Gender systems in the Putin autocracy.

Over the last 23 years, Russian President Vladimir Putin's autocracy has revealed a set of interlocking gender systems that have come to the fore particularly vividly since the full-scale invasion of Ukraine on February 24, 2022. How, this article asks, have the masculinist cultural and political practices of the Putin regime undermined democratic practices and engagement broadly speaking? How have they organized Russian state and society in ways that have led to today's war in Ukraine with its massive destruction, violence, and brutality? And have there been earlier signals that should have warned observers that this regime might undertake such a war of aggression? Drawing on public, mass media data, this article analyzes the gendered structures of power in Russia that have contributed to the degeneration of democracy in three main areas: (1) male-on-male domination in discourse and practice that supports Putin's personal rule and emasculates his enemies; (2) the elevation of male power clans, including the President's personal praetorian guard and the Russian private military companies; and (3) the overall taming and emasculation of the Russian Parliament combined with the elevation of tough women deputies, whom I call the Baba Commissars. These female MPs support the President's domination by creating an appearance of a threatening outside world that needs to be kept at bay. At the same time, they support a neo-traditional gender order with women managing the house under the direction of the patriarchal male leader.

Bidirectional brain-body interactions during natural story listening.

Narratives can synchronize neural and physiological signals between individuals, but the relationship between these signals, and the underlying mechanism, is unclear. We hypothesized a top-down effect of cognition on arousal and predicted that auditory narratives will drive not only brain signals but also peripheral physiological signals. We find that auditory narratives entrained gaze variation, saccade initiation, pupil size, and heart rate. This is consistent with a top-down effect of cognition on autonomic function. We also hypothesized a bottom-up effect, whereby autonomic physiology affects arousal. Controlled breathing affected pupil size, and heart rate was entrained by controlled saccades. Additionally, fluctuations in heart rate preceded fluctuations of pupil size and brain signals. Gaze variation, pupil size, and heart rate were all associated with anterior-central brain signals. Together, these results suggest bidirectional causal effects between peripheral autonomic function and central brain circuits involved in the control of arousal.

Narrative influence on support of a public policy: The case of nuclear power in The Netherlands.

We propose a new methodology to systematically transform presurveyed argument preferences into fictional narratives, that can help people to imagine the consequences of future events, and measure how they impact willingness to pay for a public policy. We apply narrative theory to construct two short narratives that depict an imaginary future, bleak due to climate change or energy dependence, and show experimentally that exposure to these narratives increases contributions in a Public Goods game, framed as payments toward the construction of new nuclear plant in The Netherlands. Our results suggest that fictional narratives can be used (and misused) as a tool of economic policy that allows conveying relevant information to people about complex issues. We discuss the ethical use of narratives and the value of their transparent construction for democratic will-formation and policy implementation when abstract factual information can be difficult to process or comprehend.

Manifestations, social impact, and decay of conceptual beliefs: A cultural perspective.

INTRODUCTION: Believing comprises multifaceted processes that integrate information from the outside world through meaning-making processes with personal relevance. METHODS: Qualitative Review of the current literature in social cognitive neuroscience. RESULTS: Although believing develops rapidly outside an individual's conscious awareness, it results in the formation of beliefs that are stored in memory and play an important role in determining an individual's behavior. Primal beliefs reflect an individual's experience of objects and events, whereas conceptual beliefs are based on narratives that are held in social groups. Conceptual beliefs can be about autobiographical, political, religious, and other aspects of life and may be encouraged by participation in group rituals. We hypothesize that assertions of future gains and rewards that transcend but are inherent in these codices provide incentives to follow the norms and rules of social groups. CONCLUSION: The power of conceptual beliefs to provide cultural orientation is likely to fade when circumstances and evidence make it clear that what was asserted no longer applies.

A Long Parents' Journey After Children's Coming Out: Obstacles, Relationships, Generativity, and Life Balance.

Parents' perspective on their child's coming out (CO) remains an under-researched area, especially the investigation of parents adapting to their role post-CO years. The study qualitatively explored parents' recollections of their children's CO, spanning over 15 years. The study involved 15 parents (9 mothers, 6 fathers) of 4 lesbian daughters (Mage = 20.7; SDage = 7.8) and 11 gay sons (Mage = 23.0; SDage = 6.2). A semi-structured interview was employed to probe parents' responses to their child's CO and the long-term evolution of their CO experiences (M = 20.1; SD = 4.8). A thematic analysis was conducted through the software ATLAS.ti. Four themes were observed: (1) risk and protective factors; (2) effects of CO on relationships; (3) parents' generativity; (4) life balance. Acceptance challenges included a lack of LGBQ+ awareness and difficulties in sharing the disclosure with extended family, particularly grandparents. Parents reported numerous strategies, some involving parental generativity, like LGBQ+ activism. Milestones like marriage and the arrival of grandchildren reinforced parents' protective role as they aged, with the child's LGBQ+ disclosure marking a transformative moment leading to a more authentic relationship.

Making end-of-life health disparities in the U.S. visible through family bereavement narratives.

Objective: End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. Methods: Semi-structured interviews with 25 bereaved individuals were conducted regarding their experiences with the terminal illness and death of an immediate family member. Using a framework of family bereavement narratives, a cross-case data analysis demonstrated qualitative patterns between (in)access to end-of-life care and how participants framed bereavement stories. Results: Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond. Innovation: This innovative qualitative connection between family members' bereavement stories and end-of-life care emphasizes the importance of employing a health equity lens within hospice and palliative care, especially in addressing the important aim of comprehensively supporting families even when illness ends. This study demonstrates that access to, quality of, and imagining beyond current structures for EOL may be vital factors for facilitating effective sense-making for the dying and their family systems. Conclusion: These findings illustrate the potential interconnections between (in)access to end-of-life care, sense-making, and communication for individuals and families experiencing terminal illness and bereavement.

'It's like being in a tunnel': Understanding the patient journey from tooth loss to life with removable dentures.

INTRODUCTION: The aim of this study was to conceptualise the key stages of the patient journey in the provision of a new denture and examine the factors leading to successful patient-related outcomes. METHODS: Two partially dentate patient samples were included: (i) Denture wearers - patients who had a denture fitted within the previous five years and (ii) New dentures - patients receiving treatment for a new or replacement denture. The methods involved direct targeted participant observations of the denture fitting process, debriefing interviews and a follow-up focus group exploring the patient journey. Data were analysed through the use of phenomenology and grounded theory. RESULTS: Interviews were completed with twenty participants of the denture-wearing sample (11 males and nine females, age range 22 to 86 years). Thirteen participants were included in the treatment journey sample in two primary care settings (six males and seven females, age range 55 to 101 years). Tooth loss and recovery was described as being in an 'emotional tunnel' resulting from 'bodyphonic processes' associated with tooth loss. 'Bodyphonia' subsequently became the context for 'taking control' and 'managing disclosure' when living with a removable denture. Different courses through this process can be readily observed, moderated by different variables (i.e., previous experience, working knowledge, a good fit, the treatment alliance, negotiated compromises and bounded responsibility). CONCLUSIONS: An'integrating framework' that seeks to describe the patient journey from the experience of tooth loss to recovery with a denture is proposed. This framework could be used to aid development of a clinical pathway to guide treatment options. CLINICAL SIGNIFICANCE: This paper conceptualises the patient journey. It stresses the importance of understanding the stages patients go through and highlights that for the dental team, the try-in stage is perhaps the best stage to give information about the denture and plans for continued care.

Experiences of living kidney donors: A synthesis of unsolicited patient narratives.

INTRODUCTION: Despite the lauded benefits of living kidney donation, there is growing evidence of the challenges that living kidney donors (LKD) encounter in their donation trajectory and gaps in healthcare service provision. However, most of the evidence is derived from research conducted by clinicians or academic investigators. Significantly less attention has been devoted to analyzing unsolicited accounts of LKDs' experiences. METHODS: We conducted a review and synthesis of published unsolicited first-person narratives of LKDs and aimed to synthesize their experiences and identify care needs. Four electronic databases were searched and 27 LKD narratives were included in our final analysis. Thematic synthesis was used to generate themes inductively. RESULTS: Although the majority of LKDs reported the act of donation to be a fulfilling experience, almost 48% reported encountering challenges in the care that they received. Also, 29% of LKDs reported experiencing an adverse clinical event. Five distinct themes emerged surrounding the donation experience and healthcare needs: 1) Educational needs due to perceived lack of transparency and compensating for knowledge gaps; 2) Respect for donor autonomy due to coercive influences from family or healthcare providers, lack of respect for donor preferences and loopholes in the consent process; 3) Unmet care needs related to poor communication with healthcare providers, coordination issues and inconsistent and inadequate long-term care; 4) Unanticipated outcomes due to economic costs and the emotional burden of donation; and 5) Contributing beyond the donation event by advocating for a balanced view of donation and generating support mechanisms. CONCLUSION: In this synthesis of LKDs narratives, important care gaps and the need to advocate for a balanced perspective on living kidney donation were highlighted. Our review underscores the value of patients' own stories as critical evidence that can inform improvement in healthcare service delivery.

The Health Narratives Research Group (HeNReG): A self-direction process offered to help decrease burnout in public health nurse practitioners.

Founded in accordance with 19th century sex roles and public health concerns, nursing evolved as other-directed, dependent on physician-focused diagnosis, prescription decisions, and public health advancements. The result of this other direction is that public health nurse practitioners have endured significant workplace stress resulting in burnout, especially during COVID-19. To help decrease their burnout, nurses require development of self-direction. The Health Narratives Research Group (HeNReG) has the potential to reduce burnout in nurse practitioners by encouraging the development of self-direction. The HeNReG process is presented through historically analyzed documents regarding reducing burnout in health researchers by developing self-direction including: (1) three years of archived year-end feedback results provided by participants, (2) archived participant responses to specific HeNReG-related writing prompts, and (3) a comparison of HeNReG results with the outcomes of resilience programs. The conclusion-the HeNReG offers an effective option for reducing burnout in health researchers that has the potential to decrease nurse practitioner burnout in a way that resilience programs do not. Tailoring the HeNReG process to public health nurses is discussed, inviting future research for reducing burnout in public health nurses.

AI and narrative embeddings detect PTSD following childbirth via birth stories.

Free-text analysis using machine learning (ML)-based natural language processing (NLP) shows promise for diagnosing psychiatric conditions. Chat Generative Pre-trained Transformer (ChatGPT) has demonstrated preliminary initial feasibility for this purpose; however, whether it can accurately assess mental illness remains to be determined. This study evaluates the effectiveness of ChatGPT and the text-embedding-ada-002 (ADA) model in detecting post-traumatic stress disorder following childbirth (CB-PTSD), a maternal postpartum mental illness affecting millions of women annually, with no standard screening protocol. Using a sample of 1295 women who gave birth in the last six months and were 18+ years old, recruited through hospital announcements, social media, and professional organizations, we explore ChatGPT's and ADA's potential to screen for CB-PTSD by analyzing maternal childbirth narratives. The PTSD Checklist for DSM-5 (PCL-5; cutoff 31) was used to assess CB-PTSD. By developing an ML model that utilizes numerical vector representation of the ADA model, we identify CB-PTSD via narrative classification. Our model outperformed (F1 score: 0.81) ChatGPT and six previously published large text-embedding models trained on mental health or clinical domains data, suggesting that the ADA model can be harnessed to identify CB-PTSD. Our modeling approach could be generalized to assess other mental health disorders.

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.

Portals to the past and bridges to the future: exploring the impact of doulas on the birthing experiences of black and Latinx women.

INTRODUCTION: In the USA, maternal morbidity and mortality is markedly higher for women of colour than for white women. The presence of a doula has been associated with positive birthing outcomes for white individuals, but the experiences of women of colour remain underexplored. The purpose of this qualitative paper is to understand the attitudes of black and Latinx communities towards doula-supported birthing practices. METHODS: The perspectives of people of colour, both birthing women and doulas, were investigated through popular media sources, including blogs, magazine articles, podcasts and video interviews. Of 108 popular media sources identified in the initial search, 27 included direct accounts from birthing women or doulas and were therefore included in this paper. Thematic analysis was conducted by the grounded theory method. RESULTS: Emerging themes reveal that doula presence allows for the experience of ancestral power, connection to the granny midwives, cultural translation in medical settings and physical protection of the birthing woman. When labouring with the support of a doula, women report the emotional and physical presence of their ancestors. Similarly, doulas recognise an ancestral presence within the birthing woman, and doulas experience their occupation as carrying on ancestral tradition and feel a strong vocational tie to the granny midwives of the American South. Lastly, doulas mediate communication between birthing women, their families and medical providers by emphasising the need for consent and patient autonomy. CONCLUSION: By connecting women of colour to historic and ancient spaces as well as providing comfort and familiarity in the birthing space, doulas grant their clients the self-advocacy and empowerment needed to survive the present. Doulas serve as protectors of women of colour and have become an important piece to bridging society from the current maternal health crisis to a more equitable future.

"In the end, the story of climate change was one of hope and redemption": ChatGPT's narrative on global warming.

AI chatbots such as ChatGPT help people produce texts. According to media reporting, these texts are also used for educational purposes. Thus, AI influences people's knowledge and perception of current issues. This paper examines the narrative of ChatGPT's stories on climate change. Our explorative analysis reveals that ChatGPT's stories on climate change show a relatively uniform structure and similar content. Generally, the narrative is in line with scientific knowledge on climate change; the stories convey no significant misinformation. However, specific topics in current debates on global warming are conspicuously missing. According to the ChatGPT narrative, humans as a species are responsible for climate change and specific economic activities or actors associated with carbon emissions play no role. Analogously, the social structuration of vulnerability to climate impacts and issues of climate justice are hardly addressed. ChatGPT's narrative consists of de-politicized stories that are highly optimistic about technological progress.

Stories to Prevent Cancer: A Pilot Study Using Cancer Survivor Narratives to Increase Human Papillomavirus Vaccine Intentions.

INTRODUCTION: Human papillomavirus (HPV) vaccination rates are lower than other recommended adolescent vaccines. Cancer survivor narratives are used to promote cancer prevention and control, but little is known about their impact on adolescent HPV vaccination. OBJECTIVE: This pilot study explored the feasibility and effects of a video education intervention using a cancer survivor narrative to improve parents' attitudes toward and intentions to get the HPV vaccine. METHODS: This study utilized a one-group design; participants completed a pre-intervention survey, watched the video before attending their sons' wellness visits, and completed a post-intervention survey within one week of their appointment. Using the narrative persuasion framework, we developed a 4-minute video of a local HPV-related cancer survivor to promote the HPV vaccine as cancer prevention. We recruited 37 participants between June and October 2020. Participants were parents of males ages 9-17 who had not yet initiated HPV vaccination. RESULTS: After the video, more parents agreed that HPV vaccination is safe (pre: 66% vs. post: 82%; P = .045) and that their child's chances of getting HPV-related cancer in the future are high (pre: 24% vs. post: 46%; P = .014). Overall, 91% of parents felt the cancer survivor story helped them understand the risks of HPV cancers, and 52% said the story influenced their decision to start HPV vaccination for their child. CONCLUSIONS: Our findings suggest that cancer survivor narratives influence parents' vaccine opinions and understanding of their child's risk of HPV infection, leading to increased parental intent to get the HPV vaccine for their adolescent males.

Professional values at the beginning of medical school: a quasi-experimental study.

BACKGROUND: Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students' levels of reflection. METHODS: We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students. RESULTS: Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students' perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group. CONCLUSIONS: Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.

The language of antimicrobial and antibiotic resistance is blocking global collective action.

Sustainable access to effective antibiotics is a foundational need for functioning health care that is increasingly threatened by antibiotic resistance. Although resistance has been known as long as antibiotics have been in clinical use, there are still multiple gaps in the global and local responses. One often cited cause for this complacency is the language that is used to describe the problem and its consequences. In this paper, we survey some examples of the current discussions around antibiotic resistance and seek to offer a path towards unified and understandable messaging that is relevant both to the public and policymakers by using narratives that highlight the individual and societal consequences of antibiotic resistance. Major shortcomings in the current language that hamper both the understanding of antibiotic resistance and needed behaviour change have been identified in scientific papers and special reports. These shortcomings range from terminology that is difficult to understand, through a lack of personal relevance, to a fragmented response in the policy field. We propose that scientists, including behaviour change experts, and other key stakeholders that are engaged in the issue take lead to agreement on the core scientific facts and to formulate a vision that can be a foundation for creation of consistent global narratives. These narratives must in turn be adapted to local contexts. Development of such narratives should be viewed as an essential component in national action plans on AMR to raise awareness, empower citizens and incentivise societal behaviour change, policy development and implementation of governance structures.

Zoofolkloristics: Imagination as a Critical Component.

Nonhuman animal protagonists of folklore texts in the European space have tended to be perceived primarily as performing a symbolic and metaphoric function. But behind the symbols and the metaphors hide real flesh-and-blood nonhuman animals, and flesh-and-blood humans interacting with them, mostly from a position of power. The emerging discipline of zoofolkloristics considers nonhuman animals in their own right. Through critical analysis of folklore material, zoofolkloristics examines the role of animals and power relations within the interspecies entanglement with the aim of deconstructing the oppressive system and establishing multispecies justice. We begin this paper with a brief reflection on the 'historical animal' as an embodied being and a human construct. We then perform a critical re-reading of three animal-related folklore texts from the Slovenian tradition and, applying Hubert Zapf's concept of imaginative counter-discourse, consider the potential of imagination as a methodological tool in the transformative program of zoofolkloristics. Implications for animal ethics, liberation, and conservation are also discussed.

Applying narrative medicine to prepare empathetic healthcare providers in undergraduate pharmacy education in Singapore: a mixed methods study.

BACKGROUND: Narrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students. METHODS: Narrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students' empathy using the Jefferson Scale of Empathy- Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students' emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach. RESULTS: There was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 ("Standing in People's Shoes") following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students' motivation and faculty's perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students' motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation. CONCLUSION: This study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients' perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.

"If the college adjusted the prices ": comparing food secure and insecure college students during the COVID-19 pandemic.

Objective: We examined how students' food insecurity related to their demographic information, academic experiences, use of food programs, and reflections on food during the COVID-19 pandemic. Participants: 246 NYC undergraduates during the first 9 months of the pandemic. Methods: Students reported on food insecurity (eg, USDA's 10-item AFSSM), household income, impact of food insecurity on academics, GPA, and use of food programs. They wrote two food narratives. Results: 135 (54.88%) participants reported high food security; 51 (20.73%) reported low or very low food security. Compared to high food security students, low and very low-security students were more likely to identify as Black and first-generation immigrants, reported lower household income, more frequently used food programs, had a lower GPA, reported more academic difficulties, and wrote more often about financial and programmatic difficulties related to food. Conclusions: Food-insecure students need greater financial, academic, and programmatic support during public health crises.