Haptic Resources in Pain Communication: New Amputees Redirecting Doctors' Professional Touch at the Prosthetic Clinic.

Pain assessment is key in deciding whether amputee patients are fit to receive a prosthesis, but its interactional accomplishment is still underexplored. This study adopts multimodal conversation analysis to investigate how pain assessment is carried out during medical visits at an Italian prosthetic clinic involving 77 patients and 24 health professionals. In the analyzed data, doctors carry out pain assessment by asking patients whether they feel pain during palpation of the stump, and patients respond by elaborating on their sensations and using touch in turn. The analysis focuses on a collection of 10 cases in which patients use response expansions and self-touch to reorient doctors' ongoing inquiry by specifying the type of sensation they experience and its location or to correct doctors' previous inquiry. The analysis illuminates how the patient's body becomes a resource for tactile practices that are shared between doctors and patients in the service of a common understanding of patients' pain. This analysis provides new knowledge of a practice patients use to redirect doctors' attention and understandings.

Proposing surgery at the prosthetic clinic: managing patient resistance.

OBJECTIVE: Investigating doctors' communicative practices for recommending surgery to amputees when the proposal counters patients' expectation. METHOD: Conversation Analysis of 77 videorecorded medical consultations at an Italian prosthesis clinic. RESULTS: Compared to the direct format doctors used to prescribe prosthesis, when suggesting surgery doctors adopted a more circuitous, indirect approach. They used a range of communication strategies, orientating to patients' likely resistance - indeed, patients were frequently observed to reject surgical options. CONCLUSIONS: Considering patients' expectations is part of a patient centred approach, hence the cautious ways in which doctors introduce the option of surgery. Moreover, doctors do not pursue recommending surgery when patients display their reluctance or resistance. PRACTICE IMPLICATIONS: Doctors in prosthetics clinics might adopt a more balanced communicative strategy that takes into account patients' perspectives, concerns and expectations, whilst but also providing patients with the necessary information to collaborate meaningfully to decision making.

Does social distancing affect the processing of brand logos?

Social distancing and isolation have been imposed to contrast the spread of COVID-19. The present study investigates whether social distancing affects our cognitive system, in particular the processing of different types of brand logos in different moments of the pandemic spread in Italy. In a size discrimination task, six different logos belonging to three categories (letters, symbols, and social images) were presented in their original format and spaced. Two samples of participants were tested: one just after the pandemic spread in Italy, the other one after 6 months. Results showed an overall distancing effect (i.e., spaced stimuli are processed slower than original ones) that interacted with the sample, revealing a significant effect only for participants belonging to the second sample. However, both groups showed a distancing effect modulated by the type of logo as it only emerged for social images. Results suggest that social distancing behaviors have been integrated in our cognitive system as they appear to affect our perception of distance when social images are involved.

Territories of knowledge, professional identities and patients' participation in specialized visits with a team of practitioners.

OBJECTIVE: In specialized healthcare visits with a team of practitioners, the examination phase is a collaborative work where multiple professional competences are indexed and activated, contributing to a complex ecology of knowledge. The doctors' need to consult their colleagues might take over and collide with patients' understanding and willingness to participate. We describe the practices through which practitioners accomplish teamwork and how these impact on patients' participation. METHODS: Using conversation analysis we investigate 30 video-recorded visits where patients with an injured upper limb meet a team of practitioners in an Italian centre for prosthesis construction and application. RESULTS: Analysis shows the collaborative practices and division of labour through which practitioners activate their territories of knowledge in the service of the joint activity of evaluating the patient limbs' conditions. Whereas professionals orient to their different competences, patients keep their body available for inspection, monitor the ongoing activity, draw assumptions about their own conditions and tentatively claim their epistemic rights. CONCLUSIONS: Doctors' orientation to teamwork involves the enactment of tacit communicative practices and the use of technical language, which might prevent or mislead patients' participation. PRACTICE IMPLICATIONS: Doctors should employ communicative practices to ensure patients' understanding and participation in the unfolding examination activities.

The modality-switch effect: visually and aurally presented prime sentences activate our senses.

Verifying different sensory modality properties for concepts results in a processing cost known as the modality-switch effect. It has been argued that this cognitive cost is the result of a perceptual simulation. This paper extends this argument and reports an experiment investigating whether the effect is the result of an activation of sensory information which can also be triggered by perceptual linguistically described stimuli. Participants were first exposed to a prime sentence describing a light or a sound's perceptual property (e.g., "The light is flickering", "The sound is echoing"), then required to perform a property-verification task on a target sentence (e.g., "Butter is yellowish", "Leaves rustle"). The content modalities of the prime and target sentences could be compatible (i.e., in the same modality: e.g., visual-visual) or not (i.e., in different modalities). Crucially, we manipulated the stimuli's presentation modality such that half of the participants was faced with written sentences while the other half was faced with aurally presented sentences. Results show a cost when two different modalities alternate, compared to when the same modality is repeated with both visual and aural stimuli presentations. This result supports the embodied and grounded cognition view which claims that conceptual knowledge is grounded into the perceptual system. Specifically, this evidence suggests that sensory modalities can be pre-activated through the simulation of either read or listened linguistic stimuli describing visual or acoustic perceptual properties.