent with past research, narratives of negative income shock increased delay discounting compared to control narratives. No significant differences existed in delay discounting after self-generating compared to reading experimenter-provided narratives. Positive affect was lower and negative affect was higher in response to narratives of job loss, but affect measures did not differ based on whether narratives were experimenter-provided or self-generated. All narratives were rated as equally realistic, but self-generated narratives (whether negative or neutral) were rated as more vivid and relevant than experimenter-provided narratives. These results indicate that the content of negative income shock narratives, regardless of source, consistently drives short-term choices. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Tatikonda, Vamsi Krishna; El-Ocla, Hosam
This essay highlights three graduate student papers in an effort to explore the use of a relatively new methodology in the social sciences known as narratives of self. The seminar, in which the student papers were written, was formulated on the tenets of critical pedagogy and cultural studies. This paper positions the use of narratives of self…
Winchester, Jules; Williams, Simon
This paper aims to provide Business English and EAP practitioners with a rationale for including the analysis of narrative elements in business addresses in their language teaching in order to encourage critical thinking in learners. By studying these elements, and the rhetorical function of the narrative in particular, students can become more…
Sher-Censor, Efrat; Grey, Izabela; Yates, Tuppett M.
Intergenerational congruence of mothers' and preschoolers' narratives about the mother-child relationship was examined in a sample of 198 Hispanic (59.1%), Black (19.2%), and White (21.7%) mothers and their preschool child. Mothers' narratives were obtained with the Five Minute Speech Sample and were coded for negative and positive affective…
Hunter, Lisa; Emerald, Elke
Narrative research has been employed by many researchers in the field of physical culture (including movement, play, dance, sport, leisure, physical pursuits, physical activity, physical education and health). From our storied worlds, narrative research reveals complex embodied and emplaced social phenomena within this field. However, there are…
DeGout, Yasmin Y.
The differences between early African American narratives written by women and those written by men can be seen in a comparison of Harriet A. Jacobs's "Incidents in the Life of a Slave Girl, Written by Herself" and Frederick Douglass's "Narrative of the Life of Frederick Douglass, An American Slave." A comparison of these works…
Christopher Key Chapple
Full Text Available This essay explores the mechanics associated with rebirth, noting differences between Hindu, Buddhist, and Jain narratives. It examines the concept of subtle body and the liṅgam in Sāṃkhya. According to the Hindu tradition, the remains of the departed person, when cremated, merge with clouds in the upper atmosphere. As the monsoon rain clouds gather, the leftovers mingle with the clouds, returning to earth and eventually finding new life in complex biological cycles. According to Tibetan and Chinese Buddhism, the remains of a person take a ghostly form for 49 days until taking a new birth. According to Jainism, the departed soul immediately travels to the new birth realm at the moment of death. According to Jain karma theory, in the last third of one’s life, a living being makes a fateful choice that determines his or her next embodiment. The 20th century Hindu Yoga teacher Paramahamsa Yogananda, in his commentary on the Bhagavad Gita, provides an alternate description of a twofold astral and causal body. One hallmark of the Buddha and of the 24 Jain Tīrthaṅkaras was that they remembered all the lives they had lived and the lessons learned in those lives. The Buddha recalled 550 past lives and used these memories to fuel many of his lectures. Mahāvīra remembered his past lives and also the past lives of others. Patañjali’s Yoga Sūtra states that through the perfection of giving up all things, including psychological attachments, one spontaneously will remember past lives. In the Yogavāsiṣṭha, a Hindu text, Puṇya remembers the past lives of his grieving brother as well as his own prior experiences.
Users are informed that as from 1 September 2001 all Shipping Requests must be made on EDH using the appropriate electronic form. The submission of user requests directly into EDH will help rationalise the activities of the Shipping Service (Import & Export), with requests being automatically forwarded to hierarchical supervisors thereby improving the processing speed and facilitating the follow-up. Thank you for your collaboration.
Conroy, Sherrill A; Dobson, Stephen
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.
Dina Al Raffie
Full Text Available Since the advent of the Global War on Terror, the world has witnessed the continuation of terrorist activity under the banner of Salafi Jihad. With military action proving insufficient to defeat the propagators of the ideology, attention has turned to the ideology itself. Understanding the narratives that constitute this ideology and the systems in place that help propagate it is crucial to defeating it. Analysis brings to light elements that arguably constitute a Jihadist master narrative as well as support structures that help perpetuate key underlying messages of this master narrative. Successful counter-narratives should focus on rolling back and containing Jihadist narratives whilst simultaneously highlighting the values and attitudes of democratic, free societies
Crowley, M. Sue
The study explored types of memory for childhood sexual abuse (CSA) in a clinical sample of 30 women and identified factors that led some women (n = 24) to report recovered memories. Questionnaires produced three types of memory: always (n = 6), recovered (n = 14), both (n = 10); however, analysis of narrative data also revealed the use of…
Rebeca Silva de Barros
Full Text Available O foco deste artigo é o cuidado em saúde bucal na Atenção Básica. Esta é lugar potencial para geração de encontros e produção de subjetividade. Por isso, discutiremos o tema tomando como foco a relação da escuta-acolhimento-vínculo debatendo sobre a existência de dicotomia entre clínica-saúde coletiva. Esta pesquisa-intervenção realizou-se de julho a dezembro de 2007 no município de Cotia-SP, a partir dos pressupostos: 1 atendimento ao problema bucal relevante para o usuário; 2 descentramento dentário; 3 constituição do caso clínico por meio da anamnese e 4 integração com os serviços da unidade. A escuta da queixa, o exame clínico bucal e o levantamento da história clínica foram registrados no prontuário, sem o uso de odontograma. Para discussão de abordagens na clínica, relataremos 08 `Hestórias Patográficas'. Os objetivos da comunicação na consulta são acolher, promover o diagnóstico seguro e interferir na evolução do sofrimento do outro restabelecendo a homeostasia corporal e produzindo vínculo, com modificação de referenciais teóricos e da linguagem clínica. O vínculo é resultado do diálogo, da assunção de responsabilidades tanto do profissional quanto do usuário e da resolução das suas queixas e necessidades.The focus of this article is on oral healthcare in Primary Healthcare. We discuss the issue taking the relationship of listening-host-link as a focus debating on the existence of a dichotomy between clinical-collective health. This investigation, took place in Cotia, São Paulo State between July and December 2007, based on the following assumptions: 1 answer the user's relevant oral care problem; 2 remove the dental focus; 3 establish the case through anamnesis; and 4 use electronic scheduling, medical files and sterilization of the health unit. Listening to the complaint, the oral clinical examination and compilation of the clinic history were recorded in the medical file, without
This article examines the narratives of suffering expressed by a group of South Asian immigrant survivors of domestic violence who accessed a mental health clinic in New York City. These accounts illustrate women's own perceptions of their suffering and symptoms and provide a window into the South Asian immigrant community's ideologies and moral domains regarding gender, violence, and sickness, as well as how individuals vary in their endorsement of these ideologies. The women's narratives illustrate how migration and culture interact with the deeply personal experience of suffering caused by domestic and sexual violence.
Hullman, Jessica; Diakopoulos, Nicholas
Narrative visualizations combine conventions of communicative and exploratory information visualization to convey an intended story. We demonstrate visualization rhetoric as an analytical framework for understanding how design techniques that prioritize particular interpretations in visualizations that "tell a story" can significantly affect end-user interpretation. We draw a parallel between narrative visualization interpretation and evidence from framing studies in political messaging, decision-making, and literary studies. Devices for understanding the rhetorical nature of narrative information visualizations are presented, informed by the rigorous application of concepts from critical theory, semiotics, journalism, and political theory. We draw attention to how design tactics represent additions or omissions of information at various levels-the data, visual representation, textual annotations, and interactivity-and how visualizations denote and connote phenomena with reference to unstated viewing conventions and codes. Classes of rhetorical techniques identified via a systematic analysis of recent narrative visualizations are presented, and characterized according to their rhetorical contribution to the visualization. We describe how designers and researchers can benefit from the potentially positive aspects of visualization rhetoric in designing engaging, layered narrative visualizations and how our framework can shed light on how a visualization design prioritizes specific interpretations. We identify areas where future inquiry into visualization rhetoric can improve understanding of visualization interpretation. © 2011 IEEE
Full Text Available Following the recent “animal turn” in literary studies, which has inspired scholars to revisit traditional human-centered interpretations of texts narrated by animals, this article focuses on the convergence of animal studies and trauma theory. It offers new animal-centered close readings of Tolstoy’s Strider and Bulgakov’s Heart of a Dog, paying attention to animal pain rather than seeing it, and the text as a whole, as an allegory of human society. Like many other authors of literary fiction featuring animal narrators, Tolstoy and Bulgakov employ a kind of empathic ventriloquism to narrate animal pain, an important project which, however, given the status of both the animal and trauma outside human language, and thus susceptible to being distorted by it, produces inauthentic discourse (animal-like, rather than animal narration; therefore, these authors get closest to animal pain, not through sophisticated narration, but through the use of ellipses and onomatopoeia. Ultimately, any narratological difficulty with animal focalization is minor compared to the ethical imperative of anti-speciesist animal-standpoint criticism, and the goal is to reconceive the status of animals in literature so as to change their ontological place in the world, urging that this critical work and animal rights advocacy be continued in the classroom.
Full Text Available In engaging with acts of self-narration that cross species lines, creators of animal autobiographies also broach questions about genre, truth status, and the structure as well as the politics of narrative representation. To address these questions, the present article draws not just on scholarship on (animal autobiography but also on ideas from the fields of linguistic semantics, politeness theory, and discourse analysis, including the “framing and footing” approach that focuses on talk emerging in contexts of face-to-face interaction and that derives most directly from the work of Erving Goffman. On the basis of this research, and using case studies that range from animal riddles to Ceridwen Dovey’s Only the Animals (2014, a collection of life stories posthumously narrated by a variety of nonhuman tellers, I profile autobiographical acts that reach beyond the human as ways of speaking for or in behalf of animal others. Some animal autobiographies correlate with acts of telling for which humans themselves remain the principals as well as authors; their animal animators remain relegated to the role of commenting on human institutions, values, practices, and artifacts. Other examples, however, can be read as co-authored acts of narrating in behalf of equally hybrid (or “humanimal” principals. These experiments with narration beyond the human afford solidarity-building projections of other creatures’ ways of being-in-the-world—projections that enable a reassessment, in turn, of forms of human being.
The main things which have been focused on so far in the narration of this work are those relating to the blurring of the viewpoints of the narrator and the main character. However, it can be argued that the real strength in the narration of this work is found when the narrator narrates at a distance from the main character. This is revealed in 3 characteristics of narration. By using a literary construction which brings a concord between paradoxical conjunctions like the adverb "muron"(=of c...
John C. Pruit
Full Text Available The “big” story of human progress has polarizing tendencies featuring the binary options of progress or decline. I consider human progress narratives in the context of everyday life. Analysis of the “little” stories from two narrative environments focusing on peak oil offers a more complex picture of the meaning and contours of the narrative. I consider the impact of differential blog site commitments to peak oil perspectives and identify five narrative types culled from two narrative dimensions. I argue that the lived experience complicates human progress narratives, which is no longer an either/or proposition.
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.
Jorge Luiz da Cunha
Full Text Available The thematic focus in this text are the estrangement/denaturation processes in (autobiographical narrations. The aim of this study was to reflect on the possibility to promote estrangement/denatura - tion in (autobiographical writings made by teenagers in the space/ time of the classroom environment. The methodological proposal consisted on developing (autobiographical writings by students from sociology classes in High School. A total of 138 teenagers from a public school, attending the first school trimester in the year 2013, have participated in the study. The concepts of estrangement/de - naturation are located in the anthropology field and, the work with (autobiographical narrations is located in the socio-clinic perspec - tives and of biographization processes. The results indicate that (autobiographical narrations provide estrangements/denaturation and go towards teaching what one does not know. We can, then, conclude that this possibility, as an educational act, may generate knowledge suspension to self-inventiveness.
Bernard, Aaron W; Malone, Matthew; Kman, Nicholas E; Caterino, Jeffrey M; Khandelwal, Sorabh
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.
Full Text Available Objectives: The spontaneous language sample analysis is an important part of the language assessment protocol. Language samples give us useful information about how children use language in the natural situations of daily life. The purpose of this study was to compare Conversation, Freeplay, and narrative speech in aspects of Mean Length of Utterance (MLU, Type-token ratio (TTR, and the number of utterances. Methods: By cluster sampling method, a total of 30 Semnanian five-year-old boys with normal speech and language development were selected from the active kindergartens in Semnan city. Conversation, Freeplay, and narrative speech were three applied language sample elicitation methods to obtain 15 minutes of children’s spontaneous language samples. Means for MLU, TTR, and the number of utterances are analyzed by dependent ANOVA. Results: The result showed no significant difference in number of elicited utterances among these three language sampling methods. Narrative speech elicited longer MLU than freeplay and conversation, and compared to freeplay and narrative speech, conversation elicited higher TTR. Discussion: Results suggest that in the clinical assessment of the Persian-language children, it is better to use narrative speech to elicit longer MLU and to use conversation to elicit higher TTR.
Arnould, Eric; Press, Melea
In this paper, we look at how alternative marketing organisations communicate transparency in a climate of generalised risk and scepticism. We contrast the traditional numeric approach to transparency, which involves auditing and third-party certifications; with an alternative approach that we call...... narrative transparency. Central to narrative transparency is an emphasis on stake-holder dialogue and an invitation to stake-holders to play the role of auditor. This article illustrates how alternative marketing organisations engage in rhetorical tactics central to a narrative approach, to communicate...... transparency to their stakeholders. These rhetorical tactics include persona, allegory, consumer sovereignty and enlightenment. Community supported agriculture programmes from across the United States are the context for this study. Findings enrich discussions about best practices for transparency...
Knutz, Eva; Markussen, Thomas; Desmet, Pieter
In this paper, we introduce a new approach to designing games for serious contexts. In contrast to Serious Games we argue that learning is a too narrow focus for serious contexts and that simulation of real world problems ought to be supplemented with other design strategies that place greater...... emphasis on fiction and narratives. The approach is exemplified through three game prototypes designed to be played by an inmate and his child in a prison during visiting hours. By analyzing these game prototypes we demonstrate how a game can be structured around a narrative plot in three different ways....... Moreover, we discuss how narrative plots in a game may open up for developing player’s emotional experiences over time and grow social relationships between inmate and child. On the basis of our case analysis we discuss, in more detail, how our approach differs from Serious Games and we single out some key...
Robert, Glenn; Maben, Jill
We trace the legacies of filmed patient narratives that were edited and screened to encourage engagement with a participatory quality improvement project in an acute hospital setting in England. Using Gabriel’s theory of “narrative contract,” we examine the initial success of the films in establishing common grounds for participatory project and later, and more varied, interpretations of the films. Over time, the films were interpreted by staff as either useful sources of learning by critical reflection, dubious (invalid or unreliable) representations of patient experience, or as “closed” items available as auditable evidence of completed quality improvement work. We find these interpretations of the films to be shaped by the effect of social distance, the differential outcomes of project work, and changing organizational agendas. We consider the wider conditions of patient narrative as a form of quality improvement knowledge with immediate potency and fragile or fluid legitimacy over time. PMID:25576480
Full Text Available The paper deals with the main linguistic indications of Lithuanian preschoolers’ narratives. The analysis is based on experimental data of 24 typically developing monolingual Lithuanian children (6–7 years of age from middle-class families, attending a state kindergarten in Kaunas (Lithuania. During the experiment, the children were asked to tell a story according to the Cat Story (Hickmann 1993 picture sequence. The stories were recorded, transcribed and annotated for an automatic analysis using CHILDES software. During the analysis, the syntactic complexity, lexical diversity, and general productivity (MLUw and type/token ratio of the narratives were investigated. The results indicated the main microstructural tendencies of Lithuanian narrative language at preschool age.DOI: http://dx.doi.org/10.5128/ERYa8.02
Knutz, Eva; Markussen, Thomas; Desmet, Pieter
In this paper, we introduce a new approach to designing games for serious contexts. In contrast to Serious Games we argue that learning is a too narrow focus for serious contexts and that simulation of real world problems ought to be supplemented with other design strategies that place greater....... Moreover, we discuss how narrative plots in a game may open up for developing player’s emotional experiences over time and grow social relationships between inmate and child. On the basis of our case analysis we discuss, in more detail, how our approach differs from Serious Games and we single out some key...... emphasis on fiction and narratives. The approach is exemplified through three game prototypes designed to be played by an inmate and his child in a prison during visiting hours. By analyzing these game prototypes we demonstrate how a game can be structured around a narrative plot in three different ways...
Bogers, Toine; Koolen, Marijn
Research into recommendation algorithms has made great strides in recent years. However, these algorithms are typically applied in relatively straightforward scenarios: given information about a user's past preferences, what will they like in the future? Recommendation is often more complex......: evaluating recommended items never takes place in a vacuum, and it is often a single step in the user's more complex background task. In this paper, we define a specific type of recommendation scenario called narrative-driven recommendation, where the recommendation process is driven by both a log...... of the user's past transactions as well as a narrative description of their current interest(s). Through an analysis of a set of real-world recommendation narratives from the LibraryThing forums, we demonstrate the uniqueness and richness of this scenario and highlight common patterns and properties...
Full Text Available Preserved ships and other vessels are associated with a historiography, in Europe at least, which is still marked by parochialism, antiquarianism, and celebratory narrative. Many evidence difficult histories, and they are also extremely expensive to preserve. Yet, they are clearly valued, as nations in Europe invest heavily in them. This survey examines a range of European examples as sites of cultural, political and national identity. An analytical framework foregrounding the role of narrative and story reveals three aspects to these exhibits: explicit stories connected with specific nations, often reinforcing broader, sometimes implicit, national narratives; and a teleological sequence of loss, recovery and preservation, influenced by nationality, but very similar in form across Europe
Full Text Available Abstract 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
In eighteenth-century France, geodesy (the measure of the earth's shape) became an arena where mathematics and narrative intersected productively. Mathematics played a crucial role not only in the measurements and analysis necessary to geodesy but also in the narrative accounts that presented the results of elaborate and expensive expeditions to the reading public. When they returned to France to write these accounts after their travels, mathematician-observers developed a variety of ways to display numbers and mathematical arguments and techniques. The numbers, equations, and diagrams they produced could not be separated from the story of their acquisition. Reading these accounts for the interplay of these two aspects--the mathematical and the narrative--shows how travelers articulated the intellectual and physical difficulties of their work to enhance the value of their results for specialist and lay readers alike.
Full Text Available The article presents the object and results of a study which combines the psychology of religion and folkloristics in the form of a qualitative analysis of empirical ethnographic material compiled from sources in a local neo-charismatic congregation called the ‘Word of Life’. Personal narrative is discussed as a genre which represents the collective tradition of a religious community. It is a socially-learned speech act and a means of interpreting and sharing religious experience, thus constructing and confirming the faith of the community, both individually and collectively. In the neo-charismatic tradition, everyday speech draws on a literal (biblical tradition as well as on socially-shared narrative genres such as ritual testimonies, prophecies, sermons and casual, personal narratives of co-believers. The faith-creative power of these stories can be found in their performative utterances and evaluative structures as well as in non-communication.
Evaluation of the medical justifications (Clinical Information) provided in the request for exams using ionizing radiation at the Hospital de Clínicas de Porto Alegre (HCPA), RS, Brazil; Avaliação das justificativas médicas (Informações Clínicas) fornecidas na solicitação de exames com radiação ionizante no Hospital de Clínicas de Porto Alegre
Goulart, J.M.; Lucena, R.A.; Bacelar, A.; Pinto, A.L.A., E-mail: email@example.com [Hospital de Clínicas de Porto Alegre (HCPA), RS (Brazil)
Justification (clinical information) is the universal basic principle of radiation protection. Adequate clinical information with the maximum possible information related to the patient's pathology is essential to avoid unnecessary radiological exposures. Through a monthly analysis performed in 2016, all the clinical information described in the HIS system of HCPA was evaluated. The numbers of clinical information unsuitable for performing the tests using ionizing radiation were identified. Capacity in radiological protection at the requesting services of imaging exams were carried out, as well as a block in the system in relation to the number of characters in the field clinical information of the request of image exams. From the training and effective blockade in the system, a significant reduction of 20% in the number of inappropriate clinical information was observed. The implemented system optimizes the radiological protection, causing the requesting physician to describe adequate and sufficient clinical information for a medical justification in the request for examinations with the use of ionizing radiation.
Full Text Available A single narrative about the Gorongosa Restoration Project (GRP in Mozambique circulates widely in the popular media. This story characterises the project as an innovative intervention into an ecological crisis situation. The narrative hails the project′s aim to use profits from tourism to address the goals of both human development and conservation of biodiversity, and portrays the park project as widely embraced by long-term residents. This representation helps the project attract broad acclaim, donor funding, and socially conscious visitors, yet it obscures the early emergence of unified opposition to the project′s interventions among long-term residents of Gorongosa Mountain. This article draws on ethnographic research conducted on Gorongosa Mountain between 2006 and 2008 to examine the project′s early activities there. I examine two crisis narratives that led to entrenched conflict between park-based actors and mountain residents. Focusing on the emergence and solidification of divergent narratives-narrative fortresses-about the extension of the park′s activities to Gorongosa Mountain offers insight into the powerful role of crisis narratives in producing and maintaining conflict, leading to outcomes counter to the desires of conservationists. Ultimately, the article points to ways in which narratives of environmental crisis work against aspirations of partnership and collaboration with resident populations in conservation and development schemes.
Some types of first-person narrations of mental processes that constitute phenomenological accounts and texts, such as internal monolog statements, epitomize the best expressions and representations of human consciousness available and therefore may be used to model phenomenological streams of consciousness. The type of autonomous monolog in which an author or narrator declares actual mental processes in a think aloud manner seems particularly suitable for modeling streams of consciousness. A narrative method to extract and depict conscious processes, operations, contents, and states from an acceptable phenomenological text would require three subsequent steps: operational criteria for producing and/or selecting a phenomenological text, a system for detecting text items that are indicative of conscious contents and processes, and a procedure for representing such items in formal dynamic system devices such as Petri nets. The requirements and restrictions of each of these steps are presented, analyzed, and applied to phenomenological texts in the following manner: (1) the relevance of introspective language and narrative analyses to consciousness research and the idea that specific narratives are of paramount interest for such investigation is justified; (2) some of the obstacles and constraints to attain plausible consciousness inferences from narrative texts and the methodological requirements to extract and depict items relevant to consciousness contents and operations from a suitable phenomenological text are examined; (3) a preliminary exercise of the proposed method is used to analyze and chart a classical interior monolog excerpted from James Joyce’s Ulysses, a masterpiece of the stream-of-consciousness literary technique and, finally, (4) an inter-subjective evaluation for inter-observer agreement of mental attributions of another phenomenological text (an excerpt from the Intimate Journal of Miguel de Unamuno) is presented using some mathematical tools
Full Text Available Some types of first person narrations of mental processes that constitute phenomenological parliaments and texts, such as internal monologue statements, epitomize the best expressions and representations of human consciousness available and therefore may be used to model phenomenological streams of consciousness. The type of autonomous monologue in which an author or narrator declares actual mental processes in a think aloud manner seems particularly suitable for modeling streams of consciousness. A narrative method to extract and depict conscious processes, operations, contents, and states from an acceptable phenomenological text would require three subsequent steps: operational criteria for producing and/or selecting a phenomenological text, a system for detecting text items that are indicative of conscious contents and processes, and a procedure for representing such items in formal dynamic system devices such as Petri nets. The requirements and restrictions of each of these steps are presented, analyzed, and applied to phenomenological texts in the following manner: (1 The relevance of introspective language and narrative analyses to consciousness research and the idea that specific narratives are of paramount interest for such investigation is justified; (2 Some of the obstacles and constraints to attain plausible consciousness inferences from narrative texts and the methodological requirements to extract and depict items relevant to consciousness contents and operations from a suitable phenomenological text are examined; (3 A preliminary exercise of the proposed method is used to analyze and chart a classical interior monologue excerpted from James Joyce’s Ulysses, a masterpiece of the stream-of-consciousness literary technique and, finally, an inter-subjective evaluation for inter-observer agreement of mental attributions of another phenomenological text (an excerpt from the Intimate Journal of Miguel de Unamuno is presented using some
Some types of first-person narrations of mental processes that constitute phenomenological accounts and texts, such as internal monolog statements, epitomize the best expressions and representations of human consciousness available and therefore may be used to model phenomenological streams of consciousness. The type of autonomous monolog in which an author or narrator declares actual mental processes in a think aloud manner seems particularly suitable for modeling streams of consciousness. A narrative method to extract and depict conscious processes, operations, contents, and states from an acceptable phenomenological text would require three subsequent steps: operational criteria for producing and/or selecting a phenomenological text, a system for detecting text items that are indicative of conscious contents and processes, and a procedure for representing such items in formal dynamic system devices such as Petri nets. The requirements and restrictions of each of these steps are presented, analyzed, and applied to phenomenological texts in the following manner: (1) the relevance of introspective language and narrative analyses to consciousness research and the idea that specific narratives are of paramount interest for such investigation is justified; (2) some of the obstacles and constraints to attain plausible consciousness inferences from narrative texts and the methodological requirements to extract and depict items relevant to consciousness contents and operations from a suitable phenomenological text are examined; (3) a preliminary exercise of the proposed method is used to analyze and chart a classical interior monolog excerpted from James Joyce's Ulysses, a masterpiece of the stream-of-consciousness literary technique and, finally, (4) an inter-subjective evaluation for inter-observer agreement of mental attributions of another phenomenological text (an excerpt from the Intimate Journal of Miguel de Unamuno) is presented using some mathematical tools.
Kesler, Richard W.; And Others
Chaplains and seminary students enrolled in the University of Virginia Medical Center's Clinical Pastoral Program were asked to judge physicians' performances while requesting autopsies by completing a confidential evaluation form. The results of the evaluations were correlated with the physicians' success in obtaining autopsies. (MLW)
Most of the appropriate SPE test requests were from clinical haematology, renal ... implementation of principles of demand management and the ... electrophoresis (IFE)) in a South African (SA) pathology laboratory setting are limited. Objectives. ... (NHLS) hospital information system database from 1 July 2010 to. 30 June ...
Hayes, Gillian R; Lee, Charlotte P; Dourish, Paul
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.
Urhammer, Emil; Røpke, Inge
Since the financial crisis in 2008, a series of publications on macroeconomic responses to the compound crises of the economy and the environment have emerged. Under labels such as green new deal, green growth and the great transition, attempts at offering coherent responses to the crises have been...... discourse theory and narrative analysis and investigates discourses by studying the narratives they produce. The study thus contributes to the long line of analyses on discourses on sustainable economy: empirically, by investigating and analysing a number of macroeconomic proposals for solving the system...
Henriksen, Lars Bo
that the traditional project management tools are not always sufficient when it comes to managing engineering projects. In this chapter, an engineering project is examined, and it turns out that the language, the stories, and the narratives connected to the project is of greater importance to the engineers than...... the formal project management tools that were offered to the engineers. It also turns out that the term “project” could itself be a problem when it comes to fulfilling the project goals. Therefore, it is concluded that when working on engineering projects, language, stories, and narratives are just...
Full Text Available This latest book by Tony Davenport represents not only a very useful guide to the different types of narrative associated with the Middle Ages but also succinctly describes their origins in Antiquity as well as linking up the various genres of medieval story-telling to present-day fiction in prose and film. The introductory pages thus give a global picture of narrative both before and after the medieval period and the Middle Ages are thereby not left in a vacuum. Although the focus is on Engl...
Knudsen, Ann-Christina; Gram-Skjoldager, Karen
The ‘transnational turn’ has been one of the most widely debated historiographical directions in the past decade or so. This article explores one of its landmark publications: The Palgrave dictionary of transnational history (2009), which presents around 400 entries on transnational history written...... by around 350 authors from some 25 countries. Drawing on narrative theory and the sociology of knowledge, the article develops an extensive quantitative and qualitative analysis of the most prominent narrative structures that can be found across the Dictionary, thus piecing together a coherent...
Full Text Available The purpose of this article is to conceptualize a feminist narrative approach to male anorexia nervosa (MAN. Both narrative and feminist theories have been utilized to enrich the discourse of AN among women. An unintended result of this primary focus on women’s experiences has been a limited focus on the experiences of men with AN. This article will explore a contemporary social discourse on masculinity, why some men utilize AN as a means of attaining the ideals put forth through such discourse, and how a feminist narrative approach can be applied to working with men struggling with AN.
Hersh, Deborah; Armstrong, Elizabeth; Bourke, Noni
To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation. This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions. The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation. Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. Implications for Rehabilitation Speech pathologists (SPs) can learn from hearing the clinical stories of colleagues with experience of providing rehabilitation in culturally diverse contexts, as well as from ongoing training in culturally competent and safe practices. Such stories help bridge understanding from the general to the particular. SPs working with Indigenous Australians with acquired communication disorders post-stroke and brain injury may find it helpful to consider how the themes, drawn from an interview with the clinician in this study - flexibility, awareness of cultural context, person-centredness, being practical and working ethically - might apply to their practice. Narratives may be helpful in staff training and form an important
Sakr, Mona; Connelly, Vince; Wild, Mary
Digital technologies have material and social properties that have the potential to create new opportunities for children’s expressive arts practices. The presence and development of oral narratives in young children’s visual art-making on paper has been noted in previous research, but little is known about the narratives children create when they engage in digital art-making. How do young children construct narratives during digital art-making? How do the features of these narratives relate ...
Sools, Anna Maria; Murray, Michael; Westerhof, Gerben Johan
In this editorial, we position narrative health psychology as a variety of narrative psychology, a form of qualitative research in health psychology, and a psychological perspective that falls under the interdisciplinary term narrative health research. The aim of this positioning is to explore what
Hallqvist, Anders; Hyden, Lars-Christer
In this article, we introduce a narrative approach to biographical learning; that is, an approach that considers autobiographical storytelling as a practice through which claims about life history are performed and negotiated. Using insights from narrative theory, we highlight evaluations in those narratives and suggest their crucial role in…
Parylo, Oksana; Zepeda, Sally J.; Bengtson, Ed
This qualitative study analyzes the career path narratives of active principals. Structural narrative analysis was supplemented with sociolinguistic theory and thematic narrative analysis to discern the similarities and differences, as well as the patterns in the language used by participating principals. Thematic analysis found four major themes…
The paper extends the critique in earlier research of human rights as exclusive of otherness and difference by introducing the work of Adriana Cavarero (2000) on a "narratable self." Hence, the formation of human rights is thus about the relations between different narratable selves, not just Western ones. A narrative learning, drawing…
Marunda-Piki, Chipo J.
Narrative and story play a central role in cognitive and cultural development of children. In this article, I explore a narrative-centred pedagogy used to address the teaching and learning concerns of my pupils from Helena infant school, Zimbabwe. I document how, as a novice teacher, I deployed narrative learning in my teaching of English as a…
However, many scholars have concentrated their critical attention on the themes and characterization of Nollywood movies but neglecting her narratives. This study, therefore examines the African film narrative using three Nollywood films as case study thereby justifying the discourse on the impoverished state of narratives ...
The purpose of this book is to provide a reasoned account of narrative structure, the elements of storytelling, and their combination and articulation. As explained in the introductory chapter, the "what" of narrative is the story, its events (actions, happenings) and existents (characters and settings); the "way" of narrative is discourse, or…
Bamberg, Michael; Marchman, Virginia
Explores the relationship between linguistic and conceptual structuring of narratives, focusing on linguistic devices used by German and U.S. narrators to identify transitions in text structure. Identifies and outlines two types of narrative orientation: differentiating events and integrating events. (SR)
Wong, Miranda Kit-Yi; So, Wing Chee
This study developed a spoken narrative (i.e., storytelling) assessment as a supplementary measure of children's creativity. Both spoken and gestural contents of children's spoken narratives were coded to assess their verbal and nonverbal creativity. The psychometric properties of the coding system for the spoken narrative assessment were…
... 7 Agriculture 15 2010-01-01 2010-01-01 false Budget and budget narrative. 3402.14 Section 3402.14... GRADUATE AND POSTGRADUATE FELLOWSHIP GRANTS PROGRAM Preparation of an Application § 3402.14 Budget and budget narrative. Applicants must prepare the Budget, Form CSREES-2004, and a budget narrative...
Rezzonico, Stefano; Chen, Xi; Cleave, Patricia L.; Greenberg, Janice; Hipfner-Boucher, Kathleen; Johnson, Carla J.; Milburn, Trelani; Pelletier, Janette; Weitzman, Elaine; Girolametto, Luigi
Background: The body of literature on narratives of bilingual children with and without specific language impairment (SLI) is growing. However, little is known about the narrative abilities of bilingual preschool children with SLI and their patterns of growth. Aims: To determine the similarities and differences in narrative abilities between…
Bohanek, Jennifer G.; Fivush, Robyn
Relations between narratives, especially the inclusion of internal state language within narratives, and well-being have been found in adults. However, research with adolescents has been sparse and the findings inconsistent. We examined gender differences in adolescents' personal autobiographical narratives as well as relations between internal…
Pryor, Robert G. L.; Bright, Jim E. H.
This paper seeks to extend previous work on narrative career counselling by considering the role of plot within clients' narratives. Seven archetypal narratives derived from the work of Booker (2004) are introduced that represent systems of meaning to provide insight into how individuals interpret their experience. These plots can be understood…
Spector-Mersel, Gabriela; Knaifel, Evgeny
Despite the breadth of narrative studies on individuals with severe mental illness, the suitability of narrative inquiry to exploring mental health recovery (MHR) has not been examined. (1) Examining the appropriateness of narrative inquiry to studying MHR; (2) assessing the extent to which narrative studies on MHR conform to the unique features of narrative research, as a distinctive form of qualitative inquiry. Review of empirical, theoretical and methodological literature on recovery and narrative inquiry. Considering the perspectives of recovery and narrative as paradigms, the similarity between their ontology and epistemology is shown, evident in 10 common emphases: meaning, identity, change and development, agency, holism, culture, uniqueness, context, language and giving voice. The resemblance between these "sister" paradigms makes narrative methodology especially fruitful for accessing the experiences of individuals in recovery. Reviewing narrative studies on MHR suggests that, currently, narrative research's uniqueness, centered on the holistic principle, is blurred on the philosophical, methodological and textual levels. Well-established narrative research has major implications for practice and policy in recovery-oriented mental health care. The narrative inquiry paradigm offers a possible path to enhancing the distinctive virtues of this research, realizing its potential in understanding and promoting MHR.
Randall, William Lowell; Kenyon, Gary M.
Narrative approaches in the field of aging are receiving increasing attention by theorists and practitioners alike. This article draws on recent thinking in narrative gerontology to look at three aspects of aging on which a narrative perspective can shed further light. In relation to the temporal aspects, the notion of storytime is examined.…
In this paper, I will tell two of my personal stories to try to explore the secret or opaque space between the original telling and retelling of stories in narrative inquiry. Based upon my difficult struggles with the two stories of tea, school, and narrative, I suggest that narrative inquiry has to be a complex loop of relationship, reflexivity,…
Ioannou, Maria; Canter, David; Youngs, Donna
A neglected area of research within criminality has been that of the experience of the offence for the offender. The present study investigates the emotions and narrative roles that are experienced by an offender while committing a broad range of crimes and proposes a model of criminal narrative experience (CNE). Hypotheses were derived from the circumplex of emotions, Frye, narrative theory, and its link with investigative psychology. The analysis was based on 120 cases. Convicted for a variety of crimes, incarcerated criminals were interviewed and the data were subjected to smallest space analysis (SSA). Four themes of CNE were identified: Elated Hero, Calm Professional, Distressed Revenger, and Depressed Victim in line with the recent theoretical framework posited for narrative offence roles. The theoretical implications for understanding crime on the basis of the CNE as well as practical implications are discussed.
Fritsch, Jonas; Judice, Andrea; Soini, Katja
study. In this paper, we show how we attained an empathic understanding through storytelling and aroused empathy to others using repetitive narratives in an experimental presentation bringing forth factual, reflective and experiential aspects of the user information. Taking as a starting point our...
Somerville, Craig; Somerville, Kirra; Wyld, Frances
The Martu people originate from the Pilbara region in Western Australia. Despite policies of removal, incarceration in prison and the need to leave community for health services, Martu maintain identity and connection to country. Their narratives have been used to inform a wider Australian audience about the history and culture of Aboriginal…
This is the second of two articles that are connected in a reading of "The plague" by Albert Camus. The other article is a determined narration of the events of a tragedy that befalls a city on the coast of Algeria. That article resists analysis beyond the decisions that are made regarding text to use, and of course interpretations to…
Yoo, Y.; Tussyadiah, Iis; Fesenmaier, D.R.
While experiencing space and time at a destination, tourists interact with people and artifacts to create meaning and sense of their experiences. Narratives are the ways in which they communicate, recall and enact the lived experiences of travel. This study deconstructs elements of tourists' narr...
Themis Panagiotis Kaniklidou
Full Text Available This paper looks see how meaning is constructed in translated news texts about health and science and awards a narrative potential to unforced translation shifts, moving along the theoretical lines of Baker's Narrative Theory (2006. The thematic thread of health zooms in on “emotional frames” (Nabi, 2003 of risk and fear of human health that is narrated as being 'under attack’ by potentially dangerous diseases. Themes also orbit around schemas that promote hope and optimism about science represented as coming to the rescue of man from fear of the disease. The data consists of 21 pairs of English-Greek health news articles culled from the Greek newspapers I Kathimerini, To Vima and Ta Nea. Findings point towards translation as a process that employs lexicogrammatical and intrasentential configurations to a give emphasis to the risk or hope dimensions underlying a heath or science story, b enable the reflection or emergence of a cascade of public, conceptual and master narratives.
Full Text Available AIM – This article explores the multiplicity of former heavy drinkers’ narratives. The focus lies on turning points from heavy drinking among people who have recovered through self-change and among those who recovered by participating in Alcoholics Anonymous (AA meetings.
Massive open online courses (MOOCs) have generated considerable media interest, more than other education initiatives such as Open Education Resources (OERs). In this article the author argues that this can be seen as an example of the battle for narrative in open education. MOOCs attracted media interest because they appealed to broader…
This critical narrative inquiry was guided by two overarching research questions. First, this study examined how white undergraduates interpreted and gave meaning to their white racial identities. This line of inquiry sought to understand how participants made sense of their white racial selves, the self in relation to people of color, and the…
Knoop, J.; Steultjens, M.P.M.; van der Leeden, M.; van der Esch, M.; Thorstensson, C.A.; Roorda, L.D.; Lems, W.F.; Dekker, J.
Objective: To give an overview of the literature on knee proprioception in knee osteoarthritis (OA) patients. Method: A literature search was performed and reviewed using the narrative approach. Results: (1) Three presumed functions of knee proprioception have been described in the literature:
Romano-Soares, Soraia; Soares, Aparecido José Couto; Cárnio, Maria Silvia
Promotion of a written narratives production program in the third grade of an Elementary School. To analyze two written narrative practice proposals in order to verify which resources are more efficient in benefitting the textual productions of third grade Elementary School students. Sixty students were selected from two third grade groups of a public Elementary School in São Paulo (Brazil). For the analysis, students were divided into two groups (Group A and Group B). Fourteen children's storybooks were used. In Group A, the story was orally told by the researchers in a colloquial manner, keeping the narrator role and the original structure proposed by the author. In Group B, the story was fully read. The book was projected onto a screen and read aloud so the students could follow the reading and observe the corresponding illustrations. Voice changing resources in the characters' dialogues were used. In the overall comparison, statistically significant results were found for moment (initial and final assessments) and for interaction between groups. It was observed that both groups presented substantial development from initial to final assessment. The Written Narratives Promotion Program based on the shared reading of children's storybooks constituted a more effective strategy than telling the stories using a single reader.
Kucer, Stephen B.
This research explores the impact of flashbacks and changes in settings and narrators on reader comprehension. Individually, 34 fourth graders (9 and 10 years of age), mostly with above average reading abilities (5.0), orally read the first chapter of a novel. Both publisher and readability formulae estimated the text to be at a fourth- grade…
Zilber, Tammar B.; Tuval-Mashiach, Rivka; Lieblich, Amia
Narrative psychology theoreticians emphasized the importance of context to the construction, communication, and understanding of individuals' life stories. Still, the various contexts in which, and in reference to which, life stories are told, the methodological implications of the importance of context, and the possible interpretive moves…
de Johnson, Teresa H.; O'Connell, Daniel C.
In order to ascertain the effect of different demands on cognitive processes as reflected in speech rate, pause and hesitation phenomena, 90 young men, 45 native speakers of English (U.S.A.) and 45 native speakers of Spanish (Mexico), were asked to retell a story presented in one of three ways: (1) film plus narration; (2) film only; (3) narration…
I share a number of experiences of writing as a mode of educational inquiry, with particular reference to narrative experiments inspired by Gilles Deleuze and Félix Guattari's figuration of the rhizome — a process characterised as rhizosemiotic play — and demonstrate the generativity of intertextual readings of selected ...
The soundtrack of the TV spot Village tells a story of its own. Some of the sounds communicate meaning very close to the visuals, for example by creating an African soundscape. But the soundtrack also supplies narrative elements of its own, which is most remarkable when it adds a happy ending...
Williams, Rachel; Taylor, Janette Y.
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…
Smith, Craig, Ed.; Nylund, David, Ed.
Through transcripts and case examples this book explores how drama, art, play, and humor can be used to engage children of different ages in therapy and to honor their idiosyncratic language, knowledge, and perspectives. Chapters are: (1) "Introduction: Comparing Traditional Therapies with Narrative Approaches" (C. Smith); (2) "'I…
Lardinois, A.P.M.H.; Levie, S.A.; Hoeken, H.; Lüthy, C.H.
The papers collected in this volume study the function and meaning of narrative texts from a variety of perspectives. The word 'text' is used here in the broadest sense of the term: it denotes literary books, but also oral tales, speeches, newspaper articles and comics. One of the purposes of this
Thorne, Michelle Moore
Using narrative method in the form of journaling has the power to shape identity and relationships between teachers and students. This article reflects on such journaling and the process of writing poetry to create a space of understanding between two very different people who found themselves in the relationship of teacher and student. "The…
Lofranco, Lee Ann L.; Pena, Elizabeth D.; Bedore, Lisa M.
Purpose: The current study focuses on describing the English language narrative skills of children who have been exposed to the Filipino language. Method: Eight children between the ages of 6;0 (years;months) and 7;7 who spoke primarily English but who were exposed to the Filipino language at home participated. Each child produced three narrative…
Bevensee, Sebastian Hurup; Schoenau-Fog, Henrik
Contemporary projects examining how to design for emergence in virtual environments have suggested very applicable and plausible design-oriented material. However, authors of such works cannot avoid influencing the experience by providing pre-written narrative material which can become trivial fo...
Sanders, James H., III
Krystle Merrow, a recent graduate of the Ohio State University, is a victim of the declining economy and is currently searching for opportunities in the photographic field. The photographic essay at the heart of this interview establishes a range of autobiographical narratives and coming out stories of LGBT youth in central Ohio. The interview…
Full Text Available Autobiographical narratives, which include autobiography, autobiographical novel, memoir, and chronicle, constitute a major genre in African francophone literature. Informed by history, they do not celebrate personal accomplishment, but rather accentuate the group experience. These self-stories rely on realistic representation in order to document events for future generations and function to correct stereotypical misconceptions—therein lies their political consciousness.
Full Text Available In the 21st century, our life is strongly affected by the information technology. Educational technology has been rapidly improved by the development of audiovisual tools. Teachers may choose a number of different types of resources for teaching purposes, including videos and movies. Therefore, this study is aimed at evaluating animated narrative videos from YouTube for the teaching narrative text and identifying potential factors which influence the quality of educational videos. The videos were examined by using assessment rubric to see the quality and suitability of animated narrative videos which might be used in the teaching narrative text. The rubric was adapted from Prince Edward Island (PEI Department of Education: Evaluation and Selection of Learning Resources. It consists of four criteria, content, structure, instructional design, and technical design In addition, the study presents critical awareness of how these aspects can be interpreted to measure animated narrative videos and at the same time the engagement of the teachers in exploring animated narrative videos used in classroom.
Evaluation of clinical trials by Ethics Committees in Germany: Experience of applicants with the review of requests for opinion of the Ethics Committees - results of a survey among members of the German Association of Research-Based Pharmaceutical Companies (VFA
Full Text Available The review of requests for a positive opinion of the ethics committees (application procedure as a requirement to start a clinical trial in Germany has been completely redesigned with the transposition of EU Directive 2001/20/EC in the 12th Amendment of the German Medicines Act in August 2004. The experience of applicants (sponsors, legal representatives of sponsors in the EU and persons or organizations authorized by the sponsors to make the application, respectively in terms of interactions with the ethics committees in Germany has been positive overall, especially with respect to ethics committee adherence to the statutory timelines applicable for review of requests. However, inconsistencies between ethics committees exist in terms of the form and content of the requirements for application documents and their evaluation.With the objective of further improving both the quality of applications and the evaluation of those applications by ethics committees, a survey among members of the German Association of Research-Based Pharmaceutical Companies (VFA was conducted from January to April 2008. Based on reasoned opinions issued by the respective ethics committee in charge of the coordinating principal investigator (coordinating ethics committee, the type and frequency of formal and content-related objections to applications according to § 7 of the German Good Clinical Practice (GCP Regulation were systematically documented, and qualitative and quantitative analyses performed. 21 out of 44 members of the VFA participated in the survey. 288 applications for Phase I–IV studies submitted between January and December 2007 to 40 ethics committees were evaluated.This survey shows that about one in six applications is incomplete and has formal and/or content objections, respectively, especially those that pertain to documents demonstrating the qualification of the investigator and/or suitability of the facilities. These objections are attributable to
Full Text Available The assessment of possible genetic relationships between pairs of proposed narrative parallels currently relies on subjective conventional wisdom-based criteria. This essay presents an attempt at categorizing patterns of narrative evolution through the comparison of variants of orally-composed, fixed-text Sanskrit tales. Systematic examination of the changes that took place over the developmental arc of _The Tale of Cyavana_ offers a number of insights that may be applied to the understanding of the evolution of oral narratives in general. An evidence-based exposition of the principles that govern the process of narrative evolution could provide more accurate diagnostic tools for evaluating narrative parallels.
Dahlstrom, Michael F.
Although storytelling often has negative connotations within science, narrative formats of communication should not be disregarded when communicating science to nonexpert audiences. Narratives offer increased comprehension, interest, and engagement. Nonexperts get most of their science information from mass media content, which is itself already biased toward narrative formats. Narratives are also intrinsically persuasive, which offers science communicators tactics for persuading otherwise resistant audiences, although such use also raises ethical considerations. Future intersections of narrative research with ongoing discussions in science communication are introduced. PMID:25225368
Pontikides, Nikolaos; Karras, Spyridon; Kaprara, Athina; Anagnostis, Panagiotis; Mintziori, Gesthimani; Goulis, Dimitrios G; Memi, Eleni; Krassas, Gerasimos
Primary hyperparathyroidism is a heterogeneous clinical entity. In the clinical setting, the diagnosis and management of familial isolated hyperparathyroidism (FIHP) and other familial hyperparathyroidism (FHPT) forms continue to rely on clinical, laboratory, and histological findings, with careful examination of the family. In this article, we report a case series of FIHP in a four-generation Greek family, with no identifiable gene mutations. Clinical approach and long-term follow-up are discussed and a narrative review of the genetic basis of this entity has been performed.
Department of Transportation — Lotus Notes application used by local support to request AWA Tier 3 support (RMATS). Consolidates and automates several routine IT support tasks and facilitates more...
A new EDH document entitled 'Transport/Handling Request' will be in operation as of Monday, 11th February 2002, when the corresponding icon will be accessible from the EDH desktop, together with the application instructions. This EDH form will replace the paper-format transport/handling request form for all activities involving the transport of equipment and materials. However, the paper form will still be used for all vehicle-hire requests. The introduction of the EDH transport/handling request form is accompanied by the establishment of the following time limits for the various services concerned: 24 hours for the removal of office items, 48 hours for the transport of heavy items (of up to 6 metric tons and of standard road width), 5 working days for a crane operation, extra-heavy transport operation or complete removal, 5 working days for all transport operations relating to LHC installation. ST/HM Group, Logistics Section Tel: 72672 - 72202
Johnels, Jakob Åsberg; Hagberg, Bibbi; Gillberg, Christopher; Miniscalco, Carmela
Oral narrative retelling is often problematic for children with communicative and neurodevelopmental disorders. However, beyond a suggested role of language level, little is known about the basis of narrative performance. In this study we examine whether oral narrative retelling might be associated not just with language level but also with skills related to nonverbal narrative temporal sequencing. A diagnostically heterogeneous sample of Swedish-speaking children with a full scale IQ >70 was included in the study (N = 55; age 6-9 years). Narrative retelling skills were measured using the three subscores from the bus story test (BST). Independent predictors included (1) temporal sequencing skills according to a picture arrangement test and (2) a language skills factor consisting of definitional vocabulary and receptive grammar. Regression analyses show that language skills predicted BST Sentence Length and Subordinate Clauses subscores, while both temporal sequencing and language were independently linked with the BST Information subscore. When subdividing the sample based on nonverbal temporal sequencing level, a significant subgroup difference was found only for BST Information. Finally, a principal component analysis shows that temporal sequencing and BST Information loaded on a common factor, separately from the language measures. It is concluded that language level is an important correlate of narrative performance more generally in this diagnostically heterogeneous sample, and that nonverbal temporal sequencing functions are important especially for conveying story information. Theoretical and clinical implications are discussed. © 2013 The Scandinavian Psychological Associations.
Sumner, Jennifer A.; Mineka, Susan; McAdams, Dan P.
Reduced autobiographical memory specificity (AMS) is an important cognitive marker in depression that is typically measured with the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). The AMT is widely used, but the overreliance on a single methodology for assessing AMS is a limitation in the field. The current study investigated memory narratives as an alternative measure of AMS in an undergraduate student sample selected for being high or low on a measure of depressive symptoms (N = 55). We employed a multi-method design to compare narrative- and AMT-based measures of AMS. Participants generated personally significant self-defining memory narratives, and also completed two versions of the AMT (with and without instructions to retrieve specific memories). Greater AMS in self-defining memory narratives correlated with greater AMS in performance on both versions of the AMT in the full sample, and the patterns of relationships between the different AMS measures were generally similar in low and high dysphoric participants. Furthermore, AMS in self-defining memory narratives was prospectively associated with depressive symptom levels. Specifically, greater AMS in self-defining memory narratives predicted fewer depressive symptoms at a 10-week follow-up over and above baseline symptom levels. Implications for future research and clinical applications are discussed. PMID:23240988
Weinstein, Michael S
Contrasting traditional and common forms if ethics consultation with bioethics mediation. I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, let to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.
Clandinin, D Jean; Cave, Marie T; Berendonk, Charlotte
Narrative research, an inclusive term for a range of methodologies, has rapidly become part of medical education scholarship. In this paper we identify narrative inquiry as a particular theoretical and methodological framework within narrative research and outline its characteristics. We briefly summarise how narrative research has been used in studying medical learners' identity making in medical education. We then turn to the uses of narrative inquiry in studying medical learners' professional identity making. With the turn to narrative inquiry, the shift is to thinking with stories instead of about stories. We highlight four challenges in engaging in narrative inquiry in medical education and point toward promising future research and practice possibilities. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Full Text Available Narratives that resonate in the cultural imagination inform the ways in which we apprehend the world. This paper considers how certain images and stories that have been valorised over time, bleed into reality and become socially and politically affective. The identity of an entire people, for example, can be rendered down so that those social groups come to seem more spectral than human, through either misrecognition or a lack of acknowledgment. This idea will be discussed through two examples: one provided by traditional anti-Semitism, in which the Jew is viewed as a vampiristic agent of decay; and another in which the Arab presence becomes ‘spectralised’ in contemporary Israel/Palestine. We will look at the development of narratives that create these images, and also consider the liminal zone wherein those images have their source, because it is through imagination and storytelling that we continually create and recreate the realities we must then inhabit.
Full Text Available In this paper the rationale and the first draft of a formal ontology for modeling narrative texts are presented. Building on the semiotic and structuralist narratology, and on the work carried out in the late 1980s by Giuseppe Gigliozzi in Italy, the focus of my research are the concepts of character and of narrative world/space. This formal model is expressed in the OWL 2 ontology language. The main reason to adopt a formal modeling approach is that I consider the purely probabilistic-quantitative methods (now widespread in digital literary studies inadequate. An ontology, on one hand provides a tool for the analysis of strictly literary texts. On the other hand (though beyond the scope of the present work, its formalization can also represent a significant contribution towards grounding the application of storytelling methods outside of scholarly contexts.
This narrative is taken from a memoir about my son, Jesse, who died at age 19 in 1995 after a liver transplant. It covers two periods-from May 5, his admission date at the hospital to wait for a transplant, until May 9, when a perforation, caused by cutting through intestinal adhesions during transplant surgery, was discovered, and from May 20 to May 22, when his condition became extremely critical. Since Jesse was largely unconscious or semi-conscious during a good part of the period this narrative covers, his personality and conscious struggles shine through less here than they do in other parts of the memoir. Here, the relative emphasis is on parents and physicians and on facing the critical illness, and possible death, of one's child in an intensive care unit, following the very intervention that was to give him a new chance at a healthy life.
Caio Antônio de Medeiros Nóbrega Nunes Gomes
Full Text Available In this article, we suggest the concepts of performance (Butler, 1990 and narrative performativity (Berns, 2013 as analytical tools for reflecting upon Toda Lana Turner tem seu Johnny Stompanato, a short story by the Brazilian writer Sonia Coutinho. A double movement will guide our analysis: we present an articulation between a perspective that takes into account the gender constitution of the characters and a narratological approach towards the reflexive/metafictional form which marks the composition of the short story. By making use of an ironical, intertextual and multi-layered style of writing, Sonia Coutinho constructs a narrative that proposes different discursive agencies in relation to the many instances in which characters’ subjectivities take place. In this sense, we consider this short story as having a deep mark of what we might understand as post-modern literature, for the multiplicity of spaces, characters and times is characteristic of a collective agency between reality and fiction.
Murray, Michael; Ziegler, Friederike
Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work. © The Author(s) 2015.
Application of inquiry in teacher education is gaining momentum. Inquiry is used to build connections with the local community (Nicholas, Baker-Sennett, McClanahan, & Harwood, 2012), student-centered inquiry is used as a curricular model (Oliver et al., 2015), inquiry is used to accentuate......’-module is a 6 week full-time study including a 2 weeks stay at a youth folk high school, where the teacher students are to focus on a self-determined element of the praxis. The students are to study this focus through narrative inquiry based on the North-American tradition within narrative inquiry (Clandinin....... Aarhus; Kbh.: Klim; i samarbejde med Folkehøjskolernes Forening. Salerno, A. S., & Kibler, A. K. (2015). Questions they ask: Considering teacher-inquiry questions posed by pre-service english teachers. Educational Action Research, 23(3), 399-415....
Combs, Gene; Freedman, Jill
We describe how we think of identity as relational, distributed, performed, and fluid, and we illustrate the use of this conceptualization within a narrative worldview. Drawing on the work of Michael White, we describe how this relational view of identity leads to therapeutic responses that give value to interconnection across multiple contexts and that focus on becoming rather than on being. We show how a narrative worldview helps focus on the relational, co-evolving perspective that was the basis of our early attraction to family therapy. We offer detailed examples from our work of practices that help us stay firmly situated in a relational worldview that is counter to the pervasive influence of individualism in our contemporary culture. © 2016 Family Process Institute.
Fernandes Davies, Vanessa; Mafra, Rafaella; Beltran, Alicia; Baranowski, Thomas; Lu, Amy Shirong
This article presents the results of interviews conducted with children regarding their cognitive and affective responses toward a narrative and a non-narrative cartoon. The findings will be used to further explore the role of a narrative in motivating continued active videogame play. Twenty children (8-11 years old of mixed gender) watched two cartoons (narrative and non-narrative) and were subsequently interviewed. A thematic matrix was used to analyze the interviews. The narrative cartoon (n = 11) was only slightly preferred compared with the non-narrative one (n = 9), with little difference among the participants. The theme categories identified during the analyses were plot, characters, and suggestions. The fight scenes were mentioned by the children as a likeable aspect of the narrative cartoon. In the non-narrative cartoon, the vast majority (n = 17) liked the information about physical activity that was provided. The children enjoyed the appearance and personalities of the characters in both cartoons. A discrepancy in the data about the fight scenes (narrative cartoon) and characters (both cartoons) was found among the female participants (i.e., some girls did not like the fight and thought the characters were too aggressive). However, most of the children wanted to see more action in the story, an increase in the number of fight scenes (narrative cartoon), or more information about exercise and examples of exercises they could do (non-narrative cartoon). They also suggested adding a game to the non-narrative cartoon, including more characters, and improving the animation in both cartoons. The children preferred the narrative cartoon because of the story and the fight. Some gender differences were found, which further studies should investigate.
Gifreu-Castells, Arnau; Misek, Richard; Verbruggen, Erwin
abstractOver the last years, interactive digital media have greatly affected the logics of production, exhibition and reception of non-fiction audiovisual works, leading to the emergence of a new area called ‘interactive and transmedia non-fiction’. Whilethe audiovisual non-fiction field has been partially studied, a few years ago emerged a new field focusing on interactive and transmedia non-fiction narratives, an unexplored territory that needs new theories and taxonomies to differentiate f...
Preserved ships and other vessels are associated with a historiography, in Europe at least, which is still marked by parochialism, antiquarianism, and celebratory narrative. Many evidence difficult histories, and they are also extremely expensive to preserve. Yet, they are clearly valued, as nations in Europe invest heavily in them. This survey examines a range of European examples as sites of cultural, political and national identity. An analytical framework foregrounding the role of narrati...
Full Text Available Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony. The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.
Maxwell, Deborah; Speed, Chris; Pschetz, Larissa
Digital technology is changing, and has changed the ways we create and consume narratives, from moving images and immersive storyworlds to digital longform and multi-branched story experiences. At the same time, blockchain, the technology that underpins cryptocurrencies such as Bitcoin, is revolutionising the way that transactions and exchanges occur. As a globally stored and collaboratively written list of all transactions that have ever taken place within a given system, the blockchain dece...
Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Carlos
To study the regional variability of requests for anaemia chemistry tests in primary care in Spain and the associated economic costs of potential over-requesting. Requests for anaemia tests were examined in a cross-sectional study. Clinical laboratories from different autonomous communities (AACCs) were invited to report on primary care anaemia chemistry tests requested during 2014. Demand for iron, ferritin, vitamin B12 and folate tests per 1000 inhabitants and the ratios of the folate/vitamin B12 and transferrin/ferritin requests were compared between AACCs. We also calculated reagent costs and the number of iron, transferrin and folate tests and the economic saving if every AACC had obtained the results achieved by the AACC with best practice. 110 laboratories participated (59.8% of the Spanish population). More than 12 million tests were requested, resulting in reagent costs exceeding €16.5 million. The serum iron test was the most often requested, and the ferritin test was the most costly (over €7 million). Close to €4.5 million could potentially have been saved if iron, transferrin and folate had been appropriately requested (€6 million when extrapolated to the whole Spanish population). The demand for and expenditure on anaemia chemistry tests in primary care in Spain is high, with significant regional differences between different AACCs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
The Sierra de Atapuerca in northern Spain is ranked among the most important excavation sites in human origins research worldwide. The project boasts not only spectacular hominid fossils, among them the 'oldest European', but also a fully fledged 'popularization industry'. This article interprets this multimedia industry as a generator of different narratives about the researchers as well as about the prehistoric hominids of Atapuerca. It focuses on the popular works of the three co-directors of the project. Juan Luis Arsuaga, José María Bermúdez de Castro and Eudald Carbonell make deliberate use of a variety of narrative devices, resonant cultural references and strategies of scientific self-commodification. All three, in different ways, use the history of science and of their own research project to mark their place in the field of human origins research, drawing on mythical elements to tell the story of the rise of a humble Spanish team overcoming all odds to achieve universal acclaim. Furthermore, the co-directors make skilful use of palaeofiction - that of Björn Kurtén and Jean Auel, as well as writing their own - in order to tell gripping stories about compassion and solidarity in human prehistory. This mixture of nationalist and universalist narratives invites the Spanish audience to identify not just with 'their ancestors' but also with the scientists, as objects and subjects of research become conflated through popularization.
Simpson, Jane; Heath, James; Wall, Gemma
This study aimed to synthesise the illness narratives of individuals living with a pituitary tumour. Eight adults with a pituitary tumour were recruited from an endocrinology service in the north-west of England. A narrative methodology was adopted which investigated elements of the individual narratives such as metaphor and structure but which also aimed to produce a joint account of experience in this particular illness context by extracting themes across the stories; these are presented as part of a chronological narrative. However, the resulting group story was also analysed in terms of different types of narrative plots. The group narrative started from the recognition of symptoms and then diagnosis though treatment to post-treatment and future plans. In terms of narrative plots, one notable element of the joint narrative was the flow between the culturally dominant restitution narrative, where participants focused on treatment and recovery and the chaos narrative when recovery did not seem possible. The findings contain many elements consistent with previous research; however, the use of a celebrity figure to communicate about the illness experience and a perception that objects or individuals should not be taken at face value emerged as more novel findings.
Diez-Itza, Eliseo; Martínez, Verónica; Antón, Aránzazu
Williams syndrome (WS) is a genetic disorder associated with intellectual disability and characterised by displaying an atypical neuropsychological profile, with peaks and valleys, where language skills seem better preserved than non-verbal intelligence. This study researches the narrative competence of nine Spanish-speaking adults with WS. Oral narratives were elicited from a silent film, and narrative coherence was analysed as a function of sequential order of the events narrated at three structure levels, while narrative cohesion was assessed through the frequency of use and type of discourse markers. WS subjects were able to remember a significant proportion of the events from the film, but coherence of narratives, i.e., sequential order of events, was more impaired. Consistently with their linguistic abilities, cohesion of narratives was better preserved, as they used discourse markers to introduce a high proportion of events. Construction of mental models of the narratives may be constrained in WS by non-verbal cognitive abilities, but narrative competence is also determined by textual pragmatic abilities to organize discourse, which should be addressed by specific intervention in narrative competence.
This paper aims to (re)ignite debate about the role of narrative in the medical humanities. It begins with a critical review of the ways in which narrative has been mobilised by humanities and social science scholars to understand the experience of health and illness. I highlight seven dangers or blind spots in the dominant medical humanities approach to narrative, including the frequently unexamined assumption that all human beings are 'naturally narrative'. I then explore this assumption further through an analysis of philosopher Galen Strawson's influential article 'Against Narrativity'. Strawson rejects the descriptive claim that "human beings typically see or live or experience their lives as a narrative" and the normative claim that "a richly Narrative outlook is essential to a well-lived life, to true or full personhood". His work has been taken up across a range of disciplines, but its implications in the context of health and illness have not yet been sufficiently discussed. This article argues that 'Against Narrativity' can and should stimulate robust debate within the medical humanities regarding the limits of narrative, and concludes by discussing a range of possibilities for venturing 'beyond narrative'.
Kelly Anne Correa
Full Text Available Research on narrative persuasion has yet to investigate whether this process influences behavior. The current study explored whether: 1 a narrative could persuade participants to donate to a charity, a prosocial, behavioral decision; 2 psychophysiological metrics can delineate the differences between donation/non-donation behaviors; and 3 donation behavior can be correlated with measures of psychophysiology, self-reported reactions to the narrative, and intrinsic characteristics. Participants (n = 49 completed personality/disposition questionnaires, viewed one of two versions of a narrative while EEG and ECG were recorded, completed a questionnaire regarding their reactions to the narrative, and were given an opportunity to donate to a charity related to the themes of the narrative. Results showed that 1 34.7% of participants donated; 2 psychophysiological metrics successfully delineated between donation behaviors and the effects of narrative version; and 3 psychophysiology and reactions to the narrative were better able to explain the variance (88% and 65%, respectively in the amount donated than all 3 metrics combined as well as any metric alone. These findings demonstrate the promise of narrative persuasion for influencing prosocial, behavioral decisions. Our results also illustrate the utility of the previously stated metrics for understanding and possibly even manipulating behaviors resulting from narrative persuasion.
Full Text Available In the institutional pathway for recognition of asylum right, the narrative becomes, according to current regulations, the element to be sieved in order to ascertain title to international protection. The aim of this essay is analyzing the various declensions assumed by the narrative in this institutional process. Weaving together clinical and ethnographic data, drawn from the main phases that foreigners have to pass through in this event, I would like to highlight how, in the asylum system, the narrative takes the value of a tool directed, first of all at checking the applicant’s past, and second at co-producing a subject fitting to the media and legal dominant imaginary features. In this specific context, the treatment of traumatic injuries, recognized as basis of interrupted narratives, emerges as issue played in its turn on a double register: as adherence to specific schemes of "therapeutic governance" and as further control of specific events, experienced by asylum seekers in the past.
Robertson, Sarah M C; Swickert, Rhonda J
Researchers have been attempting to understand the variables that predict differences in autobiographical narratives, given that these differences often reveal important information about the psychological characteristics of the person providing the narrative. A sample of young adults (n = 80) and older adults (n = 80) completed a battery of self-report measures in addition to an autobiographical narrative task in which they described a negative emotional experience. These narratives were transcribed and entered into a text analysis program. Results indicated a significant three-way interaction (age × gender × forgiveness) for negative emotion words. Results also indicated two significant two-way interactions (age × forgiveness and gender × forgiveness) and one significant main effect for anger words. There were no significant findings related to anxiety or sad words. Results are discussed in the context of Socioemotional Selectivity Theory, which asserts that social and emotional goals shift throughout the lifespan such that older adults are more motivated to regulate their emotions than young adults. Clinical applications and future directions are discussed.
Dolan, Brigid M; O'Brien, Celia Laird; Cameron, Kenzie A; Green, Marianne M
Construct: Students entering the health professions require competency in teamwork. Although many teamwork curricula and assessments exist, studies have not demonstrated robust longitudinal assessment of preclerkship students' teamwork skills and attitudes. Assessment portfolios may serve to fill this gap, but it is unknown how narrative comments within portfolios describe student teamwork behaviors. We performed a qualitative analysis of narrative data in 15 assessment portfolios. Student portfolios were randomly selected from 3 groups stratified by quantitative ratings of teamwork performance gathered from small-group and clinical preceptor assessment forms. Narrative data included peer and faculty feedback from these same forms. Data were coded for teamwork-related behaviors using a constant comparative approach combined with an identification of the valence of the coded statements as either "positive observation" or "suggestion for improvement." Eight codes related to teamwork emerged: attitude and demeanor, information facilitation, leadership, preparation and dependability, professionalism, team orientation, values team member contributions, and nonspecific teamwork comments. The frequency of codes and valence varied across the 3 performance groups, with students in the low-performing group receiving more suggestions for improvement across all teamwork codes. Narrative data from assessment portfolios included specific descriptions of teamwork behavior, with important contributions provided by both faculty and peers. A variety of teamwork domains were represented. Such feedback as collected in an assessment portfolio can be used for longitudinal assessment of preclerkship student teamwork skills and attitudes.
Full Text Available Transmedia narrators can use the intermediacy of images and text as a foundation to develop story networks. These narrators can also use various forms of technology to recreate a variety of aesthetic responses in readers. In this study, we analyzed the narrative strategies of adaptation in examples of transmedia adaptation among winners of international picture book awards. In artistic terms, the horizons of expectation of adapters, the readers of fiction, and the inviting structures extended from intermediacy play key roles in aesthetic communication. How adapters use the materials of intermediacy as filler or to expand on negative speculation also influences the relaying process. In this study, we clarified that in addition to considering aesthetic judgments, adaptation must also adhere to the economy of aesthetics.
Kyle J Wilby
Full Text Available Objectives: 1 to explore clinical assessor’s values regarding behaviours related to cultural aspects of care, 2 to generate standardized narrative profiles regarding cultural behavioural outcomes within clinical teaching settings, and 3 to rank order standardized narrative profiles according to performance expectations. Methods: Ten interviews were completed with clinicians to determine values and performance expectations for culturally competent behaviours. Transcripts were produced and coded. Six narrative profiles were developed based on data obtained. Twenty clinicians categorized profiles according to performance expectations and rank ordered. Intraclass correlation coefficients (ICCs determined inter-rater reliability. Clinicians rated usability of profiles in clinical training settings. Results: Eighteen categories were coded with communication, awareness and ability most frequently reported with each ranging from 9.6-11.5% of the utterances. Consensus for categorization of all profiles was achieved at a level of 70% (ICC = 0.837, 95% CI 0.654-0.969. High inter-rater reliability was achieved for rank ordering (ICC = 0.815, 95% CI 0.561 to 0.984. Seventeen (85% clinicians agreed that the profiles would be usable in clinical training settings. Conclusions: Standardized narrative profiles may aid assessment and self-reflection for student performance within culturally diverse interactions. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Original Research
Costabile, Kristi A
The present investigation examined how three salient features of narrative thinking (situation model construction, linguistic concreteness, and perspective-taking) influenced the social inference process. Results of four experiments indicated that compared with those given other objectives, perceivers given narrative objectives were: (a) more likely to make situation rather than trait attributions for observed behaviors (Experiment 1), (b) less likely to make implicit trait inferences (Experiment 2), and (c) less likely to rely on behavior valence when making evaluative judgments (Experiment 4). Linguistic analyses indicated that narrative construction consistently entailed the creation of situation models of events and linguistic concreteness, but only situation model creation mediated the relationship between narrative and inferences. Experiment 3 confirmed the mediating role of situation models: Perceivers with narrative objectives made trait inferences only when behaviors were inconsistent with contextual information. The role of these core narrative features on social perceptions is discussed. © 2016 by the Society for Personality and Social Psychology, Inc.
Ash, Sharon; McMillan, Corey; Gross, Rachel G.; Cook, Philip; Morgan, Brianna; Boller, Ashley; Dreyfuss, Michael; Siderowf, Andrew; Grossman, Murray
Narrative discourse is an essential component of day-to-day communication, but little is known about narrative in Lewy Body spectrum disorder (LBSD), including Parkinson's disease (PD), Parkinson's disease with dementia (PDD), and dementia with Lewy bodies (DLB). We performed a detailed analysis of a semi-structured speech sample in 32 non-aphasic patients with LBSD, and we related their narrative impairments to gray matter (GM) atrophy using voxel-based morphometry. We found that patients with PDD and DLB have significant difficulty organizing their narrative speech. This was correlated with deficits on measures of executive functioning and speech fluency. Regression analyses associated this deficit with reduced cortical volume in inferior frontal and anterior cingulate regions. These findings are consistent with a model of narrative discourse that includes executive as well as language components and with an impairment of the organizational component of narrative discourse in patients with PDD and DLB. PMID:21689852
Aleksić Slađana M.
Full Text Available A story is one of the forms of human communication, and one of the oldest ways of understanding the world and exchanging knowledge. The story is told through words, images and movement, and therefore the phenomenon of narration cannot be limited to verbal expression only. One can narrate about real or imaginary events in order to convey a message, provide knowledge or entertainment, and also to create an art form as well as achieve aesthetic communication. The process by means of which the inner world is built within a literary work is certainly the story or narrative. Modern theory of narration enumerates a number of forms of narration indifferent media: in folklore and art, oral or written linguistic narrative form, in pantomime, picture, vitrage, and film. This paper discusses various contemporary narratological ideas.
As of the 08/03/2004 all the repair requests and other communication concerning the CERN tertiary buildings that so far have been transmitted to the TCR via 72201 will be handled directly by the FM helpdesk under the phone number 77777, i.e. problems on systems and equipment as: Electricity and lighting in office buildings, halls and workshops Heating and air conditioning in office buildings, halls and workshops Lifts (excluded the ones in shafts) Motorised doors Building structure and equipment: roofs, doors, windows, blinds, etc. Plumbing Toilets Cleaning (CERN wide) Restaurant equipment Roads and green areas Wastes collection The FM Helpdesk is available between 07h30 and 18h30. Troubleshooting requests, complaints and work requests will only be accepted during these opening hours. Outside these opening hours and for any problem in a machine building or on equipment that is ...
Sommer, Anita Friis
and its customers. The study provides an insight into a new area of supply chain management, including the process activity flow and challenges involved across the process. Furthermore, the method is dyadic including the customer in the case study, which is rare in related research....... profitability. This research study seeks to investigate the challenges of RQM in practice. Existing demand chain management literature is used as a basis for developing a RQM framework. RQM is investigated through an explorative research design in a dyadic B2B case study including a global industrial company......Request management (RQM) is a new term used for managing customer requests for new products. It is the counterpart to typical product development processes, which has no direct customer involvement. It is essential to manage customer requests in a structured and efficient way to obtain...
Full Text Available It is often assumed that narrating a story from the protagonist’s perspective increases the readers’ inclination to take over this perspective. In a questionnaire study, we examined to which degree different textual modes of narration (a increase the degree to which the reader can generally relate to the protagonist (what we will call 'relatedness', (b make the reader prone to imagine the scene from the 'spatial point-of-view 'of the protagonist, and (c enhance the psychological perspective-taking of the reader, measured as 'identification 'with the protagonist. We employed two different types of texts—one literary and one non-literary—and tested them in four different modes of narration: free indirect discourse, psycho-narration, first-person narration and external focalization. In terms of the 'relatedness 'between the reader and protagonist and 'spatial perspective-taking 'the largest differences (descriptively occurred between external focalization and psycho-narration ('p'& .05 for 'relatedness', 'p'& .05 for 'spatial perspective-taking' and between external focalization and first-person narration ('p'& .05 for 'relatedness', for 'spatial perspective-taking p'& .1. 'Identification', measured with items from a questionnaire on reading experience (Appel et al. 2002, was highest for first-person narration. Here, the difference between first-person narration and external focalization turned out significant only after including dispositional empathy, thematic interest for the text and attention during reading as covariates. Results for the other two perspective-taking measures were unaffected by the inclusion of the same covariates. In conclusion, our data show that first-person and psycho-narration increased the tendency to take over the perspective of the protagonist, but FID did not. This article is part of the special collection: Perspective Taking
Steensma, David P
Storytelling is a deeply human act-ancient, universal, and familiar. But in this data-driven "Information Age," is there still room for narrative? As oncologists, we often feel overclocked, increasingly forced to microtask and live by the business world's mantra of "faster, cheaper, better," while our carefully honed humanistic clinical skills are coldly commoditized into Relative Value Units, our aptitude measured with tools that emphasize form over substance. In such an environment, can we still afford the inefficiency of anecdotes? Some might argue that we no longer need patient and physician narratives to inform care; instead, accurate molecular subtyping of tumors, good pharmaceutical agents, and rigorous clinical trial results are enough. Yet stories and reflections about being a doctor or being a patient remain important and instructive even in this era of molecular cancer medicine, even in the face of our increasing reliance on high-tech diagnostics and narrowly targeted smart therapeutics. Amid the pressures of rapidly changing practice patterns and the daily emotional challenges of working with seriously ill and dying patients, the acts of reflection and storytelling can also help keep us sane. Here I discuss the persistent importance of narrative in the context of the "Art of Oncology" forum of the Journal of Clinical Oncology.
Kusuma, Rina Sari
Movie, as a means of mass communication, narrating life in a set of binary - that have different privilege. This research wants to examine movie entitled Rashomon, directed by Akira Kurosawa in 1950, in narrating gender as one of characters code that gave diverse contradictive testimonies about the same events; rape and murder. Rashomon used multiple narrators that build the same story from different point of view that lead to the subjectivity and relativity of truth which the director didn’t...
International audience; As professor Amia Lieblich has said, "People are story tellers by nature" (Lieblich et al., 1988). Storytelling technique is well-founded in narrative theory, phenomenology, psychoanalytic theory, trauma studies and aesthetics. Both my own research and my Art Therapy practice have been enriched by the use of narrative and storytelling as therapy interventions. Storytelling ability emanates from narrative knowledge. Notably, it is reframed as the patient's ability to us...
He, Qiwei; Veldkamp, Bernard P.; Glas, Cornelis A.W.; de Vries, Theo
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