Negotiating Awareness: Dutch Midwives' Experiences of Noninvasive Prenatal Screening Counseling.

BACKGROUND: Discussion of the topic of noninvasive prenatal screening (NIPS) has become a standard part of Dutch maternity care practice. This means that pregnant women who are contemplating NIPS can receive counseling from their midwife or obstetrician. The aim of this study is to understand the communicative practices and decision-making principles regarding first-tier use of NIPS, as experienced by Dutch midwives. METHODS: Qualitative analysis of in-depth interviews with Dutch midwives (n = 10) exploring their conversations about NIPS counseling and decision making. RESULTS: Midwives value the autonomy of women in decisions on NIPS. They consider it a midwifery task to assess women's awareness of the risks and implications of using or not using this mode of screening. The optimal level of awareness may differ between women and midwives, creating novel challenges for informed decision making in midwifery communication. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Negotiating awareness about NIPS in individual women is a relatively new and complex midwifery task in need of counseling time and skill. NIPS practices call for a reflection on midwifery values in the context of integrated maternity care.

'I want to die on my own terms': Dominant interpretative repertoires of 'a good death' in old age in Dutch newspapers.

RATIONALE: There is a paucity of empirical studies exploring how death and dying in old age are actually represented and debated within the Dutch society. OBJECTIVE: This study examines the discourse used in Dutch newspapers on the good death and dignified dying. It analyses how different types of social actions and positions are construed, thereby describing how death and dying in old age are portrayed in newspaper media. METHODS: 173 newspaper articles between 2010 and 2020 were selected from five Dutch national newspapers. Data were thematically coded and scrutinised for discursive patterns in order to identify interpretative repertoires and their functions. RESULTS: Four interpretative repertoires of good death and dying in old age were identified, all drawing on the assisted dying debate: Choice, Risk, Care, and Complexity. Each repertoire constructs a particular image of death and dying, varying from it being a personal choice; a last resort; a joint journey; to a contingent quest. The different repertoires imply distinct identities and actions. The Choice-repertoire construes older people as active subjects who autonomously determine their own death. The Risk- and Care-repertoires both construe older people primarily as passive and acted upon: either threatened by illness, decline and death; or protected and cared for by others and society. The Complexity-repertoire construes older people's situation as an object of reflection. DISCUSSION AND CONCLUSION: The strong prevalence of the Choice-repertoire in Dutch newspapers construes good death and dignified dying in old age in a salient way, unrepresentatively highlighting assisted dying as the preferred imagined practice. It is hypothesised that reimaging the Care- and Complexity-repertoires in such a way that they construe older persons in a more active subject role could help depolarise the debate on death and dying in old age.

Facts Tell, Stories Sell? Assessing the Availability Heuristic and Resistance as Cognitive Mechanisms Underlying the Persuasive Effects of Vaccination Narratives.

Online vaccine-critical sentiments are often expressed in appealing personal narratives, whereas vaccine-supporting information is often presented in a non-narrative, expository mode describing scientific facts. In two experiments, we empirically test whether and how these different formats impact the way in which readers process and retrieve information about childhood vaccination, and how this may impact their perceptions regarding vaccination. We assess two psychological mechanisms that are hypothesized to underlie the persuasive nature of vaccination narratives: the availability heuristic (experiment 1, N = 418) and cognitive resistance (experiment 2, N = 403). The results of experiment 1 showed no empirical evidence for the availability heuristic, but exploratory analyses did indicate that an anti-vaccination narrative (vs. expository) might reduce cognitive resistance, decrease vaccination attitudes and reduce attitude certainty in a generally pro-vaccination sample, especially for those who were more vaccine hesitant. Preregistered experiment 2 formally tested this and showed that not narrative format, but prior vaccine hesitancy predicts cognitive resistance and post-reading attitudes. Hesitant participants showed less resistance toward an anti-vaccine text than vaccine-supporting participants, as well as less positive post-reading attitudes and attitude certainty. These findings demonstrate belief consistency effects rather than narrative persuasion, which has implications for scientific research as well as public health policy.

Narrative recognition and identification: a qualitative pilot study into reading literary texts with advanced cancer patients.

PURPOSE: Patients with advanced cancer can experience their disease as a contingent life event. The sudden interruption of their life stories can obscure life goals and disrupt meaning making. In the context of the research project "In search of stories," we aim to investigate the reading and discussion of selected stories which present ways of dealing with a contingent life event. In addition, we examine the use of a newly developed guide for reading these exemplary texts together with advanced cancer patients. METHODS: This qualitative study describes the experiences of five patients with advanced cancer who participated in a guided reading and discussion about selected literary texts. The intervention consisted of reading a selected story, after which each patient was interviewed, using the reading guide as a conversation template. The interviews were then thematically analyzed for their conceptual content using a template analysis. RESULTS: All five conversations showed some form of recognition in reaction to the chosen text, which led to personal identification of experiences of contingency, such as loss of life goals, impending death, or feelings of uncertainty. Besides the important role of identification, revealed by the responses to the questions in the reading guide, the discussion of the text helped them articulate their own experience and sources of meaning. Diverse worldviews came to the fore and concepts of meaning such as fate, life goals, quality of life, and death. CONCLUSIONS: First experiences with our newly developed reading guide designed to support a structured reading of stories containing experiences of contingency suggest that it may help patients to express their own experiences of contingency and to reflect on these experiences. IMPLICATIONS FOR CANCER SURVIVORS: The intervention tested in this study may contribute to supportive care for survivors with advanced cancer, but further research is needed to evaluate its effect on quality of life.

Reading Minds, Reading Stories: Social-Cognitive Abilities Affect the Linguistic Processing of Narrative Viewpoint.

Although various studies have shown that narrative reading draws on social-cognitive abilities, not much is known about the precise aspects of narrative processing that engage these abilities. We hypothesized that the linguistic processing of narrative viewpoint-expressed by elements that provide access to the inner world of characters-might play an important role in engaging social-cognitive abilities. Using eye tracking, we studied the effect of lexical markers of perceptual, cognitive, and emotional viewpoint on eye movements during reading of a 5,000-word narrative. Next, we investigated how this relationship was modulated by individual differences in social-cognitive abilities. Our results show diverging patterns of eye movements for perceptual viewpoint markers on the one hand, and cognitive and emotional viewpoint markers on the other. Whereas the former are processed relatively fast compared to non-viewpoint markers, the latter are processed relatively slow. Moreover, we found that social-cognitive abilities impacted the processing of words in general, and of perceptual and cognitive viewpoint markers in particular, such that both perspective-taking abilities and self-reported perspective-taking traits facilitated the processing of these markers. All in all, our study extends earlier findings that social cognition is of importance for story reading, showing that individual differences in social-cognitive abilities are related to the linguistic processing of narrative viewpoint.

They promised this ten years ago. Effects of diabetes news characteristics on patients' perceptions and attitudes towards medical innovations and therapy adherence.

Patients have ever-increasing access to web-based news about hopeful scientific developments that may or may not cure them in the future. Science communication experts agree that the quality of news provision is not always guaranteed. However, literature does not clarify in what way users are actually affected by typical news characteristics such as the news object (described developmental phase of an innovation), the news source (degree of authority), and the news style (degree of language intensification). An online vignette experiment (N = 259) investigated causal relationships between characteristics of news about diabetes innovations and patients' perceptions of future success, their interest in the innovation, and attitudes regarding current therapy adherence. Findings show that descriptions of success in mice led to higher estimations of future success chances than earlier and later developmental phases. Furthermore, news from a nonauthoritative source led to an increased interest in the innovation, and a more negative attitude towards current lifestyle advice. Lastly, the intensification of the language used in news messages showed slight adverse effects on the readers' attitude. These findings, combined with their small effect sizes, support the optimistic view that diabetes patients are generally critical assessors of health news and that future research on this topic should focus on affected fragile subgroups.

Storytelling on Oral Grounds: Viewpoint Alignment and Perspective Taking in Narrative Discourse.

In this paper, we seek to explain the power of perspective taking in narrative discourse by turning to research on the oral foundations of storytelling in human communication and language. We argue that narratives function through a central process of alignment between the viewpoints of narrator, hearer/reader, and character and develop an analytical framework that is capable of generating general claims about the processes and outcomes of narrative discourse while flexibly accounting for the great linguistic variability both across and within stories. The central propositions of this viewpoint alignment framework are that the distance between the viewpoints of participants in the narrative construal - narrator, character, reader - is dynamic and regulated by linguistic choices as well as contextual factors. Fundamentally, viewpoint alignment is grounded in oral narrative interaction and, from this conversation, transferred to the written narrative situation, varying between demonstration and invasion of the narrative subjects and guiding readers' route of processing the narrative (experiential versus reflective). Our claim is that variations in viewpoint alignment are functional to the communicative context and intended outcomes of narratives. This is illustrated with the analysis of a corporate journalistic narrative that comprises both interactional and non-interactional aspects of storytelling. The concept of viewpoint alignment further explains the oral fundaments of narrative discourse in conversational storytelling and poses new questions on the relation between the dynamic processing of stories on the one hand and their static outcomes on the other.

Associations Between Characteristics of Web-Based Diabetes News and Readers' Sentiments: Observational Study in the Netherlands.

BACKGROUND: Although experts agree that Web-based health information often contains exaggeration and misrepresentation of science, it is not yet known how this information affects the readers' sentiments. OBJECTIVE: This study aimed to investigate whether specific aspects of Web-based diabetes research news are associated with positive or negative sentiments in readers. METHODS: A retrospective observational study of the comments on diabetes research news posted on Facebook pages was conducted as a function of the innovations' developmental phase, the intended treatment effect, and the use of strong language to intensify the news messages (superlatives). Data for the investigation were drawn from the diabetes research news posted between January 2014 and January 2018 on the two largest Dutch Facebook pages on diabetes and the corresponding reader comments. By manually coding these Facebook user comments, three binary outcome variables were created, reflecting the presence of a positive sentiment, the presence of a negative sentiment, and the presence of a statement expressing hopefulness. RESULTS: Facebook users made a total of 3710 comments on 173 diabetes research news posts that were eligible for further analysis. Facebook user comments on posts about diabetes prevention (odds ratio [OR] 0.55, 95% CI 0.37-0.84), improved blood glucose regulation (OR 0.68, 95% CI 0.56-0.84), and symptom relief (OR 0.31, 95% CI 0.21-0.44) were associated with less positive sentiments as compared with potential diabetes cures. Furthermore, comments on innovations supported by preclinical evidence in animals were associated with more positive sentiments (OR 1.46, 95% CI 1.07-1.99) and statements expressing hope (OR 1.47, 95% CI 1.01-2.14), when compared with innovations that have evidence from large human trials. This study found no evidence for the associations between language intensification of the news posts and the readers' sentiments. CONCLUSIONS: Our finding that the attitudes toward diabetes research news on Facebook are most positive when clinical efficacy is not (or not yet) proven in large patient trials suggests that news authors and editors, as well as medical professionals, must exercise caution when acting as a conduit for diabetes research news.

Deictic Navigation Network: Linguistic Viewpoint Disturbances in Schizophrenia.

This paper introduces the Deictic Navigation Network, a cognitive-linguistic framework to analyze and clarify the nature of viewpoint disturbances in language, applied to schizophrenia. We argue that such disturbances have linguistic counterparts in the use of deixis: linguistic elements of which the interpretation relies on the situational context of the discourse and their connection to a subject-bound perspective. The DNN connects such linguistic phenomena to three viewpoint disturbances, which can manifest in different degrees of extremity: (i) the reduced capacity to recognize one's own subjective perspective and the subjective perspectives of others; (ii) the reduced capacity to separate present perspectives from distinct past, future, and hypothetical perspectives; and (iii) the reduced capacity to integrate projected viewpoint structures into the actual here-and-now. We explain how application of the DNN to language in schizophrenia enables the localization of perspectivization disturbances and helps to clarify the nature of disturbances in the ability to build complex viewpoint structures in language as well as cognition.

Sharing special birth stories. An explorative study of online childbirth narratives.

BACKGROUND: Increasingly, pregnant women, as active online media users, incorporate media driven values on childbirth that may not agree with professional midwifery values. In Dutch midwifery practice, online searching for other women's stories is often discouraged. However, online birth stories attract women as a means to learn from one another's experiences of childbirth. AIM: This study aims to explore Dutch women's use of an online social media platform (Instagram) to represent childbirth by analyzing their narrative strategies. METHOD: A collection of 110 Instagram-linked childbirth narratives (2015-2017) were analyzed applying an approach of interpretative repertoires. FINDINGS: The Dutch women in this study linked birth stories on their Instagram accounts that represented impactful experiences of childbirth. In their narratives, three interconnected repertoires are played out: sharing your story, going into details, and doing it yourself. This study highlights that narrative details of the online birth stories illustrate the physical and procedural obstacles that women overcame in giving birth. DISCUSSION: Reporting their emotional experiences in detail, women's online sharing of birth stories puts a focus on their personal preferences and decision making, and may ease the way for medical interventions. Without giving explicit advice, personal online birth stories could be instrumental in reformulating the standards of what childbirth is, or should be, like. CONCLUSION: Social media networks allow women to exchange stories that structure narrating women's childbirth experiences and offer a structure for the lived or future experiences of others. This may have an impact on women's decision-making during pregnancy and childbirth.

Exploring Narrative Structure and Hero Enactment in Brand Stories.

This study examines how audiovisual brand stories both invite and enable consumers to enact heroic archetypes. Integrating research on the archetypal structure of narratives with research on the event structure of narratives, we distinguish singular plot stories (i.e., stories that show a Hero's Journey) from embedded plot stories (i.e., stories that not only show but also tell one or more Hero's Journeys) and develop a conceptual and narratological framework to analyze their structural elements. Application of the framework to 20 brand stories representing 8 different brands reveals meaningful variation in elements between the singular plot stories and embedded plot stories. Differences in the expression of archetypes and event structure are argued to evoke different types of Hero enactment which in turn result in different outcomes. We specifically hypothesize that the enactment of heroic archetypes in singular plot stories primarily results in catharsis (pleasure), whereas the enactment of heroic archetypes in embedded plot stories primarily results in an outcome we describe as phronesis: a form of moral sense making of the self that advances one's practical wisdom and prudence. The final section of the paper discusses how cathartic and phronetic outcomes of hero enactment may foster the psychological bonding between brand and consumer, and invite consumers to align their moral values with the values that are reflected by heroic character traits. The central aims of the analysis presented are to provide an exploration of narrative phenomena in a reasonably broad range of brand story videos and foremost to provide a conceptual framework with an applicable instrument suited to analyze relevant categories in these brand stories. The present study is interdisciplinary in its approach to a contemporary, developing marketing phenomenon, applying psychological modeling of archetypes and heroic values with narratological insights on perspective-taking and story structure. Its contribution is to systemize, from a narratological viewpoint, how various narrative archetypes in brand video stories may contribute to the development of brand-consumer relations.

Storybridging: Four steps for constructing effective health narratives.

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 well as principles enshrined in the Health Action Process Approach. RESULTS: The 'storybridging' method for constructing health narratives is described as consisting of four concrete steps: (a) identifying the stage of change, (b) identifying the key elements, (c) building the story, and (d) pre-testing the story. These steps are illustrated by means of a case study in which an effective narrative health intervention was developed for Dutch truck drivers: a high-risk, underprivileged occupational group. CONCLUSION: Although time and labour intensive, the Storybridging approach suggests integrating the target audience as an important stakeholder throughout the development process. Implications and recommendations are provided for health promotion targeting truck drivers specifically and for constructing narrative health interventions in general.

Framing narrative journalism as a new genre: A case study of the Netherlands.

Although narrative journalism has a long history in the Netherlands, it is in recent years being promoted as a 'new' genre. This study examines the motives underlying this promotional tactic. To that end, we analyze how narrative journalism is framed in (1) public expressions of the initiatives aimed at professionalization of the genre and (2) interviews with journalists and lecturers in journalism programs. Results indicate that in public discourse on narrative journalism, the genre is framed as moving, essential, and as high quality journalism. These frames indicate that the current promotion of narrative journalism as 'new' can be seen as a strategy that journalists apply to withstand the pressures they are facing in the competition with new media. These frames are deepened in the interviews with lecturers and practitioners, who frame narrative journalism as a dangerous game, a paradigm shift, and as the Holy Grail. These frames indicate that narrative journalism is regarded as the highest achievable goal for journalists, but that its practice comes with dangers and risks: it tempts journalists to abandon the traditional principles of objectivity and factuality, which can ultimately cause journalism to lose its credibility and authority. We discuss these findings in terms of boundary work and reflect on implications for narrative journalism's societal function.

Evoking and Measuring Identification with Narrative Characters - A Linguistic Cues Framework.

Current research on identification with narrative characters poses two problems. First, although identification is seen as a dynamic process of which the intensity varies during reading, it is usually measured by means of post-reading questionnaires containing self-report items. Second, it is not clear which linguistic characteristics evoke identification. The present paper proposes that an interdisciplinary framework allows for more precise manipulations and measurements of identification, which will ultimately advance our understanding of the antecedents and nature of this process. The central hypothesis of our Linguistic Cues Framework is that identification with a narrative character is a multidimensional experience for which different dimensions are evoked by different linguistic cues. The first part of the paper presents a literature review on identification, resulting in a renewed conceptualization of identification which distinguishes six dimensions: a spatiotemporal, a perceptual, a cognitive, a moral, an emotional, and an embodied dimension. The second part argues that each of these dimensions is influenced by specific linguistic cues which represent various aspects of the narrative character's perspective. The proposed relations between linguistic cues and identification dimensions are specified in six propositions. The third part discusses what psychological and neurocognitive methods enable the measurement of the various identification dimensions in order to test the propositions. By establishing explicit connections between the linguistic characteristics of narratives and readers' physical, psychological, and neurocognitive responses to narratives, this paper develops a research agenda for future empirical research on identification with narrative characters.

An analysis of health promotion materials for Dutch truck drivers: Off target and too complex?

BACKGROUND: Despite various health promotion initiatives, unfavorable figures regarding Dutch truck drivers' eating behaviors, exercise behaviors, and absenteeism have not improved. OBJECTIVE: The aim was to obtain a better understanding of the low level of effectiveness of current health interventions for Dutch truck drivers by examining to what extent these are tailored to the target group's particular mindset (focus of content) and health literacy skills (presentation of content). METHODS: The article analyzes 21 health promotion materials for Dutch truck drivers using a two-step approach: (a) an analysis of the materials' focus, guided by the Health Action Process Approach; and (b) an argumentation analysis, guided by pragma-dialectics. RESULTS: The corpus analysis revealed: (a) a predominant focus on the motivation phase; and (b) in line with the aim of motivating the target group, a consistent use of pragmatic arguments, which were typically presented in an implicit way. CONCLUSIONS: The results indicate that existing health promotion materials for Dutch truck drivers are not sufficiently tailored to the target group's mindset and health literacy skills. Recommendations are offered to develop more tailored/effective health interventions targeting this high-risk, underserved occupational group.

Health promotion in the trucking setting: Understanding Dutch truck drivers' road to healthy lifestyle changes.

BACKGROUND: The working environment, the nature of the work, and the characteristics of truck drivers as a social group typically pose great challenges for the truck drivers' health and health promotion activities aiming to improve it. OBJECTIVE: The purpose was to obtain a better understanding of (a) Dutch truck drivers' perceptions of health and lifestyle themes, and (b) the challenges they experience in their pursuit of a more healthy lifestyle, as a guiding framework for the development of health interventions targeting this occupational group. METHODS: In this qualitative study, we conducted and analyzed 20 semi-structured interviews and seven cases of participant observations with Dutch truck drivers. Grounded theory was used to analyze the data. RESULTS: Our findings illustrate that Dutch truck drivers wish to improve their lifestyle but have unproductive associations with concepts of healthy living as well as a tendency to downplay their health risks. In addition, they experience barriers within their work and personal environment that prevent them from translating their intentions into actual lifestyle changes. CONCLUSIONS: Based on the insights derived from the interviews, we discuss recommendations for the development of more effective health promotion interventions for truck drivers.

Application of molecular topology to the prediction of the antimalarial activity of a group of uracil-based acyclic and deoxyuridine compounds.

A topological-mathematical model has been arranged to search for new derivatives of deoxyuridine and related compounds acting as antimalarials against Plasmodium falciparum. By using linear discriminant and multilinear regression analysis a model with two functions was capable to predict adequately the IC(50) for each compound of the training and test series. After carrying out a virtual screening based upon such a model, new structures potentially active against P. falciparum are proposed.