Acceptability and feasibility of a theatre-based wellness programme to support people living with long COVID: a single-arm feasibility study.

OBJECTIVES: To determine acceptability and feasibility of a theatre-based wellness programme to support the health and well-being of people with long COVID. DESIGN: Single-group, repeated-measures feasibility study. SETTING: Community centre and online. PARTICIPANTS: Adults with diagnosed long COVID experiencing breathlessness, pain and/or loneliness. INTERVENTION: Six-week participatory creative programme delivered to one online and one in-person group facilitated by movement, voice and drama consultants using breathing, visualisation, singing, poetry, storytelling and movement exercises. PRIMARY OUTCOME MEASURES: Programme acceptability and feasibility measured via uptake, reasons for non-attendance and barriers to engagement. SECONDARY OUTCOME MEASURES: Feasibility of recruitment and data collection procedures measured through proportion of missing data and follow-up rates, mechanisms of action of the programme identified through qualitative interviews, changes in mental health, well-being, quality of life, loneliness, social support, fatigue, breathlessness and post-COVID-19 functional status at 8-week follow-up. RESULTS: 21 people expressed interest in participating, 20 people took part in the programme, 19 completed baseline and 16 completed follow-up assessments. Participants attended an average of 4.8 of 6 sessions (SD=1.5, range 2-6). Exploratory analyses demonstrated significant improvements in self-rated health (t-test mean difference=0.12, 95% CI=0.00, 0.23, p=0.04) and chronic fatigue symptoms (mean difference=-3.50, 95% CI=-6.97, -0.03, p=0.05) at 8 weeks. Key mechanisms of action that supported health and well-being included: increased sense of community, illness acceptance, experiencing joy, increased confidence in managing everyday life, increased ability to relax and reconnection with previous identity. Barriers to engagement included: activities being outside of the participant's comfort zone, ongoing long COVID symptoms, emotional consequences of sharing experiences and connectivity and connecting online. CONCLUSIONS: A 6-week theatre-based programme was perceived as acceptable to most participants and resulted in some positive psychosocial impacts. The findings provide a rationale for supporting the ongoing development and scale-up of this and related arts programmes to support people living with long COVID.

Theater for Healthcare Equity; A Model for Inclusion and Anti-Bias Training in Academic Medicine.

There are no standardized methods for training medical personnel in antiracist action, such as how to be an upstander or how to use micro-resistance. Roleplay and drama-based pedagogy can empower and educate healthcare professionals by providing experiential training and a safe space for antiracist practice and discussion. The Theater for Healthcare Equity (THE) is an innovative methodology that explores upstander techniques in real time with facilitated instruction. We implemented eight THE sessions at our institution and assessed participant responses via a voluntary survey. Forty-one participants completed a REDCap survey, and 32 participants completed the Continuing Medical Education survey. Participants appreciated the creation of safe spaces, the practice format, and the learning experience, which provided an honest and open environment for the sharing of experiences, addressing race-based bias, and practicing responses to real-life scenarios. Constructive feedback included changes to session duration, participant discomfort with improvisation, and lack of printed tools.

The effect of drama on psychosocial problems and emotional states of hospitalized children with cancer.

BACKGROUND AND PURPOSE: Hospitalization is a traumatic experience for children. Especially in the case of childhood cancers that require long-term hospitalization, children need psychosocial support. The study aimed to examine the effectiveness of drama in reducing psychosocial problems in hospitalized paediatric children diagnosed with cancer. METHODS: The study used a mixed method approach, combining both qualitative and quantitative methods with a single group. Drama sessions prepared according to the Tasks and Skills Model were used to support their psychosocial conditions. The Facial Expression Form, The Assessment Scale for Psychosocial Symptoms in Hospitalized Children, and the Drawing and Writing Technique were used before and after the drama sessions. RESULTS: This study differs from others in its use of drama intervention to reduce psychosocial problems in children undergoing cancer treatment. As a result of the study, it was found that there was a decrease in anxiety, hopelessness, anger-aggression and communication difficulties among psychosocial problems and a change in mood towards feeling happy. The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients. CONCLUSION: The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients. PRACTICE IMPLICATIONS: Applying drama to children undergoing long-term hospital treatment can help alleviate psychosocial problems by reducing stress, emotional suppression, and compensating for trauma.

Leadership dynamics in musical groups: Quantifying effects of musical structure on directionality of influence in concert performance videos.

Music ensemble performance provides an ecologically valid context for investigating leadership dynamics in small group interactions. Musical texture, specifically the relative salience of simultaneously sounding ensemble parts, is a feature that can potentially alter leadership dynamics by introducing hierarchical relationships between individual parts. The present study extended previous work on quantifying interpersonal coupling in musical ensembles by examining the relationship between musical texture and leader-follower relations, operationalised as directionality of influence between co-performers' body motion in concert video recordings. It was hypothesised that the directionality of influence, indexed by Granger Causality, would be greater for 'homophonic' textures with a clear distinction between melody and accompaniment parts than for 'polyphonic' textures with less distinction between melody and accompaniment. This hypothesis was tested by using pose estimation algorithms to track instrumentalists' body movements in a string quartet and a clarinet quintet, and then applying Granger Causality analysis to their head motion to estimate directional influence between instrumentalist pairs for sections of the pieces that varied in texture. It was found that Granger Causality values were generally higher (indicating greater directionality of influence) for homophonic than polyphonic textures. Furthermore, considering melody and accompaniment instrument roles revealed more evidence for the melody instrument influencing accompanying instruments than vice versa, plus a high degree of directionality among accompanying instruments, in homophonic textures. These observed patterns of directional information flow in co-performer body motion are consistent with changing leader-follower relations depending on hierarchical relations between ensemble parts in terms of the relative salience of melodic material in the musical texture. The finding that automatic pose estimation can detect modulations of leadership dynamics in standard video recordings under naturalistic performance conditions has implications for investigating interpersonal coordination in large-scale music video datasets representing different cultural traditions, and for exploring nonverbal communication in group activities more generally.

Empowering students to create their dramatizations increases understanding of physiology.

Complex subjects such as physiology can be challenging for students to learn. These challenges are not uncommon in implementing the learning process in physiology and affect learning outcomes. Dramatization is an interactive and effective method to improve learning outcomes. In a project designed by senior medical students, junior medical students were guided in creating dramatizations related to three topics. Senior students were trained and assisted to prepare scenarios and make videos. The dramatizations were then carried out with junior medical students to help them better understand physiology and pathophysiology topics. A group of junior students receiving the same topics in a lecture format served as a control group. Pretest and posttest questionnaires were used to measure the improvement of learning outcomes. Assessment results showed an increase in performance in both groups. This study shows that dramatizations provide an effective alternative to lectures for instructing junior medical students.NEW & NOTEWORTHY The preparation of dramatizations involved students. The ideas, analogies, and dramatizations were originally from students. Dramatization is an alternative form of understanding learning objectives of medical physiology in an interesting way to increase motivation.

Storylines of family medicine VI: ways of being-in the office with patients.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'VI: ways of being-in the office with patients', authors address the following themes: 'Patient-centred care-cultivating deep listening skills', 'Doctor as witness', 'Words matter', 'Understanding others-metaphor and its use in medicine', 'Communicating with patients-making good use of time', 'The patient-centred medical home-aspirations for the future', 'Routine, ceremony or drama?' and 'The life course'. May readers better appreciate the nuances of patient care through these essays.

The effect of creative drama on nursing image: Randomized controlled study.

AIM: This study aimed to examine the effects of the creative drama method on first-year nursing students' perceptions of the image of nursing. BACKGROUND: Nursing students' perceptions of professional image can be affected by many processes during their transition to professional life. Therefore, supporting their development of a positive professional image at the beginning of their careers is necessary. DESIGN: This was a randomized controlled trial with a pre-test/post-test design and a control group. METHODS: The study was carried out at a nursing school located in the Eastern Black Sea region of Türkiye. The sample of this study consisted of 77 participants, with 38 in the experimental group and 39 in the control group. The subjects of professional image and the image of nursing were explained to the control group using presentations and case analysis and to the experimental group using the creative drama method. Research data were collected with the Student Information Form and Nursing Image Scale. RESULTS: The post-test scores obtained by the control group after receiving traditional education were higher than the pre-test scores. The post-test scores obtained by the experimental group after receiving education based on creative drama were higher than the pre-test scores. The scores of the experimental group were significantly higher after the educational intervention. CONCLUSION: Creative drama is far more effective in nursing image education for first-year nursing students than presentation and case analysis, which are conventional education methods. Creative drama can be used as an effective method to develop positive perceptions of nursing.

Vicarious punishment of moral violations in naturalistic drama narratives predicts cortical synchronization.

Punishment of moral norm violators is instrumental for human cooperation. Yet, social and affective neuroscience research has primarily focused on second- and third-party norm enforcement, neglecting the neural architecture underlying observed (vicarious) punishment of moral wrongdoers. We used naturalistic television drama as a sampling space for observing outcomes of morally-relevant behaviors to assess how individuals cognitively process dynamically evolving moral actions and their consequences. Drawing on Affective Disposition Theory, we derived hypotheses linking character morality with viewers' neural processing of characters' rewards and punishments. We used functional magnetic resonance imaging (fMRI) to examine neural responses of 28 female participants while free-viewing 15 short story summary video clips of episodes from a popular US television soap opera. Each summary included a complete narrative structure, fully crossing main character behaviors (moral/immoral) and the consequences (reward/punishment) characters faced for their actions. Narrative engagement was examined via intersubject correlation and representational similarity analysis. Highest cortical synchronization in 9 specifically selected regions previously implicated in processing moral information was observed when characters who act immorally are punished for their actions with participants' empathy as an important moderator. The results advance our understanding of the moral brain and the role of normative considerations and character outcomes in viewers' engagement with popular narratives.

I'm Great! I'm no good .: A case illustration of drama therapeutic work with a male offender of domestic violence in a forensic outpatient setting.

Treating perpetrators of aggressive behavior, like verbal aggression, intimidation, and bullying behavior resulting in aggressive incidents with others, is difficult. This group is often diagnosed with personality disorders and when legal measures applied, they are more often treated in a forensic setting for their problems. This article presents the case of a 54-year-old man, diagnosed with Borderline personality disorder, narcissistic and antisocial traits, mild depressive symptoms, and loss and grief, who has voluntarily had treatment in a forensic outpatient center to reduce aggression and change destructive patterns in relationships. Hating, judging, and self-defeating were the main reasons why the patient found himself ending up in the same situation repeatedly. The client received individual drama therapy sessions. The drama therapeutic approach included schema therapeutic elements, such as schema mode work with cards, as well as roleplay, imagery (with rescripting), improvisation, and psycho drama elements. As a result of drama therapy, the client reported less (active) aggression, less aggression in his relationships (partners/children/friends), but also an increased level of loneliness, and mild depressive symptoms. The client was more in touch with his vulnerability and was able to behave in a more adequate healthy way in relationships. Although self-esteem was still building up, there was a decrease of aggression and less conflict-seeking behavior as a result. Risk assessment tools (FARE-2 & HONOS) and Schema therapy scales (YSQ and SMI) were used pre- and posttreatment confirming the improvements. This case promotes the use of dramatherapy in forensic outpatient care to be valuable in lowering risk recidivism and changing deeply rooted behavioral patterns.

Citrination and its Discontents: Yellow as a Sign of Alchemical Change.

Many of the "signs and tokens" described in alchemical texts relate to colour, from the Crow's Bill signifying putrefaction to the philosophical solvents disguised as Green Lions, Red Dragons, and Grey Wolves. While the process of yellowing, or citrination, often appears in medieval recipes, it seems to have interested commentators less than the more familiar processes of blackening, whitening, or reddening. Yet beyond these canonical colours, yellowness turns out to be ubiquitous in alchemy and its associated craft practices, both in Latin texts and vernacular translations. This paper uses source criticism and experimental reconstruction to interrogate the role of yellowness at the beginning, middle, and end of practice, focusing on fifteenth- and sixteenth-century England. As starting ingredients, yellow vitriol and litharge offered the potential for transmutation but also posed problems for identification and preparation. As an intermediate stage, yellowness offered promising signs of future success, in the form of dramatic colour changes and unexpected products. But yellowness also offered an end in itself, as appears from the many citrination processes attested in recipe collections which aimed to imitate the properties of gold - suggesting that yellowing was prized as a significant indicator of chemical change across diverse areas of craft practice.

Using theater as an innovative knowledge translation approach for health research: a scoping review protocol.

OBJECTIVE: The objective of this review is to synthesize the existing literature on how theater has been used as a knowledge translation approach for health research and to identify the outcome measures employed for evaluation as well as the facilitators/challenges related to this approach. INTRODUCTION: The use of arts-based knowledge translation methods is relatively new in health research but has already shown to have positive impacts on knowledge, attitudes, policy, and practice. Specifically, theater has proven to be an effective approach for communicating research findings in a way that stimulates thought and discussion on important health-related topics. INCLUSION CRITERIA: This review will include scholarly literature on how theater is being used as a knowledge translation approach for health research. The review will not impose any limitations related to demographic variables, health issues, or settings. The review will consider papers using any study design, and will also consider other literature, such as protocols, descriptive papers, unpublished papers, and evaluation reports. METHODS: This review will be conducted in accordance with the JBI methodology for scoping reviews. The databases to be searched will include CINAHL (EBSCOhost), Embase, MEDLINE (Ovid), Academic Search Premier (EBSCOhost), and Scopus. Google/Google Scholar and ProQuest Dissertations and Theses will also be searched for unpublished studies and gray literature. All literature identified in the search will be screened by 2 independent reviewers and the results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The data extracted from the included literature will be presented in both tabular and narrative format. REVIEW REGISTRATION: Open Science Framework https://osf.io/gbcpj.

Effect of postmortem care education using a creative drama method on nursing students' knowledge, skills, and satisfaction: A randomized controlled trial.

BACKGROUND: Postmortem care is one of the most difficult aspects of the nursing profession and is frequently given in healthcare settings today. It is important to provide appropriate teaching experiences in order to prepare nursing students for their future professional roles in postmortem care. OBJECTIVES: This study was conducted to examine the effect of a creative drama method on nursing students' postmortem care knowledge and skill levels, learning retention, and satisfaction with the education method. DESIGN: A randomized controlled model with a pretest-posttest control group was used in this study. SETTINGS: One university school of nursing in Turkey. PARTICIPANTS: The sample consisted of 70 nursing students. METHOD: Information about postmortem care was shared with the control group using the classical education method of lectures and demonstration techniques, while the experimental group was taught with a creative drama method. Research data were collected with the Descriptive Characteristics Form, Postmortem Care Knowledge Test, Postmortem Care Skills Checklist, and Education Methods Satisfaction Survey. RESULTS: It was observed that the postmortem care education provided to both experimental and control group was effective in improving the knowledge and skill levels of nursing students regarding postmortem care (p < 0.05). However, the knowledge and skill levels of the experimental group regarding postmortem care, learning retention, and level of satisfaction with the education method were higher than those of the control group (p < 0.05). CONCLUSION: Creative drama was thus found to be a more effective method than the classical education method in providing postmortem care education to nursing students. In addition, it was observed that the students were more satisfied with the education given with creative drama.

"It'll never end, I'll never go": Representation of Caregiving in Samuel Beckett's Endgame and Footfalls.

Research on the unrepresentability of death in Samuel Beckett's oeuvre abound in Beckett scholarship, but little attention has been given to the artist's representation of caregiving to the dying in his plays. With reference to Martin Heidegger's concept of care and Albert Camus's idea of the absurd, this article analyzes Endgame (1957) and Footfalls (1976) by attending to Beckett's dramatic representation of caregiving as undergirded by a sense of its absurdity. The almost 20-year gap between the writing of both plays highlights the development of an understanding that this sense of absurdity is never about the caregiver's questioning of one's obligation to the dependent but about how one chooses to respond to caregiving as an absurd predicament. The pertinence of such a representation of caregiving by Beckett lies in its poignant articulation of a complex experience that is often left unexpressed by caregivers who prioritize their dependent loved ones over themselves.

[Feaver Concepts in the Early Work of Poeta Medicus Friedrich Schiller]. / Fieberkrankheiten im frühen Werk des Poeta medicus Friedrich Schiller.

Friedrich Schiller wrote a Latin "Prüfschrift" (thesis) on fever diseases in 1780 as part of his medical studies in Stuttgart. In it, he accuses nature of aggravating inflammation through excessive resistance. This concept of fever interacts with Schiller's early literary texts: In his first drama, "Die Räuber" (1781), the two protagonists embody the two main types of fever. Accordingly, the descriptions of the two main types of fever in the "Prüfschrift" do not turn out to be "objective" either but contain positive and negative connotations: In a sense, personified heroes and hypocrites are medically juxtaposed and pathologised. In another early poem about the plague (1782), Schiller also interpreted and used fever as an expression of human vitality and natural power, as an anthropological sign for the interconnectedness of soul and body: soul forces are revealed in fever, and the drama of human existence becomes particularly clear in the struggle between nature and disease.

Mourning in Hamlet: Turning ancestral ghosts into ancestors.

Extracts from Shakespeare's Hamlet are used to show how obstacles to mourning may arise from the persistent demands of melancholic internal objects demanding repair and revenge. It is only with the development of symbolic function as a result of separateness between self and object that reparation becomes possible and ghosts are turned into ancestors.