Prevention of mother-to-child transmission of HIV service interruptions amid COVID-19 pandemic.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) caused global disruptions in healthcare service delivery. The prevention of mother-to-child transmission (PMTCT) of human immunodeficiency viruses (HIV) services were also interrupted, threatening the attainment of Sustainable Development Goal 3. This article describes the PMTCT service interruptions experienced during the COVID-19 pandemic in Tshwane healthcare facilities. METHODS:  A descriptive phenomenological design was used to explore and describe the experiences of healthcare providers offering PMTCT services during COVID-19 in the Tshwane district, Gauteng province. Purposive sampling was used to recruit participants. Data were collected through in-depth interviews with 16 participants, and Colaizzi's data analysis steps were followed in analysing the findings. RESULTS:  Participants reported interruptions in PMTCT service delivery during the pandemic. Non-adherence to scheduled visits resulted in patients defaulting or not adhering to treatment regimens, high viral loads and mother-infant pairs' loss to follow-up. Other features of service disruption included late antenatal bookings, low client flow and delays in conducting deoxyribonucleic acid-polymerase chain reaction (DNA-PCR) testing in HIV-exposed babies. In addition, staff shortages occurred because of re-assignments to COVID-19-related activities. Study participants were psychologically affected by the fear of contracting COVID-19 and worked in a frustrating and stressful environment. CONCLUSION:  Improved community-based follow-up services are critical to enhance PMTCT service outcomes and prevent infant HIV infections.Contribution: The findings may influence policymakers in developing strategies to curb HIV infections among mothers and children during pandemics.

'It's like crystal gazing': the lived experience of anticipating end-of-life choices in older adults and their close ones.

BACKGROUND AND OBJECTIVES: Nowadays people increasingly try to take control over the end of their lives by anticipating end-of-life choices. Explication of these choices is encouraged using advance care planning (ACP). We aim to deepen our understanding of how choice-making processes are lived in real life, exploring the experience of community-dwelling older adults and their close ones over time. RESEARCH DESIGN AND METHODS: A multiperspective and longitudinal approach grounded in phenomenology was chosen. Ten triads consisting of an older adult (75+) and two close ones (n=30) were interviewed, twice individually and once as a group, over 20 months (=70 interviews). Data were thematically analyzed both longitudinally and from all three perspectives. RESULTS: The essential meaning of anticipating choice-making processes was described as a dynamic and relationally entangled decisional process, to navigate between paradoxical choices for an opaque future. Three fields of tension were created due to ambivalence in these choice-making processes: navigation between having and losing control, between taking away and burdening with responsibility, and between expressing and holding back oneself. DISCUSSION AND IMPLICATIONS: Anticipation of choices for hypothetical end-of-life scenarios turned out to be complex and ambivalent. Most older adults resisted ambivalence and ignored complexity in an attempt to stay in control over their end of life. The burdening impact of choices on close ones illuminated the relationality of choice-making processes. These aspects of end-of-life choice-making processes should be integrated into ACP in order to better understand and care for people and their close ones faced with these choices.

Motherhood experiences of nurses receiving postgraduate education: A phenomenological research study.

OBJECTIVE: Trying to juggle multiple roles and responsibilities as a student, nurse, and mother can be challenging due to pressures from overlapping time management. This study was conducted to explore the experiences of graduate students who work as nurses and are mothers. METHODS: The qualitative phenomenological data for this study were gathered from nurses at a training and research hospital between August and November 2022, utilizing face-to-face interviews. The study cohort comprised twelve nurses aged 28 to 48, all actively engaged in postgraduate education. Data were collected using a descriptive information form and semi-structured interviews. Thematic analysis was executed through inductive coding, facilitated by the Max Qualitative Data Analysis (MAXQDA) Analytics Pro2022 software. RESULTS: Four central themes were developed: "Experiences During the Breastfeeding Process," "Positive Effects," "Encountered Challenges," and "Expectations." CONCLUSIONS: The findings underscored that nurses who are mothers and pursuing postgraduate education encounter difficulties throughout their academic pursuits, notably attributed to working conditions and professional cultural values.

"You can be cured, but cancer never leaves you behind": an interdisciplinary approach into the embodied cancer experiences among adult Colombian childhood/adolescent cancer survivors.

PURPOSE: Childhood or adolescent cancer survivors (CACS) are an understudied population in Colombia and, in general, in Central and South America. Worldwide, studies typically focus on high-income settings while approaching CACS' experiences from a biomedical or psychological perspective. However, both perspectives miss an important aspect of survivorship after childhood or adolescent cancer: the affected individual's subjective experiences of having a disabled body. This qualitative study aimed to explore the embodied experiences of Colombian adults who survived cancer during their childhood or adolescence to better understand how CACS relate to their altered body and world. METHODS: By integrating phenomenological insights and conducting comprehensive life-story interviews, we explored the various ways in which survivors' cancer experiences affect their bodily sense of self-from the acute phase of the disease until well into adulthood. A total of ten life-stories interviews and one focus group were carried out with seven CACS. All participants were survivors of a different type of childhood/adolescent cancer. The results were analyzed thematically, focusing on the embodied aspects of participants' experiences. RESULTS: We developed three main themes regarding the embodied cancer experience among participating CACS: Firstly, participants' body changes because of the cancer and its treatment, which makes them aware of their body. Secondly, they adapt to this experience in different bodily ways. Finally, they carry bodily traces of their cancer experience in the present as well as into the future. CONCLUSIONS: The CACS participating in this study report that their experience with cancer has been embodied throughout their lives, changing their sense of their body and how they relate to it, and leaving traces into the present and their imagined future.

Cue-Reactive Phenomenology Mediates the Relationship Between Positive Schizotypy and Cue-Reactive Urge to Gamble in Poker-Machine Gamblers.

Although ubiquitous in numerous nightlife cultures, poker-machines present a high risk for problematic use and addiction. Previous research has demonstrated that gambling cues (e.g., flashing lights) can activate gambling urges in poker-machine gamblers. However, the processes that contribute to the maintenance of cue-reactive urges to gamble remain unclear. Consequently, the present study explored whether positive schizotypy predicted gambling urge, and whether cue-reactive altered state of awareness, cue-reactive altered time sense, and cue-reactive absorption mediated this relationship. Seventy adults aged between 19 and 68 (M = 48.86, SD = 12.82) participated in an online cue-reactivity experiment. Participants first completed the Problem Gambling Severity Index and the Unusual Experiences subscale of the Short Oxford-Liverpool Inventory of Feelings and Experiences. Subsequently, at three time points (i.e., baseline, directly after a neutral cue, and directly after a gambling cue) participants completed the Altered State of Awareness, Altered Time Sense, and Absorption subscales of the Phenomenology of Consciousness Inventory and a visual analogue scale measuring cue-reactive urge to gamble. It was found that positive schizotypy was significantly positively correlated with cue-reactive urge to gamble. Additionally, cue-reactive altered state of awareness, cue-reactive altered time sense, and cue-reactive absorption mediated this relationship. The theoretical, clinical and practical implications are discussed.

The Personal and The Transpersonal Psyche: Human Suffering, the Archetypes and the Clinical Encounter.

While Jung's notion of archetypes has had far-reaching universal appeal and significance, it remains less obvious how these ideas might benefit the analytic patient. In particular, the therapist and/or patient may struggle to hold the tension between the latter's personal neuroses and how transpersonal/archetypal elements inform his/her experience. While Jung strove to develop a treatment that dealt primarily with the archetypal/objective psyche, the personal psyche is arguably the medium through which the archetypes are experienced. I contend that the "discipline" of Jungian analysis evolved from a transposition of Jung's ideas around transpersonal, philosophical and religious themes (borne out of his own self-analysis), into a two-person psychotherapeutic process. Jung provides little description of his clinical encounters and the way in which he conducted his analyses leaving an uncertainty that has likely contributed to the divergence of approaches practised today by analytical psychologists. This article considers the implication of these divergences for contemporary Jungian practice and proposes a way of working in the Jungian spirit that maintains a connection to the symbolic realm while at the same time remaining focused on the complexities of personal and relational dynamics.

Alors que le concept jungien d'archétype a eu un attrait et une importance majeure et universelle, ce qui demeure moins évident est de savoir comment ces idées peuvent bénéficier au patient en analyse. En particulier, le thérapeute et/ou le patient peuvent peiner à contenir la tension entre les névroses personnelles du patient et la manière dont les éléments transpersonnels/archétypaux façonnent son expérience. Alors que Jung s'est efforcé de développer un traitement qui s'occupait essentiellement de la psyché objective/archétypale, c'est la psyché personnelle qui est probablement l'intermédiaire par lequel on fait l'expérience des archétypes. Je soutiens que la « discipline ¼ analyse jungienne est issue de la transposition des idées de Jung autour de thèmes transpersonnels, philosophiques et religieux (issus de sa propre auto­analyse), et qu'elle est progressivement devenue un processus psychothérapeutique impliquant deux personnes. Jung fournit peu de descriptions de ses rencontres cliniques et de la manière dont il conduisait ses analyses, ce qui laisse de l'incertitude. Ceci a probablement contribué au fait qu'il y a des divergences dans les approches utilisées aujourd'hui par les psychologues analytiques. Cet article examine les conséquences de ces divergences pour la pratique contemporaine de l'analyse jungienne. Il propose une manière de travailler dans l'esprit jungien c'est­à­dire en maintenant le lien avec le domaine symbolique, mais tout en restant concentré sur les complexités des dynamiques personnelles et relationnelles.

Aunque la noción de arquetipos de Jung ha tenido un atractivo y una relevancia extensa y universal, sigue siendo menos obvio cómo estas ideas pueden beneficiar al paciente analítico. En particular, el terapeuta y/o el paciente pueden tener dificultades para mantener la tensión entre las neurosis personales de este último y el modo en que los elementos transpersonales/arquetípicos informan su experiencia. Aunque Jung se esforzó por desarrollar un tratamiento que se ocupara principalmente de la psique arquetípica/objetiva, la psique personal es el medio a través del cual se experimentan los arquetipos. Sostengo que la "disciplina" del análisis Junguiano evolucionó a partir de una transposición de las ideas de Jung en torno a temas transpersonales, filosóficos y religiosos (surgidos de su propio análisis de sí mismo), en un proceso psicoterapéutico de dos personas. Jung brinda poca descripción de sus encuentros clínicos y de la forma en que llevó a cabo sus análisis, dejando una incerteza que probablemente ha contribuido a la divergencia de abordajes practicados en la actualidad por analistas Junguianos. Este artículo considera la implicancia de estas divergencias para la práctica Junguiana contemporánea y propone una manera de trabajar en el espíritu Junguiano que mantiene una conexión con la dimensión simbólica mientras que al mismo tiempo permanece centrado en las complejidades de las dinámicas personales y relacionales.

The Perceived Functions and Phenomenological Characteristics of Future Thinking and Clinically Significant Generalized Anxiety Disorder Symptoms.

Current research indicates that anxiety disorders and elevated levels of trait anxiety are associated with biases and impairments when thinking of personally relevant future events, that is, future thinking. However, to date, little research has been conducted into how people with symptoms of clinical anxiety perceive the functions of future thinking. The current study presents a cross-sectional survey comparing individuals with elevated symptoms of generalized anxiety disorder (GAD) and related functional impact (N = 51, 43.1% female, Mage = 33.1, SD = 10.2) matched on age and gender with individuals with no clinically significant symptoms of GAD (N = 51, 43.1% female, Mage = 33.3, SD = 10.1) on self-reported functions of future thinking and a battery of items assessing the phenomenological characteristics. The results indicated various significant differences in the perceived functions of future thinking and its phenomenological characteristics in those with elevated GAD symptoms. Broadly, they indicate more frequent future thinking and more commonly for self-distraction or processing negatively valenced future events, and generally less adaptive mental representations that support current thinking on the psychopathological process of increased worry, anxious arousal and maladaptive cognition in clinical anxiety symptoms.

Exploring medical students' experiences with indigenous patient care: a phenomenological study.

BACKGROUND: Indigenous Peoples in Canada bear a disproportionate burden of disease and experience poorer health outcomes as compared to non-Indigenous populations within Canada; these conditions are said to be mediated and exacerbated by pervasive and uninterrupted anti-Indigenous racism. Third and fourth-year medical students at a Canadian medical school were asked to reflect on their experiences working with Indigenous patients in clinical settings, and how their preclinical Indigenous health curriculum impacted these experiences. METHOD: Phenomenology was used, guided by Goffman's theory of social stigma. Eleven undergraduate medical students were recruited using purposeful sampling. Semi-structured phone interviews were conducted to gain an in-depth understanding of the participants' experiences. Interviews were recorded and transcribed verbatim. Data were analyzed using the four main processes for phenomenological analysis. RESULTS: Four main themes emerged from students' descriptions of clinical experiences involving Indigenous patients: 1) students describe how their Indigenous patients encounter the health care system and their own lack of cultural sensitivity in this context; 2) racism was evident in students' clinical interactions with Indigenous patients, but students do not always perceive these biases nor the impact of this on patient care; 3) identifying the impact of racism on care is complicated by situational clinical encounters; and 4) practicality of preclinical Indigenous health education is desired by students to prepare them for working with Indigenous patients in the clinical setting. CONCLUSIONS: In their clinical experiences, students witness racism against Indigenous peoples yet are unprepared to stand up against it. Findings highlight the importance of enhancing undergraduate medical training to allow students to better understand the unique experiences and perspectives of Indigenous patients. The results support the need for ongoing Indigenous health education, to foster culturally sensitive experiences while learning about Indigenous patients.

The Lived Experiences of Palliative Care Professionals in Cultivating Mindfulness: A Phenomenological Study.

Purpose: The aim of this study was to explore the essence of the lived experiences of palliative care professionals in cultivating mindfulness, with a focus on the meaning of mindfulness in their lives and how mindfulness is experienced throughout their process of caring for others. Design: This was a qualitative study using a phenomenological approach. Methods: Eleven palliative care professionals (three physicians, four nurses, three psychologists, and one spiritual care provider) partook in in-depth interviews. Data were collected from the in-depth interviews and analyzed according to the method of Giorgi. Findings: Two major themes emerged from this study. First, the palliative care professionals realized the need for self-care amid emotional burden, including recognizing their feelings of guilt and self-doubt, emotional contagion of grief, reflections of others' fragility on themself, and their self-imposed limitations. Second, they noticed the transformative impact of mindfulness on them, including detecting reconnection with their body, changes in their personal values, self-acceptance, and liberation. Conclusion: Palliative care professionals can cultivate self-acceptance and facilitate entirely new life experiences through the practice of mindfulness. For them, mindfulness is not merely a self-regulation technique but an existential epiphany, offering hope for self-care and empowerment.

Scale for time and space experience in anxiety (STEA): Phenomenology and its clinical relevance.

Anxiety is a pervasive emotional state where, phenomenologically, subjects often report changes in their experience of time and space. However, a systematic and quantified examination of time and space experience in terms of a self-report scale is still missing which eventually could also be used for clinical differential diagnosis. Based on historical phenomenological literature and patients' subjective reports, we here introduce, in a first step, the Scale for Time and Space Experience of Anxiety (STEA) in a smaller sample of 19 subjects with anxiety disorders and, in a second step, validate its shorter clinical version (cSTEA) in a larger sample of 48 anxiety subjects. The main findings are (i) high convergent and divergent validity of STEA with both Beck Anxiety Inventory (BAI) (r = 0.7325; p < 0.001) and Beck Depression Inventory (BDI) (r = 0.7749; p < 0.0001), as well as with spontaneous mind wandering (MWS) (r = 0.7343; p < 0.001) and deliberate mind wandering (MWD) (r = 0.1152; p > 0.05), (ii) statistical feature selection shows 8 key items for future clinical usage (cSTEA) focusing on the experience of temporal and spatial constriction, (iii) the effects of time and space experience (i.e., for both STEA and cSTEA scores) on the level of anxiety (BAI) are mediated by the degree of spontaneous mind wandering (MWS), (iv) cSTEA allows for differentiating high levels of anxiety from the severity of comorbid depressive symptoms, and (v) significant reduction in the cSTEA scores after a therapeutic intervention (breathing therapy). Together, our study introduces a novel fully quantified and highly valid self-report instrument, the STEA, for measuring time-space experiences in anxiety. Further we develop a shorter clinical version (cSTEA) which allows assessing time space experience in a valid, quick, and simple way for diagnosis, differential diagnosis, and therapeutic monitoring of anxiety.

What Is It Like to Be in Alcohol Addiction Recovery? A Dialectical Phenomenological Analysis.

INTRODUCTION: Currently, there is no scientific consensus on the concept of alcohol addiction recovery beyond substance use control. This conceptual issue challenges the implementation of therapeutic strategies and mental health policies that are unrestricted to symptomatic remission. Aiming to contribute to its definition, this study aimed to examine the recovery experience of individuals with alcohol addiction using dialectical phenomenological psychopathology (DPP) as a theoretical and methodological framework. METHODS: A dialectical phenomenological analysis was conducted through an examination of online interviews with eight Brazilian, São Paulo state citizens who were self-declared to be undergoing alcohol addiction recovery (or who declared that they had completely recovered). RESULTS: Participants' reports generated eight categories that were subdivided into two groups. The first group indicated experiential elements of recovery, such as changes in self-relation, changes in interpersonal relations, and changes in time relations, giving new meanings to suffering and alcohol use, and recovery as a continuous process. The second group referred to how the participants interpreted recovery according to their worldviews: as a spiritual experience, moral reformation, and mentality change. CONCLUSION: These categories can be understood through the lens of DPP as a process of change in the subjects' being in the world, characterized by the continued management of their existential imbalances in the dimensions of spatiality, temporality, selfhood, and intersubjectivity. The results are preliminary when it comes to conceptualizing recovery but may help future studies to develop recovery-oriented therapeutic strategies.

"Parents are our greatest asset but also our greatest challenge": A Qualitative Study of Anesthesia Staff's Experiences of Parental Presence During Anesthesia Induction.

PURPOSE: The perioperative period is a stressful experience for both the child and their parents. Anesthesia staff generally have a positive attitude to the parental presence in the operating room. They can be a powerful resource in creating a caring environment, but they are challenged by limited time to establish a relationship. The present study describes the anesthesia staff's experience of parental presence during their child's anesthesia induction. DESIGN: A descriptive design with a phenomenological approach. METHODS: A total of 22 anesthesia staff from four Swedish hospitals were interviewed. The study has been carried out using a reflective lifeworld research (RLR) approach. FINDINGS: The following four constituents describe anesthesia staff's experiences of parental presence: a conditional presence; a relationship that is secondary; a shared but two-part responsibility; and a need to demonstrate professionalism. CONCLUSIONS: Parental presence is natural and essentially irreplaceable, as it creates security for the child. However, the results show that parental presence is not free of obligations and expectations. Designing for good perioperative care is important, and the staff plays a key role in cooperating with the parents to improve the quality of care.

Pain and temporality: a merleau-pontyian approach.

Chronic pain is a common disorder with enormous sociomedical importance. A major part of primary and secondary costs of illness is caused by the various pain syndromes. Nociception - the sensory perception of a painful stimulus - is a complex process relying on an intricate system of anatomical, neurophysiological and biochemical networks. This applies even more so to pain - the state of experiencing a nociceptive event, of interpreting it in terms of meaning for the affected individual and of suffering a range of emotions it elicits. This intricacy renders it obvious, that the empirical medical sciences alone cannot explain all aspects of pain. Hence, it has also become a focus of phenomenological research. One aspect of these investigations is the interaction of pain and the perception of the lived body's spatiality. The focus of this article will build on these concepts to develop a construct of the alteration of temporality caused by chronic pain and the effects this spells out for the affected subject. To this end, I will primarily draw on Merleau-Ponty's ideas of the lived body as well as on theories of enactivism and embodiment. I will also point out parallels to neuroscientific data, thereby demonstrating the proximity of phenomenology and neuroscience. A possible partial solution to the pain dilemma may be derived from psychology: techniques relying on cognitive behavioural intervention, awareness training, and existential analysis may provide alleviation to patients suffering from chronic pain.

Examining the influence of episode number and age of onset on individual depressive symptoms across episodes of major depression.

Major depression is characterized by an episodic course with symptom manifestations differing across episodes. Previous work has found that symptom presentation differs across age. However, studies of symptom presentation have largely focused on symptoms in individual episodes, requiring further investigation of longitudinal symptom change. This study explored the impact of the initial age of onset, the number of episodes, and age of onset of each episode on individual depressive symptoms, while accounting for episode severity. We used data from the Oregon Adolescent Depression Project (N = 629) examining participants with at least one major depressive episode, assessed by diagnostic interview, across a 15-year follow-up. Multilevel logistic regression models revealed that approximately 20-25% of the main effects were significant and some were qualified by cross-level interactions. However, only a few associations remained robust after correcting for multiple comparisons. Specifically, older initial age of onset was associated with fatigue, younger initial age of onset for the first episode was associated with suicidal ideation, and a lower episode number was associated with weight loss. These findings highlight potential initial age of onset and scar effects influencing symptom manifestation, but require replication.

Major Depression as a Disorder of the Narrative Self: A Qualitative Study.

INTRODUCTION: Abnormal self-experiences are a common feature of major depression despite their absence from current diagnostic manuals. Current diagnostic criteria leave us with an impoverished conception of depressive disorders, and they fail to exploit the diverse experiential alterations that might be useful for understanding and diagnosing patients, and last but not least for explaining the aetiology of these disorders. Although some phenomenological descriptions of abnormal self-experiences in major depression are available, further research is needed to validate these through detailed clinical interviews. METHODS: To characterize these phenomena in more detail and to verify and consolidate previous accounts, we conducted a qualitative study using the Consensual Qualitative Research method. RESULTS: Our findings identified three categories of abnormal self-experiences: (1) impossibility to project oneself forward, (2) not recognizing one's self, and (3) losing control on one's self. CONCLUSION: Before delving into these results, we briefly described how the self is conceptualized in phenomenological psychopathology and explored in the literature on the self-experience in major depression. After discussing our results in the light of recent and contemporary phenomenological literature, we suggest that the inability to recognize otherness as part of oneself - which is the core of depressive experiences - ends in specific symptoms of depersonalization that differ from schizophrenic ones. We conclude that the self-experience, and in particular narrative identity, is central to the development and maintenance of depression.

Exploring suicide resilience experiences in Chinese youth after self-poisoning: A qualitative study.

OBJECTIVE: This inquiry probes the suicide resilience experiences in suicide attempts by self-poisoning among Chinese youth. The study's goal is to provide healthcare professionals with critical insights to develop effective interventions that enhance suicide prevention measures and diminish the likelihood of subsequent attempts. METHODS: Utilizing a qualitative phenomenological approach, we conducted semi-structured interviews with 12 youths (Mean age = 21.1 ± 2.8 years; n = 7 females) who survived suicide attempts by self-poisoning. Data analysis was performed using Colaizzi's seven-step method, a rigorous method entailing iterative reading for the extraction of key statements and the distillation of thematic essence. RESULTS: Four primary themes with ten sub-themes were extracted: (1) New understanding of life (cherish life, and meaning of life), (2) Self-Reconciliation (self-acceptance, self-understanding, and self-openness), (3) Personal empowerment (increased self-reliance, increased responsibility, and increased emotional regulation), and (4) Life redesigning (faith in the future, and plan for the future). CONCLUSIONS: The findings reveal a potential for psychological growth and beneficial transformation in youth following suicide attempts by self-poisoning. These insights advocate for the integration of positive psychology principles in therapeutic interventions for this demographic.

The SU(3)C × SU(3)L × U(1)X (331) Model: Addressing the Fermion Families Problem within Horizontal Anomalies Cancellation.

One of the most important and unanswered problems in particle physics is the origin of the three generations of quarks and leptons. The Standard Model does not provide any hint regarding its sequential charge assignments, which remain a fundamental mystery of Nature. One possible solution of the puzzle is to look for charge assignments, in a given gauge theory, that are inter-generational, by employing the cancellation of the gravitational and gauge anomalies horizontally. The 331 model, based on an SU(3)C×SU(3)L×U(1)X does this in an economical way and defines a possible extension of the Standard Model, where the number of families has necessarily to be three. We review the model in Pisano, Pleitez, and Frampton's formulation, which predicts the existence of bileptons. Another characteristics of the model is to unify the SU(3)C×SU(2)L×U(1)X into the 331 symmetry at a scale that is in the TeV range. Expressions of the scalar mass eigenstates and of the renormalization group equations of the model are also presented.

What frailty can tell us about ageing well: towards an alternative paradigm to 'successful ageing'.

This paper considers the concept of successful ageing by means of a dialogue with the concept of frailty. This dialogue reveals the limits and blindspots of both concepts as well as their apparent dichotomy and the importance of understanding both the objective and subjective experience of ageing. In particular, the dialogue highlights that both frailty and successful ageing are social constructs that derive their meaning from what society values (autonomy, youthful capacities). They cannot by themselves account for the fact that flourishing and frailty are often found together whilst conversely successful ageing may not bring satisfaction. I argue that the arts and humanities supply us with conceptual and methodological tools with which to revisit what it is to age well offering a holistic approach that combines sensitivity both to older people's lived experience and to the underpinning material conditions and embodied realities. For this purpose, and building on previous scholarship in cultural gerontology, I suggest the unique value of concepts and frameworks associated by Simone de Beauvoir. When brought into alignment with the tenets of cultural and narrative gerontology, these concepts facilitate a rich understanding of the nuances and paradoxes of flourishing in deep old age which can also aid in restorying both old age and the life course more generally. I illustrate this through two examples: a feminist self-help guide to ageing, which accepts both limitations and growth and a film that imagines the possibilities of authentic ageing even despite a context of poverty, patriarchy and Alzheimer's Disease.

Insights into the experiences of nurse educators in end-of-life care: A qualitative study.

AIM: This study elucidated the experience of nurse educators instructing practicums for nursing students assigned to the care of end-of-life patients in fundamental nursing education. BACKGROUND: With the growing population of older adults and increased mortality, nurses providing care for people at the end-of-life stage and their families (referred to as end-of-life nursing) will be increasingly important in Japanese healthcare settings. Acquiring knowledge and action-level methods can be insufficient for nursing students to approach the illness experiences of people at the end of their life and their families, increasing the importance of practicum in end-of-life nursing to enable learning from experience. This situation raised the need to study how nurse educators for nursing care for end-of-life patients experience the situation and what they practice as observed through the educator's standpoint to devise better teaching methods for end-of-life nursing practica. DESIGN: Interpretative phenomenology was used. METHODS: Semi-structured interviews were conducted with six nurse educators. Participants were interviewed about their experiences in teaching nursing students who care for people in the final stages of life. Data were analyzed using Benner's Interpretive phenomenological approach. RESULTS: Nurse educators teaching students assigned to end-of-life patients experienced the [sudden appearance of patients themselves] and were involved in the nursing care for these end-of-life patients. They [seized the opportune "moments" for teaching] while [placing the value of practicum in end-of-life nursing in the "fragments" that students find] and then acknowledged that students were becoming aware of the core values of end-of-life nursing, even though they could not perform the techniques of care. Nurse educators also [recognized students as learners at the "borderline stage"] who are still distinct from nurses and valued students in their current state of development with hopes and expectations for further growth. CONCLUSIONS: This study highlighted the importance of nurse educators leveraging their practical knowledge to provide direct guidance to nursing students in clinical settings. The educators approached patient care with intentionality, prioritizing the well-being of patients while engaging in co-existent care alongside the students. Simultaneously, they respected the nursing students in their transition to becoming nurses, harboring hopes and expectations for continued growth. Concurrently, they were curious about the patient and student. They sought to balance the interests of the two parties representing dissimilar temporality, thereby applying their intuitive embodied intelligence into practice. Such experiences were also interpreted from the temporality of nursing students in a transitional stage of becoming nurses.