The Loss of Spatiality and Temporality in Twilight Consciousness: The Emergence of Exogenous Psychosis Induced by Novel Psychoactive Substances.

BACKGROUND: The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience. SUMMARY: Substances of abuse, particularly new psychoactive substances, play a significant role in inducing this twilight state. They achieve this by deconstructing essential components of consciousness, such as the perception of time and space. KEY MESSAGE: This paper aimed to explore the phenomenon of the twilight state of consciousness and shed light on how new psychoactive substances can alter the perception of time and space during this twilight phase, potentially triggering exogenous psychosis. This comprehensive inquiry employs a phenomenological approach to the study of consciousness, recognizing it as the primary tool for ascribing significance to this intricate yet often overlooked aspect of psychopathology.

Temporalities of peer support: the role of digital platforms in the 'living presents' of mental ill-health.

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze's concept of the 'living present', the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being 'on tap', which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support.

The timescapes of older adults living alone and receiving home care: An interview study.

In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the 'here and now' and thereby enhance the provision of person-centred care.

The role of temporality in adolescent refugees' sense of well-being.

Adolescent refugees confront a complex interplay of trauma arising from forced displacement, resettlement, and the challenges of transitioning from childhood to adulthood. Using photovoice methodology, this study engaged 14 Iraqi and Syrian adolescent refugees now residing in the United States with the aim to illuminate their well-being experiences. Our findings show that temporal continuities and discontinuities in adolescent refugees' lives contributed to their sense of well-being by helping satisfy their basic psychological needs for autonomy, competence, relatedness, and safety. Temporal continuities involved drawing upon past resources and formulating future career aspirations based on present experiences. Temporal discontinuities encompassed contrasting past and present and processing adversities endured. This study underscores that, beyond current circumstances, the interpretation of life experiences over extended timeframes influences the well-being of adolescent refugees.

Uncertainty Work: Dealing with a Psychiatric Crisis in Two European Community Mental Health Teams.

The quest for how to deal with a crisis in a community setting, with the aim of deinstitutionalizing mental health care, and reducing hospitalization and coercion, is important. In this article, we argue that to understand how this can be done, we need to shift the attention from acute moments to daily uncertainty work conducted in community mental health teams. By drawing on an empirical ethics approach, we contrast the modes of caring of two teams in Utrecht and Trieste. Our analysis shows how temporality structures, such as watchful waiting, are important in dealing with the uncertainty of a crisis.

Temporal topic model for clinical pathway mining from electronic medical records.

BACKGROUND: In recent years, the discovery of clinical pathways (CPs) from electronic medical records (EMRs) data has received increasing attention because it can directly support clinical doctors with explicit treatment knowledge, which is one of the key challenges in the development of intelligent healthcare services. However, the existing work has focused on topic probabilistic models, which usually produce treatment patterns with similar treatment activities, and such discovered treatment patterns do not take into account the temporal process of patient treatment which does not meet the needs of practical medical applications. METHODS: Based on the assumption that CPs can be derived from the data of EMRs which usually record the treatment process of patients, this paper proposes a new CPs mining method from EMRs, an extended form of the traditional topic model - the temporal topic model (TTM). The method can capture the treatment topics and the corresponding treatment timestamps for each treatment day. RESULTS: Experimental research conducted on a real-world dataset of patients' hospitalization processes, and the achieved results demonstrate the applicability and usefulness of the proposed methodology for CPs mining. Compared to existing benchmarks, our model shows significant improvement and robustness. CONCLUSION: Our TTM provides a more competitive way to mine potential CPs considering the temporal features of the EMR data, providing a very prospective tool to support clinical diagnostic decisions.

Bohemia at the Pacific seabed: Archiving the future of deep-sea mining with the Interoceanmetal Joint Organization.

This article uses historical and ethnographic methods to examine the primarily East-Central European Interoceanmetal Joint Organization (IOM). I ask how and why the IOM has survived as an institution since its inception in 1987, working especially with the personal archive of Vratislav Kubista. Kubista was a metallurgist and former Deputy Director General at IOM who after retirement sought to develop a local deep-sea mining museum. This is a story about the work that archives do, but even more about how institutions maintain archives. I draw on recent work in the history and anthropology of time and archival practice to situate IOM's history and Kubista's collection in narratives of ruin, the unbuilt, and the experience of multiple temporalities within spaces of resource speculation and anticipation. I suggest that IOM's history highlights the contingencies of resources in the temporality of indefinite pause, their attendant data, and scientific labor and life under the shifting political, economic, and scientific circumstances of the ongoing not-yet. In broadening the history of what is once more a hotly contested potential resource, this account speaks to the claims of contemporary would-be seabed miners, who frequently frame the practice in terms of innovation, urgency, and novelty.

'I am just a shadow of who I used to be'-Exploring existential loss of identity among people living with chronic conditions of Long COVID.

Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how disruptions can touch upon and further threaten the very roots of existence, by which people reflexively perceive a coherent and stable sense of 'being-in-the-world'. Whilst medical sociologists have shown interest in 'existential loss' in chronic illness, this question remains largely underexplored. Adopting a qualitative study on Long COVID (LC) as an example, this article illuminates existential identity loss as a deeply painful experience of losing body as a fundamental medium to retain continuity and consistency of one's narratively constructed identity. Interviews with 80 LC sufferers in the UK revealed that living with persistent and often uncertain symptoms and disruptions can cause the loss of biographical resources and resilience, making it difficult to reflexively understand their own being within the world. Their dynamic responses to LC also highlighted how sufferers' longing for a narratively coherent self can profoundly shape the ongoing construction of their identity in chronic health conditions. These insights into the complicated and often hard-to-express existential pain of identity loss can also nurture more holistic understandings of and support for LC and chronic illness more broadly.

Generations, events, and social movement legacies: Unpacking social change in English football (1980-2023).

This article critically employs the case of association football in England, from 1980 to 2023, as a social movement timescape, to examine the political consciousness and long-term mobilisations of a generation of football supporter activists, and their capacity to influence politics, and respond to new, emerging, critical junctures, through networks of trust and shared memories of historical events. This is of crucial importance to sociology because it reveals the tensions between what are considered legitimate and illegitimate social practices which characterise contemporary society's moral economy. Focusing on temporal contestations over regulation, policing, governance and cultural rituals, the article deconstructs the role of generations in social movements, and critically synthesises relational-temporal sociology and classic and contemporary work on the sociology of generations, to show how legacy operates as a multifaceted maturing concept of power and time. In English football's neoliberal timescape, the supporters' movement has reached a critical juncture; the future will require a new generation of activists, to negotiate, resist and contest the new hegemonic politics of social control and supporter engagement.

Parenthood, spatial temporal environmental exposure, and leisure-time physical activity participation: Evidence from a micro-timescale retrospective longitudinal study.

Parents with dependent children are at a high risk of physical inactivity. While previous studies have mostly focused on how parents' time constraints and changing social network may inhibit leisure time physical activity (LTPA) over the long-term, less is known about the integrated effects of parenting and spatial-temporal environmental exposure on the execution of LTPA during certain episodes of a day. By adopting an integrated social-spatiotemporal-environmental model (ST-ISEM) based on micro-timescale retrospective longitudinal analysis, we examine the association between LTPA participation and spatial-temporal environmental exposure at a micro-timescale, i.e., at the episode-level in working adults' workday, and specifically how parenting integrated with spatial-temporal environmental exposure can jointly influence episode-level LTPA participation. Using data from the day reconstruction method from 701 individuals in Shenzhen, China, we find that parenting may affect the participation of LTPA on workdays not only by shaping temporal environmental factors (time constraint path and social network path), but also by interacting with built environmental exposures (spatial path), both at the episode-level. This study contributes to the theorizing of an integrated social-environmental model for health and wellbeing by extending the ISEM from the life span to the micro-timescale and also by highlighting the importance of temporality in environmental exposure and health studies. It also contributes to the spatial temporal behavioral perspective of time geography literature by clarifying multiple pathways through which social and spatiotemporal environmental factors could interact and jointly affect health behaviors at a micro-timescale. This study contributes to the literature on parenting and LTPA decline by enriching and deepening the understanding of the time constraint and social network pathways through which parenting leads to LTPA change at the micro-timescale. While time constraints may decrease parents' LTPA at long-term, increasing physical activities related to childcare after work may strongly obstruct moderate-to-vigorous LTPA at a micro-timescale. This study also identifies a spatial pathway by which parenting hinders LTPA due to changing understanding and usage of urban spaces. This pathway warrants attention from social epidemiologists, health geographers, and urban planners since existing interventions promoting physical activity in urban spaces may be ineffective for parents.

"Time work": An analysis of temporal experiences and agentic practices in the "good" doctor-patient relationship in general practice.

This article contributes to social health research by presenting an analysis of the temporal dimensions of the "good" doctor-patient relationship as perceived and enacted by patients and general practitioners (GPs). The empirical data derive from ethnographic fieldwork comprising participant observation in four general practice clinics in Denmark, and semi-structured interviews with 27 patients and eight GPs. The analysis draws from Michael Flaherty's sociology of time: notions of temporal agency and "time work" are used as analytical tools to demonstrate that the "good" doctor-patient relationship is constructed in a tension between external temporal structures and internal temporal experiences that are the result of GPs' and patients' agentic practices of "doing time." Thus, the findings illustrate how temporal determinism and self-determinism are equally interwoven when GPs and patients talk about, enact and seek meaningful temporal experiences within the doctor-patient relationship, while resisting and avoiding others that undermine the relationship. The results challenge 1. deterministic conceptions of time demands in today's healthcare systems that are said to control healthcare providers' behavior and 2. the taken-for-granted understanding of continuity as a resource in itself.

Creating critical palliative hypnotic adjustments: temporality, hope, and meaning.

When cure is not possible, suffering often takes form as pain and distressing symptoms, death anxiety, existential distress, and meaninglessness. This paper describes important elements connecting palliative care principles with hypnotic approaches designed to provide support, palliate symptoms, foster hope, and address existential and spiritual distress. We offer a developmental process for and examples of hypnotic suggestions customized to simultaneously ameliorate physical symptoms and address profound distress arising from physical, social, psychological, existential, and spiritual challenges commonly encountered in terminal illness. This process necessarily requires use of the patient's vernacular to hypnotically deepen inwardly focused attention in order to explore and access internal resources, reframe negative automatic thoughts, and create positive meanings for experiences that disinvite suffering. Effective delivery utilizes cognitive tools such as clinical and scientific principles, artistic forms such as poetry and haiku, and a thorough assessment of needs. This approach strategically addresses an overarching dimension of temporality through suggestions that sequentially address multiple sources of suffering that are layered throughout the various dimensions of self. This requires focus and presence in the present moment; it ultimately fosters a therapeutic relationship that can safely hold past painful experience as helpful new meanings emerge that build resiliency for that experience. This work benefits from inwardly focused concentration and a holding environment to identify and access helpful inner resources, which include an increasingly malleable relationship with temporal memories.

Wait for Me: Chronic Mental Illness and Experiences of Time During the Pandemic.

As someone diagnosed with severe chronic mental illness early in my adolescence, I have spent over half of my life feeling out of step with the rest of the world due to hospitalizations, treatment programs, and the disruptions caused by anxiety, anorexia, depression, and obsessive-compulsive disorder. The effect of my mental health conditions compounded by these treatment environments means I often feel that I experience time passing differently, which results in sensations of removal and isolation from those around me. The global shutdown caused by the COVID-19 pandemic seemed a way for normative bodies to experience the passing of time the way I always have. In this paper, I extend Dr. Sara Wasson's analysis of the ways in which chronic pain resists narrative coherence to my own temporal experience of chronic mental illness, specifically my embodied experience of the pandemic. I use that embodied experience as a case study for examining how the reciprocal nature of time and narrativity, as outlined by Dr. Paul Ricoeur, can create isolation for those struggling with their temporality due to chronic mental illness. To acknowledge and grapple with the ramifications of discursive and material privilege involved in such situations, I include an analysis of Robert Desjarlais's 1994 article "Struggling Along: The Possibilities for Experience among the Homeless Mentally Ill," in which he investigates a similar phenomenon of being outside of structured sequential narrative time in the residents of a Boston shelter for the mentally ill.

Chronic Pain and Time - A Theoretical Analysis.

Background: When theoretically discussing pain, the distinction between acute and chronic pain is not always taken into consideration. By contrast, informed by the pain medicine distinction between acute and chronic pain, the present theoretical paper analyses the phenomena of chronicity and chronification in the pain setting. Methods: Philosopher Fredrik Svenaeus and his paper The phenomenology of chronic pain: embodiment and alienation (Continental Philosophy Review 2015;48:107-122) is used as a dialogue partner. Results: Three aspects, relevant for clinicians, are discussed: (1) the distinction between emotion and mood, arguing that the process of chronification entails pain evolving from the former to the latter; (2) chronification as a process in which the pain patient becomes aware of his/her temporality, both the past and the future coming to the fore (as opposed to severe acute pain in which only the present counts, ie, getting rid of the pain now); (3) the acquisition of a pain-related narrative identity, interdisciplinary pain rehabilitation programs being described as helping patients regain a narrative identity that is not dominated by pain or by a fruitless chase after pain relief. Conclusion: Chronic pain reminds us of our temporality and of the narrative character of our lives.

The Long or the Post of It? Temporality, Suffering, and Uncertainty in Narratives Following COVID-19.

Long COVID affects millions of individuals worldwide but remains poorly understood and contested. This article turns to accounts of patients' experiences to ask: What might narrative be doing both to long COVID and for those who live with the condition? What particular narrative strategies were present in 2020, as millions of people became ill, en masse, with a novel virus, which have prevailed three years after the first lockdowns? And what can this tell us about illness and narrative and about the importance of literary critical approaches to the topic in a digital, post-pandemic age? Through a close reading of journalist Lucy Adams's autobiographical accounts of long COVID, this article explores the interplay between individual illness narratives and the collective narrativizing (or making) of an illness. Our focus on temporality and suffering knits together the phenomenological and the social with the aim of opening up Adams's narrative and ascertaining a deeper understanding of what it means to live with the condition. Finally, we look to the stories currently circulating around long COVID and consider how illness narratives-and open, curious, patient-centered approaches to them-might shape medicine, patient involvement, and critical medical humanities research.

Spacetimematter of aging - The material temporalities of later life.

Material gerontology poses the question of how aging processes are co-constituted in relation to different forms of (human and non-human) materiality. This paper makes a novel contribution by asking when aging processes are co-constituted and how these temporalities of aging are entangled with different forms of materiality. In this paper, we explore the entanglements of temporality and materiality in shaping later life by framing them as spacetimematters (Barad, 2013). By drawing on empirical examples from data from a qualitative case study in a long-term care (LTC) facility, we ask how the entanglement of materiality and temporality of a fall-detection sensor co-constitutes aging. We focus on two types of material temporality that came to matter in age-boundary-making practices at this site: the material temporality of a technology-in-training and the material temporality of (false) alarms. Both are interwoven, produced and reproduced through spacetimematterings that established age-boundaries. Against the backdrop of these findings, we propose to understand age(ing) as a situated, distributed, more-than-human process of practices: It emerges in an assemblage of technological innovation discourses, problematizations of demographic change, digitized and analog practices of care and caring, bodily functioning, daily routines, institutionalized spaces and much more. Finally, we discuss the role power plays in those spacetimematterings of aging and conclude with a research outlook for material gerontology.

An analysis of time conceptualisations and good care in an acute hospital setting.

This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the-clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising-there is a place for a fast-paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients.

Temporal capital and unaligned times as inequality mechanisms: A case study of chronic care in general practice.

Addressing persistent health inequality is one of the most critical challenges in public health. Structural features of 'time' may provide new perspectives on the link between social inequality and time in a healthcare context. Drawing on the case of chronic care in Danish general practice, we aim to use temporal capital as a theoretical frame to unfold how patients' social positions are interlinked with their medical treatment. We followed patients with multimorbidity and polypharmacy in general practice. Data were collected from interviews, observations, informal conversations, and medical records. We used the concept temporal capital to illuminate the mechanism of inequality in healthcare. We suggest understanding temporal capital as patients' abilities and possibilities to understand, navigate, negotiate, and manage the temporal rhythms of healthcare. Unaligned times, i.e. the mismatch between patients' temporal capital and healthcare organisations and/or professionals' rhythms, are unfolded in five themes: unaligned schedules (scheduling the consultation to fit everyday life and institutional rhythms and attending the consultation), sequences (preparing activities in a specific order to accommodate clinical linearity), agendas (timing the agenda to the clinical workflow), efficiency (ensuring efficiency in the consultation and balancing on-task and off-task content), and pace (conducting the consultation to accommodate fixed durations). Differences in temporal capital and hence abilities and possibilities for aligning with the temporal rhythms of healthcare may be facilitated or restrained by the individual patient's social position, thereby defining and establishing temporal mechanisms of social inequality in medical treatment. In conclusion, social inequality in medical treatment has several temporal references, resulting from pre-existing inequalities and causing new ones. Notions of temporal capital and temporal unalignment provide a useful lens for exploring social inequality in healthcare encounters.

Dissociation and Temporality in Substance Abuse: A Clinical Phenomenological Overview.

The term "dissociation" encompasses a wide array of symptoms and phenomena, all sharing the common characteristic of involving altered states of consciousness where an individual temporarily loses the sense of continuity of their own identity. In the context of addiction pathology, however, the dissociative paradigm remains a topic of ongoing debate. It fluctuates between the description of individual dissociative symptoms and the notion of post-traumatic dissociation as a structural process. This process involves fragmentation that extends beyond the confines of perception and experience within a singular moment, instead ensuring a persistent discontinuity of the self throughout one's existence. Pathological addiction stresses the question of the donation of sense in this deep and dramatic experience; it situates individuals within a compressed and constricted realm of vital space, alongside a frozen perception of time. Within this context, every emotion, sensation, and comprehension becomes impaired. Consequently, we have embarked on a journey starting with a historical analysis: the aim was to construct an elucidative framework for the dissociative paradigm in the context of addiction. This involves an in-depth exploration of the fundamental constructs of trauma and temporality, examined through the lens of phenomenological perspective.