Is there scope to do better? Clinical communication with adolescents and young adults with cancer-A scoping review.

INTRODUCTION: How to communicate effectively with adolescent and young adults with cancer (AYACs) is a research priority. In a UK-wide survey of young people with cancer's research priorities, communication was a striking cross-cutting theme. It is increasingly recognised that AYACs have experiences and communication needs that differ significantly from those of younger children and older adults. The purpose of this review is to explore the features of effective clinical communication with AYACs. METHODS: A literature search was undertaken to identify and map the available evidence using a broad scope to get an overview of the pertinent literature, identify knowledge gaps and clarify concepts. The searches yielded 5825 records, generating 4040 unique articles. These were screened and 71 full articles were read by four researchers with disagreements resolved by discussion leaving 29 included articles. Narrative synthesis was undertaken in relation to each of the research questions. RESULTS: Three key themes were identified: being an adolescent/young adult, supporters, and healthcare professionals (HCPs). AYACs need to feel that HCPs understand their unique perspective. They want to be involved, this changes over time and in different contexts. Supporters are a central tenet, are most often parents and undertake several roles which are not always universally supportive. HCPs enable involvement of AYACs, and this needs to be actively promoted. AYACs preference for their level of involvement requires continual assessment. The three themes are interlinked and exist within the wider scope of the triadic encounter and cancer experience. CONCLUSION: Supporters, most often parents were a key feature across the data and were seemingly paradoxical in nature. Triadic communication, the presence of a third person, is a central tenet of communication with AYACs and we propose a conceptual model to represent the nuances, components, and facets of this complex communication.

Exploring the lived experience of receiving mental health crisis care at emergency departments, crisis phone lines and crisis care alternatives.

BACKGROUND: Mental health crisis care includes emergency departments (EDs), crisis phone lines and crisis alternatives. Currently, there is an overreliance on EDs to provide mental health crisis care, with evidence that responses are often inadequate to meet the needs of people experiencing mental health crises. However, the complexities of how individuals experience crisis care across the varying contexts of EDs, crisis phone lines and crisis alternatives remain underresearched. METHOD: This study used a hermeneutical phenomenological approach to understand the lived experience of accessing care during a mental health crisis. Thirty-one Australian adults who had accessed crisis services at ED, phone lines and/or crisis alternatives participated in in-depth interviews. RESULTS: The findings are organised across the temporal narratives of participants' experiences from (1) point of contact, (2) positive and negative care experiences and (3) enduring impacts. Several themes were generated during these phases. The findings demonstrate the interrelated nature of care experiences and enduring impacts. With some exceptions, care received within EDs was harmful, resulting in lasting adverse effects. Responses from crisis phone lines were mixed, with participants appreciating the accessibility of after-hour phone support but finding standardised risk assessments unhelpful. Responses from crisis alternatives to ED were promising, aligning with the need for validation and human connection, but were not always accessible or easy to mobilise during a crisis. Notably, across all settings, positive effects were firmly attributed to the quality of the relationship with specific crisis providers. CONCLUSION: The findings bring into sharp focus the lived experience of people accessing crisis care and contribute to the shortage of literature on subjective experiences. Providers may better meet the needs of those experiencing mental health crises by understanding the enduring impact of these interactions and the role of human connection beyond a focus on risk assessment, thereby providing opportunities for a joint understanding of risk and meaning-making. Furthermore, understanding the subjective experience of crisis care can guide reforms to ED and develop crisis alternatives to better meet the needs of people in crisis. PATIENT OR CONSUMER CONTRIBUTION: The first author and the third author are in designated lived experience (Consumer) roles. The first author conducted the interviews and was explicit regarding their lived experience when engaging with participants. Service users were involved as advisors to the study and provided input into the design.

Analysis of Anonymous Student Narratives About Experiences with Emergency Medicine Residency Programs.

Background: Academic emergency medicine (EM) communities have viewed anonymous online communities (AOC) such as Reddit or specialty-specific "applicant spreadsheets" as poor advising resources. Despite this, robust EM AOCs exist, with large user bases and heavy readership. Insights about applicants' authentic experiences can be critical for applicants and program leadership decision-making. To date, there are no EM studies to qualitatively assess EM AOC narratives during the application cycle. Our goal was to perform a qualitative analysis of students' EM program experiences through a publicly available AOC. Methods: This was a qualitative analysis of a publicly available, time-stamped, user-locked AOC dataset: "Official 2020-2021 Emergency Medicine Applicant Spreadsheet." We extracted and then de-identified all data from selected sub-sheets entitled "Virtual Interview Impressions" and "Rotation Impressions." Four investigators used constant comparative method to analyze the data inductively, and they subsequently met to generate common themes discussed by students. Preliminary thematic analysis was conducted on a random sample of 37/183 (20%) independent narratives to create the initial codebook. This was used and updated iteratively to analyze the entire narrative set consisting of 841 discrete statements. Finally, two unique codes were created to distinguish whether the identified sub-themes, or program attributes, were likely "modifiable" or "non-modifiable." Results: We identified six major themes: living and working conditions; interpersonal relationships; learning experiences, postgraduate readiness, and online/virtual supplements. Common sub-themes included patient population (13%); resident personality (7%); program leadership personality (7%); relationship with faculty/leadership (6%); geography (4%); practice setting (4%); program reputation (4%), and postgraduate year-3 experiences (4%). Modifiable sub-themes outnumbered non-modifiable sub-themes, 60.7% to 39.3%. Conclusion: In this analysis of selected medical students' narratives in an AOC, the majority of identified themes represented topics that may serve as external feedback for EM residency programs and their clerkships. Selective use of AOCs may set a precedent for future program assessments by applicants and inform program leadership of important programmatic elements in the eyes of applicants. It elucidates important themes in their interactions or learning experiences with programs and creates opportunities for learner-centric program improvement.

Does Pollyanna hypothesis hold true in death narratives? A sentiment analysis approach.

Pollyanna hypothesis claims that human beings have a universal tendency to use positive words more frequently and broadly than negative words. The present study aims to test Pollyanna hypothesis in medical death narratives at both lexical and text levels by using sentiment analysis and emotion detection methods, and to qualitatively analyze the contextual use of emotion words to deepen the understanding of doctors' emotions. Sentiment analysis showed a strong token-based linguistic positivity and a weak type-based negativity bias at the lexical level, and a general positivity bias at the text level, despite the gender of the doctors. Emotion detection discovered three prominent emotions of "joy", "sadness", and "anger", and a greater diversity of negative emotions in contrast to positive emotions in medical death narratives. Contextual analysis revealed that emotion words associated with joy were primarily observed in contexts related to doctors' actions and behaviors aiming to benefit others and promote social wellbeing. Emotion words associated with sadness and anger were chiefly employed to describe situations involving patients' death and doctors' attitudes towards death. The results confirm Pollyanna hypothesis at both token-based lexical level and text level and falsify the hypothesis at type-based lexical level. Possible explanations are explored by contextual analysis, and theoretical analysis from the perspectives of cognitive linguistics and social psychology. The findings are expected to enrich the understanding of Pollyanna hypothesis as well as the junior doctors' emotional responses to clinical deaths.

[Antihistamines : An ongoing narrative]. / Antihistaminiques : une histoire sans fin.

Histamine is responsible for many processes mediated by different receptors expressed on a variety of cells. The discovery of the first H1 antihistamines in the 1940s led to the development of numerous H1 and H2 antagonists with a broad application in many indications. The recent identification of two new histamine receptors (H3, H4) in the 1980s and 2000s led to the market authorization in Switzerland of new drugs since 2018. The purpose of this review is to provide a brief overview of the physiology of histamine, the recent development of new compounds in this field, antihistamine drug indications and relevant side effects.

L'histamine possède de nombreuses propriétés physiologiques, tant centrales que périphériques, via son action sur différents récepteurs. La découverte des premiers antihistaminiques H1 dans les années 1940 stimula le développement de nombreux autres antagonistes H1, puis H2, utilisés dans diverses spécialités médicales. L'identification plus récente de deux récepteurs à l'histamine (H3, H4) dans les années 1980 et 2000 relança le développement de nouveaux composés avec, en Suisse, une première autorisation de mise sur le marché en 2018. L'objectif de cet article de revue est de présenter brièvement la physiologie de l'histamine, l'histoire du développement des antihistaminiques, leurs utilisations actuelles, ainsi que leurs effets indésirables notables.

Scientific supremacy: How do genetic narratives relate to racism?

Recent research suggests that contemporary American society is marked by heightened hostile racial rhetoric, alongside increasing salience of White nationalists who justify an ideology of racial hierarchy with claims of biological superiority. Media coverage of such genetics research has often emphasized a deterministic (or causal) narrative by suggesting that specific genes directly increase negative outcomes and highlighting reported genetic differences between racial groups. Across two experimental studies, we examine the effect of the media's portrayal of scientific findings linking genes with negative health and behavioral outcomes on measures of racism. We find that deterministic genetic attributions for health and behavioral outcomes can lead to more negative racial out-group attitudes. Importantly, we also investigate potential interventions in the presentation of genetic science research. Our research has implications for understanding racial attitudes and racialized ideology in contemporary American politics, as well as for framing scientific communication in intergroup contexts.

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.

Gabriele Meyer-Enders und Gerd Lehmkuhl Kinder gestalten Narrative ­ erste Erfahrungen mit dem revidierten Sceno 2-Test / Children Create Narratives ­ First Experience with the Revised Sceno-2 Test.

Children Create Narratives - First Experience with the Revised Sceno-2 Test The Sceno Test, created by Gerthild von Staabs, has been in use and has been useful in its original version for more than 80 years. It has now undergone a major revision.The test will retain its relevance as a projective diagnostic procedure offering children and juveniles opportunities to design scenes and to voice narratives coming along with them. It can serve as an instrument encompassing all therapeutic approaches to explore infantile wishes, perceptions, and interpretations and can provide, as intended by Gerthild von Staabs, indications of family dynamics.The revision of the test will be discussed at great length.

The Self-Narrative Role in the Diagnosis of Motivation to Achieve Personal Success.

This study aims to investigate the efficacy of self-narrative as a tool for identifying personality traits conducive to motivation for success. The research employs several methodologies, including the "Readiness for Self-Development" test by V.L. Pavlov, the Achievement Motivation Diagnosis test, and the katathym imaginative psychotherapy motive "Mountain" as a form of self-narrative. Psycholinguistic analysis tools such as the verbosity coefficient, embolism coefficient, and correlation coefficient are utilized. Through empirical analysis of self-narratives, criteria for evaluating motivational potential are established. Quantitative and qualitative analyses of respondent narratives reveal distinct patterns. Coefficients derived from psycholinguistic analysis indicate a correlation between self-narratives and motivation for achievement. Respondents demonstrating motivation for success and readiness for self-development exhibit lower verbosity and embolism coefficients. Conversely, those with a tendency to avoid failure and low readiness for self-development tend to employ narratives rich in superficial language elements. The findings suggest that self-narrative analysis can effectively gauge an individual's motivational tendencies and readiness for personal development. This method holds promise as a tool for identifying and nurturing talent within organizations, particularly in the context of forming a vertical personnel reserve. By understanding the motivational drivers revealed through self-narratives, organizations can better tailor their approaches to talent management and development.

The Greek photographer Nelly's: the interplay of personal and socio-cultural theme of 'rebirth'.

This article presents a psychobiography study of the famous Greek photographer Ellie Sougioultzoglou-Seraidari (Nelly's) (1899-1998). Nelly's was born in Aidini (Asia Minor), and in her early years she experienced the tragic events of the Greek-Turkish War (1919-1923). She studied photography in Dresden (Germany), and worked in Athens (Greece) and New York (U.S.A.). A narrative and cultural psychology framework was adopted to explore the way that Nelly's constructed her life story. An adjusted version of the 'Life-Story Interview' (McAdams & Bowman, 2001) was used that distinguishes between redemption versus contamination narratives. The narrative analysis of autobiographical materials revealed turning points and a central life theme. The photographer appeared to construct her life story as a process of reinventing herself or managing 'rebirth'. This construction matches the dominant narrative of Greek refugees of Asia Minor, following what is known in European history as the Asia Minor 'Great Catastrophe' (1922). Both narratives are surviving and thriving stories of 'rebirth'. The importance of making meaning of life stories within a specific socio-cultural and historical context is emphasised. Practice and research suggestions are provided.

When I am sixty-four evaluating language markers of well-being in healthy aging narratives.

Natural language use is a promising candidate for the development of innovative measures of well-being to complement self-report measures. The type of words individuals use can reveal important psychological processes that underlie well-being across the lifespan. In this preregistered, cross-sectional study, we propose a conceptual model of language markers of well-being and use written narratives about healthy aging (N = 701) and computerized text analysis (LIWC) to empirically validate the model. As hypothesized, we identified a model with three groups of language markers (reflecting affective, evaluative, and social processes). Initial validation with established self-report scales (N = 30 subscales) showed that these language markers reliably predict core components of well-being and underlying processes. Our results support the concurrent validity of the conceptual language model and allude to the added benefits of language-based measures, which are thought to reflect less conscious processes of well-being. Future research is needed to continue validating language markers of well-being across the lifespan in a theoretically informed and contextualized way, which will lay the foundation for inferring people's well-being from their natural language use.

Between equilibrium and chaos, with little restitution: a narrative analysis of qualitative interviews with clinicians and parent carers of children with medical complexity.

BACKGROUND: Children with medical complexity (CMC) comprise 1% of the paediatric population, but account for over 30% of health service costs. Lack of healthcare integration and coordination for CMC is well-documented. To address this, a deep understanding of local contextual factors, experiences, and family-identified needs is crucial. The aim of this research was to investigate the lived experiences of CMC, their families, and healthcare staff, focusing on understanding the dynamics of care coordination and the challenges faced in providing integrated care, in order to inform the development of effective, family-centred models of care. METHODS: In April to July 2022, 31 semi-structured interviews were conducted with parents/guardians of CMC and healthcare professionals who care for CMC. Interviews explored complex paediatric care and care coordination barriers. An inductive thematic analysis was undertaken. Themes were then further explored using Frank's narrative approach. RESULTS: Through analysis, we identified that the restitution typology was absent from both staff and parent/guardian narratives. However, we uncovered narratives reflective of the chaos and quest typologies, depicting overwhelming challenges in managing complex medical needs, and proactive efforts to overcome barriers. Importantly, a novel typology termed 'equilibrium' was uncovered. Narratives aligning with this typology described medical complexity as a balance of power and a negotiation of roles. Within the equilibrium typology, illness trajectory was described as a series of negotiations or balancing acts between healthcare stakeholders, before finally reaching equilibrium. Participants described seeking a balance, where their expertise is respected, whilst maintaining the ability to rely on professional guidance and support. These insights provide a nuanced understanding of the multifaceted narratives shaping care experiences for CMC and their families. CONCLUSIONS: Our research delineates multifaceted challenges within the care landscape for CMC, their families, and healthcare staff. Embracing the equilibrium narrative typology highlights the criticality of tailored, integrated care models. This necessitates prioritising clear role delineation and communication among caregivers, implementing support systems addressing the challenges of continuous caregiving, and integrating parents/guardians as essential members of the care team. These insights advocate for pragmatic and sustainable strategies to address the unique needs of CMC and their families within healthcare systems.

Good reasons for bad behavior: a randomized controlled experiment on the impact of narrative reading and writing on empathic concern, perspective-taking, and attitude.

Background: Empathic concern and perspective-taking may contribute to avoiding stigmatization of adverse health behavior. Narrative writing has been shown to be effective in promoting perspective-taking and empathy. But since narrative writing is time consuming, we tested in the present study narrative reading as an alternative, more parsimonious approach. Methods: In a randomized controlled experiment, we compared writing a narrative text about a fictitious person who displays disapproved of health behavior to reading such a text and to a control condition in which participants wrote about an unrelated topic. With a sample of n = 194 participants, we investigated the impact of writing and reading a narrative text on promoting empathic concern and perspective-taking as well as on attitude change. Results: We found that both writing and reading a narrative text about the fictitious character increased empathic concern, F(1, 191) = 32.85, p < 0.001, part. η2 = 0.15, and perspective-taking, F(1, 191) = 24.76, p < 0.001, part. η2 = 0.12, more strongly than writing about an unrelated topic. Writing and reading a narrative text also resulted in a more positive attitude toward this person, F(1, 191) = 17.63, p < 0.001, part. η2 = 0.08. Simply reading a narrative text was equally efficient as narrative writing with respect to empathic concern, p = 0.581, perspective-taking, p = 0.629, and attitude, p = 0.197. Conclusion: The finding that narrative reading is as effective as narrative writing suggests that the readers appear to be able to comprehend and engage with the story being told. When narrative reading is as effective as narrative writing, it can succeed with reduced effort in increasing empathic concern, perspective-taking, and attitude. We discuss the benefits of this approach for reducing stigmatization of adverse health behavior.

Narrative Play-Promoting Adolescent Health With Interactive Games.

This Arts and Medicine feature discusses INSPIRE, a digital health game designed to foster adolescent health behavior change.

Telling the story of the opioid crisis: A narrative analysis of the TV series Dopesick.

Dopesick (2021) is the first TV series whose plot deals exclusively with the opioid crisis in the United States. The current study uses narrative analysis and framing theory to explore this series, discussing its portrayal of the people and themes involved in the opioid crisis. Our analysis found that although Dopesick attempts to portray multiple dimensions of the opioid crisis, its narrative oversimplifies the story in attributing the cause of the problem almost exclusively to Purdue Pharma and its director Richard Sackler, while downplaying other factors that contributed to the opioid crisis. Thus, the narrative in this TV series tends to offer simple explanations to a complex problem for which simple solutions are likely to be inadequate.

AMSD: The Australian Message Stick Database.

Message sticks are wooden objects once widely used in Indigenous Australia for facilitating important long-distance communications. Within this tradition an individual wishing to send a message would carve a stick and apply conventional symbols to its surface. The stick was entrusted to a messenger who carried the object into the territory of another community together with a memorised oral statement. Between the 1880s and the 1910s, settlers and international scholars took great interest in message sticks and this was reflected in efforts to document, collect and store them in museums worldwide. However, by this period, the practice was already undergoing profound changes, having been abandoned in many parts of the continent and transformed in others. While message sticks were still being used in a traditional way in Western Arnhem Land up until at least the late 1970s, today they feature in public interactions between Indigenous and non-Indigenous organisations, in art production and in oral narrations. Accordingly many questions concerning the history, pragmatics and global significance of message stick communication remain unanswered. To address this we have compiled the Australian Message Stick Database, a new resource hosted at the Max Planck Institute for Evolutionary Anthropology, Leipzig, and The Australian National University, Canberra. It contains images and data for over 1500 individual message sticks sourced from museums, and supplemented with information derived from published and unpublished manuscripts, private collections, and from field recordings involving contemporary Indigenous consultants. For the first time, knowledge about Australian message sticks can be evaluated as a single set allowing scholars and Traditional Owners to explore previously intractable questions about their histories, meanings and purposes.

Gender, sex and complex PTSD clinical presentation: a systematic review.

Background: Post-traumatic stress disorder (PTSD) prevalence and clinical presentation reportedly vary with gender and/or sex. Equivalent complex PTSD (CPTSD) research is in its relative infancy and to date no systematic review has been conducted on this topic.Objective: To systematically review the literature and provide a narrative addressing the question of whether gender and/or sex differences exist in CPTSD prevalence and clinical presentation.Method: Embase, PsycINFO, PTSDpubs, PubMed, Web of Science, EThOS and Google Scholar were searched. Twelve papers were eligible for inclusion. Data were extracted and synthesised narratively.Results: Four themes were identified: (i) the reporting of gender and/or sex; (ii) index trauma; (iii) CPTSD prevalence rates; and (iv) CPTSD clinical presentation. Findings were mixed. Nine papers reported prevalence rates: eight found no gender and/or sex differences; one found higher diagnostic rates among women and/or females. Four papers reported clinical presentation: one reported higher cluster-level scores among women and/or females; two used single gender and/or sex samples; and one found higher scores in two clusters in men and/or males. Most papers failed to report in gender- and/or sex-sensitive ways.Conclusions: Gender- and sex-sensitive research and clinical practice is needed. Awareness in research and clinical practice is recommended regarding the intersect between identity and the experience and expression of complex trauma.

This narrative review aims to establish whether gender and/or sex differences exist in complex post-traumatic stress disorder diagnosis rates and clinical presentation.Most papers adopted a binary approach to sex and gender.Most papers reported no difference in overall diagnosis rates, and few papers reported mixed findings regarding CPTSD presentation.

Exploring the impact of stressful life events on quality of life: meaning making and narrative reconstruction.

PURPOSE: Stressful life events have the capacity to disrupt an individual's worldview and life goals, leading to existential questions and identity loss. The subjective perception of identity is intricately linked with quality of life (QoL), and how individuals derive meaning from these stressful life events significantly influences their well-being. This article explored the impact of stressful life events on individuals' QoL, and examined the potential for enhancing QoL through meaning making and narrative reconstruction. METHODS: Qualitative interviews were conducted with 11 individuals reporting diminished QoL and analysed using thematic analysis. RESULTS: The study reveals that stressful life events confront interviewees with the vulnerability of their values in life and the limits of their control, leading them to question their own beliefs and purpose in life. Consequently, these events prompt individuals to reconstruction their narratives to adapt to new life circumstances. CONCLUSIONS: The study suggests that "securing the base," including strong social relations and security in economic and housing conditions, is a prerequisite for enhancing QoL. The insights on "the base" have profound implications for QoL. Recognizing their fundamental importance, policymakers, healthcare professionals, and social service providers can support mechanisms to enhance these foundations, improving overall well-being for individuals and communities.